Ground golf-induced changes in the blood pressure of healthy elderly people.
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ABSTRACT:
SUBMITTER: Ebine N
PROVIDER: S-EPMC7132973 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:In a multiethnic cohort of older people with diabetes (n=1178), we assessed whether ambulatory blood pressure (BP) monitoring improves prediction of all-cause mortality and cardiovascular mortality when added to baseline covariates, including office BP and heart rate (HR). Secondary analyses assessed whether albuminuria may mediate the association of pulse pressure with mortality. The ambulatory arterial stiffness index was calculated as "1-slope" from the within-person regression of diastolic-on-systolic ambulatory BP readings. Mean follow-up was 6.6+/-0.4 years. There were 287 deaths; death certificates were available for 215 deaths (75%), and 110 of them were deemed of cardiovascular cause. Cox models were built incrementally. First, models using clinical and laboratory variables selected albuminuria and office HRs as independent predictors of all-cause and cardiovascular mortality. When ambulatory monitoring data were added, sleep:wake HR ratio and ambulatory arterial stiffness index added significantly to the prediction of all-cause mortality, but only sleep:wake HR ratio added to the prediction of cardiovascular mortality. Office HR and albuminuria retained significance as predictors of both types of mortality. Secondary analyses without adjustment for albuminuria confirmed the predictive value of office HR and sleep/wake HR, whereas 24-hour pulse pressure and sleep systolic BP were also independently predictive of all-cause and cardiovascular mortality, respectively. In conclusion, office HR and albuminuria were strong predictors of mortality. Ambulatory monitoring improved the prediction of risk through its assessment of sleep HR dipping and of ambulatory arterial stiffness index, a measure of the dynamic relationship between systolic and diastolic BPs. Albuminuria may mediate the association between BP and mortality.
| S-EPMC5559297 | biostudies-literature
Project description:We assessed whether home blood pressure monitoring improved the prediction of progression of albuminuria when added to office measurements and compared it with ambulatory blood pressure monitoring in a multiethnic cohort of older people (n=392) with diabetes mellitus, without macroalbuminuria, participating in the telemedicine arm of the Informatics for Diabetes Education and Telemedicine Study. Albuminuria was assessed by measuring the spot urine albumin:creatinine ratio at baseline and annually for 3 years. The ambulatory sleep:wake systolic blood pressure ratio was categorized as dipping (ratio: < or =0.9), nondipping (ratio: >0.9 to 1.0), and nocturnal rise (ratio: >1.0). In a repeated-measures mixed linear model, after adjustment that included office pulse pressure, home pulse pressure was independently associated with a higher follow-up albumin:creatinine ratio (P=0.001). That association persisted (P=0.01) after adjusting for 24-hour pulse pressure and nocturnal rise, which were also independent predictors (P=0.02 and P=0.03, respectively). Cox proportional hazards models examined the progression of albuminuria (n=74) as defined by cutoff values used by clinicians. After the adjustment for office pulse pressure, the hazards ratio (95% CI) per 10-mm Hg increment of home pulse pressure was 1.34 (range: 1.1 to 1.7; P=0.01). Home pulse pressure was not an independent predictor in the model including ambulatory monitoring data; a nocturnal rise was the only independent predictor (P=0.035). Cox models built separately for home pulse pressure and ambulatory monitoring exhibited similar calibration and discrimination. In conclusion, nocturnal blood pressure elevation was the strongest predictor of worsening albuminuria. Home blood pressure measurements added to office measurements and may constitute an adequate substitute for ambulatory monitoring.
| S-EPMC3855674 | biostudies-literature
Project description:PurposeTo study age-related changes of intraocular pressure (IOP) and assess the cohort effect in both cross-sectional and longitudinal settings among elderly Chinese adults.MethodsParticipants were enrolled from the Lingtou Eye Cohort Study with Chinese government officials aged 40 years and older at baseline and received physical check-up and ocular examinations from 2010 to 2012. IOP was measured using a non-contact tonometer according to standardized protocols, as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI). Participants who had attended IOP measurements in both 2010 and 2012 were included in this study. Cross-sectional association of IOP with age was assessed using multivariate liner regression analyses and based on the data of 2010. Longitudinal changes in IOP were assessed by paired t-test.ResultsA total of 3372 subjects were enrolled in the current analysis (2010 mean [SD] age, 61.9 [7.1] years; 60.2% men). The mean IOP in 2010 was 15.4 ± 2.3 mmHg for women and 15.2 ± 2.3 mmHg for men with an intersex difference (P = 0.029). Cross-sectional analysis showed that IOP was negatively associated with age (P = 0.003, β = -0.033 for women and P<0.001, β = -0.061 for men) adjusted for baseline SBP, DBP and BMI. Paired t-test suggested that IOP was higher in the year 2012 than 2010 in women (P = 0.006) but did not change significantly in men within 2 years (P = 0.345). In addition, the 2-year changes of IOP were not associated with age adjusted for baseline IOP in 2010 (P = 0.249).ConclusionCross-sectional data suggests that IOP is lower in people with older age. Longitudinal data does not support such findings and thus the identified decreasing pattern with age in cross-sectional analysis is likely caused by cohort effects.
