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Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study

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Chinese Medical Journal 2023年第8期136卷 941-950页

作者： Chen Zhou Qun Yi Yuanming Luo Hailong Wei Huiqing Ge Huiguo Liu Xianhua Li Jianchu Zhang Pinhua Pan Mengqiu Yi Lina Cheng Liang Liu Jiarui Zhang Lige Peng Adila Aili Yu Liu Jiaqi Pu Haixia Zhou West China School of Medicine Sichuan UniversityChengduSichuan 610041China Department of Respiratory and Critical Care Medicine West China HospitalSichuan UniversityChengduSichuan 610041China Sichuan Cancer Hospital and Institution Sichuan Cancer CenterCancer Hospital Affiliated to School of MedicineUESTCChengduSichuan 610041China State Key Laboratory of Respiratory Disease Guangzhou Medical UniversityGuangzhouGuangdong 510120China Department of Respiratory and Critical Care Medicine People’s Hospital of LeshanLeshanSichuan 614000China Department of Respiratory and Critical Care Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouZhejiang 310016China Department of Respiratory and Critical Care Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Respiratory and Critical Care Medicine The First People’s Hospital of Neijiang CityNeijiangSichuan 641000China Department of Respiratory and Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of Respiratory and Critical Care Medicine Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Emergency the First People’s Hospital of JiujiangJiujiangJiangxi 332000China Department of Respiratory and Critical Care Medicine The Affiliated Hospital of Chengdu UniversityChengduSichuan 610041China

Background:Although intensively studied in patients with cardiovascular diseases(CVDs),the prognostic value of diastolic blood pressure(DBP)has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).This study aimed to reveal the prognostic value of DBP in AECOPD ***:Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July *** was measured on *** primary outcome was all-cause in-hospital mortality;invasive mechanical ventilation and intensive care unit(ICU)admission were secondary *** absolute shrinkage and selection operator(LASSO)and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio(HR)and 95%confidence interval(CI)for adverse ***:Among 13,633 included patients with AECOPD,197(1.45%)died during their hospital *** Cox regression analysis showed that low DBP on admission(<70 mmHg)was associated with increased risk of in-hospital mortality(HR=2.16,95%CI:1.53–3.05,Z=4.37,P<0.01),invasive mechanical ventilation(HR=1.65,95%CI:1.32–2.05,Z=19.67,P<0.01),and ICU admission(HR=1.45,95%CI:1.24–1.69,Z=22.08,P<0.01)in the overall *** findings were observed in subgroups with or without CVDs,except for invasive mechanical ventilation in the subgroup with *** DBP was further categorized in 5-mmHg increments from<50 mmHg to≥100 mmHg,and 75 to<80 mmHg was taken as reference,HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs;higher DBP was not associated with the risk of in-hospital ***:Low on-admission DBP,particularly<70 mmHg,was associated with an increased risk of adverse outcomes among inpatients with AECOPD,with or without CVDs,which may serve as a convenient predictor of poor prognosis in these *** Trial Regist

关键词： Acute exacerbation of chronic obstructive pulmonary disease diastolic blood pressure Prognostic factors Inpatients In-hospital mortality

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diastolic blood pressure lower than 75 mmHg is associated with adverse outcomes in patients with heart failure with preserved ejection fraction induced or exacerbated by atrial fibrillation

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South China Journal of Cardiology 2021年第2期22卷 80-88,95页

作者：杨燕华郭素峡廖敏琪邓春花陈丽华周国祥简政威何如平黄志超姚永钊卢炯斌花智文黄裕立 Department of Cardiology Dongguan People's HospitalSouthern Medical UniversityDongguan 523059GuangdongChina Department of Cardiology Shunde HospitalSouthern Medical University(The first people's hospital of Shunde)Foshan 528300GuangdongChina.

