Online ISSN: 2515-8260

Keywords : hypertension


Systematic Review On Role Shodhana & Shamana Chikitsa In Ayurveda For Management Of Hypertension

Vaishnavi Paraskar; Dr. Punam Sawarkar; Dr.Gaurav Sawarkar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 3936-3952

ABSTRACT
Hypertension is a complex disease that seems to be simple but causes severe complications such as renal dysfunction, neuropathy, cerebral disorders, etc. Moreover, the side effects of the established antihypertensive medicines in contemporary science make it even worst. Due to the highly increasing prevalence rate of H.T.N. in the current era of modernization, it is the need of hour to search some alternative or adjuvant modalities to prevent & to manage it. Though Hypertension is not narrated directly in Ayurvedic sculptures, however, based on the two basic modules of Ayurveda, i.e., Hetu, Linga, it is easy to correlate the Hypertension with multiple terminologies such as Shonitdushti, Raktavruuta Prana or Vyanavrutta Prana, etc. Using these fundamentals of Ayurveda, it is possible to treat it in primary stage safely with Ayurvedic methods without using routine antihypertensive drugs or to use it as an adjuvant in the advanced stage of the disease to reduce doses & duration of conventional drugs.
This is a meta-analysis of Ayurvedic interventions in the form of Shodhana or Shamana Chikitsa used for the management of H.T.N. On extensive review of the literature, 14 clinical studies (R.C.T. & N.R.C.T.) fulfilling inclusion criteria & conducted with 995 participants at different places were critically analyzed. Both types of interventions in the form of Shodhana &Shamana Chikitsa were found to play primary or adjuvant role in the management of Hypertension in its prime or advanced stages, respectively.
The efficacy of these interventions can be justified based on pharmacological actions due to their physicochemical properties. This study demands to conduct scientific multi-centric research studies with a large sample size in the future

The Oxidative Effect Of Nlrp3 And Cyp2e1 In Development Of Renal Failure Associated With Hypertension And Diabetes Mellitus Diseases

Alyaa Abdulhadi Salih; Kareem Hamadx Kareem Hamad Ghali2

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 636-644

Renal Failure (RF) is devastating pathology with several causative factors, resulting in dialysis or kidney transplantation needed by end-stage renal disease (ESRD. The progression of RF is closely related to systemic oxidative stress, which causes various complications such as hypertension and diabetic mellitus . The current study was focusing on the oxidative effects of NLRP3 and CYP2E1 gene expression in the pathological development of renal failure disease with hypertension and diabetic mellitus as complications associated diseases. This study involved 100 patients diagnosed clinically and seriologicaly with renal failure 52 males and 48 females, their age from 17 to 80 years . Also the study comprise (18 males and 12 females) healthy volunteers as control group. RNA extracted from blood samples and converted to cDNA which subjected to real-time PCR for detection gene expression . The results detected that Hypertension and diabetic mellitus are the important risk factors that causes and advances renal failure disease . NLRP3 and CYP2E1 have significantly overexpression (1.60 folds and 5.37 folds ) respectively in RF patients compared with healthy group ( p <0.05). However, the expression of NLRP3 and CYP2E1 increase in diabetic mellitus (2.16 and 1.58 ) respectively than hypertension in RF patients with and control group (p<0.05). Diabetic mellitus generate free radical consequently causes ROS, hence elevated expression in oxidative NLRP3 and CYP2E1 genes in diabetic RF patients .

Third Trimester Ultrasonic Placental Grading In Hypertensive Disorders In Pregnancy And Its Association With Feto Maternal Outcome.

