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Comparison of Two Means
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
Suppose we are interested in investigating the effects of an antihypertensive drug treatment on persons over the age of 60 who suffer from isolated systolic hypertension [206]. By definition, individuals with this condition have a systolic blood pressure greater than 160 mm Hg while their diastolic blood pressure is below 90 mm Hg. Before the start of the study, subjects who had been randomly selected to take the active drug and those chosen to receive a placebo were comparable with respect to systolic blood pressure. After one year on the study, the mean systolic blood pressure for patients receiving the drug is denoted by μ1 and the mean for those receiving placebo by The standard deviations of the two populations are unknown, and we do not feel justified in assuming they are equal. Since we would like to determine whether the mean systolic blood pressures of the patients in these two different treatment groups remain the same, we test the null hypothesis
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Blood pressure measurement is a familiar activity for the nurse, but it is worth pausing to consider exactly what it is that is being measured. Blood pressure is the pressure the blood exerts on the inner walls of the arteries and is determined by cardiac output (CO) and systemic vascular resistance (SVR). It gives the nurse a good insight into the functioning of the left ventricle’s ability to pump blood into the aorta. Blood pressure is a product of cardiac output and systemic vascular resistance. Blood pressure is expressed as a systolic over a diastolic pressure. Normal blood pressure varies but an ideal value is between 120/85mmHg, to a high normal of 140/89 (NICE 2019a). Systolic blood pressure is generated by the strength and the volume of blood pumped by the ventricular contraction. Diastolic blood pressure is related to the tone of the blood vessels. The relationship between the factors that contribute to cardiac output are shown in Figure 6.8. It can be seen that if one of these factors change (for example preload), then stroke volume, cardiac output and blood pressure will all be affected. The sympathetic nervous system can influence each of these factors and contributes to maintaining CO and BP.
Football as Medicine against cardiovascular disease
Published in Peter Krustrup, Daniel Parnell, Football as Medicine, 2019
Magni Mohr, Peter Riis Hansen, Felipe Lobelo, Lars Nybo, Zoran Milanović, Peter Krustrup
As aforementioned, hypertension is one of the most common CVDs in both men and women, and it is predicted that the prevalence of hypertensive adults will be more than 1.56 billion by the year 2025 (Kearney et al. 2005). However, a short-term recreational football programme (40–60 min, 2–3 sessions per week) is most likely beneficial for systolic and diastolic blood pressure, with the magnitude of reduction in pre- to mildly hypertensive adults observed at 11 and 7 mmHg, respectively (Milanović et al. 2019). Moreover, recreational football reduces systolic and diastolic blood pressure by 2.9% and 8.6% in overweight children (Cvetkovic et al. 2018). The aforementioned improvements are comparable to the acute effect of taking one standard dose of a blood pressure-lowering drug (Law, Morris, and Wald 2009) and are of clinical importance given that a blood pressure reduction of such a magnitude corresponds to a lowered risk of sudden cardiac stroke by 20–30% in hypertensive individuals (Law, Morris, and Wald 2009). Recreational football is an adequate stimulus to upregulate a multitude of physiological parameters associated with CVD (Hansen et al. 2013; Andersen et al. 2010). These cardiovascular system adaptations, which are the consequence of frequent high-intensity movements performed during recreational football, also lead to a moderate decrease in resting heart rate, with a magnitude of 4–12 bpm depending on aerobic fitness at baseline (Milanović et al. 2019)
Poorly controlled hypertension is associated with elevated serum uric acid to HDL-cholesterol ratio: a cross-sectional cohort study
Published in Postgraduate Medicine, 2022
Gulali Aktas, Atiqa Khalid, Ozge Kurtkulagi, Tuba Taslamacioglu Duman, Satilmis Bilgin, Gizem Kahveci, Burcin Meryem Atak Tel, Isa Sincer, Yilmaz Gunes
Age, sex, anthropometric measurements (height, weight, waist circumference), systolic and diastolic blood pressures, and history of smoking and alcohol consumption were recruited from patients’ files and institutional database. A body mass index (BMI) was calculated using the following formula: weight (kg)/ height (m2). The means of two systolic and diastolic blood pressure measurements in each of two consecutive clinic visits were used in the definition of poorly and well-controlled hypertension groups, according to the suggestions of Joint National Committee (JNC) VIII criteria [18]. Poor control was established when at least one of the mean systolic or diastolic blood pressure measurements was higher than the threshold of recommended blood pressure levels according to JNC VIII. Thus, a systolic blood pressure equal to or higher than 140 mmHg or a diastolic blood pressure equal to or higher than 90 mmHg was considered as poor blood pressure control. Third study group was comprised of healthy volunteers as controls.
