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ObjectiveTo explore the clinical efficacy of Gouteng prescription in treating the patients with primary hypertension with anxiety disorder due to yang hyperactivity and heat toxin and the impact of the formula on the balance of inflammatory cytokines. MethodA total of 98 patients diagnosed with primary hypertension and anxiety disorder were randomized into control and observation groups. On the basis of conventional western medicine treatment for hypertension， the control group （47 patients） was treated with Shugan Jieyu capsules for 8 weeks， while the treatment group （51 patients） with Gouteng prescription for 8 weeks. The two groups were compared in terms of the blood pressure level， 24-hour blood pressure variability， Hamilton anxiety scale （HAMA） score， Pittsburgh sleep quality index （PSQI） score， quality of life （SF-36 scale） score， traditional Chinese medicine （TCM） syndrome score and efficacy， incidence of adverse reactions， and the levels of interleukin （IL）-1β， IL-6， IL-10， and IL-4 in the serum of peripheral blood. ResultThe final trial was completed with 95 patients， including 46 in the control group and 49 in the observation group. The treatment in both groups lowered the blood pressure and blood pressure variability （P<0.05， P<0.01）. The observation group outperformed the control group in recovering the systolic blood pressure （SBP）， 24-hour mean systolic blood pressure （24 h SBP）， 24-hour systolic blood pressure variability （24 h SBPV）， and 24-hour diastolic blood pressure variability （24 h DBPV） （P<0.05）. After treatment， the HAMA and PSQI scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower HAMA and PSQI scores than the control group （P<0.05）. Compared with those before treatment， the SF-36 scores in both groups increased （P<0.05， P<0.01）. After treatment， the observation group had higher scores of physiological function （PF）， bodily pain （BP）， social function （SF）， role-emotional （RE）， and mental health （MH） indicators than the control group （P<0.05）. After treatment， the TCM syndrome scores in both groups decreased （P<0.05， P<0.01）， and the observation group had lower score than the control group （P<0.05）. The total response rate regarding TCM syndrome in the observation group was 85.71% （42/49）， which was higher than that （63.04%， 29/46） in the control group （χ2=6.621， P<0.05）. The treatment in both groups lowered the levels of pro-inflammatory cytokines （IL-1β， IL-6） and elevated the levels of anti-inflammatory cytokines （IL-10， IL-4） （P<0.05， P<0.01）， and the changes were more obvious in the observation group than in the control group （P<0.05）. There were no adverse events during the research process. ConclusionGouteng prescription can recover the blood pressure level， reduce blood pressure variability， suppress anxiety state， improve sleep and quality of life， decrease TCM syndrome score， increase total response rate， lower serum IL-1β and IL-6 levels， and elevate serum IL-10 and IL-4 levels in the patients with primary hypertension complicated with anxiety disorder due to yang hyperactivity and heat toxin. It may exert the effects by regulating the balance of pro-inflammatory and anti-inflammatory cytokines.
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OBJECTIVES@#To study the distribution characteristics of methylenetetrahydrofolate reductase (MTHFR) C677T gene polymorphism in children with primary hypertension, and to explore the association between MTHFR C677T gene polymorphism and H-type hypertension in children.@*METHODS@#A total of 121 children with primary hypertension who were hospitalized in the department of cardiovascular medicine from January to July 2021, newly diagnosed, and untreated were retrospectively selected as the subjects. The children were divided into three groups: CC genotype (19 children), CT genotype (51 children), and TT genotype (51 children). According to the serum homocysteine (Hcy) level, they were divided two groups: H-type hypertension (47 children) and simple hypertension (74 children). The medical data were compared between the groups. The association between MTHFR C677T gene polymorphism and H-type hypertension was evaluated.@*RESULTS@#The mutation frequency of T allele in children with primary hypertension was significantly higher than that in healthy adults in Beijing and Chinese Han adults (P<0.001). The serum Hcy level in the TT genotype group was significantly higher than that in the CC and CT genotype groups (P<0.001). The serum Hcy level in the H-type hypertension group was significantly higher than that in the simple hypertension group (P<0.001), and MTHFR C677T was mostly TT genotype, which was associated with the risk of H-type hypertension (OR=12.71, P<0.001). There was no significant difference in the incidence rate of target organ damage between the H-type hypertension and simple hypertension groups (P>0.05). However, multiple organ involvement was observed in the H-type hypertension group at diagnosis, accounting for 11% (5/47).@*CONCLUSIONS@#The mutation rate of MTHFR C677T T allele in children with primary hypertension is high and associated with the serum Hcy level. TT genotype is an independent risk factor for H-type hypertension in children, and it may be related to the severity of early target organ damage.
