Displaying publications 41 - 60 of 733 in total

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  1. Vipin M, Sujendra DM, Imthiaz VK, Hitesh-Shah
    Malays Orthop J, 2016 Nov;10(3):46-48.
    PMID: 28553449 DOI: 10.5704/MOJ.1611.006
    An adolescent boy with spastic diplegic cerebral palsy presented with crouch gait. He had bilateral severe flexion deformities of knees and hips. He was treated with single event multilevel surgery for the correction of deformities. Surgical procedures included bilateral adductor release, iliopsoas lengthening, bilateral femoral shortening and patella plication. Persistent hypertension was noted in the post-operative period. All causes of secondary hypertension were ruled out. Having persistent hypertension following the femoral shortening procedure is unusual. Antihypertensive medication controlled his blood pressure 15 months after surgery. Hypertension following correction of knee flexion deformity and limb lengthening is well known. Hypertension has not been described with the shortening osteotomy of the femur. Hypertension is a rare complication following the corrective surgery for the treatment of crouch gait. Blood pressure should be monitored during the post-operative period to detect such a rare complication.
    Matched MeSH terms: Blood Pressure
  2. Vijay AP, Chan SP
    JUMMEC, 2009;12(2):47-56.
    MyJurnal
    Achieving and maintaining good glycaemic control remains an important goal in the management of this common and prevalent disorder. Recent evidence from important megatrials, ACCORD, ADVANCE, VADT, UKPDS-10 year follow-up as well as the STENO-2 follow-up study, have cleared doubts concerning the benefits of targeting good glycaemic control. For the first time, we have the reassurance that macrovascular benefits can be realised from good glycaemic control. The legacy effect of prior good glucose control from the UKPDS-10 year follow-up, reinforces the results seen from the DCCT-EDIC (for Type 1 diabetes). The Intervention Phase of the UKPDS revealed benefits for reduction of microvascular complications, while it was only at the end of the Post-Trial Monitoring Phase where significant improvements in both micro and macrovascular outcomes were seen. The other three Trials assessing the effect of glycaemic control on cardiovascular outcomes, although largely negative for CV benefit, give valuable insight towards appropriate patient characteristics for which aggressive glucose control can and should be instituted. Individualising glycaemic targets, which has been the approach that many clinicians have been practising, has received new impetus albeit with clearer details. Getting to glycaemic goal early in the course of T2DM and Doing to Safely (Avoiding hypoglycaemia)are the key ingredients to successful management. The legacy of the memory of initial good metabolic/glycaemic control is investment in good health with benefits of reductions in both micro and more importantly, macrovascular disease, years later. Multifactorial interventions that include blood pressure, lipid lowering in addition to glucose control in these individuals with the Metabolic Syndrome result in more immediate beneficial additive effects on cardiovascular outcomes.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  3. Verma N, Rastogi S, Chia YC, Siddique S, Turana Y, Cheng HM, et al.
    J Clin Hypertens (Greenwich), 2021 07;23(7):1275-1283.
    PMID: 33738923 DOI: 10.1111/jch.14236
    Hypertension is an insidious disease which predisposes to cardiovascular complications and if not treated properly can lead to various serious complications. Economic limitations, having additional benefits with few or almost no side effects have made non-pharmacological management of hypertension an attractive approach for dealing with hypertension, in developed and developing countries alike. A MEDLINE search was done for relevant references with emphasis on original studies, randomized controlled trials, and meta-analyses for this review paper. Lifestyle modifications including changes in the dietary pattern, adopting special