Background The effects of diastolic blood pressure(DBP)on prognosis of heart failure with preserved ejection fraction(HFp EF)are still not clear,probably due to the underlying heterogeneity of HFp *** study was aimed to evaluate the effects of DBP in patients with atrial fibrillation(AF)-induced or AF-exacerbated HFp EF,which is a clinical syndrome with high homogeneity that has seldom been *** In this retrospective cohort study,955 patients diagnosed with AF and HFp EF were *** with specific underlying cardiovascular diseases or other severe comorbidities were excluded.A total of 191 patients were *** were assigned to one of the two groups:DBP<75 mm Hg or DBP≥75 mm Hg All-cause mortality was taken as primary endpoint,and all-cause re-hospitalization and HF specific re-hospitalization were measured as secondary *** The mean follow-up was 49 *** established clinical risk factors and prognostic biomarkers for heart failure were *** with DBP<75 mm Hg demonstrated higher allcause mortality compared with patients with DBP of≥75 mm Hg[odds ratio(OR):1.669,95%confidence Interval(CI):1.040-2.679,P=0.034).The risk of all-cause re-hospitalization was also increased in the group with DBP<75 mm Hg(OR:1.426,95%CI:1.006-2.022,P=0.047).However,there was no statistically significant difference in the risk of re-hospitalization due to HF between the two groups(OR:1.005,95%CI:0.565-1.787,P=0.986).Conclusions In patients with AF-induced or AF-exacerbated HFp EF,DBP<75 mm Hg was associated with higher all-cause mortality and all-cause re-hospitalization,but was not associated with re-hospitalization due to HF.

关键词： atrial fibrillation diastolic blood pressure heart failure ejection fraction

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Relationship between diastolic blood pressure and adverse outcomes in ST-elevation myocardial infarction undergoing percutaneous coronary intervention

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South China Journal of Cardiology 2020年第1期21卷 1-5,11页

作者： YANG Da-hao LI Hua-long LIU Qiang XIAN Zhan-chao CHEN Jun-yu LIAO Zhi-yong Department of Cardiology Fuwai Hospital Chinese Academy of Medical SciencesShenzhen 518000GuangdongChina

Background Low diastolic blood pressure(DBP)was reported to be associated with reduced coronary blood flow,subclinical myocardial damage,and cardiovascular events. The aim of this study was to explore the impact of low DBP on clinical outcomes in patients with ST-elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI). Methods A total of 1232 patients with STEMI were retrospectively enrolled and divided into two groups according to admission DBP level:≥70 mm Hg(n=817)and < 70 mm Hg(n=415). The relationship between DBP and in-hospital and 1-year adverse events was *** In-hospital death occurred in 2.4% of patients. The in-hospital mortality(5.3% vs. 1.0%,P<0.001)and major adverse clinical events(11.1% vs. 7.5%,P=0.033)were significantly higher in patients with a low *** <70 mm Hg was associated with in-hospital death(adjusted odds rate=3.31,95%CI:1.36-8.07,P=0.009).Additional significant indicators included eGFR < 60 mL/min/1.73 m^2 and intra aorta balloon pump(IABP)treatment. Seventy-seven(6.3%)patients died in the one-year follow-up. DBP < 70 mm Hg was associated with increased risk of 1-year death(8.9% vs. 4.8%,Log-rank=9.9,P=0.002). Conclusion Low DBP was associated with increased risk of in-hospital and 1-year adverse prognosis in patients with STEMI undergoing PCI,which could be a tool for risk assessment.

关键词： diastolic blood pressure ST-elevation myocardial infarction prognosis

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The effectiveness of physical activity interventions on blood pressure in children and adolescents:A systematic review and network meta-analysis

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Journal of Sport and Health Science 2024年第5期13卷 699-708页

作者： Mohamed A.Hassan Wanjiang Zhou Mingyi Ye Hui He Zan Gao School of Kinesiology University of Minnesota-Twin CitiesMinneapolisMN 55455USA Department of Methods and Curriculum Physical Education College for MenHelwan UniversityCairo 12552Egypt China Institute of Sport and Health Science Beijing Sport UniversityBeijing 100084China Department of Kinesiology Recreationand Sport StudiesUniversity of TennesseeKnoxvilleTN 37996USA

Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular *** the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)*** systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on ***:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and *** controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this *** studies that compared controlled and intervention groups using PA or exercise as the major influence were *** followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)*** independent investigators performed the literature screening,data extraction,and risk of bias *** used Bayesian arm-based NMA to synthesize the *** primary outcomes were systolic BP and diastolic *** calculated the mean differences(MDs)in systolic BP and diastolic BP before and after *** treatment differences were estimated using NMA and random-effect ***:We synthesized 27 studies involving 15,220 children and *** combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP

关键词： Children diastolic blood pressure Physical activity Systolic blood pressure

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Impact of baseline blood pressure on all-cause mortality in patients with atrial fibrillation:results from a multicenter registry study

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Chinese Medical Journal 2023年第6期136卷 683-689页

