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The effect of Valsalva maneuver on diastolic filling indices in patients with essential hypertension.

Background: Left ventricular hypertrophy and diastolic dysfunction are considered to be an important risk factor for cardiovascular morbidity and mortality in asymptomatic hypertensive
patients. At the bedside, left ventricular geometric remodeling and diastolic dysfunction in hypertension can not be diagnosed without echocardiography which is a useful adjunct to the medical history, physical examination, ECG, and chest radiography. Hence, it provides an opportunity for good management and prognosis of what appears to be preclinical hypertensive complication. 
Subjects and Methods: 127 subjects with essential hypertension of either sex attending echo unit were subjected to medical history, clinical examination, physical measurements, ECG, M-mode and Doppler echocardiography. They were classified as 46 treated hypertensives where they were on regular antihypertensive medication, and 81 untreated hypertensive patients. In addition, they were sex and age matched to 39 healthy subjects who served as control group. 
Results: The results of this study revealed that hypertensive patients especially those with stage II hypertension were prone to develop left ventricular hypertrophy (LVH) of concentric geometric pattern and diastolic dysfunction. However, small percentage of those patients found to have diastolic dysfunction despite they were without LVH. In addition, Doppler echocardiography clarify that hypertensives with abnormal transmitral inflow profile; of left ventricular impaired relaxation pattern suffered left ventricular systolic dysfunction. Moreover, in this study there was no evidence of  pseudonormal transmitral inflow filling pattern which is excluded after Valsalva maneuver.
Conclusion: There is a strong association between left ventricular hypertrophy and diastolic dysfunction which was more common in patients with stage II hypertension. However, left
ventricular diastolic dysfunction is usually follows left ventricular hypertrophy, but it still may proceed especially in those patients with left ventricular hypertrophy (LVH) of concentric geometric pattern. In addition, left ventricle diastolic dysfunction is not necessary coincide with the development of systolic dysfunction, namely normal ejection fraction and fractional shortening.

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Publication Date
Sun Nov 04 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension

Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension

Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Possible Augmentive Effect of Antioxidant Vitamin C in Patients with Essential Hypertension Treated with Amlodipin or Enalapril

Hypertension is identified as one of the most significant risk factors for cardiovascular diseases (CVDs). There is growing evidence showing that oxidative stress plays a major role in hypertension. Increased production of reactive oxygen species and decrease bioavailability of antioxidant have been demonstrated in experimental and human hypertension. The present study was directed to determine the beneficial effect of the antioxidant vitamin C in patients with essential hypertension treated with the calcium channel blocker (amlodipine) or with the angiotensin converting enzyme inhibitor (enalapril). Ninety six patients (50 females and 46 males) with essential hyp

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Publication Date
Mon Oct 01 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Control of high blood pressure by Acupuncture In subjects with essential hypertension

advancing age. The risk of cardiovascular disease in adults is lowest with systolic BP <120 mm Hg and diastolic BP < 80 mm Hg and increases progressively with higher systolic and diastolic blood pressures. Acupuncture (from the Latin word acus, “needle”, and pungere, meaning “prick”) is a technique in which the practitioner inserts fine needles into specific points on the patient’s body. Accupuncture could be used as a nonpharmacological way of controlling high readings of blood pressure among cases with essential hypertension. This study aimed to investigate the effects of acupuncture on essential hypertension.
Patients and Methods: 51 hypertensive patients of both genders and 30 normotensive control subjects were inv

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Publication Date
Sun May 30 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
Effect of Diabetes and Hypertension on Right Carotid Artery Intima Media Thickness and Variable Spectral Waveform Indices And Parameters in Relation To Age for Iraqi Patients

Background: Arterial stiffness is related with atherosclerosis and cardiovascular disease events. Patients with atherosclerotic disease show to have larger diameters, reduced arterial compliance and lower flow velocities. Aim of study : To compare between patients of two age groups with concomitant diseases diabetes and hypertension in regard to intima media thickness and blood flow characteristics in order to estimate the blood perfusion to the brain via the common and internal carotid arteries. Subject and Methods : 40 patients with (diabetic and hypertension) diseases were enrolled , they were classified according to age. Color Doppler and B mode ultrasound was used to determine lumen Diameter (D), Intima – media thickness (IMT)

