AUCTORES
Globalize your Research
Research Article
*Corresponding Author: Garry F Merrill, Cell Biology and Neuroscience, Division of Life Sciences School of Arts and Sciences, Rutgers University, 604 Allison Road, Piscataway, NJ 08855
Citation: Ehmann PJ., Brush CJ, Bernard L., Dowden R., Ogilvie A., Wisniewski PJ, Piersol K., McCarthy T., and Merrill GF (2020) Influences on Blood Pressure in University Students, J.Clinical Medical Reviews and Reports. 3(1); DOI :10.31579/2690-8794/044
Copyright: © 2020, Garry F Merrill, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 14 September 2020 | Accepted: 20 October 2020 | Published: 03 February 2021
Keywords: young adults; blood pressure; time of day; male vs female
During Fall Semester, 2019, and Spring Semester, 2020, we had 287 students participate in a blood pressure measuring exercise. Subjects included both male (n=90) and female (n=197) students from multinational backgrounds and ethnicities. Pressures were measured traditionally and nontraditionally at 8:40 a.m., 1:40 p.m., and 6:40 p.m. Data were collected after the students had been instrumented and were lying quietly on a cot for 15-20 minutes (time for baseline data to reach steady state conditions). Both systolic and diastolic blood pressures were significantly greater in males than in females (P<0.05). Blood pressures were also significantly greater in the 6:40 p.m. group vs either 1:40 p.m. or 8:40 a.m. There was also a quadratic trend for blood pressures to be elevated in the morning group compared with the 1:40 p.m. group. Correlations between both systolic and diastolic blood pressures and BMI were also significant. BMI was a much stronger predictor of systolic (P<0.001) than of diastolic pressure (P<0.05). For every unit increase in BMI, systolic pressure increased 1.1 mmHg, and for each unit increase in BMI, diastolic pressure rose 0.4 mmHg. Results suggest that otherwise healthy young adult university students should be more aware of their blood pressure and the influences of obesity and overweight on it. They should try harder to achieve and maintain healthier lifestyles. This should include, but not be limited to, being more careful with their diets and being physically more active. Students should also avoid/limit unhealthy habits such as smoking, vaping, drinking (alcohol), and consuming caffeinated beverages.
Cardiovascular disease is still the leading cause of death and disability in industrialized nations, including the United States. Elevated blood pressure (hypertension) is a cardiovascular disease [1, 2]. In recent years the American College of Cardiology and the American Heart Association have redefined hypertension [1, 3-5]. Blood pressure categories in the new guidelines are: normal (normotensive): less than 120/80 mmHg; elevated: systolic pressure between 120-129 mmHg and diastolic pressure less than 80 mmHg; Stage 1hypertension: systolic pressure between 130-139 mmHg or diastolic pressure between 80-89 mmHg; Stage 2 hypertension: systolic pressure at least 140 mmHg or diastolic at least 90 mmHg; hypertensive crisis: systolic pressure over 180 mmHg and/or diastolic pressure over 120 mmHg [6]. Consistent with these definitions, patients need prompt changes in medications if there are no other indications of problems, or immediate hospitalization if there are signs of hypertension-mediated organ damage.
Few professionals and agencies seem to be concerned with the cardiovascular health of young adults, including college students. This lack of concern is unwarranted considering the numbers in this demographic population who choose to live unhealthy lifestyles such as poorly-timed consumption of foods and drinks (e.g. eating after midnight), over-eating, under-exercising, vaping, smoking, and excessive consumption of alcohol and caffeinated beverages such as coffee and energy drinks.
In Systems Physiology Laboratory (01:146:357, Rutgers University, New Brunswick, NJ, USA) we teach students experimental physiology, experimental design, and scientific writing (among other things). For example, we engage students in experiments that will help them learn about the cardiovascular system and how to care for it. We teach them about blood flow, blood pressure, and resistance to blood flow, heart rate and electrocardiography. Our course enrolls about twice as many female as male students (e.g. influence of ‘women in STEM’ emphasis at this institution). Many of them are planning to attend medical school or other health-related, post-baccalaureate graduate programs. Our course helps prepare them for medical and/or graduate physiology.
Subjects---Experimental subjects were students enrolled in Systems Physiology Laboratory at Rutgers University, New Brunswick/Piscataway, New Jersey. Students took our course either Fall, 2019, or Spring, 2020 (dates of data collection), and were all juniors or seniors from multicultural backgrounds (see Table 1) and a wide range of undergraduate majors (e.g. premed tracts, Biological Sciences, Kinesiology and Health, Marine Biology, Nutritional Sciences, etc.). They arrived at The Dr. Norman and Syril Reitman Systems Physiology Teaching Laboratory, Rutgers University, at either 8:40 a.m. or 1:40 p.m. or 6:40 p.m. Blood pressure data were collected about 45-60 minutes later when monitored cardiovascular variables were in the steady state.
