Hypotension (Low Blood Pressure)

Spinal anesthesia-induced hypotension is a common and significant complication affecting up to 50-80% of pregnant women undergoing elective cesarean section. This trial evaluates whether a brief 5-minute mindfulness-based breathing exercise given just before spinal anesthesia can influence blood pressure changes during surgery. The study compares this breathing technique to standard care in pregnant women aged 18 to 45 years scheduled for elective cesarean delivery. Participants will be randomly assigned to either perform the mindfulness-based breathing exercise or receive standard preoperative care. The breathing exercise involves slow diaphragmatic breathing at about six breaths per minute, guided by a trained anesthesiologist or nurse, with mindful repetition of the phrase "My body is relaxing as I exhale." Both groups receive spinal anesthesia with specific medications, and careful monitoring of heart rate and blood pressure is performed. During the study, participants will be closely observed for changes in systolic blood pressure and heart rate within 10 minutes after spinal anesthesia. Anxiety levels, incidence of early hypotension, and medication use to support blood pressure will also be measured. The trial includes standard monitoring such as ECG and oxygen saturation, with safety and response data collected throughout the procedure. Participants' involvement includes a short breathing exercise or equivalent wait time before anesthesia, with follow-up assessments during surgery.

This research aims to explore how PhytoRx Families, an innovative produce prescription program, can impact nutrition, health, and healthcare use among families in rural North Carolina facing food insecurity. The study focuses on adults and school-aged children, addressing barriers like limited access to affordable healthy food in lower-resourced rural communities. Participants include 30 adult-child pairs with children aged 8 to 14 years. Healthcare providers at local clinics will refer eligible families who screen positive for food insecurity. The program provides fresh produce boxes and nutrition education over a 16-week period, aiming to improve fruit and vegetable intake and related health outcomes. During the study, participants will complete dietary recalls and health assessments at the start and end of the 16 weeks. Researchers will measure fruit and vegetable intake, diet quality, food security, blood pressure, HbA1C, body mass index, and various nutrition-related behaviors. The study will also track healthcare usage and evaluate changes over the intervention period.

Researchers are evaluating the safety and effectiveness of VBI-S in raising blood pressure in patients suffering from septic shock with absolute or relative hypovolemia. Septic shock is a severe condition caused by infection leading to dangerously low blood pressure that does not improve with standard fluid treatments. This study is a Phase III, open-label, randomized controlled trial sponsored by Vivacelle Bio, aiming to address this urgent medical emergency. Participants will receive treatment with VBI-S, which consists of small particles of specific lipids called micelles and liposomes designed to treat hypotension. The study is randomized and controlled but open-label, meaning both participants and researchers know the treatment given. The Data Safety Monitoring Board will regularly review safety and study data to ensure participant well-being. During the study, participants will be closely monitored through various assessments including measurements of mean arterial pressure, doses of pressor drugs, organ function scores, oxygen levels, serum markers, and survival rates over a 12-month period. The primary outcome is the elevation in average mean arterial pressure. Assessments will help determine how VBI-S affects blood pressure and organ function while ensuring ongoing safety throughout the study duration.

Researchers are evaluating a predictive algorithm called the hypotension prediction index to optimize hemodynamic management during major vascular surgery, specifically abdominal aortic aneurysm repair. The study aims to compare this new method with standard cardiovascular parameter-based care to understand if it can better manage blood pressure during surgery. The trial is led by Fondazione Policlinico Universitario Agostino Gemelli IRCCS and uses a randomized, single-masked design. Participants are divided into two groups: the control group receives hemodynamic optimization based on standard cardiovascular parameters displayed on the Hemosphere platform, with drugs and fluids administered according to mean arterial pressure and stroke volume variation. The experimental group is managed using the hypotension prediction index to guide drug and fluid administration proactively. This study focuses on the intraoperative period during aortic surgery. During the surgery, researchers will monitor blood pressure and calculate the time-weighted average of mean arterial pressure below 65 mmHg as the primary outcome. Participants undergo continuous hemodynamic monitoring to assess the effectiveness of both approaches. The trial continues until the end of surgery, with no mention of extended follow-up periods. The total duration for participants is limited to the surgical procedure timeframe.

About 20% of adults experience recurrent fainting, leading to significant symptoms, difficulties with work and driving, injuries, and reduced quality of life. Because few treatments have been proven effective in randomized trials, researchers are conducting a phase 2, randomized, double-blind study to test if blocking serotonin 5HT3 receptors with ondansetron can prevent fainting or near fainting caused by tilt-induced vasovagal syncope (VVS). This study aims to provide preliminary data for future larger trials. Participants will be randomly assigned to receive either two doses of ondansetron 8 mg by mouth (one the evening before and one the morning of the study) or matching placebo doses on separate days. After dosing, participants undergo a tilt table test where their heart rhythm, blood pressure, and blood samples will be monitored continuously for up to 60 minutes or until fainting occurs. Additional measurements include bioelectrical impedance to assess fluid shifts in the body during posture changes and questionnaires to evaluate quality of life, anxiety, and depression. During the study, participants will have ECG electrodes and a blood pressure cuff applied, along with an intravenous line for blood sampling. Blood samples will be collected at baseline and during the tilt test to measure catecholamine levels. Participants will also complete online surveys assessing health-related quality of life and mood symptoms. The main outcome is the time until fainting or near fainting within one hour. Secondary outcomes include stroke volume, cardiac output, vascular resistance, and psychological measures monitored during the study and within 12 months. The study lasts about one day for the tilt test and includes follow-up assessments up to one year.

