Zwinderman, A. H.; Cleophas, T. A.; Cleophas, T. J.; van der Wall, E. E.
In normotensive subjects blood pressures follow a circadian rhythm. A circadian rhythm in hypertensive patients is less well established, and may be clinically important, particularly with rigorous treatments of daytime blood pressures. Polynomial analysis of ambulatory blood pressure monitoring
Nielsen, L H
Intra-arterial blood pressure measurement is often used in patients with unstable haemodynamics. The demand for accuracy in such measurements is high. Usually these demands are fulfilled, but situations can occur where the dynamic characteristics of the system are exceeded. In order to acknowledge this situation, one must be aware of these dynamic characteristics. The significance of the system's resonance frequency and damping is described. A method to control the usability of the system is described.
Kiers, H.D.; Hofstra, J.M.; Wetzels, J.F.M.
Mean arterial pressure (MAP) is often used as an index of overall blood pressure. In recent years, the use of automated oscillometric blood pressure measurement devices is increasing. These devices directly measure and display MAP; however, MAP is often calculated from systolic blood pressure (SBP)
Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob
Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological advances have led to improvements in measuring clinic blood pressure and allowed for measuring blood pressures outside the clinic. This review outlines various methods for evaluating blood pressure and the clinical utility of each type of measurement. Home blood pressures and 24 hour ambulatory blood pressures have improved our ability to evaluate risk for target organ damage and hypertension related morbidity and mortality. Measuring home blood pressures may lead to more active participation in health care by patients and has the potential to improve blood pressure control. Ambulatory blood pressure monitoring enables the measuring nighttime blood pressures and diurnal changes, which may be the most accurate predictors of risk associated with elevated blood pressure. Additionally, reducing nighttime blood pressure is feasible and may be an important component of effective antihypertensive therapy. Finally, estimating central aortic pressures and pulse wave velocity are two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624
Kékes, Ede; Kiss, István
Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability. They underline that in addition to reduction of blood pressure to target value, it is essential to influence blood pressure fluctuation and decrease blood pressure variability, because blood pressure fluctuation presents a major threat for the hypertensive subjects. Data from national studies are also presented. They welcome that measurement of blood pressure variability has been included in international guidelines.
Wang, Wei; Wang, Jing; Sun, Hongyang; Xu, Zuyang; Chai, Xinyu
The development of the integrated blood pressure system with bluetooth communication function is introduced. Experimental results show that the system can complete blood pressure measurement and data transmission wireless effectively, which can be used in m-Health in future.
Verberk, Willem J.; Kroon, Abraham A.; Kessels, Alfons G. H.; Lenders, Jacques W. M.; Thien, Theo; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.
Objective To determine how many self-measurements of blood pressure (BP) should be taken at home in order to obtain a reliable estimate of a patient's BP. Design Participants performed self blood pressure measurement (SBPM) for 7 days (triplicate morning and evening readings). In all of them, office
Obesity in adults has been related to hypertension and abnormal nocturnal dipping of blood pressure, which are associated with poor cardiovascular and renal outcomes. Here, we aimed to resolve the relationship between the degree of obesity, the severity of hypertension and dipping status on ambulatory blood pressure in obese children. A total 72 patients with primary obesity aged 7 to 18 years (mean: 13.48 ± 3.25) were selected. Patients were divided into three groups based on body mass index (BMİ) Z-score. Diagnosis and staging of ambulatory hypertension based on 24-h blood pressure measurements, obtained from ambulatory blood pressure monitoring. Based on our ambulatory blood pressure data, 35 patients (48.6%) had hypertension, 7 (20%) had ambulatory prehypertension, 21 (60%) had hypertension, and 7 patients (20%) had severe ambulatory hypertension. There was a significant relationship between severity of hypertension and the degree of obesity (p lood pressure results and loads were similar between groups. Diastolic and mean arterial blood pressure levels during the night, diastolic blood pressure loads, and heart rate during the day were significantly higher in Group 3 (p lood pressure at night, mean arterial pressure at night, diastolic blood pressure loads and heart rate at day. Increase in BMI Z-score does not a significant impact on daytime blood pressure and nocturnal dipping status.
Treatment of High Blood Pressure (JNC-7),8 with the subjects sitting quietly and the right arm on a table at the level of the heart. An appropriately sized cuff, covering at least two-thirds of the upper arm with the lower border not less than 2.5 cm from the cubital fossa, was applied after restricting clothing had been removed.
Rosholm, Jens-Ulrik; Pedersen, Sidsel Arnspang; Matzen, Lars
Auscultatory measurement using a sphygmomanometer has been the predominant method for clinical estimation of blood pressure, but it is now rapidly being replaced by oscillometric measurement.......Auscultatory measurement using a sphygmomanometer has been the predominant method for clinical estimation of blood pressure, but it is now rapidly being replaced by oscillometric measurement....
Sabater-Hernández, Daniel; Azpilicueta, Inés; Sánchez-Villegas, Pablo; Amariles, Pedro; Baena, María I; Faus, María J
To investigate whether the measurement of blood pressure in the community pharmacy is a valuable method to diagnose hypertension, to assess the need and the effectiveness of anti-hypertensive treatments, or, in general, to make clinical decisions. Information has been extracted from articles published in English and in Spanish, from January 1989 to December 2009, in indexed magazines in MEDLINE and EMBASE. To perform the search, multiple and specified terms related to the community pharmacy setting, to blood pressure measurement and to the comparison and agreement between blood pressure measurement methods were used. Selected articles were those that: (1) compared and/or measured the agreement (concordance) between community pharmacy blood pressure measurements obtained in repeated occasions, or (2) compared and/or measured the agreement between the community pharmacy blood pressure measurement method and other measurement methods used in clinical practice for decision-making purposes: blood pressure measurement by a physician, by a nurse and home or ambulatory blood pressure monitoring. Articles were included and analyzed by two investigators independently, who essentially extracted the main results of the manuscripts, emphasizing the assessment of the blood pressure measurement methods used and the completed statistical analysis. Only three studies comparing the community pharmacy blood pressure measurement method with other methods and one comparing repeated measurements of community pharmacy blood pressure were found. Moreover, these works present significant biases and limitations, both in terms of method and statistical analysis, which make difficult to draw consistent conclusions. Further research of high quality is needed, which results can guide the clinical decision-making based on the community pharmacy blood pressure measurement method.
Abdul Sukor, J; Redmond, S J; Lovell, N H; Chan, G S H
Accurate systolic and diastolic pressure estimation, using automated blood pressure measurement, is difficult to achieve when the transduced signals are contaminated with noise or interference, such as movement artifact. This study presents an algorithm for automated signal quality assessment in blood pressure measurement by determining the feasibility of accurately detecting systolic and diastolic pressures when corrupted with various levels of movement artifact. The performance of the proposed algorithm is compared to a manually annotated reference scoring (RS). Based on visual representations and audible playback of Korotkoff sounds, the creation of the RS involved two experts identifying sections of the recorded sounds and annotating sections of noise contamination. The experts determined the systolic and diastolic pressure in 100 recorded Korotkoff sound recordings, using a simultaneous electrocardiograph as a reference signal. The recorded Korotkoff sounds were acquired from 25 healthy subjects (16 men and 9 women) with a total of four measurements per subject. Two of these measurements contained purposely induced noise artifact caused by subject movement. Morphological changes in the cuff pressure signal and the width of the Korotkoff pulse were extracted features which were believed to be correlated with the noise presence in the recorded Korotkoff sounds. Verification of reliable Korotkoff pulses was also performed using extracted features from the oscillometric waveform as recorded from the inflatable cuff. The time between an identified noise section and a verified Korotkoff pulse was the key feature used to determine the validity of possible systolic and diastolic pressures in noise contaminated Korotkoff sounds. The performance of the algorithm was assessed based on the ability to: verify if a signal was contaminated with any noise; the accuracy, sensitivity and specificity of this noise classification, and the systolic and diastolic pressure
Wel, M.C. van der; Buunk, I.E.; Weel, C. van; Thien, Th.; Bakx, J.C.
PURPOSE: Current office blood pressure measurement (OBPM) is often not executed according to guidelines and cannot prevent the white-coat effect. Serial, automated, oscillometric OBPM has the potential to overcome both these problems. We therefore developed a 30-minute OBPM method that we compared
Hoffmann-Petersen, N; Lauritzen, T; Bech, J N
OBJECTIVE: Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. DESIGN AND METHOD...... of the measurements and subsequent communication by telephone or E-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. RESULTS: In both groups, daytime ABPM decreased significantly....../181), p = 0.34. Blood pressure reduction in the TBPM group varied with the different practices. CONCLUSIONS: No further reduction in ABPM or number of patients reaching blood pressure targets was observed when electronic transmission of TBPM was applied in the treatment of hypertension by GPs. Thus...
Risk factors for development of cardiovascular disease develop early in life and track into adulthood. This study investigated the relationship between blood pressure (BP) and measures of body composition in adolescents. The study participants were 307 adolescents. Blood pressure (BP) and anthropometric parameters: ...
Plichart, Matthieu; Seux, Marie-Laure; Caillard, Laure; Chaussade, Edouard; Vidal, Jean-Sébastien; Boully, Clémence; Hanon, Olivier
Home blood pressure measurement (HBPM) is recommended by guidelines for hypertension management. However, this method might be difficult to use in elderly individuals with cognitive disorders. Our aim was to assess the agreement and the feasibility of HBPM by a relative as compared with 24-h ambulatory blood pressure monitoring (ABPM) in elderly patients with dementia. Sixty outpatients with dementia aged 75 years and older with office hypertension (≥140/90 mmHg) were subjected successively to HBPM by a trained relative and 24-h ABPM. The order of the two methods was randomized. Current guidelines' thresholds for the diagnosis of hypertension were used. The mean (SD) age of the patients was 80.8 (6.1) years (55% women) and the mean (SD) mini-mental state examination score was 20.1 (6.9). The feasibility of relative-HBPM was very high, with a 97% success rate (defined by ≥12/18 measurements reported). The blood pressure measurements were highly correlated between the two methods (r=0.75 and 0.64 for systolic blood pressure and diastolic blood pressure, respectively; Pmethods for the diagnosis of sustained hypertension and white-coat hypertension was excellent (overall agreement, 92%; κ coefficient, 0.81; 95% CI, 0.61-0.93). Similar results were found for daytime-ABPM. In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM.
Full Text Available Abstract Background Automatic measurement of arterial blood pressure is important, but the available commercial automatic blood pressure meters, mostly based on oscillometry, are of low accuracy. Methods In this study, we present a cuff-based technique for automatic measurement of systolic blood pressure, based on photoplethysmographic signals measured simultaneously in fingers of both hands. After inflating the pressure cuff to a level above systolic blood pressure in a relatively slow rate, it is slowly deflated. The cuff pressure for which the photoplethysmographic signal reappeared during the deflation of the pressure-cuff was taken as the systolic blood pressure. The algorithm for the detection of the photoplethysmographic signal involves: (1 determination of the time-segments in which the photoplethysmographic signal distal to the cuff is expected to appear, utilizing the photoplethysmographic signal in the free hand, and (2 discrimination between random fluctuations and photoplethysmographic pattern. The detected pulses in the time-segments were identified as photoplethysmographic pulses if they met two criteria, based on the pulse waveform and on the correlation between the signal in each segment and the signal in the two neighboring segments. Results Comparison of the photoplethysmographic-based automatic technique to sphygmomanometry, the reference standard, shows that the standard deviation of their differences was 3.7 mmHg. For subjects with systolic blood pressure above 130 mmHg the standard deviation was even lower, 2.9 mmHg. These values are much lower than the 8 mmHg value imposed by AAMI standard for automatic blood pressure meters. Conclusion The photoplethysmographic-based technique for automatic measurement of systolic blood pressure, and the algorithm which was presented in this study, seems to be accurate.
Nitzan, Meir; Patron, Amikam; Glik, Zehava; Weiss, Abraham T
Automatic measurement of arterial blood pressure is important, but the available commercial automatic blood pressure meters, mostly based on oscillometry, are of low accuracy. In this study, we present a cuff-based technique for automatic measurement of systolic blood pressure, based on photoplethysmographic signals measured simultaneously in fingers of both hands. After inflating the pressure cuff to a level above systolic blood pressure in a relatively slow rate, it is slowly deflated. The cuff pressure for which the photoplethysmographic signal reappeared during the deflation of the pressure-cuff was taken as the systolic blood pressure. The algorithm for the detection of the photoplethysmographic signal involves: (1) determination of the time-segments in which the photoplethysmographic signal distal to the cuff is expected to appear, utilizing the photoplethysmographic signal in the free hand, and (2) discrimination between random fluctuations and photoplethysmographic pattern. The detected pulses in the time-segments were identified as photoplethysmographic pulses if they met two criteria, based on the pulse waveform and on the correlation between the signal in each segment and the signal in the two neighboring segments. Comparison of the photoplethysmographic-based automatic technique to sphygmomanometry, the reference standard, shows that the standard deviation of their differences was 3.7 mmHg. For subjects with systolic blood pressure above 130 mmHg the standard deviation was even lower, 2.9 mmHg. These values are much lower than the 8 mmHg value imposed by AAMI standard for automatic blood pressure meters. The photoplethysmographic-based technique for automatic measurement of systolic blood pressure, and the algorithm which was presented in this study, seems to be accurate.
Laugesen, Esben; Knudsen, Søren Tang; Hansen, Klavs Würgler
Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively m...
Background. Blood pressure (BP) is often measured on the ankle in the emergency department (ED), but this has never been shown to be an acceptable alternative to measurements performed on the arm. Objective. To establish whether the differences between arm and ankle non-invasive BP measurements were clinically ...
Wagner, Stefan; Kamper, Christina H.; Toftegaard, Thomas Skjødeberg
Background: Pregnant diabetic patients are often required to self- measure their blood pressure in the waiting room before consulta- tion. Currently used blood pressure devices do not guarantee valid measurements when used unsupervised. This could lead to misdi- agnosis and treatment error. The aim...... of this study was to investigate current use of blood pressure self-measurement in the waiting room in order to identify challenges that could influence the resulting data quality. Also, we wanted to investigate the potential for addressing these challenges with e-health and telemedicine technology. Subjects...... and Methods: We observed 81 pregnant diabetics’ ability to correctly self-measure in the waiting room during a 4-week observational descriptive study. Specifically, we investigated the level of patient adherence to six recommendations with which patients are in- structed to comply in order to obtain...
Liu, Xianxuan; Yuan, Xueguang; Zhang, Yangan
Optical fiber sensing has many advantages, such as volume small, light quality, low loss, strong in anti-jamming. Since the invention of the optical fiber sensing technology in 1977, optical fiber sensing technology has been applied in the military, national defense, aerospace, industrial, medical and other fields in recent years, and made a great contribution to parameter measurement in the environment under the limited condition .With the rapid development of computer, network system, the intelligent optical fiber sensing technology, the sensor technology, the combination of computer and communication technology , the detection, diagnosis and analysis can be automatically and efficiently completed. In this work, we proposed a noninvasive blood pressure detection and analysis scheme which uses optical fiber sensor. Optical fiber sensing system mainly includes the light source, optical fiber, optical detector, optical modulator, the signal processing module and so on. wavelength optical signals were led into the optical fiber sensor and the signals reflected by the human body surface were detected. By comparing actual testing data with the data got by traditional way to measure the blood pressure we can establish models for predicting the blood pressure and achieve noninvasive blood pressure measurement by using spectrum analysis technology. Blood pressure measurement method based on optical fiber sensing system is faster and more convenient than traditional way, and it can get accurate analysis results in a shorter period of time than before, so it can efficiently reduce the time cost and manpower cost.
A reasonable correlation exists between invasive and noninvasive methods of measuring systemic blood pressure. However, there are frequent individual differences between these methods and these variations have often caused the validity of the non-invasive measurement to be questioned. The hypothesis that certain ...
Myers, Martin G; Kaczorowski, Janusz; Dolovich, Lisa; Tu, Karen; Paterson, J Michael
The SPRINT (Systolic Blood Pressure Intervention Trial) reported that some older, higher risk patients might benefit from a target systolic blood pressure (BP) of <120 versus <140 mm Hg. However, it is not yet known how the BP target and measurement methods used in SPRINT relate to cardiovascular outcomes in real-world practice. SPRINT used the automated office BP technique, which requires the patient to be resting quietly and alone, with multiple readings being recorded automatically using an electronic oscillometric sphygmomanometer. We studied the relationship between achieved automated office BP at baseline and cardiovascular events in 6183 community-dwelling residents of Ontario aged ≥66 years who were receiving antihypertensive therapy and followed for a mean of 4.6 years. Adjusted hazard ratios (95% confidence intervals) were computed for 10 mm Hg increments in achieved automated office BP at baseline using Cox proportional hazards regression and the BP category with the lowest event rate as the reference category. Based on 904 fatal and nonfatal cardiovascular events, the nadir of cardiovascular events was at the systolic pressure category of 110 to 119 mm Hg, which was lower than the next highest category of 120 to 129 mm Hg (hazard ratio 1.30 [1.01, 1.66]). The hazard ratio for diastolic pressure was relatively unchanged above 60 mm Hg. Pulse pressure exhibited an increase in hazard ratio (1.33 [1.02, 1.72]) at ≥80 mm Hg. These results using automated office BP measurement in a usual treatment setting extend the finding in SPRINT of an optimum target systolic BP of <120 mm Hg to routine clinical practice. © 2016 American Heart Association, Inc.
Braga, Valdir A; Prabhakar, Nanduri R
Although considered the ‘gold standard’ for measuring blood pressure in laboratory animals, telemetry would benefit from refinement. In the present study, we tested the hypothesis that the small telemetric device used for blood pressure recording in mice would work for rats as well and would serve as an alternative for those studies where abdominal cavity space is quite limited (such as in young animals and pregnant females). Here we report that the use of a smaller and lighter telemetric device implanted in the abdominal aorta of rats led to acquisition of stable and high-quality blood pressure and heart rate data, similar to those obtained by using a larger telemetric device developed for rats. The use of smaller transmitters represents an alternative telemetry technique, especially for those cases in which space in the abdominal cavity is particularly limited such as during pregnancy. PMID:19476715
Burke, M J
This article reports the development of an electronic manometer for use in the measurement of blood pressure. It is intended to act as a replacement gauge for the mercury and aneroid manometers used in conventional sphygmomanometers. It measures pressure in the range 0-300 mm Hg (0-40 kPa) with a resolution of 1 mm Hg (0.13 kPa) and an accuracy of +/- 1 mm Hg (+/- 0.13 kPa) which is displayed on a liquid crystal display. It operates from a 9 V PP3 battery over a temperature range of 10-50 degrees C.
David, V G; Yadav, B; Jeyaseelan, L; Deborah, M N; Jacob, S; Alexander, S; Varughese, S; John, G T
Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living-related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2(nd), 4(th), 6(th), and 9(th) months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6-8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control.
V G David
Full Text Available Blood pressure (BP control at home is difficult when managed only with office blood pressure monitoring (OBPM. In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM was compared with ambulatory blood pressure monitoring (ABPM as the gold standard. Adult patients who had living-related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2 nd , 4 th , 6 th , and 9 th months and all the three methods : OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%. Systolic BP (SBP and diastolic BP (DBP measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6-8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa : 0.88 vs. 89% specificity, Kappa : 0.71. HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa : 0.71 vs. 50% specificity Kappa : 0.54. In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control.
Hogan, Jennifer L
OBJECTIVE: The accurate measurement of blood pressure requires the use of a large cuff in subjects with a high mid-arm circumference (MAC). This prospective study examined the need for a large cuff during pregnancy and its correlation with maternal obesity. METHODS: Maternal body mass index (BMI), fat mass, and MAC were measured. RESULTS: Of 179 women studied, 15.6% were obese. With a BMI of level 1 obesity, 44% needed a large cuff and with a BMI of level 2 obesity 100% needed a large cuff. CONCLUSION: All women booking for antenatal care should have their MAC measured to avoid the overdiagnosis of pregnancy hypertension.
Hoffmann-Petersen, N; Lauritzen, T; Bech, J N
of the measurements and subsequent communication by telephone or E-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. RESULTS: In both groups, daytime ABPM decreased significantly....... The decrease in daytime ABPM in the intervention group was systolic/diastolic, -8 ± 12/-4 ± 7 mmHg. This did not differ significantly from the control group's -8 ± 13/-4 ± 8 mmHg. An equal number of participants obtained normal daytime ABPM, in the intervention group 17% (31/175) versus control 21% (37....../181), p = 0.34. Blood pressure reduction in the TBPM group varied with the different practices. CONCLUSIONS: No further reduction in ABPM or number of patients reaching blood pressure targets was observed when electronic transmission of TBPM was applied in the treatment of hypertension by GPs. Thus...
Phlebographic visualisation offers the highest spatial resolution of all imaging methods both in respect of veins of the leg and pelvis and of the abdomen. Phlebography offers optimal conditions for assessing morphological changes at the veins and in their direct neighbourhood. No quantitative information is available via phlebography if haemodynamics are disturbed; qualitative information is yielded merely to a restricted extent (by assessing flow velocity and collaterals). Direct sanguinous measurement of venous blood pressure is particularly suitable for the quantitative and qualitative assessment of disturbed haemodynamic conditions; in this respect it stands out among the function tests based on the employment of apparatures. If it is combined with phlebography, it is possible not only to optimise the diagnostic yield in the hands of one investigator, but also to reduce the invasiveness of both methods to one single puncture, since the puncture needle is at the same time also an instrument to measure the pressure. The article points out the possibilities and limitations of combining a) ascending phlebography of the leg and pelvis with peripheral venous pressure measurement (phlebodynamometry) and b) visualisation of the veins of the pelvis and vena cava inferior with central sanguinous venous pressure measurement (CP). Indicatious and technical execution are described. (orig.) [de
van der Hoeven, N.V.
High blood pressure is one of the leading risk factors for cardiovascular disease, but difficult to reliably assess because there are many factors which can influence blood pressure including stress, exercise or illness. The first part of this thesis focuses on possible ways to improve the
Blood pressure monitoring is an essential component of neonatal intensive care. We compared invasive and noninvasive (Dinamap, Marquette, and Dash) recordings in newborns and also noninvasive values obtained from upper and lower limbs. Infants\\' blood pressure was recorded every 6 hours for 72 hours using three noninvasive devices and compared with invasive readings taken simultaneously. Twenty-five babies were enrolled in the study, with birth weights of 560 to 4500 g and gestation 24 + 1 to 40 + 5 weeks. Three hundred thirty-two recordings were obtained. Comparison between invasive and noninvasive readings revealed that all three noninvasive monitors overread mean blood pressure. There was no significant difference between the cuff recordings obtained from the upper or lower limbs. All three noninvasive devices overestimated mean blood pressure values compared with invasive monitoring. Clinicians may be falsely reassured by noninvasive monitoring. Mean blood pressure values obtained from the upper and lower limb are similar.