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Child , Humans , Alleles , Genotype , Hypertension/genetics , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Polymorphism, Genetic , Retrospective StudiesABSTRACT
Objective:To summarize the characteristics of hypertension and target organ damage in hospitalized children, so as to provide scientific basis for comprehensive prevention and management of hypertension children.Methods:The clinical data of 165 hospitalized children diagnosed with hypertension at Beijing Children′s Hospital from January 2017 to December 2019 were analyzed retrospectively.Data including medical history, clinical symptoms, signs, auxiliary examination and treatment strategy were collected and analyzed statistically.Results:Of 165 admitted hypertensive children who met the inclusion criteria, 35(21.2%)were classified as having primary hypertension, and 130(78.8%)were secondary hypertension.The body mass index(BMI)and the rate of family history of children with primary hypertension were higher than those of children with secondary hypertension, the differences were statistically significant( t=2.052, P=0.026; χ2=3.321, P=0.009). Among 165 children with hypertension, 137 had varying degrees of clinical symptoms(83.0%), only nine primary hypertension cases showed symptoms.The original etiologies of secondary hypertension included 78 cases of renal disease(60.0%), 23 cases of cardiogenic disease(17.7%), six cases of endocrine disease(4.6%)and five cases of rheumatic disease(3.8%). Of all admitted patients, the blood pressure of 158 cases(95.8%)decreased to normal with weight control, low-fat and low-salt diet, antihypertensive drugs and treatment of primary disease.Besides, the parents of seven cases gave up any treatment and left hospital. Conclusion:Secondary hypertension is the main type of hypertension in children, among which renal parenchymal disease is the most common etiology.The clinical symptoms also vary by its original etiology.The overall goal of this study is to reduce the risk of target organ damage, and get blood pressure under control relatively early and effectively.
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OBJECTIVE@#To evaluate whether the efficacy of Getong Tongluo Capsule (, GTC, consisted of total flavone of Radix Puerariae) on improving patients' quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba (EGB) for patients with convalescent-phase ischemic stroke and primary hypertension.@*METHODS@#This randomized, positive-drug- and placebo-controlled, double-blind trial was conducted from September 2015 to October 2017. Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions, twice a day for 12 weeks: (1) GTC 250 mg plus EGB-matching placebo 40 mg (237 cases, GTC group), (2) EGB 40 mg plus GTC-matching placebo 250 mg (120 cases, EGB group) or (3) GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg (120 cases, placebo group). Moreover, all patients were orally administered aspirin enteric-coated tablets 100 mg, once a day for 12 weeks. The primary outcome was the Barthel Index (BI). The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale (NIHSS) scores. The incidence and severity of adverse events (AEs) were calculated and assessed.@*RESULTS@#The BI relative independence rates, the clinical recovery rates of NIHSS, and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment (P0.05). The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12, 18 and 24 weeks after treatment (P0.05).@*CONCLUSION@#GTC exhibited significant efficacy in improving patients' quality of life as well as neurological function and controlling hypertension. (Registration No. ChiCTR1800016667).
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Hypertension is one of the leading causes of death and disability among adults all over the world and emerging health problem in India. Over 90% of patients with high blood pressure have Essential Hypertension. Alterations in the intracellular free Calcium regulation as well as disturbances of extracellular calcium homeostasis have been observed in patients with essential hypertension. AIM: To study the levels of serum Calcium in patients with primary hypertension and to correlate the serum Calcium levels with severity of disease. Methods: Information for the study was collected from patients admitted to BLDEDU’S Shri B.M Patil Medical college Hospital and Research center, Vijayapura from November 2016 to June 2018. Patients were screened and who met inclusion criteria where studied. Serum calcium was done in total 126 patient which were divided equally in 3 groups named Stage I Hypertensives, Stage II Hypertensives, and Controls or Normotensives, 42 patients in each groups and results were obtained and Comparative Study was done. Results: In our study mean age in hypertensive patients was 50.80 ± 19.38 and in controls it was 43.19 ± 19.171. There was no significant difference of serum calcium was obtained in relation to age in both the Stage of Hypertension. There was no significant difference in relation to gender. In total Hypertensives cases mean ± SD of S. Calcium was 8.408 ± 1.07 mg/dl while in normotensives cases it was 9.190 ± 0.7827 mg/dl. In all Stage I Hypertensive case mean ± SD of S. Calcium was 8.626 ± 0.6012 mg/dl (p = 0.032) while in Stage II Hypertensive it was 8.190 ± 1.3668 mg/dl (p = 0.0001). This results were significantly low than normotensives. But comparing both Stage of Hypertension mean was lower in stage II but it is not significantly low. So level of S. Calcium has inverse relation with Hypertension severity. Conclusion: In patients of Essential hypertension mean serum Calcium levels were found to be low in comparison to Normotensives. Further, Stage II Hypertensive patient has more reduced levels of serum calcium than Stage I, hence low Serum Calcium levels were associated as the severity of the disease increases.
