ABSTRACT
Objective To investigate the effects of obesity on blood pressure variation and plasma levels of nitric oxide (NO) and endothelin (ET) in elderly hypertensive patients.Methods A total of 175 elderly patients with hypertension were screened for this study.Based on body mass index,they were categorized into three groups with normal weight (n =69),overweight (n=56) and obesity (n=50).24 hour dynamic blood pressure,NO and ET levels were monitored.Results No significant differences in 24 h systolic blood pressure,daytime systolic blood pressure,nighttime systolic blood pressure,24 hours diastolic blood pressure (24 h-DBP) and night time diastolic blood pressure were found among the groups (all P＞0.05).Morning systolic and diastolic blood pressure were higher in obese group than in normal weight and overweight groups(both P＜0.05).The daytime diastolic blood pressure was higher in obese group than in overweight group.24 h systolic blood pressure variation,daytime systolic blood pressure variation,and blood pressure pattern were higher in obese group than in overweight and normal weight group [(12.6 ± 2.7)％ vs.(10.4 ±2.2)％ and (9.4±1.9)％,(12.2±2.9)％ vs.(10.2±2.2)％ and (9.2±2.1)％,(5.2±10.5)％vs.(1.4± 6.9) ％ and (1.8 ± 8.2) ％ group,all P＜ 0.05].The nighttime systolic blood pressure variation,24 h diastolic blood pressure variation,daytime diastolic blood pressure variation were increased in obese group as compared with normal weight group [(9.8 ± 3.7)％ vs.(8.2 ± 3.1)％,(15.3±3.3)％ vs.(13.2±4.2)％,(14.7±3.7)％ vs.(12.9±3.8)％,all P＜0.05].No differences were found in nighttime diastolic blood pressure variation among the groups.Plasma NO level was lower in obese group than in overweight and normal weight group [(29.8± 14.2)μmol/L vs.(47.9± 18.6) μmol/L and (94.6 ± 42.9) μmol/L,P＜0.01].Plasma ET level was significantly higher in obese group than in overweight group and normal weight group [(46.5± 9.8)ng/L vs.(37.3±4.8) ng/L and (31.1± 5.5) ng/L,P＜0.01].24 h systolic blood pressure variation was significantly correlated with plasma NO level (r =0.340,P =0.004) in normal weight group.Conclusions Obesity can effectively increase blood pressure variation and ET level,and reduce plasma NO level in elderly hypertensive patients.Obesity is one of the most important influencing factors for blood pressure variation,plasma NO and ET levels.
ABSTRACT
Objective To study the supportive personnel system reform for implementing the essential medicine system in Guangxi,as well as its impacts on the township hospitals and problems so incurred.Methods Deans (and/or vice deans)and financial staff of 24 townships hospitals were interviewed,while 80％ of medical staff of health centers in 8 counties were subject to a questionnaire survey,to evaluate impacts of the essential medicine system on township hospitals.Results As shown in the outcomes,44.02％of those surveyed were less enthusiastic after the new system was put in place,township health center doctors found their average salary decreased(P=0.027),and the rewarding salary failed to distinguish differences among posts,which all worsened the brain drain of these doctors.Conclusion The new personnel system is found with setbacks of poor incentive mechanism and poor operability.Thus further improvement should be made in scientific measurement of the gaps found in the performance-based pay,and the implementation of thetwo-way flow of medical personnel policy.