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Tao C, Gu M, Xu P, Wang J, Xiao L, Gui W, Li F, Jiang S, Liu X, Hu W, Sun W. Stressful life events can predict post-stroke fatigue in patients with ischemic stroke. Eur J Neurol 2021; 28:3080-3088. [PMID: 34129716 DOI: 10.1111/ene.14977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To investigate whether stressful life events (SLEs) can predict post-stroke fatigue (PSF) in patients with acute ischemic stroke (AIS). METHODS This prospective cohort study included data from patients with AIS who were followed up to 2-year interview. PSF was assessed at admission and at 6 (n = 916), 12 (n = 880), and 24 (n = 857) months with the fatigue severity scale (FSS). SLEs were measured with the Social Readjustment Rating Scale questionnaire at 6, 12 and 24 months' interview. RESULTS A significant dose-response association was found between SLEs and FSS score across all examined time-points: compared with those did not experience SLEs, FSS score was higher for those experiencing SLEs ≥3 at 6 months (β 0.53, 95% CI 0.28-0.78), 12 months (β 0.54, 95% CI 0.30-0.78) and 24 months (β 0.48, 95% CI 0.29-0.68). Longitudinal analyses indicated a significantly positive relationship between the number of SLEs and FSS score (SLEs: ≥3 vs. 0, β 0.14, 95% CI 0.09-0.19). Moreover, a distinct interaction of follow-up time and SLE numbers on FSS score was observed (p < 0.05), which means elevated exposure to SLEs during follow-up was associated with a lower rate of fatigue decline. A similar association was found in SLE load analysis. CONCLUSION Patients with severe fatigue were more likely to report increased number of SLEs in the previous 6 months, which could suggest that a non-specific stressful event leads to an extra burden to an already vulnerable psychological system.
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Affiliation(s)
- Chunrong Tao
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Mengmeng Gu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Pengfei Xu
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jinjing Wang
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lulu Xiao
- Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wei Gui
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Fengli Li
- Department of Neurology, Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shiyi Jiang
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xinfeng Liu
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Hu
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wen Sun
- Stroke Center & Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.,Department of Neurology, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Gronewold J, Engels M, van de Velde S, Cudjoe TKM, Duman EE, Jokisch M, Kleinschnitz C, Lauterbach K, Erbel R, Jöckel KH, Hermann DM. Effects of Life Events and Social Isolation on Stroke and Coronary Heart Disease. Stroke 2021; 52:735-747. [PMID: 33445957 DOI: 10.1161/strokeaha.120.032070] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The current coronavirus disease 2019 (COVID-19) pandemic represents a severe, life-changing event for people across the world. Life changes may involve job loss, income reduction due to furlough, death of a beloved one, or social stress due to life habit changes. Many people suffer from social isolation due to lockdown or physical distancing, especially those living alone and without family. This article reviews the association of life events and social isolation with cardiovascular disease, assembling the current state of knowledge for stroke and coronary heart disease. Possible mechanisms underlying the links between life events, social isolation, and cardiovascular disease are outlined. Furthermore, groups with increased vulnerability for cardiovascular disease following life events and social isolation are identified, and clinical implications of results are presented.
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Affiliation(s)
- Janine Gronewold
- Department of Neurology, University Hospital Essen (J.G., E.-E.D., M.J., C.K., D.M.H.), University of Duisburg-Essen, Germany
| | - Miriam Engels
- Institute of Medical Sociology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany (M.E.)
| | - Sarah van de Velde
- Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Belgium (S.v.d.V.)
| | - Thomas Kofi Mensah Cudjoe
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (T.K.M.C.)
| | - Ela-Emsal Duman
- Department of Neurology, University Hospital Essen (J.G., E.-E.D., M.J., C.K., D.M.H.), University of Duisburg-Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital Essen (J.G., E.-E.D., M.J., C.K., D.M.H.), University of Duisburg-Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, University Hospital Essen (J.G., E.-E.D., M.J., C.K., D.M.H.), University of Duisburg-Essen, Germany
| | - Karl Lauterbach
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Germany (K.L.)