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Hypertension is the third leading killer disease in the world and is responsible for 1 in every 8 deaths. About 1 billion people are affected by hypertension worldwide.1 There is strong positive and continuous correlation between BP and the risk of cardiovascular disease (myocardial infarction, heart failure), renal disease, stroke and mortality. The present was aimed to find low plasma vitamin D levels are the risk factors for primary hypertension or not. Aims:. To study the low plasma vitamin D levels are the risk factors for primary hypertension or not. Methods: This was a case control study carried out in 100 patients, 50 controls and 50 cases with primary hypertension, aged between 18 to 60 years , admitted in BLDEDU’s Shri B.M.Patil hospital. Results: The number of patients in both the groups was predominantly female (52%) respectively while male patients constituted 48% of the study population. The mean systolic blood pressure (SBP) value in controls was significantly lower as compared to cases (116.8 ± 6.7 vs. 155.0 ± 8.4 mmHg). The mean diastolic blood pressure (DBP) values in controls was significantly lower as compared to cases (74.5 ± 4.8 vs. 87.6 ± 5.2 mmHg). The mean Vitamin D level in controls was higher as compared to cases (21.2± 11.5 vs. 18.0 ± 6.3ng/ml). However there was no significant difference between the groups as per Student t-test (p>0.05). Conclusion: In controls, 8% patients had Vitamin D deficiency while 24% patients had Vitamin D sufficiency. In cases, 10% patients had Vitamin D deficiency while 84% patients had Vitamin D insufficiency. The systolic and diastolic blood pressure values were significantly higher in cases as compared to controls in Vitamin D deficient, insufficient and sufficient patients.
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<p><b>OBJECTIVE</b>To analyze the present situation and existing problems of acupuncture for primary hypertension (PH) based on clinical research literature in recent 20 years.</p><p><b>METHODS</b>The clinical research literature regarding acupuncture for PH were searched from China National Knowledge Infrastructure (CNKI), VIP data network (VIP) and database from 1997 through 2016; a total of 218 papers met the inclusive criteria. Microsoft Excel and Apriori algorithm of SPSS Clementine software were applied to analyze the data.</p><p><b>RESULTS</b>The main acupoints of acupuncture for PH were Taichong (LR 3), Quchi (LI 11), Zusanli (ST 36) and Hegu (LI 4), but its support degree was only 12.21%. 127 papers were randomized controlled trials, accounting for 58.26%. 158 papers had clear diagnostic criteria, accounting for 72.48%. 138 papers had clear efficacy evaluation criteria, accounting for 63.30%. Only 5.05% of the papers were classified as high-quality literature by using Jadad scale.</p><p><b>CONCLUSION</b>In recent 20 years, some rules existed in acupoint selection for PH, but the support degree was low so it could not accurately guide clinical treatment. Although the clinical literature quality of acupuncture for PH was gradually increasing, the proportion of high-quality literature was low, therefore modern medical research model and foreign similar research should be followed to design a more rigorous trial protocol. As a result, the quality of clinical research is increased to provide reference for future clinical treatment.</p>
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Humans , Acupuncture Points , Acupuncture Therapy , China , Hypertension , Therapeutics , Randomized Controlled Trials as TopicABSTRACT
Objective To carry out the investigation of common susceptibility factors of primary hypertension in young people,and to find the pathogenic factors of primary hypertension. Methods 354 cases of young patients with essential hypertension were selected from 7360 young students in School of CAPF Frontier Guards Force and compared to 115 young healthy students at the same age. Results The incidence of primary hypertension is increasing year by year. More common risk factors are seen among students with hypertension compared to those of the control group. Conclusion Risk factors of primary hypertension are commonly seen among young students in School of CAPF Frontier Guards Force. It is necessary to prevent the risk factors, apply the targeted intervention and improve the management and issue a plan for prevention and control of high blood pressure.