| S-EPMC4795753 | biostudies-literature
Project description:AimIn the present study the response of optic nerve head blood flow to an increase in ocular perfusion pressure during isometric exercise was studied. Based on our previous studies we hypothesized that subjects with an abnormal blood flow response, defined as a decrease in blood flow of more than 10% during or after isometric exercise, could be identified.MethodsA total of 40 healthy subjects were included in this study. Three periods of isometric exercise were scheduled, each consisting of 2 minutes of handgripping. Optic nerve head blood flow was measured continuously before, during and after handgripping using laser Doppler flowmetry. Blood pressure was measured non-invasively in one-minute intervals. Intraocular pressure was measured at the beginning and the end of the measurements and ocular perfusion pressure was calculated as 2/3*mean arterial pressure -intraocular pressure.ResultsIsometric exercise was associated with an increase in ocular perfusion pressure during all handgripping periods (p < 0.001). By contrast no change in optic nerve head blood flow was seen. However, in a subgroup of three subjects blood flow showed a consistent decrease of more than 10% during isometric exercise although their blood pressure values increased. In addition, three other subjects showed a consistent decline of blood flow of more than 10% during the recovery periods.ConclusionOur data confirm previous results indicating that optic nerve head blood flow is autoregulated during an increase in perfusion pressure. In addition, we observed a subgroup of 6 subjects (15%) that showed an abnormal response, which is in keeping with our previous data. The mechanisms underlying this abnormal response remain to be shown.
| S-EPMC3855769 | biostudies-literature
Project description:Dysphagia is the major pathophysiologic mechanism leading to aspiration pneumonia in the elderly. Elderly people with dysphagia who show low levels of the cough peak flow (CPF) are at greater risk for aspiration pneumonia. It has been reported that CPF values were significantly lower in the "soft" versus "hard" mode of a pressure-relieving air mattress in healthy volunteers in a supine position. Parameters such as spinal curvature, however, were not evaluated in detail. In this study, we clarified whether the changes in posture associated with two different firmness levels of a pressure-relieving air mattress were associated with cough production and related factors in the elderly with dysphagia. The body sinking distance, pelvic tilt angle, and immersion of the lumbar spine were measured to evaluate changes in posture. Forty subjects met the study criteria for dysphagia. The "soft" mode showed significantly lower CPF values than the "hard" mode (soft 274.9 ± 107.2 L/min vs. hard 325.0 ± 99.5 L/min, MD 50.0 95%CI 33.1-66.9 P < 0.001). Values of forced vital capacity (FVC) and maximal inspiratory pressure (PImax) were significantly lower in the "soft" mode than in the "hard" mode (MD 0.10 95%CI 0.04-0.17, P = 0.002, MD 3.2 95%CI 0.9-5.5, P = 0.007, respectively). Although there was no significant difference between the two firmness levels, maximal expiratory pressure (PEmax) values also tended to be lower in the "soft" than in the "hard" mode, (MD 2.9 95%CI -0.6-6.3 P = 0.1). At both firmness levels, CPF values were significantly correlated with FVC, PImax, and PEmax. The difference in sinking distance in the anterior superior iliac spine was significantly larger than that in the lesser tubercle of the humerus and patella. Additionally, in the soft mode, the pelvic tilt angle and contact area around the lumbar spine were significantly larger than those observed in the "hard" mode. Parameters associated with the production of cough, including inspiratory muscle strength, lung volume, and ultimately CPF, may be affected by immersion of the lumbar spine and curvature of the spine that results from the "soft" mode in elderly patients with dysphagia.
| S-EPMC6289577 | biostudies-literature
Project description:The nasal epithelium represents the first line of defense against inhaled pathogens, allergens, and irritants and plays a key role in the pathogenesis of a spectrum of acute and chronic airways diseases. Despite age-dependent clinical phenotypes triggered by these noxious stimuli, little is known about how ageing affects the structure and function of the airway epithelium that is crucial for lung homeostasis and host defense. The aim of this study was therefore to determine age-related differences in structural and functional properties of primary nasal epithelial cultures from healthy children and non-smoking elderly people. To achieve this goal, highly differentiated nasal epithelial cultures were established from nasal brushes at air-liquid-interface and used to study epithelial cell type composition, mucin (MUC5AC and MUC5B) expression and ion transport properties. Further, we determined age-dependent molecular signatures using global proteomic analysis. We found lower numeric densities of ciliated cells and higher levels of MUC5AC expression in cultures from children vs. elderly people. Bioelectric studies showed no differences in basal ion transport properties, ENaC-mediated sodium absorption or CFTR-mediated chloride transport, but detected decreased calcium-activated TMEM16A-mediated chloride secretory responses in cultures from children vs. elderly people. Proteome analysis identified distinct age-dependent molecular signatures associated with ciliation and mucin biosynthesis, as well as other pathways implicated in ageing. Our data identified intrinsic, age-related differences in structure and function of the nasal epithelium and provide a basis for further studies on the role of these findings in age-dependent airways disease phenotypes observed with a spectrum of respiratory infections and other noxious stimuli.