| | - Raimund Erbel
- Institute of Medical Informatics, Biometry and Epidemiology (R.E., K.-H.J.), University of Duisburg-Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology (R.E., K.-H.J.), University of Duisburg-Essen, Germany
| | - Dirk M Hermann
- Department of Neurology, University Hospital Essen (J.G., E.-E.D., M.J., C.K., D.M.H.), University of Duisburg-Essen, Germany
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Booth J, Connelly L, Lawrence M, Chalmers C, Joice S, Becker C, Dougall N. Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis. BMC Neurol 2015; 15:233. [PMID: 26563170 PMCID: PMC4643520 DOI: 10.1186/s12883-015-0456-4] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies suggest that perceived psychosocial stress is associated with increased risk of stroke; however results are inconsistent with regard to definitions and measurement of perceived stress, features of individual study design, study conduct and conclusions drawn and no meta-analysis has yet been published. We performed a systematic review and meta-analysis of studies assessing association between perceived psychosocial stress and risk of stroke in adults.The results of the meta-analysis are presented. METHODS Systematic searches of MEDLINE, EMBASE, CINAHL, PsycInfo, and Cochrane Database of Systematic Reviews were undertaken between 1980 and June 2014. Data extraction and quality appraisal was performed by two independent reviewers. Hazard ratios (HR) and odds ratios (OR) were pooled where appropriate. RESULTS 14 studies were included in the meta-analysis, 10 prospective cohort, 4 case-control design. Overall pooled adjusted effect estimate for risk of total stroke in subjects exposed to general or work stress or to stressful life events was 1.33 (95 % confidence interval [CI], 1.17, 1.50; P < 0.00001). Sub-group analyses showed perceived psychosocial stress to be associated with increased risk of fatal stroke (HR 1.45 95 % CI, 1.19,1.78; P = 0.0002), total ischaemic stroke (HR 1.40 95 % CI, 1.00,1.97; P = 0.05) and total haemorrhagic stroke (HR 1.73 95 % CI, 1.33,2.25; P > 0.0001).A sex difference was noted with higher stroke risk identified for women (HR 1.90 95 % CI, 1.4, 2.56: P < 0.0001) compared to men (HR 1.24 95 % CI, 1.12, 1.36; P < 0.0001). CONCLUSIONS Current evidence indicates that perceived psychosocial stress is independently associated with increased risk of stroke.
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Affiliation(s)
- Joanne Booth
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Lesley Connelly
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Maggie Lawrence
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Campbell Chalmers
- NHS Lanarkshire, Coathill Hospital, Hospital Street, Coatbridge, ML5 4DN, UK.
| | - Sara Joice
- School of Psychology, Massey University, Private Bag 11 222, Palmerston North, New Zealand.
| | - Clarissa Becker
- Institute for Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Nadine Dougall
- Nursing, Midwifery & Allied Health Professions Research Unit, University of Stirling Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK.
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Guiraud V, Touzé E, Rouillon F, Godefroy O, Mas JL. Stressful Life Events as Triggers of Ischemic Stroke: A Case-Crossover Study. Int J Stroke 2012; 8:300-7. [DOI: 10.1111/j.1747-4949.2012.00810.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background Acute stressors, such as stressful life events, might trigger ischemic stroke. Aims Our objective was to investigate the association between life events exposure and ischemic stroke onset. Methods Consecutive patients were interviewed about life events exposure (e.g. bereavement) using the Interview for Recent Life Events. Using a case-crossover approach, life events exposure within one month of stroke onset (hazard period) was compared with exposure during five control periods of one month preceding the hazard period. Similarly, life events exposure within one week of stroke onset was compared with exposure during three control periods of one week. Odds ratios and 95% confidence intervals were calculated using conditional logistic regression. Results Two hundred forty-seven patients were interviewed within a median time of five days (interquartile range 3–7). Life events belonging to bereavement, health, and other categories accounted for half of life events. Over the six-month period, 187 patients were exposed to ≥1 life events. Patients were exposed to ≥1 life events more often during the first month preceding stroke onset than during the five control periods (odds ratio = 2·96; 95% confidence interval, 2·19–4·00). Over the four-week period, 97 patients were exposed to ≥1 life events. Patients were exposed to ≥1 life events more often during the first week preceding stroke onset than during the three control periods (odds ratio = 2·10; 1·40–3·17). Conclusions Recent life events exposure is associated with an increased risk of ischemic stroke.
