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This study is a double-blind randomized controlled trial on the effect of intradermal acupuncture on insomnia after stroke. Hospitalized stroke patients with insomnia were enrolled in the study and were randomly assigned to either a real intradermal acupuncture group (RA group) or a sham acupuncture group (SA group). The RA group received intradermal acupuncture on Shen-Men (He-7) and Nei-Kuan (EH-6) for three days, and the SA group received sham acupuncture on the same points. The effect of acupuncture on insomnia was measured using Insomnia Severity Index (ISI) and Athens Insomnia Scale (AIS) at baseline and three days after treatment. To assess the effect of acupuncture on the autonomic nervous function, the subjects' blood pressure and heart rate variability were monitored. Fifty-two subjects (27 in the RA group and 25 in the SA group) were included in the final analysis. The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group. Moreover, there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio (heart rate variability) in the RA group than in the SA group. These results indicate that sympathetic hyperactivities were stabilized in the RA group. It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities.

Background: Diabetes and hypertension are two of the commonest diseases in the world. As they unfavorably affect people of different age groups, they have become a cause of concern and must be predicted and diagnosed well in advance.

Objective: This research aims to determine the effectiveness of artificial neural networks (ANNs) in predicting diabetes and blood pressure diseases and to point out the factors which have a high impact on these diseases.

Sample: This work used two online datasets which consist of data collected from 768 individuals. We applied neural network algorithms to predict if the individuals have those two diseases based on some factors. Diabetes prediction is based on five factors: age, weight, fat-ratio, glucose, and insulin, while blood pressure prediction is based on six factors: age, weight, fat-ratio, blood pressure, alcohol, and smoking.

Method: A model based on the Multi-Layer Perceptron Neural Network (MLP) was implemented. The inputs of the network were the factors for each disease, while the output was the prediction of the disease’s occurrence. The model performance was compared with other classifiers such as Support Vector Machine (SVM) and K-Nearest Neighbors (KNN). We used performance metrics measures to assess the accuracy and performance of MLP. Also, a tool was implemented to help diagnose the diseases and to understand the results.

Result: The model predicted the two diseases with correct classification rate (CCR) of 77.6% for diabetes and 68.7% for hypertension. The results indicate that MLP correctly predicts the probability of being diseased or not, and the performance can be significantly increased compared with both SVM and KNN. This shows MLPs effectiveness in early disease prediction.

We investigated the effect of Panax ginseng extract, which is rich in the ginsenoside protopanaxatriol (Ginseol K-g1), on blood pressure (BP). Adults over 20 years old with a systolic BP (SBP) between 120 and 159 mm Hg or a diastolic BP (DBP) between 80 and 99 mm Hg were included. At the end of an initial 2-week washout period, the patients were divided into three groups: the control group (placebo), the low-dose Ginseol K-g1 group (100 mg), and the high-dose Ginseol K-g1 (300 mg) group. The primary end point was the difference in seated SBP (seSBP) and seated DBP (seDBP) changes between the placebo and Ginseol K-g1 groups after 8 weeks of treatment. A total of 90 subjects participated in the study (mean age; 55.2 ± 11.8 years, 43 males). At week 8, levels of seSBP and seDBP were significantly decreased from baseline in the high-dose Ginseol K-g1 group (-3.1 mm Hg and -2.3 mm Hg, respectively, p < 0.05). In contrast, there was no significant decrease in seSBP or seDBP in the control or low-dose Ginseol K-g1 groups. No significant difference of seSBP and seDBP was identified among the three treatment groups at week 8. In patients who had a seSBP ≥ 130 mm Hg or an seDBP ≥ 85 mm Hg, the high dose of Ginseol K-g1 decreased the BP compared with the control group at week 4; however, there was no significant difference at week 8. The proportions of patients who experienced adverse events were comparable among the treatment groups. In conclusion, Ginseol K-g1 has a favorable effect on BP after 4 weeks of treatment, especially at a high dose. However, the effect is not maintained over 8 weeks. (Clinical trial registration information is available at http://www.clinicaltrials.gov, identifier: NCT01483430.)