Factors influencing the outcome of cardiogenic cerebral embolism: a literature review
Published in Neurological Research, 2022
Yanling Wang, Yazeed Haddad, Radhika Patel, Xiaokun Geng, Huishan Du, Yuchuan Ding
Studies of other organ system diseases that affect the prognosis of patients with cardiogenic cerebral embolism are mainly focused on complications, such as pulmonary infection, renal insufficiency, and stroke-related diseases such as carotid stenosis, hypertension, diabetes and hyperlipidemia, etc [25–28]. Many studies have shown that pulmonary infection and renal insufficiency are independent risk factors for poor outcome of cardiogenic cerebral embolism. These are thought to be associated with dehydration and edema. Patients with pulmonary infection consume more water and other nutrients, while patients with renal insufficiency are more vulnerable to maintain water and electrolyte balance. [29] Coronary and peripheral artery diseases, for example, carotid stenosis, were common in the patients with cardiogenic cerebral embolism. These reduce the proportion of good prognosis in patients with cardiogenic cerebral embolism [26]. In most studies, although hypertension and diabetes are not independent risk factors for adverse outcomes of cardiogenic cerebral embolism, the severely elevated but not well-controlled blood pressure level is one of the important reasons for cardiac remodeling. And it is important to keep in mind that excessive blood pressure lowering can sometimes worsen cerebral ischemia [30]. Diastolic blood pressure is independently associated with early neurological deterioration [2]. It has been reported that a hypoglycemic attack can result in takotsubo syndrome, leading to cardiogenic cerebral embolism [31].
Epicardial fat tissue can predict subclinical left ventricular dysfunction in patients with erectile dysfunction
Published in The Aging Male, 2021
Hayati Eren, Muhammed Bahadır Omar, Ülker Kaya, Ertuğrul Gazi Özbey, Lütfi Öcal
A total of 126 consecutive patients admitted to the urology outpatient clinic with a diagnosis of ED and planned to determine cardiovascular risk were included in the study. A total of 132 age and gender-matched volunteers were selected as the control group. Those with LV segmental motion defects, history of CAD (history of percutaneous coronary intervention and coronary bypass), DM, LV ejection fraction <55%, previous cerebrovascular disease, peripheral artery disease, conduction abnormalities, atrial fibrillation, valvular heart disease more than mild, any cardiac surgery history of pacemaker, polyneuropathy due to surgical trauma (radical retropubic prostatectomy, cystectomy, etc.), neurological diseases, poor echocardiographic image and positive cardiovascular stress test, phosphodiesterase inhibitors and the patients taking beta blockers were not included in the study. Traditional risk factors such as HT, age, smoking, and family history of CAD of all participants was recorded. Cardiovascular stress test was applied to all participants using Bruce Protocol to investigate ischemia. A 12-lead ECG with a filter range of 0.5–150 Hz (25 mm/s, 10 mm/mV) was performed in all patients. Blood samples were taken to evaluate routine biochemical and hematological parameters after 12 h of fasting. A systolic blood pressure value of 140 mm Hg and/or a diastolic blood pressure value of ≥90 mmHg was defined as HT. Informed consent was obtained from all participants and the study was approved by the local ethics committee.