2022-02-28 | PXD030130 | Pride
Project description:ObjectivesAssessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment.Materials and methodsIn a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n?=?197) and continuously (subsample, n?=?58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex.ResultsBlood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements.ConclusionContinuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.
| S-EPMC4164445 | biostudies-literature
Project description:The blood pressure (BP) control rate among treated hypertensives in China remains low at 37.5%. The relationship between home blood pressure telemonitoring (HBPT) and BP control is controversial. The authors aimed to investigate the relationship between HBPT and BP control in middle-aged and elderly hypertensives. In total, 252 hypertension patients aged between 60 and 79 years were enrolled. The patients were given either HBPT through interactive platforms between physicians and patients (telemonitoring group, n = 126) or conventional management (routine management group, n = 126). All patients were followed-up for 15 months. BP control was defined as home systolic blood pressure < 135 mm Hg and home diastolic blood pressure < 85 mm Hg. At baseline, there were no significant differences in the baseline BP control rate (p = .083). However, after 15 months, the BP control rate improved in both groups, and the telemonitoring group (71.3%) had a significantly higher BP control than the routine management group (49.8%) (p < .001). The change of BP control rate from baseline in the routine management group increased by 26.1%, and that of the telemonitoring group increased by 35.4%. The results of the fully adjusted binary logistic regression showed that HBPT was positively associated with BP control after adjusting for confounders (OR = 4.15, 95% CI 2.05-8.39). Similar results were observed after 3, 9, and 12 months. The association of HBPT with BP control was similar in subgroups. In conclusions, HBPT is recommended for BP control in middle-aged and elderly hypertensives in the community setting.
| S-EPMC8678721 | biostudies-literature
Project description:PurposeCerebral blood flow (CBF) needs to be precisely controlled to maintain brain functions. While previously believed to be autoregulated and near constant over a wide blood pressure range, CBF is now understood as more pressure passive. However, there are still questions regarding the integrated nature of CBF regulation and more specifically the role of cardiac output. Our aim was, therefore, to explore the effects of MAP and cardiac output on CBF in a combined model of reduced preload and increased afterload.Method16 healthy volunteers were exposed to combinations of different levels of simultaneous lower body negative pressure and isometric hand grip. We measured blood velocity in the middle cerebral artery (MCAV) and internal carotid artery (ICAV) by Doppler ultrasound, and cerebral oxygen saturation (ScO2) by near-infrared spectroscopy, as surrogates for CBF. The effect of changes in MAP and cardiac output on CBF was estimated with mixed multiple regression.ResultBoth MAP and cardiac output had independent effects on MCAV, ICAV and ScO2. For ICAV and ScO2 there was also a statistically significant interaction effect between MAP and cardiac output. The estimated effect of a change of 10 mmHg in MAP on MCAV was 3.11 cm/s (95% CI 2.51-3.71, P < 0.001), and the effect of a change of 1 L/min in cardiac output was 3.41 cm/s (95% CI 2.82-4.00, P < 0.001).ConclusionThe present study indicates that during reductions in cardiac output, both MAP and cardiac output have independent effects on CBF.
| S-EPMC8260418 | biostudies-literature
Project description:BackgroundArterial hypertension is facing some changes in the last years. Its prevalence is increasing in elderly subjects. This growing prevalence is due to longer survival of the population worldwide, among other factors. On the other hand, recent guidelines have insisted in the relevance of out of office blood pressure measurements, to improve diagnostic and management of hypertension. Therefore, elderly subjects with hypertension could benefit from out of office blood pressure measurements, like ambulatory blood pressure measurements; nevertheless, there are very few or no specific recommendations regarding this.AimIn this review, we will gather the most important information about this subject.ResultsAs hypertension in the elderly has some specific characteristics related to aging of the cardiovascular system, the most important aspect could be that these characteristics make ambulatory blood pressure measurement suitable for its use in elderly. Among those a higher prevalence of white coat hypertension, white coat phenomenon, and a higher nocturnal blood pressure and higher prevalence of nondipper and riser pattern, represent aspects that should be considered for better diagnostic and an improved management.ConclusionAs the prevalence of hypertension will grow in the next years, more studies specifically directed to this subject are needed.
| S-EPMC9248111 | biostudies-literature