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Affiliation(s)
- Vincent Guiraud
- Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Service de Neurologie et Unité Neurovasculaire, Hôpital Sainte-Anne, Paris, France
| | - Emmanuel Touzé
- Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Service de Neurologie et Unité Neurovasculaire, Hôpital Sainte-Anne, Paris, France
| | - Frédéric Rouillon
- Université Paris Descartes, Sorbonne Paris Cité, INSERM U 675, Clinique des Maladies Mentales et de l'Encéphale, Hôpital Sainte-Anne, Paris, France
| | - Olivier Godefroy
- Université d'Amiens, EA 4559, Service de Neurologie, Hôpital d'Amiens-Picardie, Amiens, France
| | - Jean-Louis Mas
- Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR S894, Service de Neurologie et Unité Neurovasculaire, Hôpital Sainte-Anne, Paris, France
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Kinoshita Y, Kingdon D, Kinoshita K, Sarafudheen S, Umadi D, Dayson D, Hansen L, Rathod S, Ibbotson RB, Turkington D, Furukawa TA. A semi-structured clinical interview for psychosis sub-groups (SCIPS): development and psychometric properties. Soc Psychiatry Psychiatr Epidemiol 2012; 47:563-80. [PMID: 21384122 DOI: 10.1007/s00127-011-0357-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 02/14/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Clinical sub-groups of schizophrenia, namely drug related, traumatic, anxiety and stress sensitivity sub-types, have been proposed for use in research, training and practice. They were developed on the basis of clinical observation but have not yet been used in research or clinical practice to any great extent. AIMS To develop a semi-structured clinical interview for psychosis sub-groups (SCIPS) and determine the best diagnostic criteria with the highest inter-rater reliability, test-retest reliability and concurrent validity for sub-grouping patients with schizophrenia according to a newly developed classification scheme. METHODS The SCIPS was developed based upon discussion with the clinician researchers who had developed and were using the sub-groups. Kappa coefficients were calculated between two independent diagnostic assessments with the SCIPS (for inter-rater reliability and test-retest reliability, n = 20) and between the SCIPS diagnosis and the sub-groupings as determined independently with highest achievable validity (for concurrent validity, n = 21) for patients with schizophrenia. These inter-rater reliability and concurrent validity were compared among five different sets of diagnostic criteria to determine which was most reliable and valid. RESULTS A set of diagnostic criteria with the highest inter-rater reliability and concurrent validity was determined. Kappa coefficients (95% confidence interval) for the inter-rater reliability and concurrent validity were 0.93 (0.66-1.20) and 0.73 (0.47-1.00), respectively, with these diagnostic criteria. CONCLUSIONS The SCIPS is a promising tool with which to sub-group patients with schizophrenia according to this recently developed classification scheme. The semi-structured interview achieves acceptable inter-rater and test-retest reliability and concurrent validity.
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Affiliation(s)
- Yoshihiro Kinoshita
- Department of Psychiatry, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
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González HM, Tarraf W, West BT, Chan D, Miranda PY, Leong FT. Research article: Antidepressant use among Asians in the United States. Depress Anxiety 2010; 27:46-55. [PMID: 20013960 PMCID: PMC2805045 DOI: 10.1002/da.20636] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We examined the prevalence and predictors of past-year antidepressant use in a nationally representative sample of Asian Americans and non-Latino Whites. METHODS Analyses of 12-month antidepressant medication use were based on data from the Collaborative Psychiatric Epidemiology Surveys that surveyed Asian (Chinese, Filipino, Vietnamese, and others; N=2,284) and non-Latino White (N=6,696) household residents ages 18 years and older in the 48 contiguous United States and Hawaii. RESULTS Prevalence rates for 12-month antidepressant use for Asians with major depression ranged from 8.7% among Vietnamese to 17% among Chinese respondents. Compared to non-Latino Whites (32.4%), all Asians (10.9%) meeting criteria for 12-month depressive and anxiety disorders, but especially Filipinos (8.8%) were less likely to report past-year antidepressant use. CONCLUSIONS We found disparities in past-year antidepressant use among all the examined major Asian groups meeting criteria for 12-month depressive and anxiety disorders. These disparities were not explained by mental health need or socioeconomic factors that enable access to care.