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Objective To evaluate the effectiveness of community?based standardized blood pressure control and lifestyle management in hypertensive patients in Jinhua. Methods The study included patients with primary hypertension from community health service centers in Yongkang, Lanxi, and an urban district in Jinhua. Electronic health record data from 2015 to 2017 were collected, and relevant indicators before and after standardized management were assessed. Rates and constituent ratios were used for statistical evaluation. Numeric data were compared using the chi square test, and means were compared using the t?test. Results Of 14 943 hypertensive patients who underwent standardized management, 8 052 were women (53.88%) and 6 891 were men (46.12%). The average age of these patients in early 2015 was 66.63 years. After 3 years of standardized management, the rate of blood pressure control increased from 42.85% to 49.50%. The difference was statistically significant (χ2=133.019, P<0.05). The mean systolic and diastolic blood pressure values (138.67 mmHg and 84.46 mmHg, respectively) (1 mmHg=0.133 kPa) after standardized management were significantly different from those (139.40 mmHg and 85.08 mmHg, respectively) before standardized management (t=7.667, P<0.05; t=6.583, P<0.05, respectively). The average body weight, number of cigarettes smoked daily, and regular exercise time (61.51 kg, 15.28 cigarettes, and 40.56 min, respectively) after standardized management were significantly different from those (61.62 kg, 15.49 cigarettes, and 40.31 min, respectively) before standardized management (t=5.015, P<0.05; t=1.848, P<0.05; t=2.455, P<0.05, respectively). The medication compliance and willingness of being managed had significantly increased. The difference was statistically significant (χ2=72.600, P<0.05; χ2=299.434, P<0.05, respectively). Conclusions Standardized community-based management of hypertension effectively improved the rate of blood pressure control and the overall health of residents.
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OBJECTIVE:To observe the clinical efficacy and safety of amlodipine besylate combined with lisinopril and hydro-chlorothiazide,atorvastatin in the treatment of severe primary hypertension complicating with carotid atherosclerosis. METHODS:90 patients with severe primary hypertension complicating with carotid atherosclerosis were divided into control group (45 cases) and observation group(45 cases)according to random lottery form. Both groups were given Atorvastatin calcium tablet 20 mg/time orally,qd;control group was additionally given Amlodipine besylate tablet 5 mg/time orally,qd;observation group was additional-ly given Lisinopril and hydrochlorothiazide tablet 10 mg/time orally,qd,on the basis of control group. Both groups were treated for 8 weeks. Clinical efficacies of 2 groups were compared as well as blood pressure level,IMT,PV of carotid atherosclerosis, hs-CRP,TNF-α before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was significantly higher than that of control group,with statistical significance (P0.05). After treatment,the levels of SBP,DBP, IMT,PV,hs-CRP and TNF-α level in 2 groups were significantly lower than before;the observation group was significantly lower than the control group,with statistical significance (P0.05). CONCLUSIONS:Amlodipine besylate combined with lisinopril and hydrochlorothiazide,atorvastatin in the treatment of primary hypertension complicating with carotid atherosclerosis can effectively control the blood pressure level, delay the progression process of carotid atherosclerosis,reduce the inflammatory reaction degree,but dose not increase the occur-rence of ADR with good safety.
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OBJECTIVE:To provide reference for rational use of antihypertensive drugs in the clinic. METHODS:One hun-dred and eighteen primary hypertensive inpatients were selected from our hospital during Jan.2014-Oct.2015. The application of anti-hypertensive drugs and medication compliance were summarized and analyzed by reviewing the doctor’s advice and the question-naire survey method. RESULTS:Commonly used antihypertensive drugs of our hospital included diuretic,βreceptor blocker,calci-um antagonist, angiotensin converting enzyme inhibitor, angiotensinⅡreceptor antagonist and aldosterone receptor antagonist. Among 118 patients,fewer patients treated with monotherapy(10 cases,8.47%),and three-drug regimen took up the greatest pro-portion(51 cases,43.22%). The number of patients receiving antihypertensive drugs in related internal medicine departments(94 cases)was more than in related surgical departments(24 cases). 25 patients used antihypertensive drugs irrationally,mainly from internal medicine department,heart disease department,cerebropathy department,etc. Irrational medication mainly included irratio-nal frequencies(8 cases,32.00%),pharmaceutical frame structure damage(5 cases,20.00%),irrational drug selection(4 cases, 16.00%),etc. The poor medication compliance was found in 16 patients,mainly resulted from complex therapy plan (6 cases, 37.50%),forgetting to take medicine(5 cases,31.25%). CONCLUSIONS:Irrational use of antihypertensive drugs exist in prima-ry hypertensive inpatients of our hospital. Clinical pharmacists should use their own advantage to strengthen communication with medical staff,develop in pharmaceutical care and promote rational drug use in the clinic.