diets with low sodium, saturated fat and high calcium, magnesium and potassium and trying the new methods like time restricted meal intake which work in tandem with the circadian rhythm are opening new vistas in the field of non-pharmacological management of hypertension. Lifestyle modifications that effectively lower blood pressure are increased physical activity, weight loss, limited alcohol consumption, relaxation techniques of Yoga, Acupuncture, Tai chi, mindfulness-based stress-reduction program, and Transcendental Meditation. Air pollution of the surrounding air is linked with poor health outcomes and is a major contributor to the global burden of disease. Fine particulate matter <2.5 μm in diameter (PM2.5) is strongly associated with cardiovascular morbidity and mortality. Short-term PM exposure (hours to weeks) increases the likelihood of adverse cardiovascular events including myocardial infarction, stroke, and heart failure, and longer-term exposure multiplies that risk. Non-pharmacological methods should be initiated early phase of disease and should be continued with medication.
    Matched MeSH terms: Blood Pressure
  4. Vengatasubramani, M., Vikram, M.
    Medicine & Health, 2014;9(2):109-113.
    MyJurnal
    Chronic obstructive pulmonary disease (COPD) patients are reported to have cardiovascular instability which leads to greater limitation for activities there by leads to poor quality of life. Physical training proved to be one of the moderators of these limitations. However, uncertainty prevails among the protocol and duration. The present study investigated the effect of physical training on blood pressure, heart rate and Rate pressure Product (RPP) among COPD patients. A total of thirty COPD patients aged between 40 to 55 years were recruited for the study based on the inclusion and exclusion criteria and were assigned in to experimental group (15 patients) and control group (15 patients). The mean difference of blood pressure, heart rate and RPP were analyzed using paired t-test. There was significant difference between the pre and post test values of all parameters between experimental and control group with p< 0.05. Diastolic blood pressure showed to be less significant compared to the systolic blood pressure. This showed that specifically designed physical improved the cardiovascular fitness among COPD patients.
    Matched MeSH terms: Blood Pressure
  5. Vedanthan R, Bernabe-Ortiz A, Herasme OI, Joshi R, Lopez-Jaramillo P, Thrift AG, et al.
    Cardiol Clin, 2017 Feb;35(1):99-115.
    PMID: 27886793 DOI: 10.1016/j.ccl.2016.08.010
    Elevated blood pressure, a major risk factor for ischemic heart disease, heart failure, and stroke, is the leading global risk for mortality. Treatment and control rates are very low in low- and middle-income countries. There is an urgent need to address this problem. The Global Alliance for Chronic Diseases sponsored research projects focus on controlling hypertension, including community engagement, salt reduction, salt substitution, task redistribution, mHealth, and fixed-dose combination therapies. This paper reviews the rationale for each approach and summarizes the experience of some of the research teams. The studies demonstrate innovative and practical methods for improving hypertension control.
    Matched MeSH terms: Blood Pressure*
  6. Urban John Arnold D’Souza, Vinod Kumar S., Nagesh Chodankar
    MyJurnal
    Introduction: Regular physical activity and VO2 max are correlated directly. Physical anthropometry physical ac-tivity, lung function and cardiac parameters such as systolic, diastolic blood pressure and resting heart rate are the important baseline parameters in relation to the a healthy life. In this study, a comprehensive determination of these parameters were planned among the common ethnicities of Sabah. This study in turn aims at making the sedentary people to make physically active and implicate a possible relationship between cardio-respiratory parameters with the physical activity levels. Methods: A total of 385 young adult Sabah, Malaysia college students with