This study was designed to measure changes in blood pressure (BP), urinary catecholamines and ventilatory functions of patients with mild essential hypertension after 10 weeks of Qigong (Shuxinpingxuegong). Fifty-eight patients volunteered to participate in this study and were randomly divided into either a Qigong group (n = 29), or a control group (n = 29). Systolic blood pressure and diastolic blood pressure decreased significantly in the Qigong group such that both became significantly lower after 10 weeks in the Qigong than in the control group. Also, there was a significant reduction of norepinephrine, metanephrine and epinephrine compared to baseline values in the Qigong group. The ventilatory functions, forced vital capacity and forced expiratory volume per sec, were increased in the Qigong group but not the control. These results suggest that Qigong may stabilize the sympathetic nervous system is effective in modulating levels of urinary catecholamines and BP positively, and in improving ventilatory functions in mildly hypertensive middle-aged patients.

Background: Spinal pain or misalignment is a very common disorder affecting a significant number of populations resulting in substantial disability and economic burden. Various manual therapeutic techniques such as spinal manipulations and mobilizations can be used to treat and manage pain and movement dysfunctions such as spinal mal-alignments and associated complications. These manual therapeutic techniques can affect the cardiovascular parameters.

Objective: The objective of this systematic review and meta-analysis is to assess the effect of spinal manipulation and mobilization on cardiovascular parameters.

Methods: We conducted a systematic review and meta-analysis to assess the effects of spinal mobilization and manipulation on cardiovascular responses. Mean changes in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Quality of the included studies was assessed by PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias.

Results: Results of meta-analysis showed that there was statistically significant decrease in SBP ($\mathrm{\text{MD}}=-4.56$, 95% $\mathrm{\text{CI}}=-9.20$, 0.08; $p\le 0.05$) with moderate heterogeneity ($\mathrm{\text{I}}2=75\%$, $p<0.0002$) in experimental group as compared to control group. There was statistically non-significant decrease in DBP ($\mathrm{\text{MD}}=-1.96$, 95% $\mathrm{\text{CI}}=-4.60$, 0.69; $p=0.15$) with high heterogeneity ($\mathrm{\text{I}}2=91\%$, $p<0.00001$), Change HR was statistically non-significant ($\mathrm{\text{MD}}=-0.24$, 95% $\mathrm{\text{CI}}=-3.59$, 3.11; $p=0.89$) with moderate heterogeneity ($\mathrm{\text{I}}2=60\%$, $p=0.01$). Exclusion of short duration studies in sensitivity analysis revealed a statistically significant change in DBP ($\mathrm{\text{MD}}=-0.94$, 95% $\mathrm{\text{CI}}=-1.85$, $-0.03$; $p=0.04$). However, the result was statistically non-significant for HR after sensitivity analysis.

Conclusion: Spinal manipulations and mobilizations may result in significant decrease of systolic as well as diastolic Blood Pressure.

It is a well-established fact that atherosclerosis in carotid bifurcation depends on flow parameters such as wall shear stress, flow pulsatility, and blood pressure. However, it is still not clearly verified how atherosclerosis can become aggravated when plaque experiences a high level of shear stress during advance stages of this disease. In this paper, fluid and structural properties in idealistic geometries are analyzed by using fluid-structure interaction (FSI). From our results, the relationship among blood pressure, stenotic compression, and deformation was established. We show that a high level of compression occurs at the stenotic apex, and can potentially be responsible for plaque progression. Moreover, wall shear stress and deformation are significantly affected by the degree of stenosis. Finally, through analysis of the FSI-based simulation results, we can better understand the parameters that influence flow through a stenotic artery and plaque aggravation, and apply the knowledge for the enhancement of clinical research and prediction of treatment outcomes.

Investigators collect data and present them in a way that offers the best insight regarding the questions at hand. To facilitate understanding of certain aspects, it may occasionally be useful to rearrange primary data and formulate them as derived variables. For example, the travel distance divided by the invested time yields average velocity (as m/s). Problems may arise when interpreting ratios that fail to have a physical dimension. For example, current TV-sets have a fixed ratio for height and width, implying that we need an additional detail to define its size. Size then is determined by the diagonal, which can be calculated from the two sides using the Pythagorean theorem. Similarly, paired hemodynamic variables may be expressed as ratios. Again, a fixed ratio may refer to a variety of underlying primary data which require consideration if the ratio is unitless. In this survey, we evaluate several derived metrics commonly used in cardiovascular studies, and offer comprehensive analysis strategies.