Full Text Available Jean-Philippe Baguet1,21Department of Cardiology, University Hospital, 2Bioclinic Radiopharmaceutics Laboratory, INSERM U1039, Joseph Fourier University, Grenoble, FranceAbstract: Hypertension is an important risk factor for the development of cardiovascular disease, and is a major cause of morbidity and mortality worldwide. Traditionally, hypertension diagnosis and treatment and clinical evaluations of antihypertensive efficacy have been based on office blood pressure (BP measurements; however, there is increasing evidence that office measures may provide inadequate or misleading estimates of a patient’s true BP status and level of cardiovascular risk. The introduction, and endorsement by treatment guidelines, of 24-hour ambulatory BP monitoring and self (or home BP monitoring has facilitated more reliable and reproducible estimations of true BP, including the identification of white-coat and masked hypertension, and evaluation of BP variability. In addition, ambulatory BP monitoring enables accurate assessment of treatment effectiveness over 24 hours and both ambulatory and self BP monitoring may lead to better tailoring of therapy according to BP profile and concomitant disease. This review describes the clinical benefits and limitations of out-of-office assessments and their applications for effective management of hypertension and attainment of BP control.Keywords: ambulatory, ABPM, SBPM, blood pressure measurement, hypertension
Nielsen, S L; Lassen, N A
A double-inlet plastic cuff was designed for local cooling and systolic blood pressure measurement on the middle phalanx of the fingers. With a tourniquet on the proximal phalanx of one finger, cooling for 5 min made the digital artery temperature equal the skin temperature. The difference between...... the systolic pressure in a control finger and in the cooled finger give the reopening pressure in the digital arteries. At 30, 25, 20, 15, and 10 degrees C, respectively the percent decrease of the finger pressure was 0.2 (0.2), 1.5 (2.5), 8.5 (3.7), 11.4 (3.4), and 15.3 (3.1) in normal young women....... In patients with primary or secondary Raynaud's phenomenon, the arterial tone showed an abrupt increase that most often led to complete closure of the digital arteries. The pathological response was expressed as an increased threshold temperature or a well-defined closing temperature that showed only small...
Nielsen, S L; Lassen, N A
the systolic pressure in a control finger and in the cooled finger give the reopening pressure in the digital arteries. At 30, 25, 20, 15, and 10 degrees C, respectively the percent decrease of the finger pressure was 0.2 (0.2), 1.5 (2.5), 8.5 (3.7), 11.4 (3.4), and 15.3 (3.1) in normal young women......A double-inlet plastic cuff was designed for local cooling and systolic blood pressure measurement on the middle phalanx of the fingers. With a tourniquet on the proximal phalanx of one finger, cooling for 5 min made the digital artery temperature equal the skin temperature. The difference between....... In patients with primary or secondary Raynaud's phenomenon, the arterial tone showed an abrupt increase that most often led to complete closure of the digital arteries. The pathological response was expressed as an increased threshold temperature or a well-defined closing temperature that showed only small...
Lassen, N A; Krähenbühl, B; Hirai, M
A miniaturized blood pressure cuff made of plastic material and applicable to fingers and toes is described. The cuff was compared to rubber cuffs and to bladder-free cuffs. It was found to be more reliable than the former type and much easier to use than the latter type. It is recommended for us...... in conjunction with a mercury-in-Silastic strain gauge for routine measurement of digital blood pressure and blood flow in patients with arterial disease.......A miniaturized blood pressure cuff made of plastic material and applicable to fingers and toes is described. The cuff was compared to rubber cuffs and to bladder-free cuffs. It was found to be more reliable than the former type and much easier to use than the latter type. It is recommended for use...
Sandager, Puk; Lindahl, Camilla; Schlütter, Jacob Mørup
The importance of accurate measurement of blood pressure in the screening and management of hypertension during pregnancy is well established. Blood pressure levels can be measured manually by healthcare staff or by using a blood pressure self-measurement device, either at home or in the clinic. ...... the blood pressure self-measurement process. Preliminary results indicate that such active and context-aware guidance leads to more reliable measurements by inhibiting non-adherent patient behavior......The importance of accurate measurement of blood pressure in the screening and management of hypertension during pregnancy is well established. Blood pressure levels can be measured manually by healthcare staff or by using a blood pressure self-measurement device, either at home or in the clinic...
Imholz, B. P.; Settels, J. J.; van der Meiracker, A. H.; Wesseling, K. H.; Wieling, W.
The aim of the study was to evaluate whether invasive blood pressure responses to orthostatic stress can be replaced by non-invasive continuous finger blood pressure responses. DESIGN - Intrabrachial and Finapres blood pressures were simultaneously measured during passive head up tilt and during
There are few reports on the relationship of blood pressure with cognitive function in maintenance dialysis patients. The Cognition and Dialysis Study is an ongoing investigation of cognitive function and its risk factors in six Boston area hemodialysis units. In this analysis, we evaluated the rela...
Kapoor, Raj; Roy, V K; Manna, S; Bhattacharjee, M
Measurement of blood pressure is an integral part of clinical examination. Over the years various types of instruments have been used to measure blood pressure but till date the mercury sphygmomanometer is regarded as the gold standard. However, there is a myth prevalent among health professionals regarding the level of the manometer in relation to heart at the time of measuring of blood pressure. Many professionals insist that it has to be placed at the level of the heart. We argue that the limb from which pressure is measured must be at the heart level rather than the manometer. We conducted a study in which we measured the blood pressure in adults by placing the manometer at three different levels with respect to the heart. The values of blood pressure obtained at all levels were similar and did not show any statistically significant difference. We therefore conclude that the level of sphygmomanometer per se does not affect blood pressure measurement.
Coppieters, Yves; Parent, Florence; Berghmans, Luc; Godin, Isabelle; Leveque, Alain
Background: The use of sphygmomanometers may lead to problems in investigations on health of young people. The purpose of this paper is to present the validation of the blood pressure (BP) collected during the survey 'Youth Heart Health' in Hainaut by using second sample of young people in Hainaut for which BP was measured by a manual taking of tension and by an electronic device. Methods: Validation was done with a control sample of 343 young with five successive BP measures: twice with the mercury sphygmomanometer and three with DXL. We compared the manual and the electronic measures in order to study the correlation between the two methods. The control sample was used in order to compare the BP measurements with the results of the survey on the health of young people in Hainaut. Results: The differences between manual systolic BP and Dinamap measures are significant (differences in averages 3.6 mmHg; d.s. 7.8; 95% CI: 2.8-4.4 mmHg; p < 0.001) and the regression coefficient is -0.015. Diastolic BP is significantly higher with the manual method than with Dinamap (differences in means: 8.2 mmHg; d.s. 7.0; 95% CI: 7.4-8.9 mmHg; p < 0.001) and the coefficient of regression is 0.096. We observe a difference in BP between the general survey and the control group (10.3 mmHg for systolic manual control and of 10.9 mmHg for systolic electronic control; 3.3 mmHg for diastolic manual control and of 11.5 mmHg for diastolic electronic control). Conclusions: The values of BP of the 'Youth Heart Health' are significantly higher. These observations indicate the difficulties in the choice of the tool for measurements of BP in epidemiological investigations in the teenagers. In order to decrease skews of observations in the measurement of BP, it is recommended to use a valid electronic instrument. Dinamap XL is an instrument of choice in such studies of young people. Environmental and organisational factors may also explain the observed difference, which means that survey
McGrath, Barry P
Home blood pressure monitoring is the self-measurement of blood pressure by patients. In the diagnosis and management of high blood pressure it is complementary to 24-hour ambulatory blood pressure monitoring and clinic blood pressure measurements. Home monitoring can also help to identify white-coat and masked hypertension.
Braun, H. J.; Rabouw, H.; Werner, H.; van Montfrans, G. A.; de Stigter, C.; Zwinderman, A. H.
To predict blood pressure outside the clinic from a short-term in-hospital registration for patients referred for ambulatory blood pressure monitoring (ABPM) with special attention to office hypertension. A series of measurements of blood pressure was performed by the same technician for 187
Zhou, Xia; Wu, Wenli; Bao, Shudi
IEEE Std 1708-2014 breaks through the traditional standards of cuff based blood pressure measuring devices and establishes a normative definition of wearable cuffless blood pressure measuring devices and the objective performance evaluation of this kind of devices. This study firstly introduces the background of the new standard. Then, the standard details will be described, and the impact of cuffless blood pressure measuring devices with the new standard on manufacturers and end users will be addressed.
Zheng, Dingchang; Amoore, John N; Mieke, Stephan; Murray, Alan
Cuff pressure deflation rate influences blood pressure (BP) measurement. However, there is little quantitative clinical evidence on its effect. Oscillometric pulses recorded from 75 subjects at the recommended deflation rate of 2-3 mmHg per second were analyzed. Some pulses were removed to realize six faster rates (2-7 times faster than the original). Systolic, diastolic, and mean arterial blood pressures (SBP, DBP, MAP) were determined from the original and six reconstructed oscillometric waveforms. Manual measurement was based on the appearance of oscillometric pulse peaks, and automatic measurement on two model envelopes (linear and polynomial) fitted to the sequence of oscillometric pulse amplitudes. The effects of deflation rate on BP determination and within-subject BP variability were analyzed. For SBP and DBP determined from the manual measurement, different deflation rates resulted in significant changes (both p deflation rate effect (all p > 0.3). Faster deflation increased the within-subject BP variability (all p deflation rate, and for the automatic model-based techniques, the deflation rate had little effect.
de Oliveira, Luciano Machado Ferreira Tenório; da Silva, Alison Oliveira; Diniz, Paula Rejane Beserra; Farah, Breno Quintella; Pirauá, André Luiz Torres; de Lima Neto, Antônio José; Feitosa, Wallacy Milton do Nascimento; Tassitano, Rafael Miranda; Ritti-Dias, Raphael M
The aim of this study was to analyze the influence of the number of visits and the number of blood pressure (BP) measurements on the prevalence of high blood pressure (HBP) in adolescents. A cross-sectional epidemiologic study with 481 adolescents (14-19 years old) selected using a random cluster sampling strategy. We measured the BP three times in a first visit. Adolescents with HBP performed subsequent visits. The final calculation of BP followed four strategies: the 1st measure, mean of 1st and 2nd measurements, mean of all three measurements, and averaging the 2nd and 3rd measurements. The prevalence of HBP in the first and second visits was 6.4% and 1.9%, and the prevalence of hypertension (after three visits) was 1.7%. The prevalence of HBP varied from 8.6%-18.6% for boys and 4.6%-9.2% for girls, using the average 2nd and 3rd measurements and the 1st measurement, respectively. In all strategies, HBP and hypertension were more prevalent in boys and students attending the nocturnal shift. The number of visits and number of measurements affect the prevalence of HBP and hypertension in adolescents. Thus, clinicians and researchers should consider these aspects when assessing BP in adolescents aged 14-19 years old. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Tomiyama, Hirofumi; Ohkuma, Toshiaki; Ninomiya, Toshiharu; Mastumoto, Chisa; Kario, Kazuomi; Hoshide, Satoshi; Kita, Yoshikuni; Inoguchi, Toyoshi; Maeda, Yasutaka; Kohara, Katsuhiko; Tabara, Yasuharu; Nakamura, Motoyuki; Ohkubo, Takayoshi; Watada, Hirotaka; Munakata, Masanori; Ohishi, Mitsuru; Ito, Norihisa; Nakamura, Michinari; Shoji, Tetsuo; Vlachopoulos, Charalambos; Yamashina, Akira
We conducted individual participant data meta-analysis to examine the validity of interarm blood pressure difference in simultaneous measurement as a marker to identify subjects with ankle-brachial pressure index blood pressure difference >5 mm Hg as being associated with a significant odds ratio for the presence of ankle-brachial pressure index blood pressure difference >15 mm Hg was associated with a significant Cox stratified adjusted hazard ratio for subsequent stroke (hazard ratio, 2.42; 95% confidence interval, 1.27-4.60; P blood pressure differences, measured simultaneously in both arms, may be associated with vascular damage in the systemic arterial tree. These differences may be useful for identifying subjects with an ankle-brachial pressure index of blood pressure in both arms at the first visit. © 2018 American Heart Association, Inc.
Seidlerová, Jitka; Gelžinský, Julius; Mateřánková, Markéta; Ceral, Jiří; König, Petr; Filipovský, Jan
Several papers reported that unattended automated office blood pressure (uAutoOBP) is closely related to daytime ambulatory blood pressure monitoring (ABPM). In the present study, we aim to study uAutoOBP and its relation to 24-hour ABPM and ABPM variability. Stable treated hypertensive subjects were examined in two Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP three times with auscultatory method (AuscOBP) by the physician. ABPM was performed within one week from the clinical visit. Data on 98 subjects aged 67.7 ± 9.3 years with 24-hour ABPM 120.3 ± 10.6/72.7 ± 7.9 mm Hg are reported. uAutoOBP was lower than 24-hour (by -5.2 ± 11.3/-0.5 ± 6.9 mm Hg) and daytime (by -6.7 ± 12.82.4 ± 8.0 mm Hg) ABPM and the individual variability of the difference was very large (up to 30 mm Hg). The correlation coefficients between ABPM and uAutoOBP were similar compared to AuscOBP (p ≥ .17). Variability of uAutoOBP, but not AuscOBP, readings during one clinical visit was related to short-term blood pressure variability of ABPM. The difference between AuscOBP and uAutoOBP was larger in patients with white-coat effect compared to other blood pressure control groups (25.1 ± 7.0 vs. 2.2 ± 10.3 mm Hg; p = .0036). Our study shows that uAutoOBP is not good predictor of ambulatory blood pressure monitoring, not even of the daytime values. It might, however, indicate short-term blood pressure variability and, when compared with AuscOBP, also detect patients with white-coat effect.
Acierno, Mark J; da Cunha, Anderson; Smith, Julie; Tully, Thomas N; Guzman, David Sanchez-Migallon; Serra, Verna; Mitchell, Mark A
To determine the level of agreement between direct and indirect blood pressure measurements obtained from healthy Hispaniolan Amazon parrots (Amazona ventralis) anesthetized with isoflurane. Validation study. 16 healthy adult Hispaniolan Amazon parrots. Parrots were anesthetized, and a 26-gauge, 19-mm catheter was placed percutaneously in the superficial ulnar artery for direct measurement of systolic, mean, and diastolic arterial pressures. Indirect blood pressure measurements were obtained with a Doppler ultrasonic flow detector and an oscillometric unit. The Bland-Altman method was used to compare direct and indirect blood pressure values. There was substantial disagreement between direct systolic arterial blood pressure and indirect blood pressure measurements obtained with the Doppler detector from the wing (bias, 24 mm Hg; limits of agreement, -37 to 85 mm Hg) and from the leg (bias, 14 mm Hg; limits of agreement, -14 to 42 mm Hg). Attempts to obtain indirect blood pressure measurements with the oscillometric unit were unsuccessful. Results suggested that there was substantial disagreement between indirect blood pressure measurements obtained with a Doppler ultrasonic flow detector in anesthetized Hispaniolan Amazon parrots and directly measured systolic arterial blood pressure.
Antonio Eduardo Monteiro de Almeida
Full Text Available Background: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM. Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressure monitoring (wakefulness ABPM as gold-standard and measurements taken before morning micturition (BM and in the afternoon (AM, for the best diagnosis of systemic arterial hypertension (SAH, and their association with prognostic markers. Methods: After undergoing 24-hour wakefulness ABPM, 158 participants (84 women were randomized for 3- or 5-day HBPM. Two variations of the 3-day protocol were considered: with measurements taken before morning micturition and in the afternoon (BM+AM; and with post-morning-micturition and evening measurements (PM+EM. All patients underwent echocardiography (for left ventricular hypertrophy - LVH and urinary albumin measurement (for microalbuminuria - MAU. Result: Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard 3-day HBPM, 3-day HBPM (BM+AM and (PM+EM, and 5-day HBPM were 0.660, 0.638, 0.348 and 0.387, respectively. The values of sensitivity of (BM+AM versus (PM+EM were 82.6% × 71%, respectively, and of specificity, 84.8% × 74%, respectively. The positive and negative predictive values were 69.1% × 40% and 92.2% × 91.2%, respectively. The comparisons of intraclass correlations for the diagnosis of LVH and MAU between (BM+AM and (PM+EM were 0.782 × 0.474 and 0.511 × 0.276, respectively. Conclusions: The 3 day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers.
Gholamhosseini, Hamid; Meintjes, Andries; Baig, Mirza; Linden, Maria
The increasing availability of low cost and easy to use personalized medical monitoring devices has opened the door for new and innovative methods of health monitoring to emerge. Cuff-less and continuous methods of measuring blood pressure are particularly attractive as blood pressure is one of the most important measurements of long term cardiovascular health. Current methods of noninvasive blood pressure measurement are based on inflation and deflation of a cuff with some effects on arteries where blood pressure is being measured. This inflation can also cause patient discomfort and alter the measurement results. In this work, a mobile application was developed to collate the PhotoPlethysmoGramm (PPG) waveform provided by a pulse oximeter and the electrocardiogram (ECG) for calculating the pulse transit time. This information is then indirectly related to the user's systolic blood pressure. The developed application successfully connects to the PPG and ECG monitoring devices using Bluetooth wireless connection and stores the data onto an online server. The pulse transit time is estimated in real time and the user's systolic blood pressure can be estimated after the system has been calibrated. The synchronization between the two devices was found to pose a challenge to this method of continuous blood pressure monitoring. However, the implemented continuous blood pressure monitoring system effectively serves as a proof of concept. This combined with the massive benefits that an accurate and robust continuous blood pressure monitoring system would provide indicates that it is certainly worthwhile to further develop this system.
Full Text Available We studied a wearable blood pressure sensor using a fiber Bragg grating (FBG sensor, which is a highly accurate strain sensor. This sensor is installed at the pulsation point of the human body to measure the pulse wave signal. A calibration curve is built that calculates the blood pressure by multivariate analysis using the pulse wave signal and a reference blood pressure measurement. However, if the measurement height of the FBG sensor is different from the reference measurement height, an error is included in the reference blood pressure. We verified the accuracy of the blood pressure calculation with respect to the measurement height difference and the posture of the subject. As the difference between the measurement height of the FBG sensor and the reference blood pressure measurement increased, the accuracy of the blood pressure calculation decreased. When the measurement height was identical and only posture was changed, good accuracy was achieved. In addition, when calibration curves were built using data measured in multiple postures, the blood pressure of each posture could be calculated from a single calibration curve. This will allow miniaturization of the necessary electronics of the sensor system, which is important for a wearable sensor.
... pressure monitors may have some limitations. Tracking your blood pressure readings It can be helpful in diagnosing or ... more Stage 2 high blood pressure (hypertension) Elevated blood pressure and stages 1 and 2 high blood pressure ( ...
de Morais, Polyana Resende Silva; Sousa, Ana Luiza Lima; Jardim, Thiago de Souza Veiga; Nascente, Flávia Miquetichuc Nogueira; Mendonça, Karla Lorena; Povoa, Thaís Inácio Rolim; Carneiro, Carolina de Souza; Ferreira, Vanessa Roriz; de Souza, Weimar Kunz Sebba Barroso; Jardim, Paulo César Brandão Veiga
Background Blood pressure is directly related to body mass index, and individuals with increased waist circumference have higher risk of developing hypertension, insulin resistance, and other metabolic changes, since adolescence. Objective to evaluate the correlation of blood pressure with insulin resistance, waist circumference and body mass index in adolescents. Methods Cross-section study on a representative sample of adolescent students. One group of adolescents with altered blood pressure detected by casual blood pressure and/or home blood pressure monitoring (blood pressure > 90th percentile) and one group of normotensive adolescents were studied. Body mass index, waist circumference were measured, and fasting glucose and plasma insulin levels were determined, using the HOMA-IR index to identify insulin resistance. Results A total of 162 adolescents (35 with normal blood pressure and 127 with altered blood pressure) were studied; 61% (n = 99) of them were boys and the mean age was 14.9 ± 1.62 years. Thirty-eight (23.5%) adolescents had altered HOMA-IR. The group with altered blood pressure had higher values of waist circumference, body mass index and HOMA-IR (pHOMA-IR than boys (pHOMA-IR in the group with altered blood pressure (ρ = 0.394; p HOMA-IR in both groups (ρ = 0.345; p HOMA-IR was as predictor of altered blood pressure (odds ratio - OR = 2.0; p = 0.001). Conclusion There was a significant association of insulin resistance with blood pressure and the impact of insulin resistance on blood pressure since childhood. The correlation and association between markers of cardiovascular diseases was more pronounced in adolescents with altered blood pressure, suggesting that primary prevention strategies for cardiovascular risk factors should be early implemented in childhood and adolescence. PMID:27007222
Full Text Available Introduction. Home blood pressure monitoring has several advantages over blood pressure monitoring at a physician's office, and has become a useful instrument in the management of hypertension. Objective. To explore the rate and characteristics of patients who measure their blood pressure at home. Methods. A sample of 2,752 patients with diagnosis of essential arterial hypertension was selected from 12596 consecutive office visitors. Data of 2,639 patients was appropriate for analysis. The data concerning home blood pressure measurement and patients' characteristics were obtained from the patients' case histories. Results 1,835 (69.5% out of 2,639 patients measured their blood pressure at home. 1,284 (70.0% of home blood pressure patients had their own blood pressure measurement device. There were some important differences between these two groups: home blood pressure patients were more frequently male, of younger age, better educated, from urban area, mostly non-smokers, more likely to have diabetes mellitus and ischemic heart disease and had higher number of co-morbidities and were on other drugs beside antihypertensive medication. Using the logistic regression analysis we found that the most powerful predictors of home blood pressure monitoring had higher education level than primary school OR=1.80 (95% CI 1.37-2.37, non-smoking OR=2.16 (95% CI 1.40-3.33 and having a physician in urban area OR=1.32 (95% CI 1.02-1.71. Conclusion. Home blood pressure monitoring is popular in Slovenia. Patients who measured blood pressure at home were different from patients who did not. Younger age, higher education, non-smoking, having a physician in urban area and longer duration of hypertension were predictors of home blood pressure monitoring.
Adiyaman, A.; Verhoeff, R.; Lenders, J.W.M.; Deinum, J.; Thien, Th.
