Significance: Complementary and alternative therapies (CAM) are widely used however the efficacy of many CAM therapies for specific diseases has yet to be verified. Massage therapy, specifically back massage, used to assist in the management of elevated blood pressure is one such unverified therapy. A pilot study completed in 2002 resulted in significant changes in blood pressure using a repeated application of the 10 minute back massage. Research Aims: This study, evolving from a psychophysiology framework, aimed to determine the long term efficacy of a back massage treatment and possible dosage needed to effectively assist in the management of elevated blood pressure. Primary Research Hypotheses: After adjusting for covariates: A. Systolic blood pressure (SBP) and or diastolic blood pressure (DBP) would decrease significantly over time using a back massage treatment in subjects with pre-hypertension or controlled hypertension.B. There would be a significant difference in the SBP (and or DBP) changes over time using 10 applications of back massage versus five applications of back massage in the subjects with pre-hypertension and controlled hypertension.Methods: A priori power analysis determined the three groups by four time points (repeated measures) design required a sample of 45 participants. The sample of men and women, 18-75 years of age, were recruited from a university setting. Outcome Variables: Systolic Blood Pressure, Diastolic Blood Pressure Potential Covariates: Age, BMI, Medications, Years of Hypertension, Salivary cortisol, and State and Trait Personality Indicators (anger, anxiety, depression). Intervention: Group 1: Ten 10-minute back massages given three times a week for 3.5 weeks. Group 2: Five 10-minute back massages given three times a week for 1.5 weeks. Control (group 3): Ten 10-minute relaxation sessions using learned techniques for 3.5 weeks. Findings: For participants with elevated body mass index (>̲27.85) in the 10-massage group, systolic and diastolic blood pressure changed significantly over time. The dosage analysis did not clearly reveal the direction of the trends, therefore further exploration is warranted.

The thesis investigated nicotine levels and their effects on hypertensive subjects and whether aspirin could be used in the treatment of hypertension to bring about not only an anti thrombotic effect but reduce the systemic blood pressure especially in those individuals who smoke cigarettes. The study, which also audits the use of aspirin, was conducted in Kuwait and so provides an insight of hypertensive patients very rarely considered in the literature The thesis begins in Chapter One with an extensive literature review which analyses the properties and problems that nicotine causes and its ability to cause hypertensive changes along with its multitude of other events. The physiological and pathological problems caused by nicotine are reviewed on the basis of its chemistry and pharmacological properties using a worldwide perspective rather than just focus on Kuwait. The second Chapter uses extensive analysis of the literature to determine the pharmacological properties of aspirin and its use in cardiovascular disease. The pharmacokinetics and therapeutic effects are presented with emphasis to its inhibitory effects on platelet activation which is central to the development of serious cardiovascular consequences such as stroke and myocardial infarction. The third Chapter returns to consider the literature in detail and why nicotine has specific effects on the cardiovascular system in terms of receptor stimulation and how aspirin may be able to reduce nicotine's cardiovascular effects and concludes with the Aims and Objectives of the thesis. The fourth Chapter investigates urinary nicotine levels in smokers from cigarettes available in Kuwait to indicate the actual levels which could be achieved by smokers in this study. This established that the levels would cause pharmacological effects demonstrating also the effects of passive smoking. The number of cigarettes smoked per day has an unpredictable effect on metabolism and urinary output of nicotine. The fifth Chapter is the major investigational section of the thesis and considers if aspirin ability to reduce cardiovascular effects, may be useful in terms of diastolic blood pressure and lipid levels in the 4 blood. The effects were suggestive that aspirin did reduce the blood pressure in hypertensive subjects but was not universal and was limited to those suffering from mild - moderate hypertension. It was determined that aspirin should be sued at the earliest age possible in these patients. The sixth Chapter involved a large scale trial of the effectiveness of aspirin treatment in hypertensive patients over a one year period in Kuwait. This used ambulatory blood pressure measurements to determine the effectiveness of daytime and nightime changes in blood pressure in patients with and without aspirin treatment. The overall conclusion was a reduced relative risk of suffering cardiovascular events in mild to moderate hypertension when aspirin (75mg/day) was administered. Specifically in smokers, aspirin lowers the systolic daytime BP and diastolic nightime BP. To support this work a comprehensive audit is provided of the use of the current use of aspirin in Kuwait hospitals.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Aukštas kraujo spaudimas yra aktuali problema tiek medicininiu, tiek ir socialiniu požiūriu ne tik Lietuvoje, bet ir daugiau kaip 50 milijonų žmonių visame pasaulyje. Aukštas kraujo spaudimas (AKS) yra vienas iš didžiausių koronarinių širdies ligų rizikos veiksnių. Gydant AKS didelis dėmesys skiriamas medikamentinėms priemonėms, kurios padeda atstatyti sutrikusias organizmo funkcijas. Tačiau labai svarbų vaidmenį gydant AKS atlieka kineziterapija. Tinkamai parinkti ir atliekami fiziniai pratimai padeda atstatyti pažeistą kraujagyslių tonusą, gerina širdies kraujagyslių sistemos funkciją bei judesių koordinaciją, didina darbingumą. Darbo tikslas – nustatyti fizinių pratimų ir dietos poveikį arteriniam kraujospūdžiui. Tuo tikslu buvo atliktas tyrimas, kuriame dalyvavo 488 tiriamieji, iš kurių 210 vyrų ir 278 moterys. Tiriamųjų amžius svyravo nuo 25 iki 70 metų. Visiems tiriamiesiems arterinis kraujospūdis (AKS) matuotas gyvsidabriniu sfigmomanometru dešinėje rankoje 2 mm Hg tikslumu, du kartus. Analizei naudotas dviejų matavimų vidurkis. Tiriamieji buvo sveriami medicininėmis svarstykl��mis 100 g tikslumu, matuojamas jų ūgis, Arterinė hipertenzija (AH) diagnozuota, jeigu sistolinis AKS rastas 140 mm Hg arba didesnis ir (arba) diastolinis AKS 90 mm Hg arba didesnis, arba kai AKS normalus (<140/90 mm Hg), kai paskutines dvi savaites tiriamieji vartojo kraujospūdį mažinančius vaistus. Antsvoriui vertinti apskaičiuotas kūno masės indeksas (KMI) (KMI=kūno masė (kg)/ūgis² (m)). Buvo... [toliau žr. visą tekstą] / High blood pressure is a common problem from both medical and social viewpoint in Lithuania as well as in more than 50 million people all over the world. High Blood Pressure (HBP) is one of the main risk phenomena of coronary heart illnesses. HBP medical pharmaceutical devices which help to reproduce damaged organism functions are mainly considered when curing. Nevertheless kinesytheraphy also plays a very important role in HBP treatment. Properly selected and done physical exercises support reproduction of damaged vein tonicity, improvement in heart vessel system functioning as well as coordination of movements and increase in efficiency. The aim of this work is to define the influence of physical exercises, diet and weight loss on arterial pressure. On this purpose the research was undertaken which involved 488 examined people, 210 of them were men and 278 women. Their age ranged from 25 to 70 years. For all the examined arterial pressure (HBP) was measured twice using mercurial sphigmanometer in their right hand at 2 mm Hg accuracy. For the analysis the average of both measurements was taken. The examined people were weighed on medical scales at 100 g accuracy, their height was also measured; Arterial Hypertension (AH) was diagnosed to those whose systolic HBP has been found in 140 mm Hg or more and (or) diastolic HBP in 90 mm Hg or more, or HBP is normal (<140/90 mm Hg), in the last two weeks they all have been drinking pressure reducing medicine. For the purpose of... [to full text]

Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą] / Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text]

Primary arterial hypertension is diagnosed in every third adult. The disease tends to appear in younger individuals, especially men. However, general cardiovascular disease risk factors fail to explain this trend. Insufficient attention is given to the possible relation between hypertension and birth parameters as well as growth characteristics. It was not known which of the general hypertension risk factors and which of the critical growth period characteristics have major influence on the development of elevated blood pressure in young men in our country. Therefore, this dissertation aims at evaluating the relation of elevated blood pressure in young men (18-21 years old) to the characteristics of different critical growth periods, cardiovascular risk factors, heredity and the socio-economic conditions of the young man‘s family. The research showed the following results: smaller head and chest circumferences at birth along with the body mass index at young adult age are significant prognostic factors for elevated blood pressure; higher velocity of height growth within the first seven years of life and more intensive growth of the body mass index and weight in adolescence have significant relation to elevated blood pressure at young adult age; lean body mass and fat body mass have different influence on blood pressure; young men with elevated blood pressure have bigger skeletons; risky amounts of alcohol consumed and lower physical activity have significant influence on... [to full text] / Pirminė arterinė hipertenzija diagnozuojama kas trečiam suaugusiam. Liga jaunėja, ypač tarp vyrų, šios tendencijos nepavyksta paaiškinti vien bendraisiais kardiovaskulinės rizikos veiksniais. Mažai kreipiamas dėmesys į galimą hipertenzijos ryšį su gimimo parametrais ir augimo ypatumais. Nebuvo aišku, kurie iš bendrųjų hipertenzijos rizikos veiksnių ir kokie kritinių augimo tarpsnių ypatumai daro didžiausią įtaką mūsų šalies jaunimo kraujospūdžio raidai. Todėl disertacija skirta įvertinti jaunuolystės amžiaus vyrų (18-21 metų) padidėjusio kraujospūdžio ryšį su skirtingų kritinių augimo periodų ypatumais, kardiovaskulinės rizikos veiksniais, paveldimumu ir jaunuolio šeimos socioekonominėmis sąlygomis. Ištirtas 231 asmuo (48 atvejo grupėje, 183 kontrolinėje grupėje). Darbe nustatyta, kad mažesnė galvos ir krūtinės apimtis gimus kartu su jaunuolystės kūno masės indeksu yra reikšmingi padidėjusio kraujospūdžio prognostiniai veiksniai. Greitesnis ūgio augimas per pirmus septynerius gyvenimo metus ir paauglystės tarpsnio kūno masės indekso bei svorio intensyvesnis augimo greitis turi reikšmingų sąsajų su padidėjusiu kraujospūdžiu jaunuolystėje. Nustatyta skirtinga liesos kūno masės ir riebalų masės įtaka kraujospūdžiui. Konstatuota, kad padidėjusį kraujospūdį turintys jaunuoliai yra stambesnio skeleto. Reikšmingą įtaką jo kraujospūdžiui turi rizikingais kiekiais vartojamas alkoholis ir mažesnis fizinis aktyvumas. Įvertinta mamos ankstyvo sergamumo pirmine arterine hipertenzija ir... [toliau žr. visą tekstą]