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Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.
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Objective To investigate the value of combined detection of serum cystatin C(Cys-C),alpha 1- microspheres(α1-MG)and urinary microalbumin(mAlb)in the early stage of renal damage in patients with primary hypertension(PH).Methods One hundred and twenty-eight patients with PH were divided into 3 groups according to urinary albumin excretion rate(UAER),group I,normal proteinuria,47 cases,group II microalbuminuria,43 cases,group III,massive proteinuria,38 cases and 50 healthy subjects(the control group)served as research object.Hitachi 7180 automatic biochemical analyzer was applied with latex turbidimetric immunoassay to detect serum Cys-C,α1-MG and mAlb,serum creatinine(Crea)and serum urea (Urea)were determined by enzyme method.Comparative analysis on the early diagnosis efficiency of renal damage was made o based on the combined detection results.Results PH patients were tested by Cys-C( (0.98±0.13)mg/L vs.(1.62±0.55)mg/L vs.(3.17±1.04)mg/L),α1-MG((29.32±6.46)mg/L vs. (38.58±11.79)mg/L vs.(61.42±22.71)mg/L),mAlb((26.35±6.53)mg/24 h vs.(54.24±12.78)mg/24 h vs.(373.6±98.40)mg/24 h),Crea((5.06±0.67)μmol/L vs.(89.64±28.84)μmol/L vs.(164.16 ±58.77)μmol/L),Urea((5.06 ± 0.67)mmol/L vs.(7.87 ± 2.95)mmol/L vs.(15.10 ± 7.41)mmol/L, compared with those in the control group((0.69±0.08)mg/L,(17.15±4.30)mg/L,(19.55±4.28)mg/24 h,(68.39±20.11)μmol/L,(5.05±0.78)mmol/L,there were significant differences among the four groups(F=164.74,93.01,553.27,61.38,65.24,P=0).The results of Cys-C,α1-MG and mAlb in patients with PH were higher than those in the control group(P<0.05,P<0.01).The results of Cys-C,α1-MG and mAlb in group II were higher than those in group I,but lower than those in group III(P<0.01).The detection results of Crea in group I and group II were higher than those in the control group(P>0.05),but lower than that in group III(P<0.05).The result of Urea in group I was higher than that in the control group(P>0.05),but lower than those in group II and group III(P<0.05).Crea Cys-C and Urea were positively correlated(r=0.385,r=0.310,P=0.006,P=0.025),α1-MG was positively correlated with Crea,Urea(r=0.310,r=0.228,P=0.028,P=0.043); mAlb was positively correlated with Crea and Urea(r=0.382,r=0.302,P=0.006,P=0.033). The specificity of combined detection of three markers(55.3%)was lower than the individual detection(74.5%,68.1%,80.9%)and also lower than the two-unit(70.2%,63.8%,index 78.7%); its sensitivity(90.7%)was significantly higher than that of the individual detection(65.1%,58.1%,67.4%)and the two-unit(79.1%,74.4%,69.8%).Conclusion Cys-C,α1-MG and mAlb can be used as important indicators in the diagnosis in the patients with PH renal damage,which can increase the effectiveness PH early renal damage diagnosis,can be used for early detection of renal damage in PH patients,with the disease monitoring.