OBJECTIVE: Determining the influence of the position of the arm on blood pressure measurement in the sitting position. METHODS: Blood pressure of 128 individuals (the majority being treated hypertensive patients) visiting the outpatient clinic was measured simultaneously on both arms with arms in
Arnold, Abigail; McNaughton, Amanda
This article describes an evidence-based literature review, comparing upper arm and forearm blood pressure measurements using non-invasive devices on obese patients. The focus on blood pressure monitoring was in response to regularly witnessing inappropriately applied blood pressure cuffs on obese patient's upper arms in practice. An inaccurately obtained blood pressure measurement can result in the misdiagnosis and treatment of hypertension. As the prevalence of obesity grows worldwide, healthcare settings need to ensure they have the necessary equipment and trained staff to accurately measure obese patients' blood pressure. The aim of this review was to identify whether a forearm measurement provided a suitable alternative to upper arm measurements. The article discusses the development and execution of a search strategy, as well as the critical appraisal of a selected article. The results of the review demonstrated that forearm blood pressure measurements in obese patients do not replace upper arm blood pressure measurements taken with an appropriate cuff. It is recommended that further research is undertaken in order to identify suitable alternatives for obtaining an accurate non-invasive blood pressure measurement in obese patients.
Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto
BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...
Hirai, M; Nielsen, S L; Lassen, N A
The aim of the present paper was to study the methodological problems involved in measuring systolic blood pressure in all five fingers by the strain gauge technique. In 24 normal subjects, blood pressure at the proximal phalanx of finger I and both at the proximal and the intermediate phalanx of...
Veerman, D. P.; van Montfrans, G. A.
Nurses are considered to evoke less white-coat hypertension, and might therefore be able to estimate average blood pressure as well as and more conveniently than ambulatory monitoring. The objective of the present study was to determine the correspondence between blood pressure measured by a doctor
Menezes, Ana M B; Dumith, Samuel C; Noal, Ricardo B; Nunes, Ana Paula; Mendonça, Fernanda I; Araújo, Cora L P; Duval, Marta A; Caruso, Paulo E; Hallal, Pedro C
Valid measurements of blood pressure, both at clinical and community settings, are essential for monitoring this variable at the population level. To evaluate the validity of a wrist digital monitor for measuring blood pressure among adolescents in comparison to a mercury sphygmomanometer. A validation study was carried out in the city of Pelotas, Southern Brazil. Blood pressure was measured twice using two different sphygmomanometers; an OMRON wrist digital and a desktop BD mercury one. Half of the sample was measured first with the digital manometer and subsequently with the mercury one, whereas the remaining half was evaluated in the opposite order. Agreement between both measures was evaluated using the Bland and Altman method. 120 adolescents aged 14 to 15 years were included (50% of each sex). Mean systolic blood pressure among boys was 113.7 mmHg (SD 14.2) when using the mercury manometer and 115.5 mmHg (SD 15.2) when using the digital one. Equivalent values for diastolic blood pressure were 61.5 mmHg (SD 9.9) and 69.6 mmHg (10.2), respectively. Among girls, the mean systolic blood pressure was 104.7 mmHg (SD 10.1) when using the mercury manometer and 102.4 mmHg (SD 11.9) when using the digital device. Values for diastolic blood pressure were 60.0 mmHg (SD 10.4) and 65.7 mmHg (SD 7.7), respectively. The digital device showed a high level of agreement with the mercury manometer when measuring systolic blood pressure. The level of agreement was lower for diastolic blood pressure. The use of correction equations may be an alternative for studies using this wrist digital monitor in adolescent patients.
Methodology and technology for peripheral and central blood pressure and blood pressure variability measurement: current status and future directions - Position statement of the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability.
Stergiou, George S; Parati, Gianfranco; Vlachopoulos, Charalambos; Achimastos, Apostolos; Andreadis, Emanouel; Asmar, Roland; Avolio, Alberto; Benetos, Athanase; Bilo, Grzegorz; Boubouchairopoulou, Nadia; Boutouyrie, Pierre; Castiglioni, Paolo; de la Sierra, Alejandro; Dolan, Eamon; Head, Geoffrey; Imai, Yutaka; Kario, Kazuomi; Kollias, Anastasios; Kotsis, Vasilis; Manios, Efstathios; McManus, Richard; Mengden, Thomas; Mihailidou, Anastasia; Myers, Martin; Niiranen, Teemu; Ochoa, Juan Eugenio; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Papaioannou, Theodore; Protogerou, Athanasios; Redon, Josep; Verdecchia, Paolo; Wang, Jiguang; Zanchetti, Alberto; Mancia, Giuseppe; O'Brien, Eoin
Office blood pressure measurement has been the basis for hypertension evaluation for almost a century. However, the evaluation of blood pressure out of the office using ambulatory or self-home monitoring is now strongly recommended for the accurate diagnosis in many, if not all, cases with suspected hypertension. Moreover, there is evidence that the variability of blood pressure might offer prognostic information that is independent of the average blood pressure level. Recently, advancement in technology has provided noninvasive evaluation of central (aortic) blood pressure, which might have attributes that are additive to the conventional brachial blood pressure measurement. This position statement, developed by international experts, deals with key research and practical issues in regard to peripheral blood pressure measurement (office, home, and ambulatory), blood pressure variability, and central blood pressure measurement. The objective is to present current achievements, identify gaps in knowledge and issues concerning clinical application, and present relevant research questions and directions to investigators and manufacturers for future research and development (primary goal).
Holstein, P; Lassen, N A
The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...... of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two...... and peripheral neuropathy were frequent in the diabetic group. The data show that the systolic digital blood pressure is a particularly valuable prognostic parameter....
Kise, Yuya; Kuniyoshi, Yukio; Inafuku, Hitoshi; Nagano, Takaaki; Hirayasu, Tsuneo; Yamashiro, Satoshi
During thoracoabdominal surgery in which segmental arteries are sacrificed over a large area, blood supply routes from collateral networks have received attention as a means of avoiding spinal cord injury. The aim of this study was to investigate spinal cord blood supply through a collateral network by directly measuring spinal cord blood flow and spinal cord perfusion pressure experimentally. In beagle dogs (n = 8), the thoracoabdominal aorta and segmental arteries L1-L7 were exposed, and a temporary bypass was created for distal perfusion. Next, a laser blood flow meter was placed on the spinal dura mater in the L5 region to measure the spinal cord blood flow. The following were measured simultaneously when the direct blood supply from segmental arteries L2-L7 to the spinal cord was stopped: mean systemic blood pressure, spinal cord perfusion pressure (blood pressure within the aortic clamp site), and spinal cord blood flow supplied via the collateral network. These variables were then investigated for evidence of correlations. Positive correlations were observed between mean systemic blood pressure and spinal cord blood flow during interruption of segmental artery flow both with (r = 0.844, P flow with and without distal perfusion (r = 0.803, P network from outside the interrupted segmental arteries, and high systemic blood pressure (∼1.33-fold higher) was needed to obtain the preclamping spinal cord blood flow, whereas 1.68-fold higher systemic blood pressure was needed when distal perfusion was halted. Spinal cord blood flow is positively correlated with mean systemic blood pressure and spinal cord perfusion pressure under spinal cord ischemia caused by clamping a wide range of segmental arteries. In open and endovascular thoracic and thoracoabdominal surgery, elevating mean systemic blood pressure is a simple and effective means of increasing spinal cord blood flow, and measuring spinal cord perfusion pressure seems to be useful for monitoring
Nielsen, P E; Bell, G; Lassen, N A
The systolic blood pressure on the finger, toe, and ankle has been measured by a strain gauge technique in 10 normal subjects aged 17-31 years and 14 normal subjects aged 43-57 years. The standard deviation in repeated measurements lies between 2 and 6 mm Hg. The finger pressure in the younger gr...
Hypertension - infants ... and blood vessels The health of the kidneys High blood pressure in infants may be due to kidney or ... blood vessel of the kidney) In newborn babies, high blood pressure is often caused by a blood clot in ...
Avolio, Alberto P; Butlin, Mark; Walsh, Andrew
The most common method of clinical measurement of arterial blood pressure is by means of the cuff sphygmomanometer. This instrument has provided fundamental quantitative information on arterial pressure in individual subjects and in populations and facilitated estimation of cardiovascular risk related to levels of blood pressure obtained from the brachial cuff. Although the measurement is taken in a peripheral limb, the values are generally assumed to reflect the pressure throughout the arterial tree in large conduit arteries. Since the arterial pressure pulse becomes modified as it travels away from the heart towards the periphery, this is generally true for mean and diastolic pressure, but not for systolic pressure, and so pulse pressure. The relationship between central and peripheral pulse pressure depends on propagation characteristics of arteries. Hence, while the sphygmomanometer gives values of two single points on the pressure wave (systolic and diastolic pressure), there is additional information that can be obtained from the time-varying pulse waveform that enables an improved quantification of the systolic load on the heart and other central organs. This topical review will assess techniques of pressure measurement that relate to the use of the cuff sphygmomanometer and to the non-invasive registration and analysis of the peripheral and central arterial pressure waveform. Improved assessment of cardiovascular function in relation to treatment and management of high blood pressure will result from future developments in the indirect measurement of arterial blood pressure that involve the conventional cuff sphygmomanometer with the addition of information derived from the peripheral arterial pulse. (topical review)
Vizcaíno, Vicente Martínez; Aguilar, Fernando Salcedo; Martínez, Montserrat Solera; López, Mairena Sánchez; Gutiérrez, Ricardo Franquelo; Rodríguez-Artalejo, Fernando
To examine the association of body mass index (BMI), triceps skinfold thickness (TST) and percentage body fat (%BF) from bioelectrical impedance analysis (BIA) with blood lipids, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children. Cross-sectional study was conducted on 1280 schoolchildren aged 8-11 years from the Cuenca province (Spain). Data collection was conducted under standardized conditions, taking several measurements of each variable to enhance accuracy. Analyses were performed using age-adjusted correlation coefficients, and multiple linear regression adjusted for age, BMI, TST and %BF. Correlations between %BF and apolipoprotein (apo) B, total cholesterol, low-density lipoprotein cholesterol (LDL-c), total cholesterol/HDL-c ratio and DBP were higher than those for BMI and TST. In contrast, the correlations between BMI, and apo A-I and SBP were higher than those for %BF and TST. The results were similar across the sexes. The correlations between each of the three measures of body fatness, and blood lipids and blood pressure were highest in children with greatest BMI and %BF. When analyses were adjusted for the three body fatness measures, %BF showed stronger associations than did BMI or TST with blood lipids and blood pressure, with the exception of apo A-I and SBP, which were more closely associated with BMI. %BF from BIA is more strongly associated than either BMI or TST with most of the blood lipid fractions in schoolchildren aged 8-11 years.
Willig, Amanda L.; Casazza, Krista; Dulin-Keita, Akilah; Franklin, Frank A.; Amaya, Michelle; Fernandez, Jose R.
BACKGROUND Adiposity measures are associated with increased pediatric blood pressure. However, this correlation can be confounded by the relationship of both variables to height. We evaluated whether adiposity and anthropometric measures were associated with pediatric blood pressure before and after adjusting each value for height. METHODS Participants included 281 African-American, European-American, and Hispanic-American children aged 7–12 years. Blood pressure percentiles were calculated according to pediatric guidelines using the average of four measurements. Total fat mass was determined using dual-energy x-ray absorptiometry. Socioeconomic status was calculated with the Hollingshead index. Adiposity measures were indexed for height using log-log regression analysis. Partial correlations identified measures associated with blood pressure. Linear regression was used to test the association of those measures with absolute blood pressure, while logistic regression was used to evaluate the odds for hypertension. RESULTS More African-Americans (16.3%) presented with potential hypertension than European-American (5.1%) or Hispanic-American (2.7%) children. After adjusting for covariates, fat mass, body mass index, and waist circumference were positively significantly associated with absolute blood pressure and hypertension in African-American and European-American children (P < 0.05). When these measures were height-indexed, only waist remained significantly positively associated with hypertension risk in these two groups. No measures were significantly associated with blood pressure among Hispanic-American children. CONCLUSIONS In this multiethnic pediatric population, waist circumference was the strongest significant adiposity predictor of hypertension risk among African-American and European-American children. Additional research is needed to determine which environmental and genetic factors contribute to pediatric hypertension, particularly among Hispanic
de Graaff, Jurgen C.; Ubbink, Dirk Th; Lagarde, Sjoerd M.; Jacobs, Michael J. H. M.
Capillary blood pressure is an essential parameter in the study of the (patho-)physiology of microvascular perfusion. Currently, capillary pressure measurements in humans are performed using a servo-nulling micropressure system containing an oil-water interface, which suffers some drawbacks. In
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... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has high ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...
Holstein, P; Lassen, N A
The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...... (SPPH) as measured with a photocell. Thirty-two patients (35 feet with ulcerations) had diabetes mellitus. The treatment was conservative. In 42 feet the ulcers healed after an average period of 5.8 months; in 24 feet major amputation became necessary after an average of 4.3 months. The frequency...... of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two...
Li, H; Dong, Z; Ma, A J; Dong, J; Fang, K; Xie, C; Qi, K; Xie, J; Zhou, Y; Zhao, Y
Objective: To understand the practices and effects of different measures for blood pressure control in hypertension patients. Methods: Patients who have known hypertension from the subjects of "2014 Beijing adult (aged 18-79 years) chronic diseases and risk factors survey" were selected. The choices of different hypertension control measures, the relationship between the measures and demographic characteristics of hypertension patients, and the effects of different control measures were analyzed. Results: A total of 2 229 known hypertension patients were included, the analysis was conducted through a questionnaire survey. Those who answered "never taking any measures" , "taking medication according to doctor's instructions" and "taking medication when blood pressure rose" accounted for 7.0%, 79.8% and 8.3%, respectively. Those who had "diet control" , "physical exercises" and "blood pressure monitoring" accounted for 22.4%, 23.7% and 22.1%, respectively. In terms of "taking medicine according to doctor's instructions" , women (84.3%), those aged ≥60 years (87.6%), those living in urban area (81.5%), those living alone (83.8%), and Beijing local residents (82.3%) had higher compliance rates. As for "diet control" , women (24.4%), those aged ≥60 years (25.8%) and those with educational level of college or above (29.5%) had better practices. In terms of "physical exercise" , those aged ≥60 years (27.9%), those living in urban area (25.3%), those with educational level of college or above (32.5%) had better practice. Women (24.2%) and those aged ≥60 years (28.4%) had higher "blood pressure monitoring" rate. More men (9.7%), those aged 18-44 years (14.7%), those with educational level of high school (9.3%), the unmarried (18.2%), and non-Beijing local residents (14.7%) answered "never taking any measure" , and in terms of "taking medication when blood pressure rose" , non-Beijing local residents (12.8%) had higher rate. In the field survey, more patients who
Paaske, William; Tønnesen, K H
The clinical course was followed and the ankle and toe blood pressures were measured with the strain gauge technique on 5 occasions during 2 years in 43 patients with pain at rest and/or ischaemic ulceration due to severe ischaemia of the legs on the basis of occlusive arterial disease. Although...... arteriosclerosis of the legs in non-diabetic patients is generally considered a benign disease from the standpoint of limb survival, the critical level of TPI (systolic toe blood pressure/systolic arm blood pressure) was found to be 0.07 as a TPI below this value was associated with an overall 82% risk...... of amputation. With TPI above 0.07, the chance of successful conservative therapy was about 40%. Diabetics with severe ischaemia must be regarded as a high risk group in respect of amputation (64%) and lethality (64%). A variance analysis was made on the pressure data: In patients with low pressure peripheral...
Paige, Ellie; Barrett, Jessica; Pennells, Lisa
The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data...... encompassing 1962-2014) with more than 1 million measurements of systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Over a median 12 years of follow-up, 21,170 CVD events occurred. Risk prediction models using cumulative mean values of repeated measurements and summary...... improvements were 0.0369 (95% CI: 0.0303, 0.0436) for the cumulative-means model and 0.0177 (95% CI: 0.0110, 0.0243) for the longitudinal model. In conclusion, incorporating repeated measurements of blood pressure and cholesterol into CVD risk prediction models slightly improves risk prediction....
The study provides correlative information with respect to the comparative accuracy of the traditional 'cuff' clinical method of obtaining blood pressure and the laboratory catheterization procedure which measures actual blood pressure. The informati...
Wagner, Stefan; Kamper, C. H.; Rasmussen, Niels H
Background: Patients often fail to adhere to clinical recommendations when using current blood pressure self-measurement (BPSM) methods and equipment. As existing BPSM equipment is not able to detect non-adherent behavior, this could result in misdiagnosis and treatment error. To overcome...... patients scheduled for self-measuring their blood pressure (BP) in the waiting room at an obstetrics department's outpatient clinic to perform an additional BPSM using ValidAid. We then compared the automatically measured and classified values from ValidAid with our manual observations. Results: We found...
Babbs, Charles F
The oscillometric method of measuring blood pressure with an automated cuff yields valid estimates of mean pressure but questionable estimates of systolic and diastolic pressures. Existing algorithms are sensitive to differences in pulse pressure and artery stiffness. Some are closely guarded trade secrets. Accurate extraction of systolic and diastolic pressures from the envelope of cuff pressure oscillations remains an open problem in biomedical engineering. A new analysis of relevant anatomy, physiology and physics reveals the mechanisms underlying the production of cuff pressure oscillations as well as a way to extract systolic and diastolic pressures from the envelope of oscillations in any individual subject. Stiffness characteristics of the compressed artery segment can be extracted from the envelope shape to create an individualized mathematical model. The model is tested with a matrix of possible systolic and diastolic pressure values, and the minimum least squares difference between observed and predicted envelope functions indicates the best fit choices of systolic and diastolic pressure within the test matrix. The model reproduces realistic cuff pressure oscillations. The regression procedure extracts systolic and diastolic pressures accurately in the face of varying pulse pressure and arterial stiffness. The root mean squared error in extracted systolic and diastolic pressures over a range of challenging test scenarios is 0.3 mmHg. A new algorithm based on physics and physiology allows accurate extraction of systolic and diastolic pressures from cuff pressure oscillations in a way that can be validated, criticized, and updated in the public domain.
Babbs Charles F
Full Text Available Abstract Background The oscillometric method of measuring blood pressure with an automated cuff yields valid estimates of mean pressure but questionable estimates of systolic and diastolic pressures. Existing algorithms are sensitive to differences in pulse pressure and artery stiffness. Some are closely guarded trade secrets. Accurate extraction of systolic and diastolic pressures from the envelope of cuff pressure oscillations remains an open problem in biomedical engineering. Methods A new analysis of relevant anatomy, physiology and physics reveals the mechanisms underlying the production of cuff pressure oscillations as well as a way to extract systolic and diastolic pressures from the envelope of oscillations in any individual subject. Stiffness characteristics of the compressed artery segment can be extracted from the envelope shape to create an individualized mathematical model. The model is tested with a matrix of possible systolic and diastolic pressure values, and the minimum least squares difference between observed and predicted envelope functions indicates the best fit choices of systolic and diastolic pressure within the test matrix. Results The model reproduces realistic cuff pressure oscillations. The regression procedure extracts systolic and diastolic pressures accurately in the face of varying pulse pressure and arterial stiffness. The root mean squared error in extracted systolic and diastolic pressures over a range of challenging test scenarios is 0.3 mmHg. Conclusions A new algorithm based on physics and physiology allows accurate extraction of systolic and diastolic pressures from cuff pressure oscillations in a way that can be validated, criticized, and updated in the public domain.
Hirai, M; Nielsen, S L; Lassen, N A
The aim of the present paper was to study the methodological problems involved in measuring systolic blood pressure in all five fingers by the strain gauge technique. In 24 normal subjects, blood pressure at the proximal phalanx of finger I and both at the proximal and the intermediate phalanx...... of the other fingers was measured using a 24-mm-wide cuff. Blood pressure at the proximal phalanx was higher than that at the intermediate phalanx in all fingers except finger V. The difference of blood pressure values corresponded well with circumference of the finger. In 15 normal subjects, blood pressure...... of the mean values was larter with the 27-mm-wide cuff than with the 24-mm-wide cuff, the 24-mm-wide cuff was considered to be most suitable for clinical use in fingers I, II, III, and IV. By using the 20-mm-wide cuff in finger V and the 24-mm-wide cuff in the other fingers, normal value of finger blood...
Funamoto, Kenichi; Hayase, Toshiyuki
Ultrasonic-measurement-integrated (UMI) simulation of blood flow is used to analyze the velocity and pressure fields by applying feedback signals of artificial body forces based on differences of Doppler velocities between ultrasonic measurement and numerical simulation. Previous studies have revealed that UMI simulation accurately reproduces the velocity field of a target blood flow, but that the reproducibility of the pressure field is not necessarily satisfactory. In the present study, the reproduction of the pressure field by UMI simulation was investigated. The effect of feedback on the pressure field was first examined by theoretical analysis, and a pressure compensation method was devised. When the divergence of the feedback force vector was not zero, it influenced the pressure field in the UMI simulation while improving the computational accuracy of the velocity field. Hence, the correct pressure was estimated by adding pressure compensation to remove the deteriorating effect of the feedback. A numerical experiment was conducted dealing with the reproduction of a synthetic three-dimensional steady flow in a thoracic aneurysm to validate results of the theoretical analysis and the proposed pressure compensation method. The ability of the UMI simulation to reproduce the pressure field deteriorated with a large feedback gain. However, by properly compensating the effects of the feedback signals on the pressure, the error in the pressure field was reduced, exhibiting improvement of the computational accuracy. It is thus concluded that the UMI simulation with pressure compensation allows for the reproduction of both velocity and pressure fields of blood flow. Copyright © 2012 John Wiley & Sons, Ltd.
McCarthy, B M; O'Flynn, B; Mathewson, A
The objective of this paper is to examine the Pulse Transit Method (PTT) as a non-invasive means to track Blood Pressure over a short period of time. PTT was measured as the time it takes for an ECG R-wave to propagate to the finger, where it is detected by a photoplethysmograph sensor. The PTT method is ideal for continuous 24-hour Blood Pressure Measurement (BPM) since it is both cuff-less and non-invasive and therefore comfortable and unobtrusive for the patient. Other techniques, such as the oscillometric method, have shown to be accurate and reliable but require a cuff for operation, making them unsuitable for long term monitoring. Although a relatively new technique, the PTT method has shown to be able to accurately track blood pressure changes over short periods of time, after which re-calibration is necessary. The purpose of this study is to determine the accuracy of the method.