Dr. Twisha Patel; Dr. Sandhya Pajai

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 3823-3830

BACKGROUND: About 5-8% of all pregnant females are affected by hypertensive disorders of pregnancy which has become a major cause of maternal and fetal adverse outcome particularly in developing nations. Hence, identifying this entity in pregnant females and its timely management is of utmost importance for both mother and baby. Hypertensive disorders are graded into 4 groups:
1) Chronic hypertension
2) Pre-eclampsia-eclampsia
3) Pre-eclampsia superimposed on chronic hypertension
4) Gestational hypertension
Hypertensive disorders lead to placental insufficiency due to narrowing and occlusion of utero placental vessels due to which fetal circulation is compromised leading to intra uterine growth retardation. In hypertension specific micro and macroscopic changes occurs leading to placental changes. Physiologically, calcium deposition occurs throughout pregnancy, which determines placental grade. Increased placental grade is associated with increased perinatal complications as derived from certain studies. But there are conflicting views regarding it. Hence this study has been designed to detect placental grading by ultrasonography in third trimester in hypertensive disorders in pregnancy and to correlate it with fetal and maternal outcome.
OBJECTIVES:
1) Detecting sonographic placental grading in hypertensive disorders of pregnancy and normotensive patients.
2) To compare the placental grading in hypertensive disorder of pregnancy and normotensives.
3) To know mode of delivery.
4) To compare fetal outcome in terms of APGAR score at 1 and 5 mins and NICU admission in both hypertensive disorders in pregnancy with normotensives.
METHODOLOGY: This cross sectional study will be conducted in the Department of Obstetrics and Gynaecology, at Acharya Vinoba Bhave rural Hospital (AVBRH), a tertiary care teaching hospital situated in the rural area of Wardha District among 130 pregnant
normotensive females and 130 hypertensive pregnant females. Detailed history, examination, lab investigations and sonography of the patients will be undertaken. Baseline data such as age, sex, parity , routine laboratory data, PIH profile, sonography scans will be collected. All the patients will be followed till delivery. Fetal and maternal outcome will be assessed.
Expected outcome : We expect from our results that higher placental grading will be associated with hypertensive pregnant females as compared to normotensive patients for gestational age and will be associated with increased perinatal and fetal morbidity .

EFFECT OF YOGIC PRACTICES ON LOW DENSITY LIPOPROTIEN (LDL) AND HIGH DENSITY LIPOPROTIEN (HDL) AMONG HYPERTENSIVE MIDDLE AGED WOMEN

M. Subha; S. Murugesan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 1090-1095

To access the influence of the yogic behaviours of Low density lipoprotein (LDL) and High Density Lipoprotein random group laboratory study was accessed which is the aim.  Using the Chennai random sampling group method 30 middle aged hypersensitive women were randomly selected in the age group of 35-45 years which were further divided into two groups of 15 participants, I and II. In hypertensive middle aged women than in control group low density lipoprotein (LDL) and high density lipoprotein (HDL) have been predicted for important differences in selected biochemical variables.  Before the launch of the training programme a preliminary test for two types of low density lipoprotein (LDL) and high density lipoprotein (HDL) was performed. Yogic practice for 60 minutes, 6 days a week for a total period of eight weeks were given to Group I subjects.  For group II (Control Group) there was an active resting place.  On the same selected dependent variables after the experimental period the two groups were retested again.  Between the experimental group and the control group to determine the important discrepancies the study of (ANCOVA) was used.  The significance test was set at a degree of confidence of 0.05.  Due to the Yogic behaviours among hypertensive middle aged people such as Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) the experimental group showed important differences on selected biochemical variables which was revealed by the study.

Preparation And Characterization Of Immediate Releasefilm Coated Tablets Of Valsartan -Hydrochlorothiazide (160/12.5mg)

Rakesh Kumar Sharma; Vikas Bansal; Amit Mittal; Mamta Sharma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 2915-2948

Objective:The motive of the currentworkwas to Preparation and Characterization of Immediate Release film coated tablets Valsartan -Hydrochlorothiazide (160/12.5mg) to reduce the multiple dosing and to achieve more effective reduction of hypertension.
Background: The oral route is the very effective and favoured method for the introduction of medications to systemic circulation because of ease of diagnosis, patient compliance and flexibility.
Materials and Methods: Valsartan - Hydrochlorothiazide tablet tends to film coated to prevent the drug from degradation. Preliminary studies were performed out with the excipients and the drug and their physical & chemical compatibilities were checked and the drugs and they found compatible.The method of preparation was the wet granulation method.
Results:A maximum of nine formulation batches (f1-f9) have been prepared.Prepared formulations have also been tested for weight variance, friability, disintegration, analysis, in vitro drug release profile.The criteria tested are contained within the guidelines.The parameters tested were found within the limits. Among all formulations, the product of batch f9 has acceptable friability, assay and dissolution profile. It was further exposed to an advanced stability test at 40±20C/75±5 per cent RH.