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Affiliation(s)
- Hector M. González
- Wayne State University, Institute of Gerontology and School of Medicine, Department of Family Medicine
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology and School of Medicine, Department of Family Medicine
| | - Brady T. West
- University of Michigan, Center for Statistical Consultation and Research
| | - Domin Chan
- University of Washington, Department of Psychiatry and Behavioral Sciences
| | - Patricia Y. Miranda
- University of Texas M. D. Anderson Cancer Center, Center for Research on Minority Health, Department of Health Disparities Research
| | - Fredrick T. Leong
- Michigan State University, Center for Multicultural Psychology Research
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Guiraud V, Touzé E, Rouillon F, Mas JL. Événements de vie et risque d’infarctus cérébral : une étude cas croisée. Rev Neurol (Paris) 2010. [DOI: 10.1016/s0035-3787(10)70003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
PURPOSE OF REVIEW While chronic risk factors for stroke are reasonably well understood, the acute precipitants, or triggers, of stroke, remain relatively understudied. RECENT FINDINGS Several converging lines of evidence indicate that transient perturbations in systemic metabolism may provoke the onset of cardiovascular events, including stroke. Epidemiologic data, including studies utilizing novel designs that consider intraindividual differences across different time periods, have been used to clarify triggers for myocardial ischemia, and these methods are beginning to be employed in stroke research. Acute infections, particularly upper respiratory infections, and other inflammatory stimuli have emerged as important triggers of acute ischemic stroke. The mechanisms involved include immunologically mediated activation of platelets and endothelial dysfunction. There also appears to be a period of time, or 'stroke-prone state', characterized by diffuse activation of the vasculature during which patients may be at increased risk of initial and recurrent ischemic events. SUMMARY Confirmation of these findings in further studies may help elucidate the mechanisms behind this short-term increase in stroke risk. Improved methods of assessment of this period of heightened susceptibility could lead to more temporally focused preventive interventions.
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Affiliation(s)
- Mitchell S V Elkind
- Department of Neurology, Columbia University, New York-Presbyterian Hospital, New York, New York, USA.
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Li J, Johnsen SP, Olsen J. Stroke in parents who lost a child: a nationwide follow-up study in Denmark. Neuroepidemiology 2003; 22:211-6. [PMID: 12711854 DOI: 10.1159/000069898] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The association between psychological stress and stroke remains uncertain. We therefore examined whether or not one of the most extreme psychological stressors, the death of a child, was associated with the risk of stroke in a nationwide population-based follow-up study. All 21,062 parents who lost a child in Denmark during 1980-1996 were compared with 293,745 parents who had not lost a child. The overall adjusted relative risk (RR) of stroke was 1.00 (95% CI = 0.83-1.20) among the exposed after up to 18 years of follow-up. The RRs for fatal stroke and nonfatal stroke were 0.69 (95% CI = 0.37-1.26) and 1.03 (95% CI = 0.85-1.24), respectively. The RRs for hemorrhagic and nonhemorrhagic stroke were 1.02 (95% CI = 0.77-1.36) and 0.94 (95% CI = 0.74-1.20), respectively. The risk of stroke did not differ irrespective of whether the death of the child was unexpected or not. The death of a child was not associated with any substantially increased risk of stroke in the bereaved parents.
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Affiliation(s)
- Jiong Li
- Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark.
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Menéndez Villalva C, Montes Martínez A, Núñez Losada C, Fernández Domínguez MJ, Gamarra Mondelo T, Buján Garmendia S. [Environmental stress and cardiovascular reactivity: the effect of stressful life events on hypertense patients]. Aten Primaria 2002; 30:631-7. [PMID: 12525339 PMCID: PMC7679752 DOI: 10.1016/s0212-6567(02)79125-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To assess the effect of stressful life events (SLE) on the monitoring of patients with essential hypertension. DESIGN Observational and prospective. SETTING Primary care. PARTICIPANTS 236 hypertense patients selected by systematic randomised sampling. MEASUREMENTS Age, sex, marital status, cultural level, kind of family, presence of SLE, social support, blood pressure, severity of hypertension, tobacco consumption, alcohol, presence of diabetes, hypercholesterolaemia, body mass index, compliance with hypertension treatment. RESULTS. Mean age was 63.51 (62.05; 64.96), with 66.1% being women and 33.9% men. 48.7% of the patients referred to some SLE during the follow-up. These reached a mean of 47.65 (33.16; 62.15) life change units (LCU). Patients with high-impact SLE (>150 LCU) had a significant increase of 10.91 mm Hg (0.43; 21.40) in their systolic blood pressure and of 9.48 beats per minute (3.78; 15.19) in their heart rate, after monitoring for possible factors of confusion. We observed a similar trend for diastolic pressure, but this did not reach statistical significance. CONCLUSION The presence of SLE has a negative effect on systolic blood pressure in hypertense patients.
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