McCarthy, B M; O' Flynn, B; Mathewson, A, E-mail: email@example.com [Tyndall National Institute, UCC, Lee Maltings, Prospect Row, Cork (Ireland)
The objective of this paper is to examine the Pulse Transit Method (PTT) as a non-invasive means to track Blood Pressure over a short period of time. PTT was measured as the time it takes for an ECG R-wave to propagate to the finger, where it is detected by a photoplethysmograph sensor. The PTT method is ideal for continuous 24-hour Blood Pressure Measurement (BPM) since it is both cuff-less and non-invasive and therefore comfortable and unobtrusive for the patient. Other techniques, such as the oscillometric method, have shown to be accurate and reliable but require a cuff for operation, making them unsuitable for long term monitoring. Although a relatively new technique, the PTT method has shown to be able to accurately track blood pressure changes over short periods of time, after which re-calibration is necessary. The purpose of this study is to determine the accuracy of the method.
Oikonen, Mervi; Nuotio, Joel; Magnussen, Costan G; Viikari, Jorma S A; Taittonen, Leena; Laitinen, Tomi; Hutri-Kähönen, Nina; Jokinen, Eero; Jula, Antti; Cheung, Michael; Sabin, Matthew A; Daniels, Stephen R; Raitakari, Olli T; Juonala, Markus
Hypertension may be predicted from childhood risk factors. Repeated observations of abnormal blood pressure in childhood may enhance prediction of hypertension and subclinical atherosclerosis in adulthood compared with a single observation. Participants (1927, 54% women) from the Cardiovascular Risk in Young Finns Study had systolic and diastolic blood pressure measurements performed when aged 3 to 24 years. Childhood/youth abnormal blood pressure was defined as above 90th or 95th percentile. After a 21- to 31-year follow-up, at the age of 30 to 45 years, hypertension (>140/90 mm Hg or antihypertensive medication) prevalence was found to be 19%. Carotid intima-media thickness was examined, and high-risk intima-media was defined as intima-media thickness >90th percentile or carotid plaques. Prediction of adulthood hypertension and high-risk intima-media was compared between one observation of abnormal blood pressure in childhood/youth and multiple observations by improved Pearson correlation coefficients and area under the receiver operating curve. When compared with a single measurement, 2 childhood/youth observations improved the correlation for adult systolic (r=0.44 versus 0.35, Phypertension in adulthood (0.63 for 2 versus 0.60 for 1 observation, P=0.003). When compared with 2 measurements, third observation did not provide any significant improvement for correlation or prediction (P always >0.05). A higher number of childhood/youth observations of abnormal blood pressure did not enhance prediction of adult high-risk intima-media thickness. Compared with a single measurement, the prediction of adult hypertension was enhanced by 2 observations of abnormal blood pressure in childhood/youth. © 2015 American Heart Association, Inc.
Full Text Available In the last decade, cuffless blood pressure measurement technology has been widely studied because it could be applied to a wearable apparatus. Electrocardiography (ECG, photo-plethysmography (PPG, and phonocardiography are always used to detect the pulse transit time (PTT because the changed tendencies of the PTT and blood pressure have a negative relationship. In this study, the PPG signal was replaced by the impedance plethysmography (IPG signal and was used to detect the PTT. The placement and direction of the electrode array for the IPG measurement were discussed. Then, we designed an IPG ring that could measure an accurate IPG signal. Twenty healthy subjects participated in this study. The changes in blood pressure after exercise were evaluated through the changes of the PTT. The results showed that the change of the systolic pressure had a better relationship with the change of the PTTIPG than that of the PTTPPG (r = 0.700 vs. r = 0.450. Moreover, the IPG ring with spot electrodes would be more suitable to develop with the wearable cuffless blood pressure monitor than the PPG sensor.
Vidal, Enrico; Murer, Luisa; Matteucci, Maria Chiara
The burden of hypertension has become increasingly prevalent in children. Hypertension that begins in childhood can carry on into adulthood, therefore early detection, accurate diagnosis and effective therapy of high blood pressure may improve long-term outcomes of children and adolescents. As far as pediatric hypertension is concerned, doubts still persist about the right instruments, modalities and standards of reference that should be used in routine practice. Due to the dynamic process of growth and development, many physiological parameters undergo intensive change with age. Therefore, in children, the definition of hypertension can not rely on a single blood pressure level but should be based on age- and height-specific percentiles. In this review, we introduce the nephrologist to the correct definition of high blood pressure in children. Moreover, we specifically address the main characteristics of different modalities for blood pressure measurement in children, focusing on practical aspects. The latest international guidelines and appropriate standards of reference for office, ambulatory and home blood pressure data collection are presented. As clinicians are being faced with a greater number of children with hypertension, they should be aware of these peculiarities.
Merkus, J M
Recent evidence suggests that the fifth Korotkoff sound (K5) is a much more reliable point of measurement to determine diastolic blood pressure in pregnant women than the fourth one (K4). The guidelines for obstetricians and midwives should be corrected without delay to reflect this new knowledge. In non-pregnant people K5 already is the point of reference.
van Zeeland, Y. R.A.; Wilde, A.; Bosman, I.H.; Uilenreef, J. J.; Egner, B.I.; Schoemaker, N. J.
This study was conducted to validate the use of high definition oscillometry (HDO) for non-invasive blood pressure (NIBP) measurements in ferrets and to establish reference ranges for NIBP in minimally sedated, healthy, young adult ferrets (170 mmHg) conditions. Although HDO correlated well with
Stolarz-Skrzypek, Katarzyna; Thijs, Lutgarde; Wizner, Barbara
Thomas G. Pickering spent most of his scientific career in carrying out research on clinical hypertension and blood pressure (BP) measurement. In our review of Pickering's seminal work, we first focused on white-coat hypertension and masked hypertension, two terms that he had introduced. Next, we...
Wang, Xiaoling; Ding, Xiuhua; Su, Shaoyong; Harshfield, Gregory; Treiber, Frank; Snieder, Harold
To determine to what extent the genetic influences on blood pressure (BP) measured in the office, under psychologically stressful conditions in the laboratory and during real life are different from each other. Office BP, BP during a video game challenge and a social stressor interview, and 24-h
Vrijkotte, T.G.M.; de Geus, E.J.C.
Objective: To test the validity of ambulatory heart rate (HR) assessment with a cuff ambulatory blood pressure (ABP) monitor. Design: Cross-instrument comparison of HR measured intermittently by a cuff ABP monitor (SpaceLabs, Redmond, Washington, USA), with HR derived from continuous
Vrijkotte, T.G.M.; de Geus, E.J.C.
Objective: To test the validity of ambulatory heart rate (HR) assessment with a cuff ambulatory blood pressure (ABP) monitor. Design: Cross-instrument comparison of HR measured intermittently by a cuff ABP monitor (SpaceLabs, Redmond, Washington, USA), with HR derived from continuous
Vrijkotte, T. G.; de Geus, E. J.
To test the validity of ambulatory heart rate (HR) assessment with a cuff ambulatory blood pressure (ABP) monitor. Cross-instrument comparison of HR measured intermittently by a cuff ABP monitor (SpaceLabs, Redmond, Washington, USA), with HR derived from continuous electrocardiogram (ECG) recordings
Paige, Ellie; Barrett, Jessica; Pennells, Lisa; Sweeting, Michael; Willeit, Peter; Angelantonio, Di Emanuele; Gudnason, Vilmundur; Nordestgaard, Børge G.; Psaty, Bruce M.; Goldbourt, Uri; Best, Lyle G.; Assmann, Gerd; Salonen, Jukka T.; Nietert, Paul J.; Verschuren, W.M.M.; Brunner, Eric J.; Kronmal, Richard A.; Salomaa, Veikko; Bakker, Stephan L.J.; Dagenais, Gilles R.; Sato, Shinichi; Jansson, Jan Håkan; Willeit, Johann; Onat, Altan; La Cámara, De Agustin Gómez; Roussel, Ronan; Völzke, Henry; Dankner, Rachel; Tipping, Robert W.; Meade, Tom W.; Donfrancesco, Chiara; Kuller, Lewis H.; Peters, Annette; Gallacher, John; Kromhout, Daan; Iso, Hiroyasu; Knuiman, Matthew W.; Casiglia, Edoardo; Kavousi, Maryam; Palmieri, Luigi; Sundström, Johan; Davis, Barry R.; Njølstad, Inger; Couper, David; Danesh, John; Thompson, Simon G.; Wood, Angela M.
The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data
Paige, Ellie; Barrett, Jessica; Pennells, Lisa
The added value of incorporating information from repeated blood pressure and cholesterol measurements to predict cardiovascular disease (CVD) risk has not been rigorously assessed. We used data on 191,445 adults from the Emerging Risk Factors Collaboration (38 cohorts from 17 countries with data...
Abshire, Demetrius A.; Mudd-Martin, Gia; Moser, Debra K.; Lennie, Terry A.
Objective: To compare anthropometric measures of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and sagittal abdominal diameter (SAD) as predictors of blood pressure in college students. Participants: Students (N = 116) were recruited from November 2012 to May 2014 at an urban university and rural community…
Chamot, S R; Movaffaghy, A; Petrig, B L; Riva, C E
To determine whether iris blood flow (IBF) is regulated in response to an acute decrease in mean ocular perfusion pressure (PPm = MOAP-IOP, MOAP = mean ophthalmic arterial pressure) induced by increasing the intraocular pressure (IOP). Iris blood flow was measured using a slit lamp incorporating a laser Doppler flowmetry (LDF) module. The study was conducted on 12 normal volunteers (14 to 59 years old). IOP was raised using a scleral suction cup. In Exp. #1, the suction pressure was successively raised in steps of 50 to 100 mm Hg, each lasting about 10 sec, until IOP reached the MOAP level. In Exp. #2, the suction was raised to 200 mm Hg in 4 successive steps of 2 min duration. In Exp. #1, no significant change of IBF was observed for small decreases of PPm ( 23%).
Malta, Deborah Carvalho; Santos, Nadir Baltazar Dos; Perillo, Rosângela Durso; Szwarcwald, Célia Landmann
High blood pressure (hypertension) is the most frequent cause of morbidity and a major risk factor for cardiovascular complications. The aim here was to describe the prevalence of blood pressure greater than or equal to 140/90 mmHg in the adult Brazilian population and federal states, along with self-reported information about previous medical diagnoses of hypertension, use of medication and medical care for hypertension control. Cross-sectional study analyzing information from the National Health Survey of 2013, relating to Brazil and its federal states. The sample size was estimated as 81,254 households and information was collected from 64,348 households. The survey consisted of interviews, physical and laboratory measurements. Systolic blood pressure was considered to be high when it was ≥ 140 mmHg and diastolic blood pressure, ≥ 90 mmHg. It was found that 22.8% of the population has blood pressure measurements ≥ 140/90 mmHg. The proportion was higher among men than among women: 25.8% versus 20.0%. The frequency increased with age, reaching 47.1% in individuals over 75 years and was highest in the southeast and south. 43.2% reported previous medical diagnoses of hypertension and, of these, 81.4% reported using medication for hypertension and 69.6%, going to the doctor within the past year for pressure monitoring, thus showing regular medical follow-up. These results are important for supporting measures for preventing and treating hypertension in Brazil, with the aim of achieving the World Health Organization's goal of reducing hypertension by 25% over the next decade.
Hellman, Yaron; Malik, Adnan S; Lane, Kathleen A; Shen, Changyu; Wang, I-Wen; Wozniak, Thomas C; Hashmi, Zubair A; Munson, Sarah D; Pickrell, Jeanette; Caccamo, Marco A; Gradus-Pizlo, Irmina; Hadi, Azam
Currently, blood pressure (BP) measurement is obtained noninvasively in patients with continuous flow left ventricular assist device (LVAD) by placing a Doppler probe over the brachial or radial artery with inflation and deflation of a manual BP cuff. We hypothesized that replacing the Doppler probe with a finger-based pulse oximeter can yield BP measurements similar to the Doppler derived mean arterial pressure (MAP). We conducted a prospective study consisting of patients with contemporary continuous flow LVADs. In a small pilot phase I inpatient study, we compared direct arterial line measurements with an automated blood pressure (ABP) cuff, Doppler and pulse oximeter derived MAP. Our main phase II study included LVAD outpatients with a comparison between Doppler, ABP, and pulse oximeter derived MAP. A total of five phase I and 36 phase II patients were recruited during February-June 2014. In phase I, the average MAP measured by pulse oximeter was closer to arterial line MAP rather than Doppler (P = 0.06) or ABP (P < 0.01). In phase II, pulse oximeter MAP (96.6 mm Hg) was significantly closer to Doppler MAP (96.5 mm Hg) when compared to ABP (82.1 mm Hg) (P = 0.0001). Pulse oximeter derived blood pressure measurement may be as reliable as Doppler in patients with continuous flow LVADs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Kitagawa, Noriyuki; Okada, Hiroshi; Tanaka, Muhei; Hashimoto, Yoshitaka; Kimura, Toshihiro; Nakano, Koji; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto; Fukui, Michiaki
The aim of this study was to investigate whether central systolic blood pressure (SBP) was associated with albuminuria, defined as urinary albumin excretion (UAE) ≥30 mg/g creatinine, and, if so, whether the relationship of central SBP with albuminuria was stronger than that of peripheral SBP in patients with type 2 diabetes. The authors performed a cross-sectional study in 294 outpatients with type 2 diabetes. The relationship between peripheral SBP or central SBP and UAE using regression analysis was evaluated, and the odds ratios of peripheral SBP or central SBP were calculated to identify albuminuria using logistic regression model. Moreover, the area under the receiver operating characteristic curve (AUC) of central SBP was compared with that of peripheral SBP to identify albuminuria. Multiple regression analysis demonstrated that peripheral SBP (β=0.255, Palbuminuria. In addition, AUC of peripheral SBP was significantly greater than that of central SBP to identify albuminuria (P=0.035). Peripheral SBP is superior to central SBP in identifying albuminuria, although both peripheral and central SBP are associated with UAE in patients with type 2 diabetes. © 2016 Wiley Periodicals, Inc.
Kalmar, A.F.; Vos, Jaap Jan; Weening, M.; Mooyaart, E.A.; Poterman, Marieke; Struys, Michel; Scheeren, Thomas
Background: Continuous invasive arterial blood pressure (IBP) monitoring remains the accepted gold standard for blood pressure monitoring because of its high accuracy. Several disadvantages of this method motivate the use of noninvasive intermittent blood pressure (NIBP) in most anesthesia cases
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Tünsmeyer, Julia; Hopster, Klaus; Feige, Karsten; Kästner, Sabine Br
To determine the agreement of high definition oscillometry (HDO) with direct arterial blood pressure measurements in normotensive, hypotensive and hypertensive horses during general anaesthesia. Experimental study. Seven healthy warmblood horses, aged 3-11 years, weighing 470-565 kg. Measurements from a HDO device with the cuff placed around the base of the tail were compared with pressures measured invasively from the facial artery. High blood pressures were induced by intravenous (IV) administration of dobutamine (5 μg kg(-1) minute(-1)) over ten minutes followed by norepinephrine (0.1 mg kg(-1) IV) and low pressures by increasing the inspired fraction of isoflurane and administration of nitroglycerine (0.05 mg kg(-1) IV). For analysis three pressure levels were determined: high (MAP>110 mmHg), normal (60 mmHgstandard deviation for SAP, MAP and DAP were 0.1 ± 19.4 mmHg, 0.5 ± 14.0, 4.7 ± 15.6, respectively. At high pressure levels bias and SD were 26.1 ± 37.3 (SAP), 4.2 ± 19.4 (MAP), 1.5 ± 16.8 (DAP) and at low pressures -20.0 ± 20.9 (SAP), -11.4 ± 19.6 (MAP), -4.7 ± 20.1 (DAP), with HDO measurements at a MAP <50 mmHg often failing. Good agreement with invasive arterial blood pressures was obtained with HDO at normotensive levels in horses. At high and low pressure ranges HDO was unreliable. Therefore, if haemodynamic instability is expected, invasive measurement remains preferable. © 2014 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
van Zeeland, Y. R.A.; Wilde, A.; Bosman, I.H.; Uilenreef, J. J.; Egner, B.I.; Schoemaker, N. J.
This study was conducted to validate the use of high definition oscillometry (HDO) for non-invasive blood pressure (NIBP) measurements in ferrets and to establish reference ranges for NIBP in minimally sedated, healthy, young adult ferrets (170 mmHg) conditions. Although HDO correlated well with DABP (r > 0.90), it showed significant proportional bias, whereby HDO generally underestimated DABP with hyper- and normotensive conditions, and overestimated DABP with hypotensive conditions. Measure...
... effects on blood pressure. Finding out what genetic patterns contribute to high blood pressure risk. NHLBI-funded researchers identified dozens of ... whether a low-sodium and low-calorie eating pattern, along with aerobic exercise, can improve blood pressure in patients who do not respond to ...
Zhang, Qiang; Chen, Xianxiang; Fang, Zhen; Xue, Yongjiao; Xia, Shanhong; Zhan, Qingyuan; Yang, Ting
The present study designs an algorithm to increase the accuracy of continuous blood pressure (BP) estimation. Pulse arrival time (PAT) has been widely used for continuous BP estimation. However, because of motion artifact and physiological activities, PAT-based methods are often troubled with low BP estimation accuracy. This paper used a signal quality modified Kalman filter to track blood pressure changes. A Kalman filter guarantees that BP estimation value is optimal in the sense of minimizing the mean square error. We propose a joint signal quality indice to adjust the measurement noise covariance, pushing the Kalman filter to weigh more heavily on measurements from cleaner data. Twenty 2 h physiological data segments selected from the MIMIC II database were used to evaluate the performance. Compared with straightforward use of the PAT-based linear regression model, the proposed model achieved higher measurement accuracy. Due to low computation complexity, the proposed algorithm can be easily transplanted into wearable sensor devices. (paper)
Zhang, Qiang; Chen, Xianxiang; Fang, Zhen; Xue, Yongjiao; Zhan, Qingyuan; Yang, Ting; Xia, Shanhong
The present study designs an algorithm to increase the accuracy of continuous blood pressure (BP) estimation. Pulse arrival time (PAT) has been widely used for continuous BP estimation. However, because of motion artifact and physiological activities, PAT-based methods are often troubled with low BP estimation accuracy. This paper used a signal quality modified Kalman filter to track blood pressure changes. A Kalman filter guarantees that BP estimation value is optimal in the sense of minimizing the mean square error. We propose a joint signal quality indice to adjust the measurement noise covariance, pushing the Kalman filter to weigh more heavily on measurements from cleaner data. Twenty 2 h physiological data segments selected from the MIMIC II database were used to evaluate the performance. Compared with straightforward use of the PAT-based linear regression model, the proposed model achieved higher measurement accuracy. Due to low computation complexity, the proposed algorithm can be easily transplanted into wearable sensor devices.
Jung, Seungah; Shin, Youngsuk
By using the conventional method of measuring two-points (systolic and diastolic) blood pressure, it is difficult to differentiate a heart disease-prone personality from normals. Recently, an oscillometric method that reflects the personalized trait of blood pressure was developed by one author. By using this new measurement technique, this study intended to test the possibility of differentiating a heart disease-prone personality (type A or type D) from normal people. TPA scale in MMPI-2 and DS14 were used for screening type A and D. Oscillometric waveforms created by the cuff pressure were segmented into window blocks based on a single beat at a minimum, allowing this method to extract maximal top and bottom amplitudes in each window block. Then, a spectrogram using a short-time Fourier transform was applied to discriminate between character types in extracted blood pressure patterns with linear discriminant analysis. Compared to a normal personality, type A and type D personalities displayed a lower frequency response on STFT with maximum negative amplitudes than normals. In particular, the type D personality showed a lower frequency response than the type A personality. These results could provide a new qualitative method for measuring different biological indices between type A or D personalities and normals.
Lele, Abhijit V; Wilson, Daren; Chalise, Prabhakar; Nazzaro, Jules; Krishnamoorthy, Vijay; Vavilala, Monica S
Blood pressure data may vary by measurement technique. We performed a technological assessment of differences in blood pressure measurement between non-invasive blood pressure (NIBP) and invasive arterial blood pressure (ABP) in neurocritically ill patients. After IRB approval, a prospective observational study was performed to study differences in systolic blood pressure (SBP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) values measured by NIBP arm, ABP at level of the phlebostatic axis (ABP heart) and ABP at level of the external auditory meatus (ABP brain) at 30 and 45-degree head of bed elevation (HOB) using repeated measure analysis of covariance and correlation coefficients. Overall, 168 patients were studied with median age of 57 ± 15 years, were mostly female (57%), with body mass index ≤30 (66%). Twenty-three percent (n = 39) had indwelling intracranial pressure monitors, and 19.7% (n = 33) received vasoactive agents. ABP heart overestimated ABP brain for SBP (11.5 ± 2.7 mmHg, p < .001), MAP (mean difference 13.3 ± 0.5 mmHg, p < .001) and CPP (13.4 ± 3.2 mmHg, p < .001). ABP heart overestimated NIBP arm for SBP (8 ± 1.5 mmHg, p < .001), MAP (mean difference 8.6 ± 0.8 mmHg, p < .001), and CPP (mean difference 9.8 ± 3.2 mmHg, p < .001). Regardless of HOB elevation, ABP heart overestimates MAP compared to ABP brain and NIBP arm. Using ABP heart data overestimates CPP and may be responsible for not achieving SBP, MAP or CPP targets aimed at the brain. Copyright © 2017 Elsevier Ltd. All rights reserved.
Pan, Fan; Zheng, Dingchang; He, Peiyu; Murray, Alan
This study aimed to investigate the effect of stethoscope position and contact pressure on auscultatory blood pressure (BP) measurement. Thirty healthy subjects were studied. Two identical stethoscopes (one under the cuff, the other outside the cuff) were used to simultaneously and digitally record 2 channels of Korotkoff sounds during linear cuff pressure deflation. For each subject, 3 measurements with different contact pressures (0, 50, and 100 mm Hg) on the stethoscope outside the cuff were each recorded at 3 repeat sessions. The Korotkoff sounds were replayed twice on separate days to each of 2 experienced listeners to determine systolic and diastolic BPs (SBP and DBP). Variance analysis was performed to study the measurement repeatability and the effect of stethoscope position and contact pressure on BPs. There was no significant BP difference between the 3 repeat sessions, between the 2 determinations from each listener, between the 2 listeners and between the 3 stethoscope contact pressures (all P > 0.06). There was no significant SBP difference between the 2 stethoscope positions at the 2 lower stethoscope pressures (P = 0.23 and 0.45), but there was a small (0.4 mm Hg, clinically unimportant) significant difference (P = 0.005) at the highest stethoscope pressure. The key result was that, DBP from the stethoscope under the cuff was significantly lower than that from outside the cuff by 2.8 mm Hg (P pressure, this study could suggest that the stethoscope position under the cuff, and closer to the arterial occlusion, might yield measurements closer to the actual invasive DBP.