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Objective To explore the correlation between catechol-O-methyltransferase (COMT) gene polymorphism and the occurrence of senile hypertension with depression.Methods Ninety-eight Han inpatients with senile hypertension complicating depression(elderly hypertension complicating depression group) in our hospitals from January 2010 to July 2014 were selected and contemporaneous 100 Han cases of senile hypertension(elderly hypertension group) and 100 healthy Han elderly people(elderly control group) served as the study subjects.PCR-RFLP was employed to detect COMT gene 1947 locus polymorphism distribution frequency for conducting analysis.Results The genotype frequencies of AA and AG at COMT 1947 locus in the elderly hypertension complicating depression group were significantly higher than those in the elderly control group(28.57 ％,51.02 ％ vs.19.00 ％,39.00％,P＜0.01).The A allele frequency in the elderly hypertensive complicating depression group was significantly higher than that in the elderly control group(54.08％ vs.38.50％,P＜0.01).The risk of hypertension complicating depression occurrence in the population carrying A allele was 1.881 times that of carrying G allele(OR =1.881,95 ％ CI:1.261-2.807,P＜0.01).The various genotypes frequencies had no statistical difference between the elderly hypertension group and elderly hypertension complicating depression group(P＞0.05).However,the COMT 1947A/G allele frequencies had statistical difference between the two groups (P＜0.05).The A allele frequencies in the hypertension complicating depression group was 54.08％,which was higher than 42.50％ in the elderly hypertension group (P＜0.01),moreover the risk of depression occurrence in the population carrying A allele was 1.593 times that of carrying G allele(OR=1.593,95％CI:1.071-2.37,P＜0.01).Conclusion COMT gene polymorphism could have correlation with the occurrence of elderly hypertensive complicating depression.Detecting COMT 1947 locus genotype in elderly patients with hypertension can serve as an important indicator for predicting depression occurrence.
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Objective To observe the clinical therapeutic effect of Qingxuan Jiangya decoction on patients with primary hypertension (PH) and its influence on their rennin-angiotensin-aldosterone system (RAAS). Methods A prospective study was conducted, including 178 patients with definite diagnosis of PH (Ⅰ-Ⅱ grade) who came from Guanggu district to the third Hospital of Wuhan City from April 2016 to March 2017, and they were divided into a control group and an observation group according to the method of taking medicine, each group 89 cases. The control group received 5 mg amlodipine besylate, orally once a day; the observation group on the basis of treatment in the control group, the Qingxuan Jiangya decoction (gastrodia rhizome 20 g, uncaria 20 g, ligusticum rhizome 15 g, salviae miltiorrhizae 10 g, puerarin 20 g, radix ophiopogonis 20 g, fructus lycii 25 g, chrysanthemum 10 g, root poria 15 g, poria cocos 10 g, radix glycyrrhizae 5 g) was added, a dose (400 mL) divided into two parts, one part taken twice daily, in the morning and in the evening after meals; the two groups took the treatment continuously for 4 weeks. The blood pressure dynamic changes and plasma levels of renin, angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and clinical efficacy were observed, and the safety of the drugs was evaluated by measuring the changes of liver and kidney functions. Results After treatment in the two groups, the daytime systolic pressure (D-SBP) and diastolic pressure (D-DBP) and nighttime SBP (N-SBP) and DBP (N-DBP), the mean of 24 hours-SBP and 24 hours-DBP were all lower than those before treatment, and the D-DBP, N-SBP and 24 hours-DBP of the observation group were significantly lower than those of control group [D-DBP (mmHg, 1 mmHg = 0.133 kPa): 78.24±5.35 vs. 81.56±6.23, N-SBP (mmHg):117.35±5.42 vs. 122.63±7.23, 24 hours-DBP (mmHg): 74.15±5.26 vs. 80.51±6.52, all P < 0.05]; after treatment, the levels of renin, Ang Ⅱ and ALD in two groups were also declined, and the degrees of decrease in the observation group were more significant than those in the control group [renin (ng/L): 5.46±0.41 vs. 7.82±0.36, ALD (ng/L):128.48±31.42 vs. 168.48±28.32, Ang Ⅱ (ng/L): 52.35±14.27 vs. 75.38±15.65, all P < 0.05]; there were no significant changes in the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), urea and creatinine (Cr) before and after treatment in the two groups, showing that the treatment was safe. Conclusion Qingxuan Jiangya decoction can effectively and safely reduce the blood pressure in PH patients, and its mechanism is possibly related to its influence on RAAS.