n=148 males and n= 237 females were randomly selected from the different colleges in Kota Kinabalu. Ethical clearance was received from Faculty of Medicine & Health Sciences UMS, and the participants were briefed on the procedures with their voluntary consent. IPAQ-Score/Met-Min/Week, BMI, resting heart rate, blood pressure, lung function parameters – forced vital capacity, peak expiratory flow rate etc were estimated by standard techniques. Data was analyzed, a regression analysis and ANOVA was performed to assess the relationship between independent and dependent variables. Results: Physical activity level has a significant correlation with the dependent variables of this study. VO2max is significantly and inversely related to body weight, BMI, blood pressure and pulse rate, whereas physical activity level is directly correlated. A weak positive correlation for VO2 max with lung function parameters.Conclusion: Physical activity, VO2 max and cardio-respiratory parameters; interdependently correlated and regular activity contributed to the rate of oxygen consumption.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  7. Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang JG, Sukonthasarn A, et al.
    J Clin Hypertens (Greenwich), 2021 Mar;23(3):513-521.
    PMID: 33190399 DOI: 10.1111/jch.14099
    Stroke is the primary cause of disability and vascular death worldwide, including Asia. Asian characteristics that differ from the West lead to higher stroke incidence. Stroke epidemiology studies in Asia have shown varying levels of mortality, incidence, prevalence, and burden of disease. Hypertension is the most prevalent risk factor found in Asia. Besides ethnicity that is associated with stroke incidence, both systolic blood pressure, diastolic blood pressure, and blood pressure variability are positively correlated with stroke incidence. Post-stroke cognitive impairment is one of the sequelae that affect one-third of stroke survivors and has become a significant public health concern that is often neglected despite its increasing prevalence. Therefore, it is very important to prevent recurrence by treating stroke optimally and effectively. Increasing awareness and treatment adherence to hypertension, the leading risk factor for stroke, became the main goal in several countries in Asia.
    Matched MeSH terms: Blood Pressure
  8. Turana Y, Tengkawan J, Chia YC, Teo BW, Shin J, Sogunuru GP, et al.
    J Clin Hypertens (Greenwich), 2020 Mar;22(3):415-422.
    PMID: 31816178 DOI: 10.1111/jch.13752
    Hypertension is an important public health concern. The prevalence keeps increasing, and it is a risk factor for several adverse health outcomes including a decline in cognitive function. Recent data also show that the prevalence of hypertension and age-related dementia is rising in Asian countries, including in the oldest old group. This study aims to discuss possible treatments for high blood pressure in the elderly and propose an optimal target for BP relative to cognitive outcomes. This review discusses several studies on related blood pressure treatments that remain controversial and the consequences if the treatment target is too low or aggressive. Longitudinal, cross-sectional, and RCT studies were included in this review. An optimum systolic blood pressure of 120-130 mm Hg is recommended, especially in nondiabetic hypertensive patients with significant risk factors. In the oldest old group of patients, hypertension might have a protective effect. The use of calcium channel blockers (CCB) and angiotensin receptor blocker (ARB) is independently associated with a decreased risk of dementia in older people. However, personalized care for patients with hypertension, especially for patients who are frail or very old, is encouraged.
    Matched MeSH terms: Blood Pressure/drug effects
  9. Turana Y, Shen R, Nathaniel M, Chia YC, Li Y, Kario K
    J Clin Hypertens (Greenwich), 2022 Sep;24(9):1204-1217.
    PMID: 36196471 DOI: 10.1111/jch.14559