M. F. VALIM
Full Text Available
Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg and recorded as two numbers: systolic pressure (as the heart contracts over diastolic pressure (as the heart relaxes between beats. High blood pressure (hypertension is defined as chronically elevated high blood pressure, with systolic blood pressure (SBP of 140 mm Hg or greater, and diastolic blood pressure (DBP of 90 mm Hg or greater. High blood pressure (HBP, smoking, abnormal blood lipid levels, obesity and diabetes are risk factors for coronary heart disease, the leading cause of death in the US. Lifestyle modifications such as engaging in regular physical activity, quitting smoking and eating a healthy diet (limiting intake of saturated fat and sodium and increasing consumption of fiber, fruits and vegetables are advocated for the prevention, treatment, and control of HBP. As multiple factors influence blood pressure, the effects of each factor are typically modest, particularly in normotensive subjects, yet the combined effects can be substantial. Nutrition plays an important role in influencing blood pressure. Orange juice should be included as part of any low sodium diet and/or any blood pressure reducing eating plan, as it is sodium free, fat-free and can help meet recommended levels of potassium intake that may contribute to lower BP.
Kim, Sehun; Park, Jin Joo; Lee, Seung-Ah; Cho, Youngjin; Yoon, Yeonyee E; Oh, Il-Young; Yoon, Chang-Hwan; Suh, Jung-Won; Cho, Young-Seok; Youn, Tae-Jin; Cho, Goo-Yeong; Chae, In-Ho; Lee, Hae-Young; Shin, Jinho; Park, Sungha; Choi, Dong-Ju
Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.
Peters, Rosalind M.; Templin, Thomas N.
The purpose of this study was to develop and conduct preliminary psychometric assessment of instruments measuring knowledge and self-care practices regarding behaviors needed for blood pressure (BP) control among African Americans. Items were empirically derived and scored on a 7-point, bipolar scale. The instruments were evaluated in a sample of 306 community-dwelling African Americans. Results revealed acceptable reliability and validity of the BP Knowledge Scale. Results for the BP Self-Ca...
Oliveras Puig, A; Dalfó-Pibernat, A; Jdid Rosàs, N; Mayor Isaac, E; Pérez-Romero, L; Gibert Llorach, E; Dalfó-Baqué, A
To assess the effectiveness of an intervention to promote standardized arm circumference measurement as way to choose appropriate cuff size to measure blood pressure. A before-after intervention study was performed in a basic health care area in Barcelona. Doctors, nurses and pharmacy staff participated by filling out an anonymous self-administered questionnaire pre- and post-intervention (3m). Variables included: demographics, type of professional, years since they finished their studies, availability of different cuff sizes, if arm circumference measurement were obtained or not, knowledge about the cutoff values for each cuff size and type of blood pressure monitor. The written results were given to the participants and presented in sessions. Pre- and post-intervention: 74.3 and 67.3% answered the questionnaires (P=ns), respectively. Determination of arm circumference varied from 1.3 to 19.1% (P=.009). A total of 37.3% and 44.1% declared that they had 2 or more available cuff sizes (P=ns). Knowledge about the correct measurement of the cuffs was 2.7 to 33.8% regarding the standard cuff size (P=.0198) and 0 to 23.5% for obese subjects (P<.05). When more than one cuff was available, reasons for the choice went from: «making a rough guess» or «when velcro stops sticking» before and after the intervention. All blood pressure devices in our primary health care center were electronic and automatic as were those of the 9 pharmacies. The intervention increased the determination of arm circumference prior to the reading of the blood pressure and the knowledge about the cutoff interval for standard and obese cuff size after intervention. There was greater availability of different sized cuffs. Despite this, the choice of the appropriate cuff size was not made based on arm circumference. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.
Dynamic response of liquid-filled catheter systems for measurement of blood pressure: precision of measurements and reliability of the Pressure Recording Analytical Method with different disposable systems.
Romagnoli, Stefano; Romano, Salvatore Mario; Bevilacqua, Sergio; Lazzeri, Chiara; Gensini, Gian Franco; Pratesi, Carlo; Quattrone, Diego; Dini, Daniele; De Gaudio, Angelo Raffaele
We aimed to compare the effects of a blood pressure transducer system specifically manufactured to limit underdamping artifacts with those of a standard system on hemodynamic parameter estimation and accuracy. Forty-three consecutive patients undergoing vascular surgery at the University of Florence, Italy, were included. Arterial blood pressure signal was simultaneously registered with 2 MostCare monitors, connected to the artery either by a standard transducer or a specific transducer manufactured to avoid underdamping artifacts (Resonance Over-Shoot Eliminator [R.O.S.E.]; Becton Dickinson, Becton Drive, NJ). Patients were divided into 2 groups: absence (C group) or presence (R group) of underdamping/resonance artifacts of blood pressure signal. Systolic blood pressure, cardiac index, maximal pressure/time ratio (dP/dt(MAX)), and cardiac cycle efficiency were recorded every 30 seconds for 30 minutes. A total of 2675 measurements were performed with 34.9% incidence of underdamping/resonance artifacts. All hemodynamic parameters showed clinically acceptable differences in the C group; in contrast, the results differed greatly in the R group between standard and R.O.S.E. transducer (systolic blood pressure bias, 16.7 mm Hg; cardiac index bias, 0.24 L min(-1) m(-2); dP/dt(MAX) bias, 0.92 mm Hg/ms; cardiac cycle efficiency bias, 0.018 units). Underdamping/resonance artifacts frequently affect blood pressure measurement in operating rooms and intensive care units and cause severe overestimation of systolic blood pressure and incorrect estimation of hemodynamic parameters when the pulse contour method is used. Copyright © 2011 Elsevier Inc. All rights reserved.
Block, Lauren; Flynn, Sarah J; Cooper, Lisa A; Lentz, Caroline; Hull, Tammie; Dietz, Katherine B; Boonyasai, Romsai T
The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners' knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique
Ahadi, Zeinab; Kelishadi, Roya; Qorbani, Mostafa; Zahedi, Hoda; Motlagh, Mohammad E; Ardalan, Gelayol; Shafiee, Gita; Asayesh, Hamid; Larijani, Bagher; Heshmat, Ramin
This study aimed to assess the association of meal frequency with anthropometric measures and blood pressure in Iranian children and adolescents. In this national survey, 14,880 students with 6-18 years of age were selected by stratified multistage sampling method from urban and rural regions of 30 provinces of Iran. Meal frequency was assessed by a questionnaire prepared based on global school-based student health survey .Physical measurements included height, weight, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP). The participation rate was 90.6% including 49.24% girls and 75.5% urban residents. Skipping breakfast and dinner were more frequent in girls than in boys (71.6% vs. 64.1%, 91.2% vs. 86.9%, respectively, P0.05). Students who had very low intake and 1 meal per week had more risk of abdominal obesity compared with those who had 3 meals (OR 1.7, CI 95%: 1.3-2.3, and OR 1.6, CI 95%: 1.4-2.0, respectively). An inverse significant association between higher meal frequency and anthropometric indices was observed. Therefore, encouraging children and adolescents for regular meal intake should be considered as a health priority in the pediatric population.
Mehlsen, Jesper; Wiinberg, Niels; Bruce, Christopher
Blood pressure at the ankle level is a reliable indicator of peripheral arterial disease (PAD) and the ankle brachial index (ABI) is a useful non-invasive screening tool for the early detection of atherosclerosis. In the first part of the study, systolic blood pressures obtained by oscillometry...... and plethysmography were compared in 80 subjects referred for possible vascular disease. In the second part of the study, 31 general practitioners enrolled 1258 consecutive patients aged more than 60 years. ABI was estimated by oscillometry. Patients with an ABI lower than 0.9 were referred to the local hospital...... of PAD was sufficiently high in subjects over the age of 60 years to warrant screening. The ankle brachial index based on measurements with an oscillometric device was shown reliable in the exclusion of PAD, thereby fulfilling an important criterion for the use in screening....
Joensen, J B; Juul, S; Abrahamsen, J; Henneberg, E W; Lindholt, Jes S
This study assesses measurement variation in the measurement of ankle systolic blood pressure (ABP) when measured with Doppler ultrasound and with the strain gauge method. Ninety-seven patients were included. ABP was measured with Doppler ultrasound and with the strain gauge method. The methods were compared graphically by scatterplots and analyzed by paired t test, analysis of variance, and Pitman's paired variance ratio test. ABP was measured by strain gauge in all extremities, whereas no Doppler signal was obtainable in 7 limbs (4%). There was no systematic difference in measurements between the means of the two measurements. However, a substantial difference of more than 25 mm Hg was found in 15% of limbs and more than 20 mm Hg in 20%. In the majority of patients, measurements of ABP by Doppler ultrasound and the strain gauge method give similar results, but for a minority the discrepancy is substantial.
Watson, S; Wenzel, R R; di Matteo, C; Meier, B; Lüscher, T F
Accurate measurement of arterial blood pressure is of great importance for the diagnosis and treatment of hypertension. Because of the chronic nature of antihypertensive drug therapy, the involvement of the patient in blood pressure control is desirable. Such an involvement, however, is only feasible if simple, user-friendly, and precise blood pressure measurement devices are available. In this study we tested a new wrist cuff oscillometric blood pressure measurement device in 100 consecutive patients undergoing cardiac catheterization. Blood pressures were simultaneously taken intraarterially (axillary artery) and with a mercury manometer and stethoscope or noninvasive measurement device (OMRON R3). Intraarterial measurements were directly compared with two measurements taken in random order with either an arm cuff mercury manometer or the wrist cuff device. Systolic and diastolic blood pressure as assessed with the mercury manometer was higher, especially when compared with the intraarterial and the wrist cuff values, which were comparable. Correlations of blood pressure values with intraarterial measurement were 0.86 systolic and 0.75 diastolic (P manometer measurements. Reproducibility of both measurements was good for the wrist cuff device ([systolic/diastolic]: r = 0.94/0.92; P manometer (r = 0.97/0.88; P manometer were higher than intraarterial values and those of the wrist cuff. Both noninvasive devices overestimated high diastolic values.
Full Text Available ... Card can help you track your blood pressure. Pregnancy Planning High blood pressure can cause problems for ... control your blood pressure before and during the pregnancy. Some women develop high blood pressure during pregnancy. ...
Sosner, P; Ott, J; Steichen, O; Bally, S; Krummel, T; Brucker, M; Lequeux, B; Dourmap, C; Llaty, P; Le Coz, S; Baguet, S; Miranne, A; Labrunée, M; Gremeaux, V; Lopez-Sublet, M
While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentaryactive" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Full Text Available Background Metabolic syndrome is a disorder that increases the risk of cardiovascular disease and diabetes. Objectives The aim of the study was to evaluate some risk factors of the metabolic syndrome and food intakes among people who lived in Ahvaz City, Iran. Methods It was a filed study that was conducted on 211 subjects who participated in health exhibition. Socioeconomic status and ethnicity were asked by a general questionnaire. Weight, height, body mass index, waist circumference (WC and WC to hip circumference ratio (WHR were obtained. Blood sugar was measured by a glucometer. Systolic and diastolic blood pressures were obtained and dietary intakes were assessed by a brief instrument. Results There was a significant difference in weight, height, WC, WHR and systolic blood pressure among different jobs. Workers had more intakes of cake and sweets. Arab subjects had more intakes of bread and fishes and Persians more intakes of vegetables. Soda, chocolate and candy were more consumed by Kurd ethnicity. Conclusions Job may be accounted as an important effective socioeconomic factor related to metabolic syndrome risk factors; also different cultures due to different ethnicities may have an influence on lifestyle and dietary intakes.
van Zeeland, Y R A; Wilde, A; Bosman, I H; Uilenreef, J J; Egner, B; Schoemaker, N J
This study was conducted to validate the use of high definition oscillometry (HDO) for non-invasive blood pressure (NIBP) measurements in ferrets and to establish reference ranges for NIBP in minimally sedated, healthy, young adult ferrets (170mmHg) conditions. Although HDO correlated well with DABP (r>0.90), it showed significant proportional bias, whereby HDO generally underestimated DABP with hyper- and normotensive conditions, and overestimated DABP with hypotensive conditions. Measurements obtained from the hind limb showed higher bias than those obtained from the tail or forelimb (Pyoung adult ferrets were established at 95-155mmHg (systolic), 69-109mmHg (mean) and 51-87mmHg (diastolic) arterial pressures. Copyright © 2017 Elsevier Ltd. All rights reserved.
Suganthi V, Navin Rajaratnam, Suzanne Maria D’cruz
Full Text Available Background: The prevalence of obesity is increasing in Indian youth and obesity is associated with complications like systemic hypertension. Often, due to the non-availability of appropriate sized cuffs, standard cuff bladders are used to measure blood pressure in the forearms of obese young adults. Aim: To compare the upper arm arterial blood pressure measured using an appropriate cuff with the forearm arterial blood pressure measured using a standard cuff and conventional sphygmomanometry in obese otherwise healthy first year medical students. Materials and Methods: Blood pressure was measured in 27 obese otherwise healthy first year medical students after five minutes of rest using a mercury sphygmomanometer with the subjects seated and the arm and forearm at heart level, using an appropriate sized cuff for the upper arm according to American Heart Association standards and a standard cuff for the fore arm. Results: A statistically significant difference in both systolic [t-test (paired = -6.921; df = 26; sig = .000 (2- tailed] and diastolic blood pressure [t-test (paired = -8.508; df = 26; sig = .000 (2- tailed] was found, with the blood pressure readings being higher in the forearm. The correlations between upper arm and forearm systolic and diastolic blood pressure were 0.785 (p = .000 and 0.870 (p = .000. Conclusion: Both systolic and diastolic blood pressure measurements were significantly higher in the forearm. Further studies with larger sample size should be conducted to confirm that forearm blood pressure measurements using standard cuff bladders cannot be considered equal to upper arm measurements made using an appropriate sized cuff in all young obese individuals
... other risk factors, like diabetes, you may need treatment. How does high blood pressure affect pregnant women? A few women will get ... HIV, Birth Control Heart Health for Women Pregnancy Menopause More Women's Health ... High Blood Pressure--Medicines to Help You Women and Diabetes Heart ...
Full Text Available To measure precise blood pressure (BP and pulse rate without using a cuff, we have developed an arterial pulsimeter consisting of a small, portable apparatus incorporating a Hall device. Regression analysis of the pulse wave measured during testing of the arterial pulsimeter was conducted using two equations of the BP algorithm. The estimated values of BP obtained by the cuffless arterial pulsimeter over 5 s were compared with values obtained using electronic or liquid mercury BP meters. The standard deviation between the estimated values and the measured values for systolic and diastolic BP were 8.3 and 4.9, respectively, which are close to the range of values of the BP International Standard. Detailed analysis of the pulse wave measured by the cuffless radial artery pulsimeter by detecting changes in the magnetic field can be used to develop a new diagnostic algorithm for BP, which can be applied to new medical apparatus such as the radial artery pulsimeter.
Myers, Martin G; Kaczorowski, Janusz; Paterson, J Michael; Dolovich, Lisa; Tu, Karen
The risk of cardiovascular events in relation to blood pressure is largely based on readings taken with a mercury sphygmomanometer in populations which differ from those of today in terms of hypertension severity and drug therapy. Given replacement of the mercury sphygmomanometer with electronic devices, we sought to determine the blood pressure threshold for a significant increase in cardiovascular risk using a fully automated device, which takes multiple readings with the subject resting quietly alone. Participants were 3627 community-dwelling residents aged >65 years untreated for hypertension. Automated office blood pressure readings were obtained in a community pharmacy with subjects seated and undisturbed. This method for recording blood pressure produces similar readings in different settings, including a pharmacy and family doctor's office providing the above procedures are followed. Subjects were followed for a mean (SD) of 4.9 (1.0) years for fatal and nonfatal cardiovascular events. Adjusted hazard ratios (95% confidence intervals) were computed for 10 mm Hg increments in blood pressure (mm Hg) using Cox proportional hazards regression and the blood pressure category with the lowest event rate as the reference category. A total of 271 subjects experienced a cardiovascular event. There was a significant (P=0.02) increase in the hazard ratio of 1.66 (1.09, 2.54) at a systolic blood pressure of 135 to 144 and 1.72 (1.21, 2.45; P=0.003) at a diastolic blood pressure of 80 to 89. A significant (P=0.03) increase in hazard ratio of 1.73 (1.04, 2.86) occurred with a pulse pressure of 80 to 89. These findings are consistent with a threshold of 135/85 for diagnosing hypertension in older subjects using automated office blood pressure. © 2015 American Heart Association, Inc.
Paskalev, Dobrin; Kircheva, Anna; Krivoshiev, Stefan
In 1905, Dr. Nikolai Korotkoff (1874-1920), a Russian surgeon, discovered a simple and precise technique to measure arterial pressure. He was born on 26th February 1874 in the central Russian city of Kursk. Korotkoff graduated from the Medical Faculty of Moscow University in 1898, but he worked later in the Surgical Clinic at the Imperial Military Medical Academy in St. Petersburg (Russia). Korotkoff served as a military surgeon during the Russo-Japanese War (1904-1905) and his major efforts were to find reliable clinical signs that could predict whether limb flow would be viable after vascular surgery of traumatic aneurysm. He found that after complete compression, the aneurysm of the arm (i.e. distal pulse on a. brachialis) disappeared with Riva-Rocci cuff and then gradually decreasing the pressure, a series of sounds could be heard by stethoscope under the artery distal to the compression. Korotkoff described four distinct phases of sounds: first sound, then compression murmurs, second tone, and disappearance of sounds. Korotkoff was also able to demonstrate the same auscultatory finding in healthy persons. He failed to notice only the muffled second sound, which was demonstrated a little later. These classical observations are now well known as the five different phases of Korotkoff sounds. In November 1905, during a conference of the Imperial Military Medical Academy, he reported his discovery in a short presentation entitled 'On the issue of the methods for measuring blood pressure'. In 1939, the Joint Committee of the American Heart Association and the Cardiac Society of Great Britain and Ireland recognized officially and accepted worldwide Korotkoff's method for blood pressure determining. Copyright (c) 2005 S. Karger AG, Basel.
Daniel D. Reidpath
Full Text Available Introduction: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers. Method: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis. Results: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5–7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: −2.9 to −10.0 for diastolic blood pressure. Conclusion: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.
Persu, Alexandre; O'Brien, Eoin; Verdecchia, Paolo
Resistant hypertension as defined by the European Society of Hypertension and American Heart Association is a blood pressure that remains uncontrolled despite concomitant intake of at least three antihypertensive drugs (one of them preferably being a diuretic) at full doses. This definition is still based on office rather than out-of-office blood pressure measurement. In this review we propose a new, stricter definition of resistant hypertension based on ambulatory blood pressure measurement. The main arguments in favor of this are: (1) in patients with resistant hypertension, ambulatory blood pressure is an independent predictor of cardiovascular morbidity whereas, after adjustment for conventional risk factors, conventional blood pressure has little added value; (2) white-coat resistant hypertension (uncontrolled office with normal ambulatory blood pressure) is frequent (30-40% of patients with apparently resistant hypertension) carrying a prognosis similar to that of controlled hypertension, and intensification of blood pressure lowering treatment, or the use of nondrug treatment strategies such as renal denervation or carotid baroreceptor stimulation, is not justified; (3) masked resistant hypertension (controlled office with elevated ambulatory blood pressure) is frequent (approximately one-third of patients with controlled office blood pressure on triple antihypertensive therapy) and associated with an increased risk of cardiovascular events; in such patients, treatment intensification should be considered; (4) the current definition of resistant hypertension (office blood pressure ⩾ 140/90 mm Hg on triple antihypertensive therapy) allows a substantial proportion of patients with spurious or white-coat resistant hypertension to undergo renal denervation in the absence of proven long-term benefits.
Lee, Soojeong; Ahmad, Awais; Jeon, Gwanggil
Blood pressure measurement based on oscillometry is one of the most popular techniques to check a health condition of individual subjects. This paper proposes a support vector using fusion estimator with a bootstrap technique for oscillometric blood pressure (BP) estimation. However, some inherent problems exist with this approach. First, it is not simple to identify the best support vector regression (SVR) estimator, and worthy information might be omitted when selecting one SVR estimator and discarding others. Additionally, our input feature data, acquired from only five BP measurements per subject, represent a very small sample size. This constitutes a critical limitation when utilizing the SVR technique and can cause overfitting or underfitting, depending on the structure of the algorithm. To overcome these challenges, a fusion with an asymptotic approach (based on combining the bootstrap with the SVR technique) is utilized to generate the pseudo features needed to predict the BP values. This ensemble estimator using the SVR technique can learn to effectively mimic the non-linear relations between the input data acquired from the oscillometry and the nurse's BPs.
Graves, John W; Grossardt, Brandon R
Guidelines for office blood pressure (BP) measurements recommend two or more readings at each visit. It has been suggested that discarding the first reading may improve the diagnostic utility of office readings. We compare two methods of office BP measurement to determine whether discarding the first BP affects their association with ambulatory blood pressure monitoring (ABPM) readings. We studied measurements in 313 mildly hypertensive patients (181 men, median age 51 years) at the end of the washout phase of a hypertension treatment trial. All patients had three auscultatory readings by a trained nurse using a mercury manometer before a 24-h ABPM and three automated readings (Omron 705 CP) to American Heart Association standards after ABPM. Daytime ABPM (09:00-21:00) of systolic BP and diastolic BP were compared with office methods using first only, second and third only, and all three readings. Associations were assessed using Bland-Altman plots and Pearson's correlations. Bland-Altman plots revealed no differences between office methods and daytime ABPM regardless of whether the first reading was included or discarded. Results were similar for both systolic BP and diastolic BP. The Pearson correlations of office method readings with ABPM readings were lowest using the first measurement alone; however, discarding the first measurement did not improve the correlation compared with using all three readings. Discarding the first office BP reading does not change the association of office BP with ABPM or improve the correlation with ABPM values in hypertensive patients.