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Objective To explore the correlation between catechol-O-methyltransferase (COMT) gene polymorphism and the occurrence of senile hypertension with depression.Methods Ninety-eight Han inpatients with senile hypertension complicating depression(elderly hypertension complicating depression group) in our hospitals from January 2010 to July 2014 were selected and contemporaneous 100 Han cases of senile hypertension(elderly hypertension group) and 100 healthy Han elderly people(elderly control group) served as the study subjects.PCR-RFLP was employed to detect COMT gene 1947 locus polymorphism distribution frequency for conducting analysis.Results The genotype frequencies of AA and AG at COMT 1947 locus in the elderly hypertension complicating depression group were significantly higher than those in the elderly control group(28.57 ％,51.02 ％ vs.19.00 ％,39.00％,P＜0.01).The A allele frequency in the elderly hypertensive complicating depression group was significantly higher than that in the elderly control group(54.08％ vs.38.50％,P＜0.01).The risk of hypertension complicating depression occurrence in the population carrying A allele was 1.881 times that of carrying G allele(OR =1.881,95 ％ CI:1.261-2.807,P＜0.01).The various genotypes frequencies had no statistical difference between the elderly hypertension group and elderly hypertension complicating depression group(P＞0.05).However,the COMT 1947A/G allele frequencies had statistical difference between the two groups (P＜0.05).The A allele frequencies in the hypertension complicating depression group was 54.08％,which was higher than 42.50％ in the elderly hypertension group (P＜0.01),moreover the risk of depression occurrence in the population carrying A allele was 1.593 times that of carrying G allele(OR=1.593,95％CI:1.071-2.37,P＜0.01).Conclusion COMT gene polymorphism could have correlation with the occurrence of elderly hypertensive complicating depression.Detecting COMT 1947 locus genotype in elderly patients with hypertension can serve as an important indicator for predicting depression occurrence.
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Objective To observe the clinical therapeutic effect of Qingxuan Jiangya decoction on patients with primary hypertension (PH) and its influence on their rennin-angiotensin-aldosterone system (RAAS). Methods A prospective study was conducted, including 178 patients with definite diagnosis of PH (Ⅰ-Ⅱ grade) who came from Guanggu district to the third Hospital of Wuhan City from April 2016 to March 2017, and they were divided into a control group and an observation group according to the method of taking medicine, each group 89 cases. The control group received 5 mg amlodipine besylate, orally once a day; the observation group on the basis of treatment in the control group, the Qingxuan Jiangya decoction (gastrodia rhizome 20 g, uncaria 20 g, ligusticum rhizome 15 g, salviae miltiorrhizae 10 g, puerarin 20 g, radix ophiopogonis 20 g, fructus lycii 25 g, chrysanthemum 10 g, root poria 15 g, poria cocos 10 g, radix glycyrrhizae 5 g) was added, a dose (400 mL) divided into two parts, one part taken twice daily, in the morning and in the evening after meals; the two groups took the treatment continuously for 4 weeks. The blood pressure dynamic changes and plasma levels of renin, angiotensin Ⅱ (Ang Ⅱ), aldosterone (ALD) and clinical efficacy were observed, and the safety of the drugs was evaluated by measuring the changes of liver and kidney functions. Results After treatment in the two groups, the daytime systolic pressure (D-SBP) and diastolic pressure (D-DBP) and nighttime SBP (N-SBP) and DBP (N-DBP), the mean of 24 hours-SBP and 24 hours-DBP were all lower than those before treatment, and the D-DBP, N-SBP and 24 hours-DBP of the observation group were significantly lower than those of control group [D-DBP (mmHg, 1 mmHg = 0.133 kPa): 78.24±5.35 vs. 81.56±6.23, N-SBP (mmHg):117.35±5.42 vs. 122.63±7.23, 24 hours-DBP (mmHg): 74.15±5.26 vs. 80.51±6.52, all P < 0.05]; after treatment, the levels of renin, Ang Ⅱ and ALD in two groups were also declined, and the degrees of decrease in the observation group were more significant than those in the control group [renin (ng/L): 5.46±0.41 vs. 7.82±0.36, ALD (ng/L):128.48±31.42 vs. 168.48±28.32, Ang Ⅱ (ng/L): 52.35±14.27 vs. 75.38±15.65, all P < 0.05]; there were no significant changes in the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), urea and creatinine (Cr) before and after treatment in the two groups, showing that the treatment was safe. Conclusion Qingxuan Jiangya decoction can effectively and safely reduce the blood pressure in PH patients, and its mechanism is possibly related to its influence on RAAS.
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@#AIM: To evaluate the efficacy of surgery in eyes with vitreous hemorrhage secondary to central retinal vein occlusion complicated with primary hypertension. <p>METHODS: Totally 83 eyes of 83 consecutive primary hypertension patients with vitreous hemorrhage underwent vitrectomy were included. In 28 eyes of 28 patients, vitreous hemorrhage was caused by central retinal vein occlusion. All patients were followed up for 9-36mo, meanly 22.4mo. Main outcome measures included the best corrected visual acuity, intraoperative and postoperative complications,and the data were statistically analyzed and compared. <p>RESULTS: The incidence of vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion was 33.7%. The best corrected visual acuity increased in 24 eyes(86%), unchanged in 4 eyes(14%), there was a significant statistical difference between pre-operation and post-operation(<i>P</i><0.05). There were 5 eyes(18%)with macular edema after the surgery.There were no serious complications in and after the surgery in all 28 eyes. <p>CONCLUSION: Vitrectomy is a safe and effective treatment for vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion.