Effects of Psychological Distress on Hypertension among Liquefaction Refugees in Petobo Shelter

Herawanto .; Vidyana Aulia Rahma; Muh. Jusman Rau; Sendhy Krisnasari

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 89-96

The purpose of this research is to know the psychological disorder in the incidence of hypertension among liquefaction refugees in Petobo Shelter. A cross-sectional design was performed. The total number of patients who visit the health post at a Petobo shelter is 3,079 people taken in accidental sampling. The analysis uses the univariate and bivariate analyses at a degree of confidence of 95% (α = 0.05). The chi-square test results show that anxiety (ρ = 0,031), depression (ρ = 0,008), and stress (ρ = 0,000) are associated with the incidence of hypertension. It is expected that hypertension sufferers should do breathing exercises, perform physical activity and meditation relaxation to avoid anxiety, negative thoughts, also avoiding depression, stress and do interact with someone else so that the mind is not saturated and easy to forget the negative thoughts.

ERYTHROCYTE TRANSMEMBRANE FLUX AND MEMBRANE TRANSPORT ABNORMALITY IN PATHOGENESIS OF HYPERTENSION LEADING TO NEPHROLITHIASIS

RENUGADEVI KARTHIKEYAN; JULIUS AMALDAS; PRAKASH DHARMALINGAM

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1698-1705

The epidemiological relationship between nephrolithiasis and hypertension is well-known. Patients with hypertension are at increased risk for nephrolithiasis and those with nephrolithiasis are at risk for hypertension. An anomaly in RBC Oxalate transport and reduced activities of adenosine triphosphatases has been reported in patients with hypertension when compare to control subjects. This study presents an abnormal increase in transmembrane flux of oxalate in RBC of hypertensive subjects and it might be due to membrane degradation caused by oxalate-induced free radicals depleting erythrocyte thiol contents and impaired adenosine triphosphatases activity resulting in tissue injury and defective membrane transport. Thus relative risk of hypertension was significantly associated with increased oxalate flux rate and impaired adenosine triphosphatases activity in stone formers. This association is important when treating patients with nephrolithiasis since those with hypertension may require unique dietary and medical therapy.

Effect of OM Chanting on Blood Pressure and Pulse Rate of Hypertensive subjectsin Covid-19 pandemic scenario

A.V.S. Keerthana Reddy; R. Archana

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 3315-3322

Hypertension is a neglected health issue and a silent killer which affects almost all the vital systems of the human body. There are primary and secondary causes for hypertension. Factors like stress ,food habits and life style can also trigger hypertension. Yoga is an ancient practice followed by the human kind for attaining peace and health .OM chanting which is a part of yoga is considered as the prominent and significant method of calming the body both physically and mentally. OM chanting is a type of pranayama known to have positive effects on hypertension. In the stressful COVID-19 induced lockdown and pandemic scenario , it is essential to calm the mind and the body to effectively reduce the blood pressure. Hence a study was conducted among 30 hypertensive patients by asking them to perform OM chanting twice a day for 15 days. Pre and post interventions values of blood pressure, pulse rate and oxygen saturation was collected from the study participants. Om chanting was found to be significantly effective in lowering blood pressure and improving the pulse rate and oxygen saturation in hypertension.

ORAL NIFEDIPINE VERSUS ORAL LABETALOL IN THE TREATMENT OF PREGNANCY INDUCED HYPERTENSION

R.P. Patange; Archna V. Rokadhe; Ghori R. Shinde; Sanjay N. Jadhav; Ashitosh Bahulekar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4136-4141

This study was undertaken to determine the effectiveness of two anti-hypertensive drugs: oral Nifedipine and oral Labetalol in cases of extreme preeclampsia in terms of their side effect profile, BP regulation, time taken to lower BP, and number of doses required. The objective of the study was to calculate the time required to reduce the blood pressure to the target level of 90 / 100 mmHg diastolic and less than 160mmHg systolic.In the labetalol group the mean SBP before treatment was 158mm of Hg which was reduced to 140 mm of Hg. The decline rate in the labetalol group was 11.77%. This study proved that labetalol reduces the BP more effectively than nifedipine and also has minimal side effects with less frequent dosing schedule as compared to nifedipine thus indicating that labetalol is better than nifedipine in lowering the BP in cases of preeclampsia.