    Asia has an enormous number of older people and is the primary contributor to the rise in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The therapy of many neurodegenerative diseases has not yet progressed to the point where it is possible to alter the course of the disease. Mid-life hypertension is an important predictor of later-life cognitive impairment and brain neurodegenerative conditions. These findings highlight the pivotal role of preventing and managing hypertension as a risk factor for neurodegenerative disease. Autonomic dysfunction, neuropsychiatric and sleep disturbances can arise in neurodegenerative diseases, resulting in blood pressure variability (BPV). The BPV itself can worsen the progression of the disease. In older people with neurodegenerative disease and hypertension, it is critical to consider 24-h blood pressure monitoring and personalized blood pressure therapy.
    Matched MeSH terms: Blood Pressure/physiology; Blood Pressure Determination/methods
  10. Treesaranuwattana T, Wong KYH, Brooks DL, Tay CS, Williams GH, Williams JS, et al.
    Hypertension, 2020 04;75(4):1045-1053.
    PMID: 32160100 DOI: 10.1161/HYPERTENSIONAHA.119.13821
    LSD1 (lysine-specific demethylase-1) is an epigenetic regulator of gene transcription. LSD1 risk allele in humans and LSD1 deficiency (LSD1+/-) in mice confer increasing salt-sensitivity of blood pressure with age, which evolves into salt-sensitive hypertension in older individuals. However, the mechanism underlying the relationship between LSD1 and salt-sensitivity of blood pressure remains elusive. Here, we show that LSD1 genotype (in humans) and LSD1 deficiency (in mice) lead to similar associations with increased blood pressure and urine potassium levels but with decreased aldosterone levels during a liberal salt diet. Thus, we hypothesized that LSD1 deficiency leads to an MR (mineralocorticoid receptor)-dependent hypertensive state. Yet, further studies in LSD1+/- mice treated with the MR antagonist eplerenone demonstrate that hypertension, kaliuria, and albuminuria are substantially improved, suggesting that the ligand-independent activation of the MR is the underlying cause of this LSD1 deficiency-mediated phenotype. Indeed, while MR and epithelial sodium channel expression levels were increased in LSD1+/- mouse kidney tissues, aldosterone secretion from LSD1+/- glomerulosa cells was significantly lower. Collectively, these data establish that LSD1 deficiency leads to an inappropriate activation and increased levels of the MR during a liberal salt regimen and suggest that inhibiting the MR pathway is a useful strategy for treatment of hypertension in human LSD1 risk allele carriers.
    Matched MeSH terms: Blood Pressure/drug effects; Blood Pressure/genetics*
  11. Tong SF, Aziz NA, Chin GL
    Med J Malaysia, 2007 Dec;62(5):390-3.
    PMID: 18705473 MyJurnal
    Thrombocytopaenia is often relied upon as an important criterion for the diagnosis of dengue infection among patients presenting with an acute non-specific febrile illness. This study was aimed to assess usefulness of thrombocytopaenia in the diagnosis of acute dengue virus infection. This was a clinic based prospective cohort study from May to November 2003. Consecutive patients presenting with acute non-specific febrile illness of less than two weeks were selected from two urban primary care centres. We did full blood count examination (FBC) on the day of visit and dengue serology on day five of illness for all patients enrolled. We repeated the FBC examination for patients who had initial normal platelet counts. Thrombocytopaenia was defined as platelet count < 150 X 10(9)/L. Eighty-seven patients enrolled in the study. Complete data was available for 73 patients. The prevalence of acute dengue virus infection was 27.6%. The sensitivity and specificity were 88% and 71% respectively. The likelihood of acute dengue infection in the presence of thrombocytopaenia was 2.52 and likelihood of not having dengue infection in normal platelet count patients was 5.22. Thrombocytopaenia has fair predictive value in diagnosing acute dengue virus infection. It was more useful to exclude than to diagnose dengue infection.

