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Biomedical subjects

Barbara Gryglewska

Publications and source records attributed to Barbara Gryglewska.

9 recordsLinked to original sources
PubMed2006

Pulse wave velocity in patients with coronary artery disease or type 2 diabetes mellitus.

OBJECTIVE: To check whether the presence of coronary artery disease (CAD) or type 2 diabetes mellitus (DM) has a differentiating effect on arterial stiffness assessed with pulse wave velocity (PWV)--a simple, reproducible and clinically feasible measure of arterial stiffening. METHODS AND RESULTS: The mean age of 101 participants was 63.5 +/- 19.7 years. Fifty-one % of them had CAD, 31.0% had DM and 52.5% were hypertensive subjects. The aortic PWV ranged from 3.40 to 27.50 m/s, with an average of 1.73 +/- 4.69 m/s. PWV was significantly higher (P < 0.01) in both CAD and DM positive groups as compared with CAD and DM negatives, respectively. After adjustment for established co-variables, patients with CAD had significantly higher PWV when compared to CAD negatives (13.0 vs. 10.5 m/s, P < 0.01). After adjustment, DM did not seem to affect PWV. CONCLUSIONS: CAD patients had higher values of PWV when compared to those without the disease. DM, a metabolic equivalent of arterial damage, after adjustment for possible confounders, did not seem to contribute per se to arterial stiffening. The presence of high PWV values in that group of patients should be viewed as an indicator of established widespread atherosclerosis possibly affecting the coronary arteries.

Adult↗
PubMed2005

How can we improve the effectiveness of treatment in elderly hypertensives?

Despite evidence for the benefits of treating hypertension in old age, only a small number of elderly patients have adequate blood pressure control. The reasons are complex and include a combination of factors related to physician, patient adherence to therapy and properties of the antihypertensive drugs. Substantial gaps have been documented between the development and dissemination of recommendations and their implementation in practice. Older patients are more likely to have difficulty with medication adherence. Better compliance achievement among the elderly patients should include a complex strategy. Moreover, physician information strategies must be improved.

Aged↗
PubMed2005

[Efficacy and tolerance of physical rehabilitation in frail hypertensives at advanced age].

BACKGROUND: Frail elderly persons often suffer from chronic illnesses, such of hypertension, for which increased physical activity presents as a nonpharmacologic element of treatment. Physical rehabilitation is underused for frail persons as a result of little information about safety and efficacy of exercises. The aim of the study was to determine tolerance and efficacy of different models of training in frail hypertensives at advanced age. MATERIAL AND METHODS: Frail hypertensives over 75 years old were assigned to different models of home rehabilitation. Subjects of group I performed diverse active exercises, inclusive of walking and safe execution of postural shifts. Group II had a more intensive model of physical rehabilitation comprised of structured activities on a pedlar exerciser, balance training and also coaching on how to safely execute postural shifts. All models of training lasted 12 weeks. At the beginning and end of the study all subjects performed the Get Up and Go test and the 6-Minute Walk test (6MW). The results in both groups were compared using t-Students test. RESULTS: Throughout 2001-2004, 65 subjects (aged 78-92 years) were examined. Group I included 25 subjects (16 F, 9 M) and group II - 40 subjects; 26 F, 14 M. Both groups were similar with regard to age, blood pressure, clinical parameters and initial results of performed tests. Exercise training was well tolerated in all patients. After 36-hours physical rehabilitation significant improvement was only noted with respect to the subjects from Group II. The time of the get up and go test was decreased and the distance covered during 6MW was longer. CONCLUSIONS: Intensive physical rehabilitation may be safetly performed in frail hypertensives at advanced age and give enhance individual functional capabilities and gait velocity.

Aged↗
PubMed2003

[Laser doppler flowmetry--repeatability of the method].

The aim of the study was to evaluate the repeatability of flow microcirculation measurements by laser doppler flowmetry (Periflix, firm Perimed, Sweden). Measurements of right forearm skin perfusion were performed twice in 3-4 day intervals in 40 healthy subject aged 39.5 +/- 18.3. Two independent investigators analysed the results. Pearson correlation and analysis ac. Bland and Altman (Lancet 1986, 1, 307-310) were performed during comparing results obtained in the same studied persons and by the investigators. There was a high correlation between the compared results performed on the same subjects within a few days interval, especially between the results for post-occlusive congestion reaction in basic temperature (r = 0.64-0.72) and the results for congestion reaction at a temperature of 44 degrees C (r = 0.5-0.56). High correlation values (r = 0.8-0.95) were also observed when comparing both investigators' evaluations. Repeatability evaluation using Bland and Altman analysis was poorer, especially for values observed in resting conditions and for some values observed after stimulation with both investigators (2.5-10% of results were out of interval: mean +/- 2SD). The results show good repeatability of microcirculation flow measurements, especially under stimulation.

Adult↗
PubMed2003

[Knowledge of hypertension and blood pressure measurement procedure among students of last year of medical school in Cracow].