Even though the course enrolls approximately 60 per cent young women, and 40 per cent young men, we made no further attempt to divide students according to ethnicities (e.g. Asian, Black, Caucasion, Hispanic, Indian, Latino, etc.). Nor were we able to collect data on lifestyles/habits that might have influenced outcomes. These are topics for follow-up investigation in this demographic group of experimental subjects.
Monitored cardiovascular variables included: heart rate (beats per minute, bpm), systolic blood pressure (BPsys), diastolic blood pressure (BPdia), mean arterial blood pressure (BPm), and finger plethysmography (microliters per cycle). A simple standard limb lead electrocardiogram (ECG, LLI) was also monitored. To help obtain these data a cardiomicrophone (model MLT201, AD Instruments, Colorado Springs, CO) was secured over the right brachial artery in the antecubital fossa using Tegaderm film (1624W, 3M Healthcare, St. Paul, MN). A pulse plethysmograph (model TN1012ST, AD Instruments, Colorado Springs) was attached to the index or middle finger. Signals from these physiological transducers were used to help identify systolic and diastolic blood pressures which were measured using a pressure cuff placed on the upper arm (model MLT0699 AD Instruments, Colorado Springs), and an electronic stethoscope (model ANR2, Think labs, Centennial, CO). All data were collected continuously using a data acquisition system (Power Lab, model 26T, 4-channel A-D converter running Lab Chart software, v. 8.1.16, December, 2019, AD Instruments, Colorado Springs) connected to a desktop computer (HP Compaq 8200 Elite, running Windows 10).
After students were instrumented they were instructed to lie as quietly and motionless as possible on a cot facing away from the computer and other equipment. When the above cardiovascular variables were in the steady state, the pressure cuff was inflated to about 200 mmHg for about 30 seconds before deflation. A second student research assistant placed the bell of the electronic stethoscope over the antecubital fossa and recorded both systolic and diastolic blood pressures. From these data a mean arterial blood pressure was calculated.
The experiment and statistical tests were designed a priori. Analysis of Variance (ANOVA) was used to detect initial variability among groups (e.g. male vs female and time of day). Tukey’s w-procedure was used to identify statistically significant differences among means. All data are expressed as means and one standard error of the mean (s.e.m.). Statistically significant differences were identified at the gold standard P<0.05 even though there were exceptions (e.g. P<0.001).
There were significant influences of gender, body mass, and time of day on both systemic mean arterial pressure and systolic and diastolic blood pressures (see Tables and Figures below). For example, regardless of time of day and body mass, blood pressures in males were significantly elevated relative to females. Also, pressures tended to be higher in the evening hours than in either the early afternoon or morning hours.
Relative to the more recent definitions of elevated blood pressure by the American College of Cardiology and the American Heart Association, the majority (66 per cent) of the 90 males in this study had some degree of hypertension. Hypertension was not as evident in the young women; in which case about 46 per cent of the 197 students showed evidence of hypertension. Still, of this group of 287 young adults, 150 or greater than fifty per cent showed signs of hypertension (Table 2, Figure 1).
On the average systolic pressure was about 5-6 mmHg greater and diastolic pressure about 3.5 mmHg greater in males than in females (P<0.05). Also, the statistical correlation between gender and blood pressure was significantly greater for young men than for young women (Figs 1, 2). And, the correlation between systolic pressure and male gender was greater than that for diastolic pressure and male gender (see Table 3).
A distinct diurnal effect on blood pressure was also evident. This was statistically significant when comparing students in the 6:40 p.m. group with those in the 1:40 p.m. group (see Tables 4 and 5, Figs 3 and 4). As a rule, students in the evening sections had significantly higher blood pressures than those in the early afternoon sections (which also appeared to be reduced when compared with data in morning sections; although this comparison did not achieve statistical significance).
Blood pressure, whether mean arterial or systolic and diastolic, were also strongly dependent on body mass index in both genders (see Tables 6 and 7; also Figs 5-8). There was a positive statistical correlation between body mass index and blood pressure throughout the study (for both males and females). The statistical correlations revealed that young male students have higher blood pressure than young female students. The statistical slope relating blood pressure to body mass is significantly greater for males than females (Figs 5-8). Finally, the heavier the student, the higher the blood pressure. This was evident throughout the experiment, regardless of time of day or gender.