作者： Wei Xu Qirui Song Han Zhang Juan Wang Xinghui Shao Shuang Wu Jun Zhu Jun Cai Yanmin Yang Emergency Center Fuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular DiseasesNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Hypertension Center Fuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular Diseases of ChinaNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background:The ideal blood pressure(BP)target for patients with atrial fibrillation(AF)is still *** present study aimed to assess the effect of the baseline BP on all-cause mortality in patients with ***:This registry study included 20 emergency centers across China and consecutively enrolled patients with AF from 2008 to *** participants were followed for 1 year±1 *** primary endpoint was all-cause ***:During the follow-up,276(13.9%)all-cause deaths ***-Meier curves showed that a systolic blood pressure(SBP)110 mmHg or>160 mmHg was associated with a higher risk of all-cause mortality(log-rank test,P=0.014),and a diastolic blood pressure(DBP)<70 mmHg was associated with the highest risk of all-cause mortality(log-rank test,P=0.002).After adjusting for confounders,the multivariable Cox regression model suggested that the risk of all-cause mortality was increased in the group with SBP110 mmHg(hazard ratio[HR],1.963;95%confidence interval[CI],1.306-2.951),and DBP<70 mmHg(HR,1.628;95%CI,1.163-2.281).In the restricted cubic splines,relations between baseline SBP or DBP and all-cause mortality showed J-shaped associations(non-linear P<0.001 and P=0.010,respectively).The risk of all-cause mortality notably increased at a lower baseline SBP and ***:Having a baseline SBP110 mmHg or DBP<70 mmHg was associated with a significantly higher risk of all-cause mortality in patients with *** excessively low BP may not be an optimal target for patients with AF.

关键词： All-cause death All-cause mortality Atrial fibrillation blood pressure diastolic blood pressure Hypertension Systolic blood pressure

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Acute Effects of Virtual Reality Exercise on Young Adults’ blood pressure and Feelings

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International Journal of Mental Health Promotion 2023年第5期25卷 711-719页

作者： Pablo Saiz-Gonzalez Daniel J.McDonough Wenxi Liu Zan Gao School of Kinesiology University of Minnesota-Twin CitiesMinneapolisMN 55455USA Faculty of Teacher Training and Education University of OviedoAsturias33001Spain School of Public Health University of Minnesota-Twin CitiesMinneapolisMN 55455USA Department of Physical Education Shanghai Jiao Tong UniversityShanghai200240China

Virtual reality(VR)seems to have the potential to provide opportunities to promote physical activity(PA)in a fun *** paper aimed to examine the acute effects of three different virtual reality-based exercise bikes on young adults’blood pressure(BP)and feelings compared to a traditional exercise cycling *** exercise sessions(immersive VR cycling,two non-immersive VR cycling,and traditional cycling)were completed by 36 young adults(22 females;Mage=23.6 years).BP was measured immediately before and after each session using a BP cuff and exercise-induced feelings were assessed via an established survey immediately after each ***-cipants’previous experience with VR was used as the covariate in the ANCOVA with repeated ***-icant main effects were observed across cycling sessions for systolic blood pressure[F(2,29)=3.04,p=0.02,(η^(2)=0.38)]and feelings[F(3,32)=7.74,pblood pressure compared to the two non-immersive VR ***,immersive VR significantly increased feelings compared to the two non-immersive VR sessions,whereas these two non-immersive VR exercises had significantly greater increased feelings compared to traditional cycling,*** suggest immersive VR-based exercise cycling may lead to higher exercise intensities compared to non-immersive VR ***,immersive VR cycling yielded higher feelings compared to non-immersive VR and traditional ***,immersive VR-based exercise can be a fun and physically active health promotion tool among young adults.

关键词： diastolic blood pressure exergaming immersive VR non-immersive VR systolic blood pressure

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Impact of intragastric balloon on blood pressure reduction:A retrospective study in Eastern North Carolina

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World Journal of Gastrointestinal Endoscopy 2021年第5期13卷 115-124页

作者： Gbeminiyi Olanrewaju Samuel Karissa Lambert Elijah Asagbra Glenn Harvin Eric Ibegbu Division of Gastroenterology East Carolina UniversityGreenvilleNC 27834United States Department of Internal Medicine Brody School of MedicineEast Carolina UniversityGreenvilleNC 27834United States Department of Health Services and Information Management East Carolina UniversityCollege of Allied Health SciencesGreenvilleNC 27834United States