The knowledge about hypertension--especially its diagnosis and therapy--among graduates of medical schools, is very important in view of hypertensive epidemics. The aim of this study was to assess the medical graduate's knowledge about recommended technique of blood pressure (BP) measurements, the factors affecting BP measurement value, the WHO/ISH--1999 hypertension diagnostic criteria, and its complications and basic therapy rules. The questionnaire investigating the respondent's knowledge was filled out by 132 medical students of the 6th year Medical College of the Jagiellonian University, in Cracow, from February till June 2000. Only 21.2% of students had good knowledge about BP measurement technique, 70% to 90% of subjects knew hypertension diagnostic criteria, about 30% gave the correct values defined as "high-normal". About 37.1% were aware of complications concerning heart, brain, kidney, eye and peripheral blood vessels. Only 11% knew all drugs recommended by WHO/ISH guidelines, as first-line medication; but 95% were only able to mention at least four of them (diuretics, beta-blockers, ACE-I, Ca-blockers). The students have unsatisfactory levels of knowledge about hypertension. This indicates poor preparation of future physicians in treatment of hypertensive problems.

Blood Pressure↗
PubMed2002

[Vascular dementia and systemic changes].

The aim of the study was to evaluate risk factors of atherosclerosis and extra-cerebral target organ damage in patients with hypertension and vascular based mild memory disorders. A group of the study included 20 persons at age of 54-75 (8 males and 12 females) with mild vascular dementia (20-25 pts in MMSE, 22.8 +/- 1.73) with treated mild hypertension. A diagnosis of vascular dementia was confirmed in MRI by two independent experts. All examined patients presented multiinfarction changes in central nervous system as a cause of dementia. The study protocol contained present history, physical examination, 24-hour ambulatory blood pressure monitoring (ABPM), ECG, biochemical tests: total cholesterol, HDL-Ch, LDL-Ch, triglycerides, glucose, urea, creatinine plasma levels and urine test for microalbuminuria. In part of the study group (55%) echocardiography with posterior wall (PW) thickness and ejection fraction (EF) evaluation was performed. In the analysed group mean 24-hour blood pressure values were not elevated (SBP 130.8 +/- 15.8 mm Hg and DBP 77.6 +/- 9.2 mm Hg at day, respectively 121.6 +/- 17.1 mm Hg and 68.2 +/- 11.6 mm Hg at night). No significant (> 10%) nocturnal SBP decrease was observed, however DBP fall was noticed. Either total cholesterol (n < 5.2 mmol/l) or LDL-Ch (n < 3.5 mmol/l) plasma levels were increased in patients with vascular dementia and ranged respectively 5.8 +/- 0.9 and 3.7 +/- 0.9 mmol/l, HDL-Ch and triglycerides levels remained normal (respectively 1.7 +/- 0.5 and 1.5 +/- 1.1 mmol/l). Mean urea and creatinine levels were maintained in normal range (urea 5.8 +/- 1.7 mmol/l, creatinine 75.5 +/- 15.1 mumol/l). In a part of study group (35%) microalbuminuria was presented (urine albumine > 20 mg/l). In majority of patients with hypertension and vascular dementia a few risk factors co-existed. No systolic blood pressure decrease observed at night in 24-hour blood pressure monitoring, though normal mean values, can play an important role in vascular abnormalities progression.

Aged↗
PubMed2002

[Disturbances in microcirculation--an early predictor of arterial hypertension?].

The aim of this study was to assess microcirculation and properties of large arteries in healthy adult subjects. In 28 individuals between the ages of 21 and 49, the microcirculation in the skin at resting conditions and under stimulation (hyperaemic reaction after a 3-minute long ischaemia at basal body temperature and at 44 degrees C) was measured with laser doppler flowmetry detection. Pulse Wave Velocity was measured by using Complior device and average values of blood pressure were calculated. Subjects were divided into two groups based on the median (pLDF = 374.5) of the hyperaemic reaction after ischaemia at basal body temperature (14 persons in each group). There were no significant differences in the age and pulse wave velocity in both groups. The group after ischaemia at basal body temperature was characterized by significantly lower values of the resting flow, higher values of blood pressure, and higher values of increase in flow after ischaemia when compared to the group after ischemia at 44 degrees C. Furthermore, there was a positive correlation between values in flow after ischaemia at basal body temperature and at 44 degrees C with systolic blood pressure (r = 0.79 and 0.62, respectively). Presented results suggest that disturbances in microcirculation can precede development of hypertension.

Adult↗
PubMed2002

[Pulse wave analysis: from the basic sciences to clinical applications].

Assessment of the pulse character is one of the earliest recorded medical skills, but objective recordings of pulse waveform emerged only in the nineteenth century. This technique fell into disuse with the advent of the sphygmomanometer, but interest has recently been rekindled with the introduction of computer technology and high fidelity applanation tonometry. Sphygmocardiography is a non-invasive and accurate technology which utilizes tonometric analysis of the radial or carotid artery pulse wave and measurement of peripheral arterial blood pressure to derive a central arterial pulse wave, central arterial blood pressure and related indices. In clinical studies pulse wave analysis is a highly reproducible method and easy to apply. This measure provides important information about arterial stiffness and heart-vascular interactions. This technique may provides better cardiovascular risk assessment associated with increased arterial stiffness and allow treatment to be targeted to those most in need.

Blood Pressure↗