Chio, Shiu-Shin; Urbina, Elaine M; Lapointe, Jeffery; Tsai, Jeffrey; Berenson, Gerald S
Listening to Korotkoff sounds (K-sounds) to determine systolic and diastolic blood pressure (BP) has been the standard for noninvasive BP measurement in medical practices for nearly 100 years. It is the essential tool used for evaluation and assessment of patients with hypertension and risks of cardiovascular diseases (CVD) by physicians and nurses despite limited understanding of the nature of K-sounds. Analyzing cuff oscillometric signals to obtain BP has been the foundation of most digital BP monitors available today. DynaPulse is an oscillometric digital BP monitor that records and analyzes subtle changes of pulse waveforms during the course of a BP measurement while cuff pressure slowly decreases from above systolic to below diastolic. This study compares systolic and diastolic readings obtained by K-sound method following the Bogalusa Heart Study protocol and BP measured by DynaPulse (DP2000A) monitor, in order to better understand the nature and difference between K-sound and oscillometric methods. Analysis of means and differences is applied to BP data collected from 803 subjects examined in the Bogalusa Heart Study. The results indicated: 1) DynaPulse systolic was 9 mm Hg higher (P sound auscultatory measurement. Understanding the methods and differences of DynaPulse oscillometric and K-sound BP measurements is important for clinic BP screening and self-BP monitoring, as well as future research to improve hypertension and CVD managements. Copyright © 2011 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
van Doorn, B A; van der Does, E; Lubsen, J; Rijsterborgh, H
The Riva-Rocci indirect method of measuring the blood pressure carries a number of sources of error. A report is presented of a study of the serviceability of an electronic blood pressure meter as compared with the conventional mercury manometer. Seventy-six paired measurements were carried out in patients selected at random using an electronic blood pressure meter and a mercury manometer meeting all Health Council requirements. The systematic error and the incidental error in both measuring procedures were compared. The differences found were so slight as to be negligible in practice. It is concluded that the electronic blood pressure meter in practice constitutes an acceptable substitute for the conventional mercury manometer.
FOKKEMA, DS; SMIT, K; VANDERGUGTEN, J; KOOLHAAS, JM
Behavioral and physiological responses of 18 chronically cannulated male TMD-S3 rats were assessed during various social interactions with conspecifics, both with and without the possibility for physical contact (social vs. psychosocial stimulation). Response magnitudes (behavior, blood pressure,
Peters, Rosalind M; Templin, Thomas N
The purpose of this study was to develop and conduct preliminary psychometric assessment of instruments measuring knowledge and self-care practices regarding behaviors needed for blood pressure (BP) control among African Americans. Items were empirically derived and scored on a 7-point, bipolar scale. The instruments were evaluated in a sample of 306 community-dwelling African Americans. Results revealed acceptable reliability and validity of the BP Knowledge Scale. Results for the BP Self-Care Scale were mixed. A structural equation model of these scales, recorded BP, and covariates fit well. There was an unexpected positive correlation between self-care and BP suggesting a potential bi-directional relationship. The scales demonstrated acceptable psychometric properties and, with minor revisions, may have clinical utility as measures of BP knowledge and self-care. (c) 2008 Wiley Periodicals, Inc.
Tao, Guocai; Chen, Yan; Wen, Changyun; Bi, Min
Although a validated oscillometry sphygmomanometer satisfies the accuracy criteria of Advancement of Medical Instrumentation (AAMI), its long-term blood pressure (BP) measurement error during operations remains to be determined. We aim to (a) compare the error range throughout surgical operations with the accuracy criteria of AAMI, and (b) investigate the probabilities of occurrence of abnormal, large errors and clinically meaningful errors. BP level were measured from 270 participants using oscillometry and arterial cannulation (invasive method) in the same BP monitor throughout surgeries. Mean deviation and SD (oscillometry vs. invasive method) were calculated from 6640 sets of data and presented in the Bland-Altman Plots. Also, the average, the largest, and the smallest measurement errors (errormean, errormax, and errormin) per patient were obtained. The probability distributions of the three types of errors were shown using histograms (percentage vs. SD). In addition, the clinically meaningful large errors (≥ 10 mmHg) of the adult patients when their systolic blood pressure (SBP) values were around 90 mmHg were investigated. The mean deviation (1.98 mmHg for SBP and 4.31 mmHg for diastolic blood pressure (DBP) satisfies the AAMI criterion (≤ 5 mmHg), but the SD (14.87 mmHg for SBP and 11.21 mmHg for DBP) exceeds the AAMI criterion (≤ 8 mmHg). The probability of errormax more than 40 mmHg is 14% for SBP and 6% for DBP. The probability of errormean more than 24 mmHg (4.07% for SBP and 1.48% for DBP), and that of errormin more than 24 mmHg (0.37% for SBP and 0.37% for DBP) are all greater than the criterion of 0.26%. The clinically meaningful errors are found in 28.78% of the adult patients. The SD of long-term BP measurement by our oscillometric method during operations exceeds AAMI accuracy criteria. And it is important to be aware of the abnormal large errors and clinically meaningful errors as their probabilities are rather significant. We analyze the
Patrick R. Steffen
Full Text Available Heart rate variability biofeedback (HRVB significantly improves heart rate variability (HRV. Breathing at resonance frequency (RF, approximately 6 breaths/min constitutes a key part of HRVB training and is hypothesized to be a pathway through which biofeedback improves HRV. No studies to date, however, have experimentally examined whether RF breathing impacts measures of HRV. The present study addressed this question by comparing three groups: the RF group breathed at their determined RF for 15 min; the RF + 1 group breathed at 1 breath/min higher than their determined RF for 15 min; and the third group sat quietly for 15 min. After this 15-min period, all groups participated in the Paced Auditory Serial Addition Task (PASAT for 8 min, and then sat quietly during a 10-min recovery period. HRV, blood pressure, and mood were measured throughout the experiment. Groups were not significantly different on any of the measures at baseline. After the breathing exercise, the RF group reported higher positive mood than the other two groups and a significantly higher LF/HF HRV ratio relative to the control group, a key goal in HRVB training (p < 0.05. Additionally, the RF group showed lower systolic blood pressure during the PASAT and during the recovery period relative to the control group, with the RF + 1 group not being significantly different from either group (p < 0.05. Overall, RF breathing appears to play an important role in the positive effect HRVB has on measures of HRV.
... can help you control high blood pressure. These habits include: Healthy eating Being physically active Maintaining a healthy weight Limiting alcohol intake Managing and coping with stress To help make lifelong lifestyle changes, try making ...
... Add less salt to your food and avoid fast food and other foods that are high in salt. Know your blood pressure and have it ... a Health Problem Cholesterol Smart Snacking Yoga for Stress Relief ...
Hillebrand, Matthias; Nouri, Ghazaleh; Hametner, Bernhard; Parragh, Stephanie; Köster, Jelena; Mortensen, Kai; Schwarz, Achim; von Kodolitsch, Yskert; Wassertheurer, Siegfried
The aim of this work is the investigation of measures of ambulatory brachial and aortic blood pressure and indices of arterial stiffness and aortic wave reflection in Marfan patients. A case-control study was conducted including patients with diagnosed Marfan syndrome following Ghent2 nosology and healthy controls matched for sex, age and daytime brachial systolic blood pressure. For each subject a 24 h ambulatory blood pressure and 24 h pulse wave analysis measurement was performed. All parameters showed a circadian pattern whereby pressure dipping was more pronounced in Marfan patients. During daytime only Marfan patients with aortic root surgery showed increased pulse wave velocity. In contrast, various nighttime measurements, wave reflection determinants and circadian patterns showed a significant difference. The findings of our study provide evidence that ambulatory measurement of arterial stiffness parameters is feasible and that these determinants are significantly different in Marfan syndrome patients compared to controls in particular at nighttime. Further investigation is therefore indicated.
Moreira Leila B
Full Text Available Abstract Background Blood pressure (BP variability has been associated with cardiovascular outcomes, but there is no consensus about the more effective method to measure it by ambulatory blood pressure monitoring (ABPM. We evaluated the association between three different methods to estimate BP variability by ABPM and the ankle brachial index (ABI. Methods and Results In a cross-sectional study of patients with hypertension, BP variability was estimated by the time rate index (the first derivative of SBP over time, standard deviation (SD of 24-hour SBP; and coefficient of variability of 24-hour SBP. ABI was measured with a doppler probe. The sample included 425 patients with a mean age of 57 ± 12 years, being 69.2% women, 26.1% current smokers and 22.1% diabetics. Abnormal ABI (≤ 0.90 or ≥ 1.40 was present in 58 patients. The time rate index was 0.516 ± 0.146 mmHg/min in patients with abnormal ABI versus 0.476 ± 0.124 mmHg/min in patients with normal ABI (P = 0.007. In a logistic regression model the time rate index was associated with ABI, regardless of age (OR = 6.9, 95% CI = 1.1- 42.1; P = 0.04. In a multiple linear regression model, adjusting for age, SBP and diabetes, the time rate index was strongly associated with ABI (P Conclusion Time rate index is a sensible method to measure BP variability by ABPM. Its performance for risk stratification of patients with hypertension should be explored in longitudinal studies.
Figueiredo, Daniela; Azevedo, Ana; Pereira, Marta; de Barros, Henrique
A diagnosis of hypertension should be based on multiple blood pressure (BP) measurements, taken on at least two separate occasions. We aimed to assess the impact of considering different criteria for a definition of hypertension, based on number of visits for blood pressure measurement, on estimates of hypertension prevalence, awareness, treatment and control, and on its association with two variables definitely related to hypertension: body mass index and left ventricular hypertrophy. We used data from a cross-sectional study of 739 participants, aged > or = 45 years, randomly selected from a non-institutionalized Portuguese population, from January 2001 to December 2003. Main outcome measures were prevalence of hypertension (systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg or current antihypertensive drug therapy) based on BP measurements on one visit, on BP measurements on a second visit or on fulfilling the same criteria on the two different visits. Estimated hypertension prevalence was 63.4% (95% CI: 59.8-66.9) using BP measurements from the first visit (HTN1) and 60.2% (95% CI: 56.6-63.8) using BP measurements from the second visit (HTN2). If both visits are used as criteria the estimated hypertension prevalence (HTN(Final)) was 56.3% (95% CI: 52.7-60.0), p (McNemar test) hypertension prevalence have a similar strong and independent association with body mass index (OR = 2.71 for body mass index > or = 30 with HTN(Final)) and with left ventricular hypertrophy (OR = 3.21 for HTN(Final) with left ventricular hypertrophy). In many individuals labeled as hypertensive on a single evaluation, hypertension was not confirmed on reassessment, leading to a significant overestimation of 12.6% of the true prevalence. For this reason BP should be measured on at least two office visits both for clinical purposes and in epidemiological studies. On the other hand, this did not reflect on the association between hypertension and body mass index or left
Muhamed, P. K.; Olsen, M. H.; Holm, Jens-Christian
Introduction: Recently, we established that a group ofobese children and adolescents had a higher blood pressure(BP) than a healthy control group. In the present study, weinvestigate whether the higher BP in the obese group wasinfluenced by BP cuff sizes.Methods: A total of 104 obese patients aged...... sizes had a significant impact on BP measurements.Despite the influence of cuff size, multiple regressionanalyses revealed that systolic BP was 68 mmHg higherand diastolic BP 32 mmHg higher in the obese groupthan in the control group. A step function, i.e. a sudden fallin BP, was seen at the point...... of switching from small to mediumcuff size in the control group, which suggests that systolicBP was overestimated when using small cuff size andunderestimated when using medium cuff size in subjectswith an AC near 23 cm.Conclusions: BP was higher in the obese group than inthe control group although BP...
Atallah, A; Pham Hoang Minh, A; Billy-Brissac, R; Dinarque, C
Current recommendations advocate self-measurement of blood pressure (SMBP) for the diagnosis and monitoring of high blood pressure (HBP). The "PEA" is an education program of the HTA GWAD network. Its mission is to train hypertensive patients with SMBP. The objective of this study is to evaluate between 6 months to 1 year after the efficiency of this program on the theoretical and practical knowledge of patients, as well as their behavior towards hypertension. Hundred and twenty patients were included in the study. In an interview, their knowledge was assessed using a questionnaire. The acquisition of the technique, reading and figures transcription, purchase of a SMBP device were also evaluated. The average questionnaire score was 5.7/13 (σ=2.7) before the educational session, 9.5/13 (σ=1.9) 1 week after the educational session. This improvement persisted over time with 8.9/13 (σ=2.9) correct answers 6 months to 1 year later. Exactly 73.3% (n=88/120) had a self-measurement device. Among them, 44.3% (n=39/88) practiced SMBP before medical consultations and 10% systematically did it before each medical consultation. A number of 84.2% (n=101/120) mastered the technique and 76.7% (n=92/120) of patients knew how to transcribe figures. Reading and understanding figures were acquired by 61.7% (n=74/120) of patients. A high level of education was correlated with a high level of practice. PEA is a sustainable solid and stable education program. However, the practice of SMBP is not yet systematic and remains to be encouraged in some patients. Given this situation, the network offers improvements in its program: highlighting of objectives, calendar reminder, "coaching" nurse. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Ishikuro, Mami; Ubeda, Sergio Ramón Gutiérrez; Obara, Taku; Watanabe, Ikue; Metoki, Hirohito; Kikuya, Masahiro; Kuriyama, Shinichi; Maruyama, Ryoko; Ohkubo, Takayoshi; Imai, Yutaka
The self-measurement of blood pressure (BP) at home is useful in predicting the level of target organ damage and in managing hypertension. Nurses are essential practitioners for managing hypertension; however, it is unclear whether they have adequate knowledge of home BP management. This study assessed the knowledge, attitudes, and practices of home BP measurement among Japanese nurses. A questionnaire regarding home BP measurement was distributed among nurses and collected by mail. A total of 6,002 (61.8%) responses were eligible for the study. The proportion of participants who correctly recognized the reference values for clinic BP and home BP was 9.9% and 2.8%. Midwives and those working for the government had the highest proportion of correct responses of reference values among all nursing subgroups. Participants who thought that home BP gave the most important BP information were 62.7%. About 60% of the participants who recommended home BP measurement to hypertensive patients preferred to recommend an upper-arm cuff device. Our findings suggested that more knowledge of home BP measurement among nurses is warranted.
Bello, Natalie A; Woolley, Jonathan J; Cleary, Kirsten Lawrence; Falzon, Louise; Alpert, Bruce S; Oparil, Suzanne; Cutter, Gary; Wapner, Ronald; Muntner, Paul; Tita, Alan T; Shimbo, Daichi
The accurate measurement of blood pressure (BP) in pregnancy is essential to guide medical decision making that affects both mother and fetus. The aim of this systematic review was to determine the accuracy of ambulatory, home, and clinic BP measurement devices in pregnant women. We searched Ovid MEDLINE, The Cochrane Library, EMBASE, CINAHL EBSCO, ClinicalTrials.gov, International Clinical Trials Registry Platform, and dabl from inception through August 3, 2017 for articles that assessed the validity of an upper arm BP measurement device against a mercury sphygmomanometer in pregnant women. Two independent investigators determined eligibility, extracted data, and adjudicated protocol violations. From 1798 potential articles identified, 41, that assessed 28 devices, met the inclusion criteria. Most articles (n=32) followed a standard or modified American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization, British Hypertension Society, or European Society of Hypertension validation protocol. Several articles described the results of validation studies performed on >1 device (n=7) or in >1 population of pregnant women (n=12), comprising 64 pairwise validity assessments. The device was validated in 61% (32 of 52) of studies which used a standard or modified protocol. Only 34% (11 of 32) of the studies wherein the device was successfully validated were performed without a protocol violation. Given the implications of inaccurate BP measurement in pregnant women, healthcare providers should be aware of and try to use the BP measurement devices which have been properly validated in this population. © 2017 American Heart Association, Inc.
Sebo, Paul; Pechère-Bertschi, Antoinette; Herrmann, François R; Haller, Dagmar M; Bovier, Patrick
To evaluate the accuracy of blood pressure (BP) measurements performed by primary care physicians (PCPs), and to assess whether it improves following a short theoretical training. Observational study in 26 primary care practices in Geneva, Switzerland. The PCPs were asked to measure BP on 10 volunteers, within the usual context of their practice. Two trained research assistants repeated the measures immediately after the PCPs. The PCPs were then randomized to receive detailed training documentation on standardized BP measurement (group I: 14 doctors) or information about high BP (group II: 12 doctors). Measures were repeated a few weeks later. We computed accuracy and diagnostic categorization of high BP comparing the PCPs' measurements to the average value of four measurements by the research assistants (gold standard). T-tests were used to compare measurements between the two educational groups, both at baseline and following exposure to the educational material. BP measurements were performed on 257 volunteers at baseline and 251 after training. At baseline, the mean BP difference between PCPs and the gold standard were 23.0 mmHg (21.3-24.6) for systolic and 15.3 mmHg (14.3-16.3) for DBP. Following training, the mean difference remained high [group I: 22.3 mmHg (20.4-24.2) and 14.4 mmHg (12.6-16.2); group II: 25.3 mmHg (22.7-27.9) and 17.0 mmHg (15.3-18.7)]. As a result, 24-32% volunteers were misdiagnosed as having systolic hypertension and 15-21% as having diastolic hypertension. Though widely used in the assessment of hypertension in ambulatory settings, in-office BP measurements are highly inaccurate, even following training.
Full Text Available Abstract Background Wrist blood pressure (BP devices have physiological limits with regards to accuracy, therefore they were not preferred for home BP monitoring. However some wrist devices have been successfully validated using etablished validation protocols. Therefore this study assessed the reproducibility of wrist home BP measurement with position sensor and automatic data storage. Methods To compare the reproducibility of three different(BP measurement methods: 1 office BP, 2 home BP (Omron wrist device HEM- 637 IT with position sensor, 3 24-hour ambulatory BP(24-h ABPM (ABPM-04, Meditech, Hunconventional sphygmomanometric office BP was measured on study days 1 and 7, 24-h ABPM on study days 7 and 14 and home BP between study days 1 and 7 and between study days 8 and 14 in 69 hypertensive and 28 normotensive subjects. The correlation coeffcient of each BP measurement method with echocardiographic left ventricular mass index was analyzed. The schedule of home readings was performed according to recently published European Society of Hypertension (ESH- guidelines. Results The reproducibility of home BP measurement analyzed by the standard deviation as well as the squared differeces of mean individual differences between the respective BP measurements was significantly higher than the reproducibility of office BP (p Conclusion The short-term reproducibility of home BP measurement with the Omron HEM-637 IT wrist device was superior to the reproducibility of office BP and 24- h ABPM measurement. Furthermore, home BP with the wrist device showed similar correlations to targed organ damage as recently reported for upper arm devices. Although wrist devices have to be used cautious and with defined limitations, the use of validated devices with position sensor according to recently recommended measurement schedules might have the potential to be used for therapy monitoring.
Full Text Available Appropriate control of blood pressure (BP is essential for prevention of future cardiovascular events. However, BP control among treated hypertensive patients has been insufficient. Recently, the usefulness of self-measured BP at home (home BP measurement for the management of hypertension has been reported in many studies. We evaluated BP control both at home and in the office among treated hypertensive patients in primary care settings in Japan (the J-HOME study. We found poor control of home and office BPs and clarified some factors affecting control. We also examined factors associated with the magnitude of the white-coat effect, the morning–evening BP difference, and home heart rate in this J-HOME study.
Aarnes, Turi K.; Hubbell, John A.E.; Lerche, Phillip; Bednarski, Richard M.
This study assessed the accuracy of the oscillometric method for arterial blood pressure (ABP) monitoring in anesthetized camelids. Twenty camelids were anesthetized and systolic ABP (SABP), mean ABP (MABP), and diastolic ABP (DABP) were measured directly and using the oscillometric method. The mean difference between SABP measurements was −9.9 ± 21.9 mmHg with a range of −76 to 54 mmHg, and the 95% limits of agreement (LOA) were −33 to 53 mmHg. The difference between DABP measurements was −1.8 ± 15.6 mmHg with a range of −81 to 36 mmHg, and the 95% LOA were −32 to 29 mmHg. The difference between MABP measurements was −2.9 ± 17.0 mmHg with a range of −81 to 36 mmHg, and the 95% LOA were −30 to 36 mmHg. Accurate ABP monitoring in anesthetized camelids cannot be accomplished using the oscillometric method. PMID:23372197
Aarnes, Turi K; Hubbell, John A E; Lerche, Phillip; Bednarski, Richard M
This study assessed the accuracy of the oscillometric method for arterial blood pressure (ABP) monitoring in anesthetized camelids. Twenty camelids were anesthetized and systolic ABP (SABP), mean ABP (MABP), and diastolic ABP (DABP) were measured directly and using the oscillometric method. The mean difference between SABP measurements was -9.9 ± 21.9 mmHg with a range of -76 to 54 mmHg, and the 95% limits of agreement (LOA) were -33 to 53 mmHg. The difference between DABP measurements was -1.8 ± 15.6 mmHg with a range of -81 to 36 mmHg, and the 95% LOA were -32 to 29 mmHg. The difference between MABP measurements was -2.9 ± 17.0 mmHg with a range of -81 to 36 mmHg, and the 95% LOA were -30 to 36 mmHg. Accurate ABP monitoring in anesthetized camelids cannot be accomplished using the oscillometric method.
Yap, Yee Guan; Duong, Trinh; Bland, J Martin
, CAMIAT, SWORD, TRACE and DIAMOND-MI studies with left ventricular ejection fraction less than 40% or asymptomatic ventricular arrhythmia surviving more than 45 days after MI were pooled. Systolic and diastolic blood pressures and pulse pressures were measured soon after MI (median 6 days, range 0-53 days...... diastolic blood pressure significantly increased the risk of all-cause mortality (HR 0.87, 95% CI 0.77-0.98; P = 0.02) and arrhythmic mortality (HR 0.80, 95% CI 0.68-0.93; P = 0.005). CONCLUSION: In post-MI patients with left ventricular ejection fraction less than 40% or asymptomatic ventricular arrhythmia......BACKGROUND: The prognostic value of blood pressure measured during hospitalization after acute myocardial infarction (MI) has not been investigated, particularly with regard to arrhythmic death. METHODS: A total of 3311 placebo patients (2612 men, median age 64 years; range 23-92) from the EMIAT...