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Objective To analyze the factors which influence the treatment compliance of hypertensive patients in health management. Methods Data of 6 325 hypertensive patients who received physical examination in our department were collected; 4 132 male cases and 2 193 female were included, their ages ranged from 28 to 84 years old;the average age was 61.2 ± 5.8 years. The patients of the health intervention group were randomly divided into 3 groups (group 1, group 2 and group 3). They were provided with regular health management (including weight management, catering management, sports management, medication management and monitoring of blood pressure), respectively, given different frequency of telephone follow-up (1 time per 2 months, 1 time per month, and 1 time per month), evaluating treatment compliance. All the results were analyzed and compared respectively according to the level of education, age and mental status. Data of 1 892 hypertensive patients who received outpatient services were enrolled as the control group. Among them, 4 132 were male and 2 193 were female, aged 28-84 years old, average (61.2 ± 5.8) years old. They received the traditional outpatient follow-up (outpatient service review and health education), their treatment compliance, timely correcting unhealthy lifestyle and medication method and self-testing blood pressure were evaluated. ANOVA and chi square test were used to analyze the treatment compliances and blood pressure control rates of the two groups. Result Compared with the control group, health intervention for hypertension patients could significantly improve the treatment compliance and blood pressure control rate(64.8%vs. 41.3%, 56.7%vs. 29.6%;χ2=2.827,1.382;P=0.032,0.007). Comparing the results of telephone follow-up frequency, the treatment compliance and blood pressure control rate of the 3 intervention groups were higher than those of the two other groups(77.3%vs. 65.4%, 51.7%,χ2=3.414,P=0.041;69.6% vs. 57.3%, 43.2%,χ2=2.763,P=0.028). The treatment compliance of patients with high education level was significantly higher than that of patients with low education level(68.7% vs. 59.1%, 46.4%,χ2=3.257,P=0.037;60.1%vs. 47.2%,32.8%,χ2=1.234,P=0.009). And the treatment compliance of patients with good mental state was significantly higher than that of patients with anxiety(Intervention group1:64.3%vs. 55.1%,41.9%,31.0%,χ2=2.257, P=0.016;59.4%vs.46.1%,20.9%,21.8%,χ2=3.34 5 P=0.021;Intervention group2:75.5%vs. 64.3%,51.8%,41.2%,χ2=2.932, P=0.030;68.3%vs.57.1%,39.2%, 32.1%,χ2=2.382, P=0.032;Intervention group3:86.5% vs.73.2%,62.6%,52.4%,χ2=2.435, P=0.026;75.2% vs. 68.0%,51.7%,43.3%,χ2=3.251, P=0.036). Conclusion More frequently follow-up can improve the treatment compliance and control rate of blood pressure in hypertensive patients;education, age and psychological condition are factors influencing treatment compliance in hypertensive patients.
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Objective To explore the effect of aerobic exercise training on artery elasticity among patients with essential hypertension.Methods A total of 155 cases of patients with essential hypertension (EH)were selected,and were divided into control group(76 cases)and aerobic exercise group(79 cases).Control group was follow routine drug therapy,and aerobic exercise group was follow aerobic exercise training besides the routine therapy for 12 weeks.CAVI,ABI values,limb blood pressure,TG,TC,LDL -C,HDL -C and U -MA were compared before and after the intervention.Results After the intervention,bilateral CAVI values of aerobic exercise group were 7.76 ±0.15,7.88 ±0.15,8.87 ±0.25 and 8.89 ± 0.22,and lower than those before the intervention(P <0.05).The decline range of bilateral CAVI value(the difference between the mean differences before and after the intervention)were 1.03 ±0.07 and 1.03 ±0.06,significantly wider than the control group of 0.33 ±1.97 and 0.15 ±0.08(P <0.05).After the intervention,limb systolic pressure,diastolic blood pressure and triglyceride,cholesterol decreased in the aerobic exercise group(P <0.05).The limb systolic blood pressure and left limb diastolic blood pressure decreased in the control group after intervention (P <0.05),but the decline range was smaller than the aerobic exercise group(P <0.05 ).Conclusion The aerobic exercise training could significantly improve arterial elasticity among patients with essential hypertension.