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Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Clinical study of patients with primary pulmonary hypertension (PPH)

Background: Pulmonary hypertension (PH) is a hemodynamic and pathophysiological condition
defined as an increase in mean pulmonary arterial pressure (PAP) ≥25 mmHg at rest as assessed by
right heart catheterization (RHC). Although there is some underestimation and overestimation of PAP
between transthoracic Doppler echo (DE) and RHC, Doppler echo remains an indispensable screening
tool for the assessment of PH.
Objective: clinical evaluation of patients with primary pulmonary hypertension (PPH) and assess
vasoreactivity testing to identify patients who may benefit from long term therapy with calcium channel
blockers (CCBs).
Patients and methods: This prospective study was performed in the cardiac catheterization

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning Non-Pharmacological Guideline on Controlling Essential Hypertension among Patients at AL-Sader Hospital in AL-Najaf AL-Ashraf City

Objective: The aims of present study to detect the effectiveness of instruction program of non-pharmacological guideline on blood pressure and laboratory test.

 

Methodology: A pre-experimental study was conducted in Al-Sader Teaching Hospital   from 8th of September 2019 to 25th of May 2020, in order to find out the effectiveness of instruction program concerning non-pharmacological guideline on controlling essential hypertension among patients. A non- probability (purposive sample) of 50 patients with essential hypertension is selected. Those patients are already diagnosed with Essential Hypertension

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Publication Date
Wed Jan 01 2014
Journal Name
International Journal Of Medical Physics, Clinical Engineering And Radiation Oncology
The Use of Left Ventricular Myocardial Stiffness Index as a Predictor of Myocardial Performance in Patients with Systemic Hypertension

Our aim was to investigate the changes in the myocardium stiffness index for patients suffering from systemic hypertension, and to assess their left ventricular performance. We studied 263 hypertensive patients and 166 healthy subjects as a control group. By using conventional Doppler echocardiography, the following parameters were measured—Left ventricular end diastolic diameter, left ventricular end systolic diameter, transmitral early velocity, isovolumic relaxation time, and isovolumic contraction time. Tissue Doppler imaging (TDI) was used in the measurements of the early mitral annular velocity (Ea) and the diastolic stiffness was obtained by calculating the ratio E\Ea\LVIDd. Index myocardial performance (IMP) was calculated

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Publication Date
Tue Jul 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Effect of hypertension on diabetic peripheral neuropathy

Back ground: Two groups of diabetic patients ((the first include 20 patients complaining from diabetes mellitus alone, and the second include patients that
complain from both hypertension and diabetes mellitus)) were included in this study. These patients were chosen((from a large number of patients, with a proved
diagnosis, that are referred to the neurophysiology unit from the department of medicine)) to be of the same age group and gender, so that any of these two factors
can no longer be a source of any possible error in the results.
Patients & methods: The electrophysiological tests that were done to all of our patients include: sensory latency and sensory amplitude for the ulnar and sural
nerv

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Publication Date
Wed Apr 02 2014
Journal Name
Iraqi Journal Of Physics
The evaluation of left ventricle stiffness index in patients suffering from hypertension

Many diseases can produce cardiac overload, of these disease hypertension, valve disease congenital anomaly in addition to many other disease. One of the most common diseases causing left ventricle overload is hypertension. A long term hypertension can cause myocardium hypertrophy leading to changes in the cardiac contractility and reduced efficiency. The investigations were carried out using conventional echocardiography techniques in addition to the tissue Doppler imaging (TDI) from which many noninvasive measurements can be readily obtained. The study has involved the effect of hypertension on the myocardium stiffness index through the measurement of early diastolic filling (E) and the early velocity of lateral mitral annulus (E

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