Hypertension is a major risk factor for ischemic cardiovascular disease and cerebrovascular disease, which are respectively the primary and secondary most common causes of morbidity and mortality across the globe. To alleviate the risks of hypertension, there are a number of effective antihypertensive drugs available. However, the optimal treatment blood pressure goal for antihypertensive therapy remains an area of controversy. The results of the recent Systolic Blood Pressure Intervention Trial (SPRINT) trial, which found benefits for intensive lowering of systolic blood pressure, have been debated for several reasons. We aimed to assess the benefits of treating to four different blood pressure targets and to compare our results to those of SPRINT using a method for causal inference called the parametric g formula. We applied this method to blood pressure measurements obtained from the electronic health records of approximately 200,000 patients who visited the Mount Sinai Hospital in New York, NY. We simulated the effect of four clinically relevant dynamic treatment regimes, assessing the effectiveness of treating to four different blood pressure targets: 150 mmHg, 140 mmHg, 130 mmHg, and 120 mmHg. In contrast to current American Heart Association guidelines and in concordance with SPRINT, we find that targeting 120 mmHg systolic blood pressure is significantly associated with decreased incidence of major adverse cardiovascular events. Causal inference methods applied to electronic methods are a powerful and flexible technique and medicine may benefit from their increased usage.

Cinnamon is one of the world’s oldest and most popular spices, and is derived from the inner bark of several tree species from the genus Cinnamomum. During the last two decades, cinnamon has demonstrated beneficial metabolic effects not only in animal experiments but also in clinical trials. Even recent meta-analyses have shown the protective effects of cinnamon on different components of metabolic syndrome and their complications. In the last 5 years, several experimental studies have unraveled the intricate molecular mechanisms underlying the antihypertensive, antihyperglycemic, lipid-lowering, weight-lowering, and cardioprotective properties of cinnamon. This review paper will discuss how cinnamon and its active components, particularly cinnamaldehyde, suppress inflammation and oxidative stress, modulate mitochondrial dysfunction, and regulate glucose uptake, insulin resistance, lipogenesis, beta-oxidation, Ca2+ signaling, and other cellar events at the molecular level. Specifically, we will delve into the molecular mechanisms involved in the metabolic effects of cinnamon to provide a deeper insight into how cinnamon can bring such beneficial effects. This review hopes to encourage the use of cinnamon in clinical settings, guide the combination of cinnamon with other drugs used to treat different components of metabolic syndrome based on their mechanism of action, and support the concept of complementary medicine for metabolic diseases.

Traditional arterial tonometry permits noninvasive and continuous recording of the arterial pressure waveform, by applanating a superficial artery supported by a bone. In the paper, we present an arterial tonometer to simultaneously register the blood pressure waveform and the arterial time-varying volume. The tonometer consisted mainly of a chamber filled with a conductive fluid, a flexible diphragm in touch with an artery, and a pressure sensor used to detect the underlying arterial pressure. In addition, four electrodes were in parallel diposed in the chamber, two of them were triggered with a constant-current source, and the voltage difference between the other two inner electrodes was assocated with the amount of change in the arterial volume. The pressure calibration curve performed with a mercury sphygmomanometer showed a fairly linear relationship (r = 0.998) between the tonometer's chamber pressure and the voltage output of the pressure-sensing circuit. The volume calibration was carried out with vessel-like cylinders of various diameters and a linear relationship (r = 0.884) of the change in vessel volume to the voltage output of the volume-sensing circuit was obtained. Clinical testing results revealed that the noninvasive blood pressure measurement with the tonometer was appreciably consistent with the invasive measurement with the catheter-tipped pressure transducer. In summary, the arterial applanation tonometer developed may be used to reliably determine the full arterial blood pressure waveform and the change in the arterial volume, and to make the wall compliance assessment of a superficial artery possible.