    Study site: Primary Care Centre of Hospital Universiti
    Kebangsaan Malaysia (HUKM) and Batu 9 Health Clinic Hulu Langat,
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  12. Tomitani N, Hoshide S, Buranakitjaroen P, Chia YC, Park S, Chen CH, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):606-613.
    PMID: 33694262 DOI: 10.1111/jch.14239
    Increased heart rate is a predictor of cardiovascular disease, heart failure, and all-cause mortality. In those with high heart rates, interventions for heart rate reduction have been associated with reductions in coronary events. Asia is a diverse continent, and the prevalences of hypertension and cardiovascular disease differ among its countries. The present analysis of AsiaBP@Home study data investigated differences among resting heart rates (RHRs) in 1443 hypertensive patients from three Asian regions: East Asia (N = 595), Southeast Asia (N = 680), and South Asia (N = 168). This is the first study to investigate self-measured RHR values in different Asian countries/regions using the same validated home BP monitoring device (Omron HEM-7130-AP/HEM-7131-E). Subjects in South Asia had higher RHR values compared with the other two regions, and the regional tendency found in RHR values was different from that found in BP values. Even after adjusting for age, sex, BMI, habitual alcohol consumption, current smoking habit, shift worker, hyperlipidemia, diabetes, chronic kidney disease, history of heart failure, and beta-blocker use, both office and home RHR values in South Asia were the highest among Asia (mean values ± SE of office: East Asia [E] 75.2 ± 1.5 bpm, Southeast Asia [Se] 76.7 ± 1.5 bpm, South Asia [S] 81.9 ± 1.4 bpm; home morning: [E] 69.0 ± 1.2 bpm, [Se] 72.9 ± 1.2 bpm, [S] 74.9 ± 1.1 bpm; home evening: [E] 74.6 ± 1.2 bpm, [Se] 78.3 ± 1.2 bpm, [S] 83.8 ± 1.1 bpm). Given what is known about the impact of RHR on heart disease, our findings suggest the possible benefit of regionally tailored clinical strategies for cardiovascular disease prevention.
    Matched MeSH terms: Blood Pressure Determination; Blood Pressure Monitoring, Ambulatory
  13. Toh, Teck Hock, Nurhilda Abdullah, Chua, Soh Yian, Muhamad Rais Abdullah, Islia Nahazatul, Chieng, Lee Ling
    Int J Public Health Res, 2011;1(2):66-71.
    MyJurnal
    Introduction Special Olympics (SO) Inc. is an organization for people with intellectual disability (ID) to actively engaging in Olympic-type sport and participating in competition. Special Olympic Inc. provides Healthy Athletes Programme (HAP®) in screening and providing health education to Special Olympic Athletes. Objective To study the body mass index (BMI), blood pressure (BP), visual acuity and hearing status of children and young adult with ID in Special Olympics Sarawak. Methods Health data were collected by trained health professionals under HAP®held in conjunction with Special Olympics Sarawak State Games on 17th and 18th April 2010 in Sibu. Health data collected were athletes' weight, BMI, BP, ear canal screen and hearing status (oto-acoustic emission, pure tone audiometry), as well as eye health and visual acuity, using guidelines set by HAP®. Results 195 athletes attended the State Games in 2010 of which 138 were screened. Significant number of athletes was considered overweight / obese (31.5% for children and 36.9% for adult). More than 20% of the adult athletes were hypertensive or at risk of hypertension. Sixteen percent of the adult athletes had hearing loss. More than half of the adult and children athletes never had eye checks, and a significant numbers of them had abnormal eye tests results. Conclusions Health screening conducted during the HAP® is a useful screening program in this population. Health data collected can bring awareness to athletes and their family, and corrective measures in hearing and visual impairment can be taken immediately.
    Matched MeSH terms: Blood Pressure
  14. Tiong XT, Nursara Shahirah A, Pun VC, Wong KY, Fong AYY, Sy RG, et al.
    Nutr Metab Cardiovasc Dis, 2018 08;28(8):856-863.
    PMID: 29853430 DOI: 10.1016/j.numecd.2018.04.014
    BACKGROUND AND AIM: Despite a growing body of evidence from Western populations on the health benefits of Dietary Approaches to Stop Hypertension (DASH) diets, their applicability in South East Asian settings is not clear. We examined cross-sectional associations between DASH diet and cardio-metabolic risk factors among 1837 Malaysian and 2898 Philippines participants in a multi-national cohort.