BACKGROUND Obesity has evolved into a global *** prevalence of obesity and hypertension in eastern North Carolina are comparable,if not higher,than the national *** the United States,an estimated 34%of adults have hypertension,the most modifiable risk factor for heart disease and *** and pharmacological interventions often do not provide sustained weight loss in obese *** surgery offers an effective weight reduction with short-and long-term health improvements;however,a higher body mass index is associated with higher surgical morbidity and mortality,longer hospitalization,and increasing rates of 30-day readmission due to *** balloon may bridge a critical gap in the treatment of *** objective of this paper is to showcase the impact of endoscopic bariatric therapy on blood pressure *** To investigate the impact of intragastric balloon on blood pressure *** A retrospective chart review was conducted from January 1,2016 to January 31,2019 of consecutive adults who received intragastric balloon therapy(IGBT)in a gastroenterology private practice in Eastern North *** balloon was introduced into the stomach under endoscopic guidance,and while in the region of the gastric body,inflation with saline was performed at increments of 50 mL until target volume between 500 to 650 mL of saline was attained depending on the patient's gastric *** procedural complications were noted during endoscopic placement and removal of the balloon.A cohort study design was used for data analysis.A total of 172 patients had the Orbera^(■)intragastric balloon *** the 172 patients who had IGBT at baseline,11 patients(6.4%)requested early balloon removal due to foreign body sensation(n=1),and/or intolerable gastrointestinal adverse events(n=10).The reported gastrointestinal adverse events were nausea,vomiting,abdominal pain,and ***,6-mo follow-up data were ava

关键词： Intragastric balloon Orbera^(■) Obesity Hypertension Systolic blood pressure diastolic blood pressure

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Association between Mean Ocular Perfusion pressure and Diabetic Retinopathy in a Northeastern Chinese Population

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Biomedical and Environmental Sciences 2020年第9期33卷 701-707页

作者： ZHAI Gang LIN Zhong WANG Feng Hua WANG Yu LI Dong WEN Liang DING Xiao Xia JIANG Jing FENG Ke Mi LIANG Yuan Bo XIE Cong Fushun Eye Hospital Fushun 113006LiaoningChina School of Ophthalmology&Optometry Wenzhou Medical UniversityEye Hospital of Wenzhou Medical UniversityWenzhou 325035ZhejiangChina Beijing Tongren Eye Center Beijing Tongren HospitalCapital Medical UniversityBeijing Ophthalmology&Visual Science Key LabBeijing 100730China

Objective To evaluate the association between diabetic retinopathy(DR) and mean ocular perfusion pressure(MOPP) in patients with type 2 diabetes mellitus(T2 DM).Methods Patients from the Fushun Diabetic Retinopathy Cohort Study(FS-DIRECT), a communitybased prospective cohort study conducted in northeast China, were included in this study. The presence and severity of DR were determined by grading fundus photographs according to the Early Treatment Diabetic Retinopathy Study(ETDRS) retinopathy scale. Systolic and diastolic blood pressure(SBP and DBP) were recorded using an electronic sphygmomanometer. Intraocular pressure(IOP) was measured using an iCare rebound tonometer. MOPP was calculated using the formula MOPP = 2/3 [DBP + 1/3(SBP-DBP)]-*** In total, 1,857 patients who had gradable fundus photography and MOPP data were enrolled in this study. Male patients had a higher MOPP than female patients(52.25 ± 8.75 vs. 50.96 ± 8.74 mmHg, P = 0.002). Overall, both male and female patients with any type of DR, non-proliferative DR(NPDR), or non-sight-threatening DR(non-STDR) had significantly higher MOPP relative to patients without DR. Increased MOPP(per 1 mmHg) was in turn associated with the presence of any type of DR[odds ratio(OR) = 1.03, 95% confidence interval(CI) : 1.02–1.04], NPDR(OR = 1.03 95% CI: 1.02–1.04),and non-STDR(OR = 1.03, 95% CI: 1.01–1.04) after adjusting for confounders. Increased MOPP(per 1 mmHg) was also associated with an increased likelihood of macular edema(OR = 1.02, 95% CI:1.01–1.04).Conclusions The results suggest that increased MOPP was associated with DR and macular edema in northeastern Chinese patients with T2 DM.

关键词： Diabetic retinopathy Ocular perfusion pressure Systolic blood pressure diastolic blood pressure

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