Sant Cassia, Emma V; Boswood, Adrian; Tordiffe, Adrian S W
Blood pressure measurement reveals important insights into the health of conscious and anesthetized individuals. This is of particular interest in cheetahs (Acinonyx jubatus), which in captivity are known to suffer from chronic diseases that may be associated with hypertension and which often require immobilization for transport or veterinary treatment. Invasive testing methods are considered the gold standard but are not practical in many settings. Consequently, it is important to evaluate the use of noninvasive methods in this species. Measurements for systolic, diastolic, and mean arterial pressure obtained using high-definition oscillometry (HDO) at the coccygeal artery were compared to simultaneous direct measurements obtained via catheterization of the femoral or dorsal pedal artery in eight anesthetized captive cheetahs during nine anesthetic events. Overall, HDO and direct measurements agreed most closely for mean arterial pressure, and the poorest agreement was observed for systolic pressure. There was a tendency for low diastolic pressures to be underestimated and for high diastolic pressures to be overestimated. Across all three parameters, HDO measurements from the tail overestimated directly measured pressures in the femoral artery and underestimated those in the dorsal pedal artery. HDO agreed most closely with directly measured dorsal pedal pressures. Mean arterial pressure showed the greatest precision (standard deviation of 10.2 mm Hg) and lowest bias (-1.2 mm Hg), with 75.9% of readings within 10 mm Hg of the direct dorsal pedal pressure. Agreement with systolic pressure was hindered by a high bias (-10.4 mm Hg), but if a correction factor of +10 mm Hg was applied to all systolic measurements, agreement was improved and 65.7% of readings were within 10 mm Hg of the direct pressure. When compared to criteria defined by the American College of Veterinary Internal Medicine for validation of blood pressure devices, results were favorable, but a
Duncombe, Stephanie L; Voss, Christine; Harris, Kevin C
The phase-out of mercury from clinical settings calls for valid alternatives to assess blood pressure (BP) in children. Aneroid devices provide a mercury-free alternative to BP measurements by auscultation, whereas oscillometric (automated) devices are increasingly becoming the norm in clinical practice due to their ease of use. The aim of this systematic review and meta-analysis was to investigate the accuracy of oscillometric and aneroid BP devices compared with the mercury sphygmomanometer for the measurement of BP in children. We systematically searched four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) and relevant journals for eligible articles published before 30 July 2015. We screened 1415 articles, and two authors independently reviewed 92 full-text articles. We included 29 articles (38 studies) with 26 879 children. Random-effects model meta-analyses revealed that oscillometric devices yield higher measurements of SBP than auscultation with a mercury sphygmomanometer (pooled effect estimate 2.53 mmHg; 95% CI 0.57-4.50; P devices and found comparable results. Oscillometric devices may serve as a suitable alternative to auscultation for initial BP screening in the pediatric population.
Kikuya, Masahiro; Ohkubo, Takayoshi; Satoh, Michihiro; Hashimoto, Takanao; Hirose, Takuo; Metoki, Hirohito; Obara, Taku; Inoue, Ryusuke; Asayama, Kei; Totsune, Kazuhito; Imai, Yutaka
The PS-501 device (Parama-Tech, Fukuoka, Japan), an automated device for office blood pressure measurement based on the Korotkoff method and designed for professional use in clinical settings, was validated. Consecutive outpatients with hypertension and ≥30 years old at an outpatient hypertension clinic were recruited. According to the European Society of Hypertension protocol, 33 participants were included in the validation study (phase 1, n = 15; phase 2, n = 18). The cuff deflation rate can be selected manually from 2, 3, and 4 mm Hg/beat. The validation was performed with the device deflating at a rate of 2 mm Hg/beat. All blood pressure readings were measured on the left arm. The tested device passed all criteria for both systolic and diastolic blood pressure measurements. The mean (± standard deviation) differences in systolic and diastolic blood pressure between the tested device and the mean of observer readings were -1.9 ± 4.6 and -2.5 ± 2.9 mm Hg, respectively. The PS-501 device for office blood pressure measurement passed all the validation criteria of the European Society of Hypertension and can therefore be recommended for clinical use in an adult population.
Nguyen, Xuan P.; Kronemayer, Ralf; Herrmann, Peter; Mejía, Atila; Daw, Zamira; Nguyen, Xuan D.; Kränzlin, Bettina; Gretz, Norbert
In the present article, we describe the validation of a new non-invasive method for measuring blood pressure (BP) which also enables to determine the three BP values: systolic, diastolic and mean value. Our method is based on the pulse transit time (PTT) measurement along an artery directly at the BP cuff. The accuracy of this method was evaluated by comparison with the direct simultaneous measurement of blood pressure from 40 anesthetized female mice. Close correlation ...
A Spacelab experiment is described which proposes to obtain data on the degree of engorgement of the cephalad circulation during weightlessness by recording central venous pressure. Of practical importance is the question of how close the astronauts are to pulmonary edema and whether the pressure falls toward normal during the time of the mission. Another experiment to investigate deviations from normal fluid and mineral metabolism, possibly initiated by the central engorgement of the low pressure system, is discussed. Hormones responsible for the control of water and mineral balance (vasopressin, catecholamines, renin, aldosterone, corticosteroids, and prostaglandin E1) will be analyzed from blood samples.
Full Text Available ... are two main types of high blood pressure: primary and secondary high blood pressure. Primary High Blood Pressure Primary, ... plan based on whether you were diagnosed with primary or secondary high blood pressure and if there is a ...
Asai, Y; Kawamoto, R; Nago, N; Kajii, E
To examine the usual methods of blood pressure (BP) measurement by primary care physicians and to compare them with the standard methods. Cross-sectional survey by self-administered questionnaire. Primary care physicians who graduated from Jichi Medical School and were working at clinics. Each standard method for 20 items was defined as the one that was most frequently recommended by 6 guidelines (USA 3, UK 1, Canada 1, Japan 1) and a recent comprehensive review about BP measurement. Of 333 physicians, 190 (58%) responded (median age 33, range 26 to 45 years). Standard methods and percentages of physicians who follow them are: [BP measurement, 17 items] supported arm 96%; measurement to 2 mmHg 91%; sitting position 86%; mercury sphygmomanometer 83%; waiting > or = 1 minute between readings 58%; palpation to assess systolic BP before auscultation 57%; check accuracy of home BP monitor 56%; Korotkoff Phase V for diastolic BP 51%; bilateral measurements on initial visit 44%; small cuff available 41%; > or = 2 readings in patients with atrial fibrillation 38%; > or = 2 readings on one visit 20%; cuff deflation rate of 2 mmHg/pulse 14%; large cuff available 13%; check accuracy of monitor used for home visit 8%; waiting time > or = 5 minute 3%; readings from the arm with the higher BP 1%. [Knowledge about BP monitor, 2 items] appropriate size bladder: length 11%; width 11%. [Check of sphygmomanometer for leakage, inflate to 200 mmHg then close valve for 1 minute] leakage < 2 mmHg 6%; median 10 (range 0-200) mmHg. Average percentage of all 20 items was 39%. Number of methods physicians follow as standard: median 8 (range 4 to 15) and this number did not correlate with any background characteristics of the physicians. Furthermore, we also obtained information on methods not compared with the standard. Fifty-four percentage of physicians used more standard methods in deciding the start or change of treatment than in measuring BP of patients with good control. About 80% of
Andreadis, Emmanuel A; Geladari, Charalampia V; Angelopoulos, Epameinondas T; Savva, Florentia S; Georgantoni, Anna I; Papademetriou, Vasilios
Automated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the "white coat effect" and shows a strong association with ambulatory blood pressure. We conducted a cross-sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland-Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (-5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, -6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and -2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician). Our findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Moni, M A; Rahman, M A; Haque, M A; Islam, M S; Ahmed, K
This cross-sectional study was done to assess the blood pressure of the senior citizens in relation to the anthropometric measurements and indices. It was conducted among the Bangladeshi elderly citizens of selected areas of Dhaka city. Samples were selected by convenient technique. A pre-tested questionnaire and a check list were used for data collection. Data analysis was done by SPSS for Windows. Three areas of Dhaka city namely Nakhal Para, Badda and Mirpur were selected in this study. The study was conducted during January to June 2006. A total of 317 samples were studied. Mean age of the respondents was 67.1 years (+/-6.6 SD). Mean SBP and DBP measured were 126 mm of Hg (+/-20 SD) and 72 mm of Hg (+/-12 SD), respectively. Among them, 33.1% were hypertensive on BP measurement; amongst which 32.4% had both SBP and DBP raised; 55.2% had isolated systolic hypertension and 12.4% had DBP raised. Of them 44.8% were identified finally as hypertensive considering BP measurement and those taking antihypertensive medication. The majority were well nourished and at less health risk in terms of BMI, WC and WHR. There was a tendency of being hypertensive with overweight/obese (p<0.05), high WC (male p<0.05 and female p<0.01) and high WHR (female p<0.001). Percentage of hypertensive was higher among the seniors of the study areas especially among those who were overweight/obese or at health risk by WC/WHR.
Full Text Available Background: Measurement of blood pressure (BP is done poorly because of both human and machine errors.Aim: To assess the difference between BP recorded in a pragmatic way and that recorded using standard guidelines; to assess differences between wrist- and mercury sphygmomanometerbased readings; and to assess the impact on clinical decision-making.Setting: Royal Swaziland Sugar Corporation Mhlume hospital, Swaziland.Method: After obtaining consent, BP was measured in a pragmatic way by a nurse practitioner who made treatment decisions. Thereafter, patients had their BP re-assessed using standard guidelines by mercury (gold standard and wrist sphygmomanometer.Results: The prevalence of hypertension was 25%. The mean systolic BP was 143 mmHg (pragmatic and 133 mmHg (standard using a mercury sphygmomanometer; and 140 mmHg for standard BP assessed using wrist device. The mean diastolic BP was 90 mmHg, 87 mmHg and 91 mmHg for pragmatic, standard mercury and wrist, respectively. Bland Altman analyses showed that pragmatic and standard BP measurements were different and could not be interchanged clinically.Treatment decisions between those based on pragmatic BP and standard BP agreed in 83.3% of cases, whilst 16.7% of participants had their treatment outcomes misclassified. A total of 19.5% of patients were started erroneously on anti-hypertensive therapy based on pragmatic BP.Conclusion: Clinicians need to revert to basic good clinical practice and measure BP more accurately in order to avoid unnecessary additional costs and morbidity associated within correct treatment resulting from disease misclassification. Contrary to existing research,wrist devices need to be used with caution.
Krähenbühl, B; Nielsen, S L; Lassen, N A
Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers...... by direct cooling or intra-arterial noradrenaline infusion caused a marked drop in FSP in the exposed fingers, but not in the non-exposed fingers of the same hand. The fact that the non-exposed fingers retained the normal (arm systolic) pressure level is taken to indicate that palmar arch blood pressure...... also remained normal. In the high vascular tone state, a large transmural pressure difference must apparently be established before the digital arteries are forced open. The lowered opening pressure constitutes a manifestation of the closure phenomenon of the digital arteries described in patients...
Uen, Sakir; Fimmers, Rolf; Brieger, Miriam; Nickenig, Georg; Mengden, Thomas
Background Wrist blood pressure (BP) devices have physiological limits with regards to accuracy, therefore they were not preferred for home BP monitoring. However some wrist devices have been successfully validated using etablished validation protocols. Therefore this study assessed the reproducibility of wrist home BP measurement with position sensor and automatic data storage. Methods To compare the reproducibility of three different(BP) measurement methods: 1) office BP, 2) home BP (Omron wrist device HEM- 637 IT with position sensor), 3) 24-hour ambulatory BP(24-h ABPM) (ABPM-04, Meditech, Hun)conventional sphygmomanometric office BP was measured on study days 1 and 7, 24-h ABPM on study days 7 and 14 and home BP between study days 1 and 7 and between study days 8 and 14 in 69 hypertensive and 28 normotensive subjects. The correlation coeffcient of each BP measurement method with echocardiographic left ventricular mass index was analyzed. The schedule of home readings was performed according to recently published European Society of Hypertension (ESH)- guidelines. Results The reproducibility of home BP measurement analyzed by the standard deviation as well as the squared differeces of mean individual differences between the respective BP measurements was significantly higher than the reproducibility of office BP (p ABPM (p ABPM was not significantly different (p = 0.80 systolic BP, p = 0.1 diastolic BP). The correlation coefficient of 24-h ABMP (r = 0.52) with left ventricular mass index was significantly higher than with office BP (r = 0.31). The difference between 24-h ABPM and home BP (r = 0.46) was not significant. Conclusion The short-term reproducibility of home BP measurement with the Omron HEM-637 IT wrist device was superior to the reproducibility of office BP and 24- h ABPM measurement. Furthermore, home BP with the wrist device showed similar correlations to targed organ damage as recently reported for upper arm devices. Although wrist devices have
Marcelo Custódio Rubira
Full Text Available Body composition has fundamental importance in the quality of life and is a powerful predictor of mortality and morbidity in humans. The identification and monitoring of the amount of body fat have been receiving special attention in aspects related to health promotion, not just for its actions in the prevention and in the control of cardiovascular diseases but also for their induction and association with risk factors, especially in the plasmatic lipid levels and arterial pressure. It was investigated the relationship between body mass index (BMI and body fat percentage (%BF by bioelectrical impedance analysis (BIA with the blood pressure levels (systolic and diastolic and serum lipids (TC, HDL-c, LDL-c, VLDL-c, TG. In a group of fifty seven women (aged 18 to 26 years old , obesity was detected in 5 and 19 women by BMI (≥ 30 kg/m2 and %BF (≥ 30%, respectively. BMI and % BF were positively correlated with blood pressure (systolic and diastolic, and highly significant in the obese group by %BF. Moreover, BMI and % BF were significantly correlated with all lipids and lipoprotein fractions VLDL-c and triglyceride, respectively. These results suggest that %BF is a good indicator of “occult obesity” in subjects with normal body mass index. The associated use of BMI and %BF to better evaluate obesity may improve the study of blood pressure levels and serum lipid changes that are commonly associated with obesity.
Tahir Kemal SAHIN
Full Text Available Objective: The aim of this study is to determine the right knowledge of blood pressure measurement of the nurses who working in clinics. Materials and Method: 103 nurses who are working in Meram Medical Faculty Hospital were included to this descriptive study. Sampling method was stratified proportional random sampling method, with strata for the number of nurses at clinics. A questionnaire, which was formed of some questions about standard measuring methods of blood pressure, was applied to the nurses. Results: It was determined that 55.3% to 98.1% of the nurses answered the most of the questions correctly. But, they gave different answers to the questions about choosing the arm for measurement, inflation level of the cuff, deflation speed and how many measurements should be done for true result. It was found that the female nurses had much more knowledge about the tension of wrapping the cuff around the arm and the correct positioning of the stethescope than the male ones. Oppositely, the male nurses had higher correct answer rate about deflation of the cuff than the female nurses. Conclusion: It was concluded that the knowledge of blood pressure measurement of the nurses was partly insufficient. Periodical educational studies should be done for the nurses to complete the blood pressure measurement knowledge of them. [TAF Prev Med Bull 2006; 5(1.000: 8-18
Contreras, Danitza J; Vogel, Eugenio E; Saravia, Gonzalo; Stockins, Benjamin
We provide ambulatory blood pressure (BP) exams with tools based on information theory to quantify fluctuations thus increasing the capture of dynamic test components. Data from 515 ambulatory 24-hour BP exams were considered. Average age was 54 years, 54% were women, and 53% were under BP treatment. The average systolic pressure (SP) was 127 ± 8 mm Hg. A data compressor (wlzip) designed to recognize meaningful information is invoked to measure mutability which is a form of dynamical variability. For patients with the same average SP, different mutability values are obtained which reflects the differences in dynamical variability. In unadjusted linear regression models, mutability had low association with the mean systolic BP (R(2) = 0.056; P < .000001) but larger association with the SP deviation (R(2) = 0.761; P < .001). Wlzip allows detecting levels of variability in SP that could be hazardous. This new indicator can be easily added to the 24-hour BP monitors improving information toward diagnosis. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.
Jennings, G; Dart, A; Meredith, I; Korner, P; Laufer, E; Dewar, E
Reversal of left ventricular hypertrophy (LVH) is an important target of antihypertensive therapy. Nonpharmacological approaches such as weight reduction and exercise training have favorable effects on other risk factors. However, there are few data on their effects on LVH. Athletes have eccentric rather than concentric LVH. A 12-month exercise program in 13 unmedicated hypertensive subjects altered LV geometry, reducing LV wall thickness and increasing LV internal diameters (LVID). LV mass was unchanged, and the thickness/radius fell by 9%. Shorter-term studies have shown that the cardiac structural changes with a moderate exercise program occur rapidly and their onset lags only about 2 weeks behind blood pressure (BP) effects. Assessment of weight loss effects on LVH is complicated by the strong relationship between body weight and ventricular wall thickness. LVID, and LV mass. To some extent, this can be overcome by arbitrarily indexing to body surface area or height. The wall thickness/radius ratio is not related to body size. Weight reduction reduces BP and thickness/radius by 10% in controlled trials. Small studies have also reported reduction in LV mass after sodium restriction in hypertensive subjects. Studies with other nonpharmacological measures could make a substantial contribution to knowledge of their efficacy.
Zaloszyc, Ariane; Schaefer, Betti; Schaefer, Franz; Krid, Saoussen; Salomon, Rémi; Niaudet, Patrick; Schmitt, Claus Peter; Fischbach, Michel
Hypertension is frequent in chronic hemodialyzed patients and usually treated by reducing extracellular fluid. Probing dry weight only based on a clinical evaluation may be hazardous, especially in case of volume independent hypertension. We performed a 1-year retrospective study in three pediatric centers to define the relation between blood pressure (BP) and hydration status, assessed by whole-body bioimpedance spectroscopy (BIS). We analyzed 463 concomitant measurements of BP, relative overhydration (rel.OH), and plasma sodium (Napl) in 23 children (mean age 13.9 ± 5.1 years). Pre-dialytic under-hydration (rel.OH +15%) was assessed, however, the majority (73%) showed normal BP. Patient-specific Napl setpoint could not be described. Mean dialysate sodium concentration was higher than mean Napl. Hypertension is not always related to overhydration. Therefore, BIS should restrict the practice of "probing dry weight" in hypertensive children. Moreover, sodium dialytic balance needs to be considered to improve BP management.
Ma, Chunming; Lu, Qiang; Yin, Fuzai
This study evaluated the accuracy of modified blood pressure-to-height ratio (MBPHR) for identifying hypertension in Han children aged 7-12 years. In 2011, anthropometric measurements were assessed in a cross-sectional population-based study of 1352 Han children aged 7-12 years. Elevated blood pressure was defined according to the 2004 National High Blood Pressure Education Program Working Group definition (as gold standard). The following equations for MBPHR were used: modified systolic blood pressure to height ratio(MSBPHR) = SBP(mmHg)/(height(cm) + 7 × (13 - age(years))), modified diastolic blood pressure to height ratio (MDBPHR) = DBP(mmHg)/(height(cm) + 7 × (13 - age(years))). Receiver operating characteristic curve analyses were performed to assess the accuracy of MSBPHR and MDBPHR as diagnostic tests for elevated SBP and DBP, respectively. The accuracy of MSBPHR and MDBPHR (assessed by area under the curve) for identifying elevated SBP and DBP were over 0.85 (0.953-1.000). When elevated blood pressure was defined by MBPHR (age-dependent cut-off point), the sensitivities were 99.1% in boys and 97.0% in girls and the specificities were 89.0% in boys and 92.3% in girls. When elevated blood pressure was defined by MBPHR (non-age-dependent cut-off point), the sensitivities were 96.4% in boys and 99.2% in girls and the specificities were 81.2% in boys and 75.5% in girls. MBPHR is an accurate index for screening hypertension in children, but is not superior to BPHR. Compared with age-dependent BPHR cutoff points, non-age-dependent MBPHR cut-off point is simple but increase the proportion of reexamination.
INTRODUCTION: Orthostatic hypotension (OH) is associated with troublesome symptoms and increased mortality. It is treatable and deserving of accurate diagnosis. This can be time consuming. The current reference standard for its diagnosis is head-up tilt (HUT) testing with continuous beat-to-beat plethysmography. Our objective was to assess the accuracy of sit-stand testing with semi-automatic sphygmomanometry for the diagnosis of OH. DESIGN: Retrospective test of diagnostic accuracy. METHODS: This was a retrospective study performed using a database maintained by a busy syncope unit. HUT testing was performed using an automated tilt table with Finometer monitoring. A 3 min 70 degrees HUT was performed following 5 min supine. Sitting blood pressure (BP) was measured following 3 min rest. Standing BP was measured within 30 s of assuming the upright posture. The results of sit-stand testing were compared with HUT testing as a reference standard. Both tests happened within 5 min of each other and patients underwent no intervention between tests. RESULTS: From a total of 1452 consecutive HUTs, we identified 730 with pre-test measures of sitting and standing BP. The mean age of this group was 70.57 years (SD = 15.1), 62% were female. The sensitivity of sit-stand testing was calculated as 15.5%, specificity as 89.9%, positive predictive value as 61.7%, negative predictive value as 50.2% and the likelihood ratio as 1.6. The area under the Receiver Operator Curve was 0.564. CONCLUSION: We have demonstrated that sit-stand testing for OH has very low diagnostic accuracy. We recommend that the more time-consuming reference standard method of diagnosis be used if the condition is suspected.
Gill, Paramjit; Haque, M Sayeed; Martin, Una; Mant, Jonathan; Mohammed, Mohammed A; Heer, Gurdip; Johal, Amanpreet; Kaur, Ramandeep; Schwartz, Claire; Wood, Sally; Greenfield, Sheila M; McManus, Richard J
Hypertension is a major risk factor for cardiovascular disease and prevalence varies by ethnic group. The diagnosis and management of blood pressure are informed by guidelines largely based on data from white populations. This study addressed whether accuracy of blood pressure measurement in terms of diagnosis of hypertension varies by ethnicity by comparing two measurement modalities (clinic blood pressure and home monitoring) with a reference standard of ambulatory BP monitoring in three ethnic groups. Cross-sectional population study (June 2010 - December 2012) with patients (40-75 years) of white British, South Asian and African Caribbean background with and without a previous diagnosis of hypertension recruited from 28 primary care practices. The study compared the test performance of clinic BP (using various protocols) and home-monitoring (1 week) with a reference standard of mean daytime ambulatory measurements using a threshold of 140/90 mmHg for clinic and 135/85 mmHg for out of office measurement. A total of 551 participants had complete data of whom 246 were white British, 147 South Asian and 158 African Caribbean. No consistent difference in accuracy of methods of blood pressure measurement was observed between ethnic groups with or without a prior diagnosis of hypertension: for people without hypertension, clinic measurement using three different methodologies had high specificity (75-97%) but variable sensitivity (33-65%) whereas home monitoring had sensitivity of 68-88% and specificity of 64-80%. For people with hypertension, detection of a raised blood pressure using clinic measurements had sensitivities of 34-69% with specificity of 73-92% and home monitoring had sensitivity (81-88%) and specificity (55-65%). For people without hypertension, ABPM remains the choice for diagnosing hypertension compared to the other modes of BP measurement regardless of ethnicity. Differences in accuracy of home monitoring and clinic monitoring (higher sensitivity
Background Measurement of toe and ankle blood pressure is commonly used to evaluate peripheral vascular status, yet the pre-test rest period is inconsistent in published studies and among practitioners, and could affect results. The aim of this systematic review is to evaluate all research that has investigated the effect of different periods of pre-test rest on toe and ankle systolic blood pressure. Methods The following databases were searched up to April 2012: Medline (from 1946), EMBASE (from 1947), CINAHL (from 1937), and Cochrane Central Register of Controlled Trials (CENTRAL) (from 1800). No language or publication restrictions were applied. Eighty-eight content experts and researchers in the field were contacted by email to assist in the identification of published, unpublished, and ongoing studies. Studies evaluating the effect of two or more pre-test rest durations on toe or ankle systolic blood pressure were eligible for inclusion. No restrictions were placed on participant characteristics or the method of blood pressure measurement. Outcomes included toe or ankle systolic blood pressure and adverse effects. Abstracts identified from the search terms were independently assessed by two reviewers for potential inclusion. Results 1658 abstracts were identified by electronic searching. Of the 88 content experts and researchers in the field contacted by email a total of 33 replied and identified five potentially relevant studies. No studies were eligible for inclusion. Conclusions There is no evidence of the effect of different periods of pre-test rest duration on toe and ankle systolic blood pressure measurements. Rigorous trials evaluating the effect of different durations of pre-test rest are required to direct clinical practice and research. PMID:24708870
Non-invasive monitoring of blood pressure has become increasingly important in research. High-Definition Oscillometry (HDO) delivers not only accurate, reproducible and thus reliable blood pressure but also visualises the pulse waves on screen. This allows for on-screen feedback in real time on data validity but even more on additional parameters like systemic vascular resistance (SVR), stroke volume (SV), stroke volume variances (SVV), rhythm and dysrhythmia. Since complex information on drug effects are delivered within a short period of time, almost stress-free and visible in real time, it makes HDO a valuable technology in safety pharmacology and toxicology within a variety of fields like but not limited to cardiovascular, renal or metabolic research.