    METHODS AND RESULTS: Blood pressures, fasting lipid profile and fasting glucose were measured, and DASH score was computed based on a 22-item food frequency questionnaire. Older individuals, women, those not consuming alcohol and those undertaking regular physical activity were more likely to have higher DASH scores. In the Malaysian cohort, while total DASH score was not significantly associated with cardio-metabolic risk factors after adjusting for confounders, significant associations were observed for intake of green vegetable [0.011, standard error (SE): 0.004], and red and processed meat (-0.009, SE: 0.004) with total cholesterol. In the Philippines cohort, a 5-unit increase in total DASH score was significantly and inversely associated with systolic blood pressure (-1.41, SE: 0.40), diastolic blood pressure (-1.09, SE: 0.28), total cholesterol (-0.015, SE: 0.005), low-density lipoprotein cholesterol (-0.025, SE: 0.008), and triglyceride (-0.034, SE: 0.012) after adjusting for socio-demographic and lifestyle groups. Intake of milk and dairy products, red and processed meat, and sugared drinks were found to significantly associated with most risk factors.

    CONCLUSIONS: Differential associations of DASH diet and dietary components with cardio-metabolic risk factors by country suggest the need for country-specific tailoring of dietary interventions to improve cardio-metabolic risk profiles.

    Matched MeSH terms: Blood Pressure*
  15. Tey SL, Van Helvoort A, Henry CJ
    Eur J Nutr, 2016 Dec;55(8):2493-2498.
    PMID: 26467048
    PURPOSE: A limited number of studies have compared the glycaemic index (GI) and glycaemic responses (GR) to solid foods between Caucasians and Asians. These studies have demonstrated that Asians have greater GI and GR values for solid foods than Caucasians. However, no study has compared the GI and GR to liquids among various Asian ethnic groups.

    METHODS: A total of forty-eight males and females (16 Chinese, 16 Indians, and 16 Malay) took part in this randomised, crossover study. Glycaemic response to the reference food (glucose beverage) was measured on three occasions, and GR to three liquids were measured on one occasion each. Liquids with different macronutrient ratio's and carbohydrate types were chosen to be able to evaluate the response to products with different GIs. Blood glucose concentrations were measured in duplicate at baseline (-5 and 0 min) and once at 15, 30, 45, 60, 90, and 120 min after the commencement of beverage consumption.

    RESULTS: There were statistically significant differences in GI and GR between the three liquids (P 

    Matched MeSH terms: Blood Pressure
  16. Teoh SL, Lai NM, Vanichkulpitak P, Vuksan V, Ho H, Chaiyakunapruk N
    Nutr Rev, 2018 04 01;76(4):219-242.
    PMID: 29452425 DOI: 10.1093/nutrit/nux071
    Context: Chia seed is a popular dietary supplement, taken mainly for its high content of alpha-linolenic acid, vegetable protein, and dietary fiber, yet information about its clinical effects is lacking.

    Objective: This review aims to summarize the clinical evidence regarding the use of chia seed for a wide variety of health conditions.

    Data Sources: A number of databases, including PubMed and Embase, were searched systematically.

    Study Selection: Randomized controlled trials that assessed the clinical effects of chia seed consumption in human participants were included. The quality of trials was assessed using the Cochrane Risk of Bias Tool.

    Data Extraction: Data on study design, blinding status, characteristics of participants, chia seed intervention, comparator, clinical assessment, duration of intake, interval of assessment, and study funding status were extracted. Meta-analysis was performed.

    Results: Twelve trials were included. Participants included healthy persons, athletes, diabetic patients, and individuals with metabolic syndrome. Pooling of results showed no significant differences except for the following findings of subgroup analysis at higher doses of chia seed: (1) lower postprandial blood glucose level (mean difference [MD] of -33.95 incremental area under the curve [iAUC] [mmol/L × 2 h] [95%CI, -61.85, -6.05] and -51.60 iAUC [mmol/L × 2 h] [95%CI, -79.64, -23.56] at medium doses and high doses, respectively); (2) lower high-density lipoprotein in serum (MD of -0.10 mmol/L [95%CI, -0.20, -0.01]); and (3) lower diastolic blood pressure (MD of -7.14 mmHg [95%CI, -11.08, -3.19]). The quality of all evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was low or very low. All trials employed only surrogate markers as outcomes.

    Conclusions: Future trials with improved methodological quality, well-described clinical events, and validated surrogate markers as outcomes are needed to support the potential health benefits of chia seed consumption.

    Systematic Review Registration: PROSPERO registration no. CRD42015029990.

    Matched MeSH terms: Blood Pressure/drug effects
  17. Teoh SH, Razlina AR, Norwati D, Siti Suhaila MY
    Med J Malaysia, 2017 02;72(1):18-25.
    PMID: 28255135
    BACKGROUND: blood pressure (bP) control among Malaysian is poor and doctor's adherence to clinical practice guideline (cPG) has been a well-known factor that may improve it. this study was designed to evaluate patients' bP control, doctors' adherence to the latest hypertension cPG and their association. Factors associated with bP control and cPG adherence was also examined.

    METHODS: A cross-sectional study was conducted in Kuala Muda district's health clinics. 331 medical records were selected using stratified random sampling and standard proforma was used for data collection. the latest edition of the Malaysian cPG on hypertension was employed to define related variables.

