• Title/Summary/Keyword: Diastolic BP

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Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis

  • Lee, Sun Hee;Chae, Young Ran
    • Journal of Korean Academy of Nursing
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    • v.50 no.6
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    • pp.740-756
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. Methods: The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. Results: A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. Conclusion: Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.

Disagreement between direct and indirect blood pressure measurements obtained from minipigs

  • Lee, Won-Jae;Park, Lisa Soyeon
    • Korean Journal of Veterinary Research
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    • v.58 no.3
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    • pp.131-136
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    • 2018
  • Blood pressure (BP) measurement plays a pivotal role in veterinary medicine for diagnosing cardiovascular disorders and monitoring anesthesia of animals. Although indirect BP measurement has been widely applied to monitor BP because of its convenience and non-invasiveness, it is still unclear whether indirect BP measurement is compatible with direct BP measurement in minipigs. In addition, the effect of animal posture during BP measurement is not well understood in minipigs despite its importance to cardiovascular performance. Therefore, both systolic and diastolic arterial BPs in minipigs were measured via femoral artery catheterization for direct BP measurement and using a compressive cuff as an indirect BP measurement under the dorsal or right lateral recumbent postures. Numerical values were processed by the Bland-Altman method to calculate the bias ${\pm}$ SD and the limits of agreement (LOA). In accordance with the American College of Veterinary Internal Medicine guidelines, the results between direct and indirect BP measurements were determined as apparent disagreements in both systolic and diastolic arterial BPs under all postures because of large bias ${\pm}$ SD and wide LOA. The results of the present will help prevent misinterpretation of the anesthetized patient's condition during monitoring of BP by indirect measurement.

Changes in blood pressure and determinants of blood pressure level and change in Korean adolescents (성장기 청소년의 혈압변화와 결정요인)

  • Suh, Il;Nam, Chung-Mo;Jee, Sun-Ha;Kim, Suk-Il;Kim, Young-Ok;Kim, Sung-Soon;Shim, Won-Heum;Kim, Chun-Bae;Lee, Kang-Hee;Ha, Jong-Won;Kang, Hyung-Gon;Oh, Kyung-Won
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.2 s.57
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    • pp.308-326
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    • 1997
  • Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic and diastolic BP at age 12 and 16 years old were 108.7 mmHg and 118.1 mmHg(systolic), and 69.5 mmHg and 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg and 113.5 mmHg(systolic) and 75.2 mmHg and 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index, etc) increased constantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend fer females. Total fat intake increased at age 16 years compared with that at age 14 years. Compositions of carbohydrate, protein and fat among total energy intake were 66.2:12.0:19.4, 64.1:12.1:21.8 at age 14 and 16 years, respectively. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatinine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatinine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.

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Dietary Risk Factors for Hypertension among Korean Adult Men

  • Park, Jin-Young;Shim, Jae-Eun;Paik, Hee-Young
    • Journal of Community Nutrition
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    • v.8 no.4
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    • pp.193-199
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    • 2006
  • There have been many studies indicating increased salt intake is related to elevated blood pressure (BP). Hypertension and pre-hypertension are prevalent in Korea. A national survey showed that the Korean average daily salt consumption was 12.5g, which is more than twice the current recommendation in the UK or USA. This study was performed to understand which aspects of the Korean diet contributed to high salt intake and elevated BP in Korea. The subjects consisted of 1,110 Korean adult men aged 30 to 49 years who were selected from the data of 2001 Korean National Health and Nutrition Survey, a nationwide cross sectional survey. The relationship of BP with sodium and high sodium food intakes were analyzed. After categorizing subjects according to their BP, the socio-demographic information and food and nutrients intakes were analyzed. BP increased with a larger amounts of sodium intake and the trend was significant with diastolic BP. However, the trends of BP for sodium densities of the diet were not. People with hypertension significantly tended to be older, larger, and less educated than people with normal BP. And they consumed more foods from the fats, oils & sweets group and larger amounts of discretionary sodium than normal people. The current report advocates that public health intervention, which improves the awareness of the role of salt on elevated blood pressure for the public, should be implemented in Korea.

Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.24-33
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    • 2002
  • Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

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An Analytic Study on the Effect of Carbon Disulfide on the Blood Pressure (이황화탄소 폭로가 혈압에 미치는 영향에 관한 분석적 연구)

  • Park, Jong-Tae;Kim, Hae-Joon;Yum, Yong-Tae;Paek, Do-Myung
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.581-595
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    • 1994
  • To investigate the effect of carbon disulfide on blood pressure, the BP measurements in the periodic health examination results and the medical records of factory clinic were reviewed. The study subjects were composed of 1336 male and 544 female workers, who were categorized into three groups by the exposure status-highly exposed, moderately exposed and non-exposed group. The results of the study were as follows; 1. The age-adjusted mean systolic and diastolic BP of male workers were 122.35 mmHg/79.11 mmHg in highly exposed, 121.57mmHg/79.05mmHg in moderately exposed and 122.67mmHg/82.27mmHg in non-exposed group. For female workers, BPs were 115.13mmHg/74.49mmHg in moderately exposed and 113.48mmHg/74.30mmHg in non-exposed group. 2. In multiple regression analysis of maximum BP against Age and tenure, the slope coefficients of age and tenure on the systolic BP were 0.379, 0.667 respectively and those on the diastolic BP were 0.331, 0.405 respectively in highly exposed male workers. Tenure was a significant variable in this study. For female workers, however the slope coefficients of tenure on BP were significant only for systolic BP of moderately-exposed group. 3. In multiple regression analysis of Bp against age, cumulative exposure index (CEI), cholesterol, all the variables showed significant slope coefficients in male, but age and CEI on systolic BP were significant for female workers (p<0.05). 4. In the multiple analysis of the amount of Bp change and the velocity of Bp change among male workers, the slope coefficients of tenure tended to increase as exposure level increased. Among female workers, the slope coefficients of tenure were significant on the amount of Bp change and the velocity of Bp change in moderately exposed group.

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Design of Noninvasive Arterial Blood Pressure Measurement System by Using Double-Cuffs Oscillometric Method (이중 커프 오실로메트릭법을 이용한 비침습 동맥압 측정시스템의 설계)

  • Lee, Pil-Jae;Lee, Young-Jae;Kim, Dong-Jun;Lee, Jae-Ho;Lim, Min-Gyu;Lee, Jeong-Whan
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.61 no.6
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    • pp.885-890
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    • 2012
  • In this study, a new blood pressure measuring system was proposed and implemented. An additional small-cuff was placed on the center of a inner cuff to measure morphological signals and new oscillometric ratio. The proposed BP-measuring system is composed of an external cuff, an inner cuff and a small-cuff. Oscillation signal from small-cuff is interpolated with 7th-order fitting polynomials and SBP, DBP ratio were 22.2% and 87.7%. Experimental data were gathered from 20 volunteers ($25{\pm}4$ years) and arterial blood pressure values were compared with auscultation, sphygmomanometers, small-cuff and inner-cuff. As a result, the difference in systolic BP between auscultation and the small-cuff was 1.93(${\pm}1.28$) mmHg, and the inner-cuff was 4.53(${\pm}4.39$) mmHg, and sphygmomanometer was 6.68(${\pm}3.99$) mmHg, and the corresponding difference in diastolic BP was 2.50(${\pm}2.04$) mmHg, 3.50(${\pm}3.19$) mmHg, 7.35(${\pm}5.62$), respectively.

Estimating blood pressure using the pulse transit time of the two measuring from pressure pulse and PPG