Gender and blood pressure---In the current experiment we found significant influences of gender, time of day, and body mass on both systemic mean arterial and systolic and diastolic blood pressures in university-age young adults. For example, regardless of time of day and body mass, blood pressures in males were significantly elevated relative to females. Similar observations have been made before [7-11] and mechanisms are still being worked out. For example, reductions in androgens are associated with reduced longevity, risk of fatal cardiovascular events, sarcopenia, osteoporosis, frailty, cognitive impairment, depression, sleep apnea, and atrial fibrillation [12]. As a result androgen supplements are commonplace today despite the fact that both males and females become hypertensive with their use [12].
The results for gender and blood pressure are summarized in Tables 1-3 and Figures 1 and 2. Despite the recent redefining of blood pressure by the American College of Cardiology and the American Heart Association, it is alarming that so many university students can be considered at or near hypertension (e.g. 66% of males in this study). We do not know the reasons for this. Clearly, however, most students live anxious (exams, papers), careless (late p.m./early a.m. hours; little and poor quality sleep) and even unfavorable lifestyles (poor diets, excess partying). Many student athletes do not fit the above characteristics, although participating in university sports is no guarantee of normotension or freedom from risk of cardiovascular disease [13, 14].
Timing and blood pressure---There was also a temporal (diurnal) component to the current results. Blood pressures tended to be higher in the evening hours than in either the early afternoon or morning hours. Statistical significance was only achieved, however, between the 6:40 and 1:40 p.m. sections. We also have no data to explain this observation, but educated speculation can do little harm. In the evening, data were collected between about 8-10 p.m. Thus, these students had already experienced a full-day’s activities, including eating evening meals between about 5-7 p.m. Having experienced a full-day’s activities was not the case when data were collected in either the 8:40 a.m. or 1:40 p.m. sections. It is not unreasonable to speculate that unhealthy hypercaloric evening meals, coupled with a subsequent, even if misguided, compensatory visit to the gym, and/or consumption of caffeine as a pre-workout ergogenic aid, individually and/or collectively contributed to the evening elevations in blood pressure. Of course more work is needed to support/reject such speculation.
Overweight and obesity and blood pressure---One of the most highly correlated variables with elevated blood pressure is body weight, usually expressed as body mass index (BMI) [15-21]. This was clearly the case in the current experiment. Whether male or female, enrolled in morning, afternoon or evening lab sections, overweight and/or obesity were significantly correlated with elevated diastolic, systolic and systemic mean arterial blood pressures.
Our students are sophisticated, bright juniors and seniors planning careers in medicine, the life sciences and research. They are aware of the connections between obesity, overweight, and blood pressure. Still, a fairly large fraction of them is overweight and hypertensive. This suggests that they lack the determination and discipline to achieve and sustain healthy lifestyles, including eating, exercising, and sleeping properly.
While COVID-19 paralyzed the world and created anxiety for everyone during the period February-April, 2020 (and beyond), overweight and obesity has been a worldwide pandemic (two plus generations) that currently afflicts 600 million adults and 40 million children under five years of age [20]. Its burden on international healthcare is mainly expressed by life-threatening co-morbidities including metabolic syndrome, type 2 diabetes and cardiovascular diseases including hypertension [21].
Related observations---In other students who took our course earlier we found a large group who responded atypically to a cold-pressor test [22]. In those students (exaggerated responders) both systolic and diastolic blood pressures rose 3-4 times more than they did in typical responders (about 72 per cent of the group exposed to the test). Related influences (gender, responses to stressors) have been reported by others in the four or five decades before our report [23-27]. Thus, there is additional evidence that overweight and obese young adults not only have elevated blood pressure, but might be at increased risk of other cardiovascular-related diseases as they age.
Finally, when it comes to healthy lifestyles and health-consciousness, university students, as a rule, are not the ‘gold standard’ the WHO, CDC, and like organizations should point to. Still, it goes without saying that such a declaration should exclude the hundreds and even thousands of dedicated, disciplined, student-athletes and others at colleges and universities who do Herculean jobs caring for their bodies and health. As two such examples consider the records of wrestlers Anthony Ashnault and Nick Suriano. Both are NCAA Division I, Big Ten Conference and National Champions, Rutgers University, 2019. We salute them and all like-minded university athletes!
In this course of nearly 350 students per year (175 in each of the two academic semesters), there are large populations who identify themselves as White, Black, Asian, Indian, Latino and Others. Regardless of race, gender, or time of day, there are many of these students who are borderline pre-hypertensive or hypertensive. Most are not even aware of their cardiovascular status until they participate in this experiment in Systems Physiology Laboratory. If asked, we advise them to see their physicians and to modify their lifestyles to include healthier diets and routine physical activity. We also instruct them in the irrefutable evidence linking obesity and excess body weight to hypertension. Still, more work and knowledge are needed on the cardiovascular health of college and university students.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