    RESULTS: A total of 160 patients (48.3%) had controlled bP and it was significantly associated with patients' age (adjusted Odds ratio, aOr= 1.03, 95% cI: 1.004, 1.05, p= 0.016) and systolic bP at presentation (aOr= 0.95, 95% cI: 0.93, 0.96, p< 0.001). About 60.7% of the medical records showed doctor's good level of cPG adherence. this adherence has significant association with presence of chronic kidney disease (aOr= 0.51, 95% cI: 0.31, 0.85, p= 0.007) and cardiovascular disease (aOr= 2.68, 95% cI: 1.04, 6.95, p= 0.030) in the patients and physicians' treatment intensification (aOr= 2.00, 95% cI: 1.26, 3.19, p= 0.009). However, no association was found between bP control and cPG adherence.

    CONCLUSION: Hypertension control in this study was poor and the prevalence of physicians with good level of cPG adherence was slightly above average. these findings are important for relevant stakeholders to strategise an action plan to improve hypertension management outcome.
    Matched MeSH terms: Blood Pressure; Blood Pressure Determination
  18. Teoh RJJ, Mat S, Khor HM, Kamaruzzaman SB, Tan MP
    Postgrad Med, 2021 Apr;133(3):351-356.
    PMID: 33143493 DOI: 10.1080/00325481.2020.1842026
    OBJECTIVES: While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults.

    METHODS: Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers.

    RESULTS: Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss.

    CONCLUSION: Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.

    Matched MeSH terms: Blood Pressure
  19. Teoh AN, Hilmert C
    Br J Health Psychol, 2018 11;23(4):1040-1065.
    PMID: 30084181 DOI: 10.1111/bjhp.12337
    PURPOSE: The stress-buffering hypothesis (Cohen & McKay, 1984, Handbook of psychology and health IV: Social psychological aspects of health (pp. 253-256). Hillsdale, NJ: Lawrence Erlbaum) suggests that one way social support enhances health is by attenuating cardiovascular reactivity (CVR) to stress. Research that has tested this hypothesis has reported inconsistent findings. In this review, we systematically reviewed those findings and proposed a dual-effect model of social support and CVR as a potential explanation for the inconsistency in the literature. Specifically, we proposed that when participants are more engaged during a stressor, social support acts primarily as social comfort, attenuating CVR; and when participants are not engaged, social support acts primarily as social encouragement, elevating CVR.

    METHODS: We reviewed 22 previous studies that (1) empirically manipulated social support in a stressful situation, (2) measured CVR, and (3) tested a moderator of social support effects on CVR.

    RESULTS: Although a majority of studies reported a CVR-mitigating effect of social support resulting in an overall significant combined p-value, we found that there were different effects of social support on CVR when we considered high- and low-engagement contexts. That is, compared to control conditions, social support lowered CVR in more engaging situations but had no significant effect on CVR in less engaging situations.

    CONCLUSION: Our results suggest that a dual-effect model of social support effects on CVR may better capture the nature of social support, CVR, and health associations than the buffering hypothesis and emphasize a need to better understand the health implications of physiological reactivity in various contexts. Statement of contribution What is already known on this subject? According to the stress-buffering hypothesis (Cohen & McKay, ), one pathway social support benefits health is through mitigating the physiological arousal caused by stress. However, previous studies that examined the effects of social support on blood pressure and heart rate changes were not consistently supporting the hypothesis. Some studies reported that social support causes elevations in cardiovascular reactivity (CVR) to stress (Anthony & O'Brien, ; Hilmert, Christenfeld, & Kulik, ; Hilmert, Kulik, & Christenfeld, ) and others showed no effect of social support on CVR (Christian & Stoney, ; Craig & Deichert, ; Gallo, Smith, & Kircher, ). What does this study add? When participants were in more engaging conditions, social support decreased CVR relative to no support. When participants were in less engaging conditions, social support did not have a significant effect on CVR. Provide an alternative way to explain the ways social support affects cardiac health.

    Matched MeSH terms: Blood Pressure/physiology*
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