Researchers are evaluating the effects of three vasopressors—norepinephrine, phenylephrine, and ephedrine—on brain oxygen levels during general anesthesia for abdominal surgery. This randomized, double-blind trial aims to understand how these drugs influence cerebral oxygen saturation and heart function in patients undergoing surgery with either propofol or sevoflurane anesthesia. Participants receive one of six treatment groups, combining one of the three vasopressors with either propofol or sevoflurane anesthesia. When a patient’s mean arterial blood pressure drops by 20% after anesthesia induction and intubation, they are given a dose of the assigned vasopressor to study its effect on blood pressure and cerebral oxygenation. Doses are tailored by weight and administered intravenously with close monitoring. During the study, patients’ brain oxygen levels and various heart and blood pressure measures are continuously recorded using specialized monitoring devices. Measurements are taken at key times, such as after entering the operating room, during blood pressure drops, and after vasopressor administration. The study tracks changes in heart rate, stroke volume, cardiac output, and vascular resistance to better understand each drug's impact on circulation and brain oxygen supply.

Researchers are investigating the management of hypertension, a common and serious cardiovascular disease that can lead to stroke, heart attack, and heart failure. This study focuses on the use of 24-hour ambulatory blood pressure monitoring (ABPM) as recommended by European guidelines to improve hypertension diagnosis and treatment. The research aims to gather nationwide data on hypertensive patients in China to assess differences in cardiovascular outcomes based on ABPM control. Participants in this observational study have hypertension and use antihypertensive medications. They undergo 24-hour ABPM with validated devices, and their clinical information, including disease history and recent blood biochemical tests, is collected. The study promotes the clinical use of ambulatory monitoring to better detect various hypertension types and evaluate treatment effects over time. Throughout the study, researchers record major cardiovascular and cerebrovascular events for up to three years from enrollment. They also track clinic and ambulatory blood pressure control rates, as well as the occurrence of white-coat and masked hypertension. Participants provide consent and data while continuing their usual care. The study aims to improve hypertension management and reduce related health risks in the population.

Researchers are evaluating the effects of a 12-week coached Starting Strength barbell training program on blood pressure and other cardiovascular and metabolic health markers. This study focuses on adults aged 18 to 100 years who are sedentary or minimally active and aims to understand how strength training may influence systolic and diastolic blood pressure, cholesterol levels, and fasting glucose. Participants will engage in a progressive barbell strength training program conducted by certified Starting Strength coaches. The program involves core barbell movements such as squats, deadlifts, bench presses, overhead presses, and power cleans, performed three times per week for about 60 minutes per session over 12 weeks. Training sessions will be held at a designated gym. During the study, participants will undergo blood pressure measurements and laboratory tests before and after the 12-week training, including assessments of cholesterol fractions and fasting glucose. Researchers will monitor changes from baseline to 16 weeks to evaluate the program's effects. Participants will be asked to commit to regular training sessions and provide laboratory test results from the same company before and after the intervention.

Researchers are evaluating the safety and efficacy of centhaquine citrate (LYFAQUIN173), a new drug for treating hypovolemic shock, a serious condition caused by severe blood or fluid loss. This phase IV, prospective, multi-center, open-label study builds on previous findings that centhaquine can improve blood pressure, reduce blood lactate levels, increase cardiac output, and reduce death rates by acting on specific adrenergic receptors to improve blood flow. Participants with hypovolemic shock aged 18 years or older and a systolic blood pressure of 90 mmHg or lower at hospital admission will receive centhaquine in addition to standard shock care. Centhaquine is given intravenously at a dose of 0.01 mg/kg body weight over one hour in saline. A second dose may be given if blood pressure remains low, with a maximum of three doses in 24 hours, and treatment can continue for up to two days after enrollment. During hospitalization, participants will be closely monitored and followed until discharge or seven days after enrollment. Researchers will measure safety by tracking adverse events and serious adverse events up to seven days. They will also assess blood pressure, blood lactate, base deficit, time in intensive care, ventilator use, urine output, mortality rates, and organ function scores. Statistical analyses will compare patient outcomes to evaluate centhaquine's effects.

Researchers are evaluating the accuracy and reliability of a cuffless photoplethysmography (PPG) chest-patch device for 24-hour blood pressure monitoring compared to the standard ambulatory blood pressure monitoring (ABPM) using an upper arm cuff. This study follows the 2023 European Society of Hypertension (ESH) guidelines and includes adults referred for 24-hour ABPM for clinical reasons, including both hypertensive and normotensive individuals. The primary focus is on the Awake/Asleep test recommended for wearable cuffless BP devices. Participants will wear both the investigational Biobeat PPG-based chest patch and the standard cuff-based ABPM device simultaneously for 24 hours. The single-use, wireless patch continuously measures blood pressure and other vital signs via PPG technology and is calibrated with three cuff measurements at the start. The study is a prospective, multicenter, single-arm validation comparing measurements during awake, asleep, and total 24-hour periods to assess agreement between devices. During the study, participants will be monitored for blood pressure readings, device comfort, and usability. Data comparisons will focus on accuracy defined by mean difference and standard deviation thresholds. Researchers will also assess performance across blood pressure ranges and demographic groups. Safety monitoring includes observation for mild skin irritation from the adhesive patch. Total participation involves wearing both devices for a 24-hour period, followed by data analysis.