Methods: In 2015, a cross-sectional study was conducted among adults visiting an outpatient clinic in Northeast Malaysia. Face-to-face interviews were conducted using Malay and English versions of the Malaysia Non-Communicable Disease surveillance questionnaire. This instrument captured information about sociodemographic, lifestyle status, and anthropometric data. Blood pressure was measured three times with a sphygmomanometer, the first measurement value was discarded, and an average of blood pressure from the second two readings was recorded for further data analysis. Logistic regression was performed to analyse factors associated with prehypertension.
Result: A total 151 adults participated in the study, and the prevalence of prehypertension was 37.1% (95% confidence interval [CI]: 29.29, 44.69). Factors associated with prehypertension in this study were age (adjusted odds ratio [aOR] = 1.06 95% CI: 1.02, 1.11; p = 0.007), male sex (aOR = 4.44 95% CI: 1.58, 12.44; p = 0.005), and abnormal waist circumference (aOR = 31.65 95% CI: 11.25, 89.02; p
METHODS: This was a prospective study carried out in normal subjects at the Vascular Laboratory, Department of Surgery, Hospital Kuala Lumpur, from March 2006 to September 2006. The study compared the popliteal artery blood flow during change of posture from the horizontal (supine) to the sitting position and the effect of intermittent pneumatic compression (IPC) of the foot and calf on popliteal artery blood flow immediately and 10 minutes after cessation of compression.
RESULTS: A total of 15 subjects involving 30 limbs were examined in this study. On comparing flows between the horizontal and sitting position, there was a mean reduction in blood flow of 23% (p < 0.005). Immediately after compression of the foot and calf, there was an increase in blood flow of between 4% and 35% with a mean of 15% (p < 0.05). Peak systolic flows at 10 minutes postcompression were 536 +/- 95 mL/min, which was still significantly higher than precompression measurements.
CONCLUSION: There is a significant reduction in popliteal artery blood flow on changing from the supine to the sitting position. Popliteal artery blood flow is higher than baseline after 15 minutes of intermittent pneumatic foot and calf compression. The increase in popliteal artery blood flow is still present 10 minutes after cessation of IPC.
METHODS: In 20 patients undergoing cardiac surgery in sevoflurane-remifentanil anesthesia, we analyzed intraoperative S' values which were determined after 10 min exposure to sevoflurane at 1.0, 2.0, and 3.0 inspired-vol% (T1, T2, and T3, respectively) with a fixed remifentanil dose (1.0 μg/kg/min) using transesophageal echocardiography.
RESULTS: Linear mixed-effect modeling demonstrated dose-dependent declines in S' according to the end-tidal sevoflurane concentration increments (C(ET)-sevoflurane, p < 0.001): the mean value of S' reduction for each 1.0 vol%-increment of C(ET)-sevoflurane was 1.7 cm/s (95 % confidence interval 1.4-2.1 cm/s). Medians of S' at T1, T2, and T3 (9.6, 8.9, and 7.5 cm/s, respectively) also exhibited significant declines (by 6.6, 15.6, and 21.2 % for T1 vs. T2, T2 vs. T3, and T1 vs. T3, p < 0.001, =0.002, and <0.001 in Friedman pairwise comparisons, respectively).
CONCLUSIONS: Administering sevoflurane as a part of a sevoflurane-remifentanil anesthesia regimen appears to dose-dependently reduce S', indicating LV systolic performance, in patients undergoing cardiac surgery. Further studies may be required to evaluate the clinical implications of these findings.
Design: A multicenter prospective follow-up study.
Setting: Tertiary care teaching hospital and its associated private dialysis centers.
Participants: This study included 145 euvolemic eligible hypertensive patients. Various sociodemographic, clinical factors and drugs were investigated and analyzed by using appropriate statistical methods to determine the factors influencing hypertension control among the study participants.
Results: On baseline visit, the mean pre-dialysis systolic and diastolic BP (mmHg) of study participants was 161.2 ± 24. and 79.21 ± 11.8 retrospectively, and 30 (20.6%) patients were on pre-dialysis goal BP. At the end of the 6-months follow-up, the mean pre-dialysis systolic BP and diastolic BP (mmHg) of the patients was 154.6 ± 18.3 and 79.2 ± 11.8 respectively, and 42 (28.9%) were on pre-dialysis goal BP. In multivariate analysis, the use of calcium channel blockers (CCBs) was the only variable which had statistically significant association with pre-dialysis controlled hypertension at baseline (OR = 7.530, p-value = 0.001) and final (OR = 8.988, p-value
Methodology: The Cochrane central register of controlled trials, Medline (1966 to April week 1, 2020), Embase (1966 to April week 1, 2020) and trial registries for relevant randomized clinical trials were used. Published and unpublished randomized clinical trials were reviewed and evaluated. Random effects models were used to estimate the continuous outcomes and mean differences (MDs); both with 95% confidence intervals (CIs). The primary outcomes were changes in systolic and diastolic BP. The secondary outcomes were changes in lipid profile, glucose metabolism, inflammatory markers for CVD, kidney and liver functions safety parameters. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias and quality of evidence.
Results: Five trials were included involving 325 patients aged 18-80 years. Two trials involved high-income countries and three trials involved moderate-income countries. The analysis performed was based on three comparisons. No significant changes were found between systolic or diastolic blood pressure (BP) for the first comparison, 1,000 mg per day for a combined formulation of olive leaf extract versus a placebo. The second comparison, 500 mg per day of olive leaf extract versus placebo or no treatment, showed a significant reduction in systolic BP over a period of at least 8 weeks of follow up (MD -5.78 mmHg, 95% CI [-10.27 to -1.30]) and no significant changes on diastolic BP. The third comparison, 1,000 mg per day of olive leaf extract versus placebo shows no significant difference but an almost similar reduction in systolic BP (-11.5 mmHg in olive leaf extract and -13.7 mmHg in placebo, MD 2.2 mmHg, 95% CI [-0.43-4.83]) and diastolic BP (-4.8 mmHg in olive leaf extract and -6.4 mmHg in placebo, MD 1.60 mmHg, 95% CI [-0.13-3.33]). For secondary outcomes, 1,000 mg per day of olive leaf extract versus captopril showed a reduction in LDL (MD -6.00 mg/dl, 95% CI [-11.5 to -0.50]). The 500 mg per day olive leaf extract versus placebo showed a reduction in inflammatory markers for CVD IL-6 (MD -6.83 ng/L, 95% CI [-13.15 to -0.51]), IL-8 (MD -8.24 ng/L, 95% CI [-16.00 to -0.48) and TNF-alpha (MD -7.40 ng/L, 95% CI [-13.23 to -1.57]).
Conclusions: The results from this review suggest the reduction of systolic BP, LDL and inflammatory biomarkers, but it may not provide a robust conclusion regarding the effects of olive leaf extract on cardiometabolic profile due to the limited number of participants in the included trials.
Review registrations: PROSPERO CDR 42020181212.