ASSOCIATION OF ACE EXPRESSION AMONG HYPERTENSION PATIENTS IN COVID - 19 PANDEMIC

Akshayaa. L; Smiline Girija; A.S, Ezhilarasan. D

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 186-193

The present review provides valuable information about the ACE expression and its association with hypertension in COVID-19 patients. The potent use of angiotensin converting enzyme inhibitors, found to increase the ACE expression in hypertension and cardiovascular diseased patients which leads to acute lung injury. Currently there is no clear evidence that impact use of ACEI or ARBs could increase the severity of COVID -19 infection in hypertensive patients.COVID -19 being an infectious disease increases the mortality and morbidity of patients with hypertension. Previous studies have been reported that hypertension is considered as a prognostic indicator in SARS nCov infection. Few studies have also reported that there is no significant association of ACE expression with Covid 19. Review data was collected using the recent articles searched from PubMed, the google scholar, core, Cochrane, from 2000 to 2020. The present review highlights all the possible factors between ACE expression among hypertension patients and covid disease.

BLOOD PRESSURE PROFILE IN SCHOOL CHILDREN IN RURAL AND URBAN AREA IN AND AROUND KARAD

D. B. Potdar; Prashnt P. Shah; Naredra P. Porval

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4168-4174

A cross sectional study among 1000 school going children of age group 6 – 16 years was conducted to study the relation of Blood Pressure with variables Like Body Mass Index, Socio Economic Status, Family History of Hypertension, Age and Sex at our tertiary care hospital Krishna Institute of Medical Sciences Deemed University, Karad. 1.The study group had 100 (10%) children of 13, 14, 15 and 16 years, 90 (9%) children of 6, 8, 9 and 12 years and 80 (8%) children of 7, 10 and 11 years. 12.Systolic hypertension was observed in 13.3% of overweight and 6.7% of obese children. Systolic prehypertension was observed in 11.7% of overweight and 13.3% of obese children. BMI was significantly associated with pre hypertension and hypertension (SBP) in children (p<0.001). Diastolic hypertension was observed in 16.7% of overweight and 6.7% of obese children. Diastolic prehypertension was observed in 18.3% of overweight and 20% of obese children. Only 1.7% and 0.9% of prehypertension and hypertensive children had normal BMI.

AWARENESS, KNOWLEDGE AND PREVALENCE OF HYPERTENSION, SLEEP APNEA AND SLEEP - DISORDERED BREATHING DIFFICULTIES IN MALES AMONG CHENNAI POPULATION

Shruthi Manivannan; Karthik Ganesh Mohanraj; Murugan Thamaraiselvan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 810-821

Hypertension, sleep apnea and sleep disordered breathing are the important Global public health challenges the world is facing nowadays with the highest prevalence rate all over the world. Recently a large body of work has been going on in finding the association of sleep- disordered breathing, sleep Apnea and Hypertension in the Male population.The aim of this study is to determine the association of sleep- disordered breathing, sleep Apnea and Hypertension in the young, Adult and aged Male population.Standard survey questions based on sleep disordered breathing, sleep apnea and hypertension were designed and was uploaded in an online survey platform and circulated among the males. A total of 100 responses were collected and were statistically analysed. In this study we observed that there is an association of sleep disordered breathing, sleep apnea with hypertension (p<0.001, independent sample t-test).Since there were no previous studies to encounter this association in India. This study serves as an eye opener for the early diagnosis and treatment of sleep disordered breathing, sleep apnea and hypertension in the young, Adult and aged Male population. This study will be beneficial in the awareness of health care professionals to consider the evaluation of patients with hypertension, sleep apnea and sleep disordered breathing