  • Kim, Gi-Ryon;Ye, Soo-Young;Kim, Jae-Hyung;Jeon, Gye-Rok
    • Journal of Sensor Science and Technology
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    • v.17 no.2
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    • pp.87-94
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    • 2008
  • Blood pressure (BP), one of the most important vital signs, is used to identify an emergency state and reflects the blood flow characteristics of the cardiovascular system. The conventional noninvasive method of measuring BP is inconvenient because patients must wear a cuff on their arm and the measurement process takes time. This paper proposes an algorithm for estimating the BP using the pulse transit time (PTT) of the photoplethysmography (PPG) and pressure pulse from finger at the same time as a more convenient way to measure the BP. After recording the electrocardiogram (ECG), measuring the pressure pulse, and performing PPG, we calculated the PTT from the acquired signals. Then, we used a multiple regression analysis to measure the systolic and diastolic BP indirectly. Comparing the BP measured indirectly using the proposed algorithm and the real BP measured with a sphygmomanometer, the systolic pressure had a mean error of ${\pm}3.240$ mmHg and a standard deviation of 2.530 mmHg, while the diastolic pressure had a satisfactory result, i.e., a mean error of ${\pm}1.807$ mmHg and a standard deviation of 1.396 mmHg. These results are more superior than existing method estimating blood pressure using the one PTT and satisfy the ANSI/AAMI regulations for certifying a sphygmomanometer i.e., the measurement error should be within a mean error of ${\pm}5$ mmHg and a standard deviation of 8 mmHg. These results suggest the possibility of applying our method to a portable, long-term BP monitoring system.

The Effects of Purple Grape Juice Supplementation on Blood Pressure, Plasma Lipid Profile and Free Radical Levels in Korean Smokers (포도주스의 보충섭취가 흡연성인의 혈압, 혈장지질 및 자유 라디칼 생성에 미치는 영향)

  • 김정신;김혜영;박유경;박은주;강명희
    • Journal of Nutrition and Health
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    • v.37 no.6
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    • pp.455-463
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    • 2004
  • Flavonoids contained in grapes are potent antioxidants that may protect against oxidative stress and reduce the risk of chronic diseases related with free radical damage. In this study we investigated the effect of daily grape juice supplementation on blood pressure (BP), plasma lipid profiles and the generation of free radicals in 67 healthy volunteers (29 smoker, 38 nonsmokers). The daily 480 ml of grape juice supplementation for 8 weeks resulted in a significant decrease in diastolic BP by 6.5% in smokers and systolic and diastolic BP by 11.2 and 3.7% in non-smokers. Plasma total cholesterol, HDL- and LDL-cholesterollevels in smokers and total cholesterol in non-smokers were significantly increased after the intervention. Plasma triglycerides and conjugated dienes were not affected by grape juice supplementation. Levels of free radical determined by reading the lucigenin-perborate ROS generating sources, decreased significantly by 18% compared to the beginning of the study. The results indicated that the consumption of grape juice may reduce BP and free radical generation in smokers, which was possibly exerted by flavonoids. Our findings suggested that the grape juice has protective effect on chronic disease due to the overproduction of free radical in smokers.

Effect of Calcium Supplementation on Blood Pressure Response to Dietary Soldium Level in Normotensive Young Korean Women with Family History of Hypertension (칼슘의 보충섭취가 식이 나트륨 섭취수준에 따른 혈압 변동에 미치는 영향)

  • 이정원;이은양;이보경
    • Journal of Nutrition and Health
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    • v.32 no.6
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    • pp.661-670
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    • 1999
  • Effects of Ca supplementation on blood pressure(BP) response to dietary Na level were studied in 15 normotensive healthy college women with family history of hypertension. All subjects, randomly divided into 3 groups, ate low Na diet(1816mg/day) prepared in the laboratory during the first 2 weeks and normal Na diet(4064mg/day) of their own home for the next 8 weeks. The one group received daily 1g Ca supplement at both low and normal Na diet periods, the second group took daily 1g Ca supplement only at normal a diet period, and the last group took placebo during both periods. Average Ca and energy intakes at the basal of and during the trial ranged 450-600mg and 1735-1878kcal, respectively. Systolic/diastolic BP was decreased by 9.2-9.8/4.4-4.5 mmHg during low Na diet period and was increased again during next normal Na diet period. However simultaneous Ca supplementation during both low and normal Na diet period suppressed the elevation of systolic/diastolic BP occurred at normal Na diet period. Ca supplementation only at normal Na diet peroid did not affect the BP elevation. The increase of serum Ca and Ca/Mg ratio and the decrease of serum Na and Na/K ratio might be related to the BP lowering effects of Ca supplementation. In conclusion, Ca supplement could attenuate BP elevation induced by increasing Na intake. The BP lowering effect of Ca supplementation was not appeared at low Na intake. Further studies were needed to make it certain. Low Na intake was also confirmed as an effective diet control for lowering blood pressure.

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