No description available.

<p>Hypertension is one of the most common non-communicable diseases, and it is the leading cause of cardiovascular diseases, death and disability worldwide, especially in developing countries. Physical activity has been regarded as a commonly accepted modality for preventing and treating hypertension. However, despite its known benefits, this modality of treatment and prevention of&nbsp / hypertension continues to be underused. The present study aimed to determine the demographic, social and health-related factors that are associated with levels of physical activity participation among adults with hypertension in Kigali, Rwanda. This cross-sectional study was conducted with 252 adults with hypertension and 87 healthcare professionals through the Godin Leisure-Time&nbsp / Exercise Questionnaire (GLTEQ) and Physical Activity Exit Interview (PAEI). Two thirds of the participants (69.44%) were classified as sedentary. The following factors were found to be significantly&nbsp / (P&lt / 0.05) associated with the levels of physical activity: age, marital status, and level of education, residence, tobacco / past and current users, alcohol / current user, diabetes mellitus, BMI, perceived health status, self-efficacy, and blood pressure. None of the healthcare professionals were considered good physical activity counsellor. The findings of the present study highlight the need for the implementation of health promotion strategies aimed at promoting physical activity lifestyle among individuals with hypertension in Rwanda. Efforts should be made in educating people with hypertension on the benefits of integrating regular physical&nbsp / activity in their daily lives. Furthermore, healthcare professionals should be educated concerning how to promote physical&nbsp / activity to all patients especially those with hypertension.</p>

Objectives: To assess the role of ambulatory blood pressure monitoring in the diagnosis of hypertension in general practice. Background: Hypertension is usually diagnosed by casual office blood pressure readings. However, ambulatory blood pressure monitoring has shown that a significant proportion of patients diagnosed as hypertension in fact do not have hypertension. Method: Sixty four Indian patients diagnosed as having mild to moderate hypertension by casual measurements were subjected to a twenty four hour ambulatory blood pressure monitoring. A blood pressure load of >35% was classified as true hypertension and < 35% as white coat hypertension. White coat hypertensives were compared to the hypertensive group with respect to various demographic characteristics, and to correlate ambulatory blood pressure monitoring and casual blood pressure readings. Results: A prevalence of 23.44% white coat hypertension was found. In addition, the demographic profile of such patients show a preponderance of non-obese females (73.33%), the majority of whom are on concomitant medication (60%). A poor correlation was found between the casual office blood pressure readings and the twenty four hour ambulatory blood pressure readings in the white coat hypertensives as compared to the hypertensive group. Conclusion: White coat hypertension is common in patients diagnosed as having mild to moderate hypertension by casual blood pressure readings. There are no reliable clinical indicators to identify patients with white coat hypertension. Ambulatory blood pressure monitoring has been shown to be a useful method for differentiating white coat hypertensives from true hypertensives. / Thesis (M.Med)-University of Natal, 1997.

Long-term adaptation of cardiovascular system in response to regular physical activity depends not only on its type, intensity and volume, but on arterial blood pressure (ABP) during exercise as well. Although it is proved haemodynamic load is not the only factor responsible for the shaping of athlete's myocardium, both the extent and the type of cardiac remodelling are influenced greatly by the degree of pressure overload during exercise training. The aim of our study was to compare myocardium loading conditions during veloergometric and treadmill interval tests. Methods. Distance runners (all males, n = 16) served as subjects. Their age was 23.6 ± 5.5 yrs, body mass – 70.7 ± 4.7 kg, body mass index – 21.7 ± 1.9 kg/m2, training experience – 8.7 ± 5.6 yrs. Interval tests were applied on separate days. Each of them consisted of increasing intensity exercise interspaced with passive resting period (in seated position) of 4 min in duration. Heart rate (HR) was recorded throughout both tests while ABP was measured during recovery period between treadmill stages. Tests were continued till HR reached 90 percent of age-predicted maximum. Results. Systolic ABP, HR and double product were higher (p<0.05) after the discontinuation of veloergometric workload as compared with treadmill load requiring similar oxygen consumption. Runners' systolic ABP response was bigger to veloergometry as compared with treadmill running eliciting the same HR (p<0.05). Significant correlation was found... [to full text]