Lopez, Guillaume; Shuzo, Masaki; Ushida, Hiroyuki; Hidaka, Keita; Yanagimoto, Shintaro; Imai, Yasushi; Kosaka, Akio; Delaunay, Jean-Jacques; Yamada, Ichiro
Continuous monitoring of blood pressure in daily life could improve early detection of cardiovascular disorders, as well as promoting healthcare. Conventional ambulatory blood pressure monitoring (ABPM) equipment can measure blood pressure at regular intervals for 24 hours, but is limited by long measuring time, low sampling rate, and constrained measuring posture. In this paper, we demonstrate a new method for continuous real-time measurement of blood pressure during daily activities. Our method is based on blood pressure estimation from pulse wave velocity (PWV) calculation, which formula we improved to take into account changes in the inner diameter of blood vessels. Blood pressure estimation results using our new method showed a greater precision of measured data during exercise, and a better accuracy than the conventional PWV method.
Zheng, Ya-Li; Yan, Bryan P; Zhang, Yuan-Ting; Poon, Carmen C Y
24-h blood pressure (BP) has significant prognostic value for cardiovascular risk screening, but the present BP devices are mainly cuff-based, which are unsuitable for long-term BP measurement, especially during nighttime. In this paper, we developed an armband wearable pulse transit time (PTT) system for 24-h cuff-less BP measurement and evaluated it in an unattended out-of-laboratory setting. Ten healthy young subjects participated in this ambulatory study, where PTT was measured at 30-min interval by this wearable system and the reference BP was measured by a standard oscillometric ambulatory BP monitor. Due to the misalignment of BP and PTT on their recording time caused by the different measurement principles of the two BP devices, a new estimation method has been proposed: transients in PTT were removed from the raw data by defined criteria, and then evenly interpolated, low-pass filtered, and resampled to synchronize at the time when BP was recorded. The results show that with the proposed method, the correlation between PTT and systolic BP (SBP) during nighttime with dynamic range of 21.8 ± 14.2 mmHg has improved from -0.50 ± 0.24 to -0.62 ± 0.20 , and the difference between the estimated and reference SBP has improved from 0.7 ± 10.7 to 2.8 ± 8.2 mmHg with root mean square error reduced from 10.7 to 8.7 mmHg. In addition, the correlation between a very low frequency component of SBP and PTT obtained from the proposed method during nighttime is -0.80 ± 0.10 and the difference is 2.4 ± 5.7 mmHg for a dynamic BP range of 13.5 ± 8.0 mmHg. It is therefore concluded from this study that the proposed wearable system has great potential to be used for overnight SBP monitoring, especially to measure the averaged SBP over a long period.
Aarnes, Turi K; Hubbell, John Ae; Lerche, Phillip; Bednarski, Richard M
To determine the level of agreement between an oscillometric (O-NIBP) and an invasive method (IBP) of monitoring arterial blood pressure (ABP) in anesthetized sheep, goats, and cattle. Prospective clinical study. Twenty sheep and goats, 20 cattle weighing sheep and goats was 0 ± 16 (-57 to 38) mmHg, 13 ± 16 (-37 to 70) mmHg, and 8 ± 13 (-34 to 54) mmHg, respectively. Mean difference between SABP, DABP, and MABP measurements in small cattle was 0 ± 19 (-37 to 37) mmHg, 6 ± 18 (-77 to 48) mmHg, and 4 ± 16 (-73 to 48) mmHg, respectively. Mean difference between SABP, DABP, and MABP measurements in large cattle was -18 ± 32 (-107 to 71) mmHg, 7 ± 29 (-112 to 63) mmHg, and -5 ± 28 (-110 to 60) mmHg, respectively. The 95% LOAs for SABP, DABP, and MABP were -31 to +31, -19 to +44, and -19 to +34 mmHg, respectively in sheep and goats; were -37 to +37, -19 to +44, and -19 to +34 mmHg, respectively in small cattle; and were -81 to +45, -50 to +63, and -59 to +50 mmHg, respectively in large cattle. Agreement was poor between O-NIBP and IBP monitoring techniques. Arterial BP should be monitored in anesthetized sheep, goats, and cattle using IBP. © 2013 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.
Hendry, Charles; Farley, Alistair; McLafferty, Ella
This article, which forms part of the life sciences series, describes the vessels of the body's blood and lymphatic circulatory systems. Blood pressure and its regulatory systems are examined. The causes and management of hypertension are also explored. It is important that nurses and other healthcare professionals understand the various mechanisms involved in the regulation of blood pressure to prevent high blood pressure or ameliorate its damaging consequences.
Fujiwara, Takeshi; Hoshide, Satoshi; Kanegae, Hiroshi; Nishizawa, Masafumi; Kario, Kazuomi
The authors evaluated differences in the reliability of home blood pressure measurements taken in the morning, before dinner, and at bedtime. Forty-eight patients with hypertension (age range, 50-89 years; mean age, 76.4 years) measured their home blood pressure using a validated automatic information/communication technology-based device for 14 consecutive days. Those days were divided into the first seven days (1-7) and the following 8 to 14 days (days 8-14) and compared systolic blood pressure (SBP) reliability in the two periods for each measurement time point. In Bland-Altman analyses, morning SBP showed the least standard error of measurement (3.0 mm Hg). There were fixed biases in morning and before-dinner SBP with average limits of agreement of 3.9 and 6.4 mm Hg, respectively. For at-bedtime SBP, a random error was detected and the minimal detectable change was 13.8 mm Hg. The percentage of near-maximal variation of morning SBP was the smallest at 18.1%. Morning SBP therefore provided the most reliable home blood pressure value in the day. ©2018 Wiley Periodicals, Inc.
Andersen, Ulla Overgaard; Henriksen, Jens H; Jensen, Gorm
The Copenhagen City Heart Study (CCHS) is a longitudinal epidemiological study of 19698 subjects followed up since 1976. Variation in blood pressure (BP) measurement in the first three CCHS surveys is evaluated by assessing two components, systematic variation and random variation [daytime...
Krähenbühl, B; Nielsen, S L; Lassen, N A
Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers...
Martínez, María A; Garcia-Puig, Juan; Loeches, Maria P; Mateo, Maria C; Utiel, Isaías; Torres, Rosa
To compare the efficacy of two strategies of blood pressure (BP) measurement-based follow-up in hypertension and albuminuria control. Multicentre, prospective, randomised, open trial with a parallel-group design. Nineteen primary care centres and a hospital clinic participated. Adult type 2 diabetics with systolic BP ≥140mmHg without relevant renal disease were randomised to one of two follow-up strategies: 1) standard follow up, with a clinic BP target <140/90mmHg and 2) self-monitoring home BP (SMHBP)-based follow up, with a BP target <135/85mmHg. Biochemical standard blood variables, albuminuria, and 24-h ambulatory BP monitoring were performed at entry, 12 and 24 months. The main outcome measurement was 24-h ambulatory systolic BP variation. Albuminuria change was analysed as a secondary outcome. 116 patients were analysed (mean age: 66.8 years). Mean systolic ambulatory 24- h BP change in two years was 3.9mmHg (95% CI 1.8-6.1). We did not find significant differences between both groups (p=0.706). Similarly, no differences were found when we compared other ambulatory BP values. Initial albuminuria was similar in both groups and did not significantly changed throughout the follow-up period. In type 2 diabetics without relevant nephropathy a SMHBP- based follow up was equivalent to a standard clinic-based BP follow up in BP and albuminuria control. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
... Heart Disease Mineral & Bone Disorder High Blood Pressure & Kidney Disease What is high blood pressure? Blood pressure is ... are the symptoms of high blood pressure and kidney disease? Most people with high blood pressure do not ...
Krähenbühl, B; Nielsen, S L; Lassen, N A
Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers...... with vasospastic arterial disease. It implies an underestimation of palmar arch systolic pressure measured indirectly on the fingers. FSP measured under these circumstances may be taken as an estimate of the vascular tone, and can be employed in diagnosis and quantification of vasospastic disorders....
Sun, Jiahong; Steffen, Lyn M; Ma, Chuanwei; Liang, Yajun; Xi, Bo
The US Fourth Report (2004) recommended that elevated blood pressure (BP) on at least three occasions should be used to define hypertension in children and adolescents. However, there is no sufficient evidence to support this decision. This study aimed to assess the change in the prevalence of elevated BP obtained on three separate visits in children and adolescents worldwide using a meta-analysis. The PubMed database was searched for eligible studies published in English until 20 April 2016. Included studies were population based and reported on the prevalence of elevated BP measured on two or three separate occasions in pediatric populations. A meta-analysis was performed to calculate a summary prevalence of elevated BP over three different visits. A total of 21 studies with 179 561 participants aged 3-20 years were included in the present meta-analysis. The summary prevalence of elevated BP decreased across visits, from 12.1% (95% confidence interval (CI)=10.1-14.0%) during the first visit to 5.6% (95% CI=4.3-7.0%) during the second visit and to 2.7% (95% CI=2.1-3.3%) during the third visit. These findings were independent of sex, age group, ethnicity/race and the definition of elevated BP. When compared with visit 1, the prevalence of elevated BP decreased by 53.7% during visit 2 and by 77.7% during visit 3. Our study suggested that the prevalence of elevated BP decreased substantially from the first visit to the subsequent visits. Worldwide, the true prevalence of hypertension in children and adolescents is ~3% over three different visits.
Bülow, J; Jelnes, Rolf
In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion ...... extremity cannot be determined non-invasively by elevation of the extremity, probably due to collapse of segments of the vascular bed increasing the vascular resistance considerably....
The study investigated whether the relationship between sex and experimental pain report was explained by blood pressure at rest, or during pain task, or both in healthy, young adult females. Univariate analyses indicated significant positive correlation between baseline systolic blood pressure, systolic blood pressure ...
Gabin, Jessica Mira; Tambs, Kristian; Saltvedt, Ingvild; Sund, Erik; Holmen, Jostein
A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment. In Nord-Trøndelag County, Norway, incident dementia data were collected during 1995-2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects' personal identification numbers, the dementia data were linked to data from the Nord-Trøndelag Health Study (the HUNT Study), a large, population-based health study performed in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2. Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years. Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in
Ventura-Ribes, Olga; Machancoses, Francisco H; Rosel Remírez, Jesús F
Description of appearance of ecchymosis on an arm, simultaneously with a classical Leukocytoclastic Vasculitis, the proposal of alternative utilities of measuring blood pressure, and the study of side effects to that measure. Case 80-year-old male came to ER with dyspnea, heart failure, predialysis renal failure with hyperkalemia and hemodynamic instability. During his stay he developed a skin lesion that looks like palpable purpura, from the lower limit of the blood pressure cuff to the distal area of the hand that not disappeared with vitropression, and pruritus. During admission the arm injury was extended to all members, both upper and lower. The study concluded with diagnosis of Leukocytoclastic Vasculitis given the presence of eosinophils, that which suggested probable drug etiology to an antibiotic that had been taken since seven days prior to admission to ER. The need for serial monitoring of blood pressure, and the duration of such monitoring in unstable patients considering the side effects of those techniques was questioned. In addition, the study of other utilities of measuring blood pressure. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.
Steinman, Michael A; Goldstein, Mary K
Many patients with hypertension have legitimate reasons to forego standard blood pressure targets yet are nonetheless included in performance measurement systems. An approach to performance measurement incorporating clinical reasoning was developed to determine which patients to include in a performance measure. A 10-member multispecialty advisory panel refined a taxonomy of situations in which the balance of benefits and harms of anti-hypertensive treatment does not clearly favor tight blood pressure control (measurement for blood pressure control. These included (1) patients who have suffered adverse effects from multiple classes of antihypertensive medications; (2) patients already taking four or more antihypertensive medications; (3) patients with terminal disease, moderate to severe dementia, or other conditions that overwhelmingly dominate the patient's clinical status; and (4) other patient factors, including comfort care orientation and poor medication adherence despite attempts to remedy adherence difficulties. Several general principles also emerged. Performance measurement should focus on patients for whom the benefits of treatment clearly outweigh the harms and should incorporate a longitudinal approach. In addition, the criteria for exempting a patient from performance measurement should be more strict in patients at higher risk of adverse health outcomes from hypertension and more lenient for patients at lower risk. Incorporating "real world" clinical principles and judgment into performance measurement systems may improve targeting of care and, by accounting for patient case mix, allow for better comparison of performance between institutions.
Kruger, Herculina S; Botha-Ravyse, Chrisna; Havemann-Nel, Lize; Doubell, Maretha; van Rooyen, Johannes M
To derive percentage body fat (%BF) cut-points according to body mass index (BMI) categories for adult black South African women and to investigate the agreement between adiposity classifications according to WHO BMI and %BF cut-points. The secondary aim was to determine the association between these different adiposity measures and high blood pressure. Black women aged 29-65 years (n = 435) from Ikageng, South Africa, were included in this cross-sectional study. Socio-demographic and anthropometric data were collected (weight, height and BMI). %BF using dual-energy X-ray absorptiometry and blood pressure were measured. There was significant agreement between three %BF categories: low/normal (high blood pressure (OR = 1.75, 95% CI 1.09-2.81 versus OR = 1.92, 95% CI 1.15-3.23, respectively). Despite significant agreement between BMI and %BF categories, considerable misclassification occurred in the overweight range. Participants with excessive %BF had a greater odds of high blood pressure than those in the highest BMI category. © 2017 Wiley Periodicals, Inc.
... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...
... page: //medlineplus.gov/ency/article/007482.htm Blood pressure monitors for home To use the sharing features ... ask you to keep track of your blood pressure at home. To do this, you will need ...
... Matters September 26, 2011 Genes that Influence Blood Pressure In one of the largest genomic studies ever, ... consortium identified 29 genetic variations that influence blood pressure. More than half of these variants were previously ...
Full Text Available ... of physical activity Drinking too much alcohol Stress Family History A family history of high blood pressure raises the risk ... for high blood pressure and may run in families. Genetic causes of this condition are why family ...
... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Nov 13,2017 ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...
Arveschoug, Anne Kirstine; Vammen, Birthe; Yoshinaka, Emmy
reference data; the lower level of normality was therefore 215 mmHg compared to 0 mmHg in the old reference data. For group II, no significant differences between the gradients were found comparing the new and old reference data. Conclusion. These new data indicate that reference data gathered from middle-aged....... Material and methods. Group I comprised 31 healthy persons aged between 61 and 87 years and group II 14 healthy middle-aged hospital staff members aged between 45 and 58 years. Strict rules of inclusion were followed. Results. For group I, significantly greater gradients (DBPtoe - systolic arm blood......Objective. Most patients referred to our department for distal blood pressure (DBP) determination on suspicion of arterial peripheral vascular disease (apvd) are more than 60 years of age, whereas the only available reference data for resting pressure are based on data from healthy individuals aged...
This paper introduces the development of a blood pressure alarm detector, meant to be incorporated into an electronic blood pressure tracking unit, from which it detects signals for the measured blood pressure (BP), that is, the systolic blood pressure (SBP) and diastolic blood pressure (DBP). It simultaneously displays the ...
Gingival blood flow under total-combs by functional pressure evaluated with Laser-Doppler Flowmetry, a non-invasive method of blood flow measurement. Microcirculation of gum's capillary system can be measured non-invasive by Laser-Doppler-Flowmetry (LDF). Circulation, defined by the number of floating erythrocytes per unit of time, is measured by a fibro-optical Laser-Doppler-Flowmetry. The task was to examine, if there is any change of gum's circulation during strain and relief. Circulation on defined measurepoints, divided on the four quadrants, was determined among maximal strain and subsequent relief, on one probationer (complete denture bearer). Before every measure session systemic pressure was taken. LDF-value was taken on top of jaw-comb, in doing so, to get reproducible result and a satisfying fixation of the probe, there was made an artificial limb of the upper and lower comb. In the upper comb a dynamometer-box, which determined minimal and maximal comb pressure, was integrated. The received results of the LDF-measurement, expressed as perfusion units (PU) were lower under applied pressure than by pressure points more distant. Hyperemia, resulting during relief, seemed the more intense, the less perfusion was before. This new, non-invasive kind of circulation measurement seems to be quite predestined to be used for gingival diagnostic under artificial limb in the future. (author)
Ohno, Yoichi; Kanno, Yoshihiko; Takenaka, Tsuneo
In this review, we focused on the relationship between central blood pressure and chronic kidney diseases (CKD). Wave reflection is a major mechanism that determines central blood pressure in patients with CKD. Recent medical technology advances have enabled non-invasive central blood pressure measurements. Clinical trials have demonstrated that compared with brachial blood pressure, central blood pressure is a stronger risk factor for cardiovascular (CV) and renal diseases. CKD is characterized by a diminished renal autoregulatory ability, an augmented direct transmission of systemic blood pressure to glomeruli, and an increase in proteinuria. Any elevation in central blood pressure accelerates CKD progression. In the kidney, interstitial inflammation induces oxidative stress to handle proteinuria. Oxidative stress facilitates atherogenesis, increases arterial stiffness and central blood pressure, and worsens the CV prognosis in patients with CKD. A vicious cycle exists between CKD and central blood pressure. To stop this cycle, vasodilator antihypertensive drugs and statins can reduce central blood pressure and oxidative stress. Even in early-stage CKD, mineral and bone disorders (MBD) may develop. MBD promotes oxidative stress, arteriosclerosis, and elevated central blood pressure in patients with CKD. Early intervention or prevention seems necessary to maintain vascular health in patients with CKD. PMID:26788468
Machado, Juliana Pereira; Veiga, Eugenia Velludo; Ferreira, Paulo Alexandre Camargo; Martins, José Carlos Amado; Daniel, Ana Carolina Queiroz Godoy; Oliveira, Amanda dos Santos; da Silva, Patrícia Costa dos Santos
Objective To determine and to analyze the theoretical and practical knowledge of Nursing professionals on indirect blood pressure measurement. Methods This cross-sectional study included 31 professionals of a coronary care unit (86% of the Nursing staff in the unit). Of these, 38.7% of professionals were nurses and 61.3% nurse technicians. A validated questionnaire was used to theoretical evaluation and for practice assessment the auscultatory technique was applied in a simulation environment, under a non-participant observation. Results To the theoretical knowledge of the stages of preparation of patient and environment, 12.9% mentioned 5-minute of rest, 48.4% checked calibration, and 29.0% chose adequate cuff width. A total of 64.5% of professionals avoided rounding values, and 22.6% mentioned the 6-month deadline period for the equipment calibration. On average, in practice assessment, 65% of the steps were followed. Lacks in knowledge were primary concerning lack of checking the device calibration and stethoscope, measurement of arm circumference to choose the cuff size, and the record of arm used in blood pressure measurement. Conclusion Knowledge was poor and had disparities between theory and practice with evidence of steps taken without proper awareness and lack of consideration of important knowledge during implementation of blood pressure measurement. Educational and operational interventions should be applied systematically with institutional involvement to ensure safe care with reliable values. PMID:25295455
Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik
Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significan...
Arveschoug, Anne Kirstine; Vammen, Birthe; Yoshinaka, Emmy
collected in the early 1970s from healthy individuals in the age range 21-26 years. Our aims were to collect new reference data for DBP at ankle level after exercise based on older populations, and to compare between reference data for different age groups to find out whether the normal values are dependent...... for elderly and middle-aged persons are presented. Use of normal values based on young people may result in underestimation of DBP response and hence underestimation of the degree of possible apvd, especially in elderly individuals.......Objective. Distal blood pressure (DBP) determination after an exercise test is used on suspicion of arterial peripheral vascular disease (apvd). In our department. the average age of these patients is about 60 years. The usual reference values for pressures after exercise were based on data...
Study examined the associations between blood – Pb, serum cholesterol, diastolic and, systolic blood pressures, hematocrit, body weight, age and body mass index in 528 study subjects comprising 50% cigarette smoking and 50% non-smoking male residents of Abeokuta, Nigeria, aged from 15 to 80 years. Blood Pb was ...
Liu, Jiankun; Hahn, Jin-Oh; Mukkamala, Ramakrishna
The oscillometric fixed-ratio method is widely employed for non-invasive measurement of systolic and diastolic pressures (SP and DP) but is heuristic and prone to error. We investigated the accuracy of this method using an established mathematical model of oscillometry. First, to determine which factors materially affect the errors of the method, we applied a thorough parametric sensitivity analysis to the model. Then, to assess the impact of the significant parameters, we examined the errors over a physiologically relevant range of those parameters. The main findings of this model-based error analysis of the fixed-ratio method are that: (1) SP and DP errors drastically increase as the brachial artery stiffens over the zero trans-mural pressure regime; (2) SP and DP become overestimated and underestimated, respectively, as pulse pressure (PP) declines; (3) the impact of PP on SP and DP errors is more obvious as the brachial artery stiffens over the zero trans-mural pressure regime; and (4) SP and DP errors can be as large as 58 mmHg. Our final and main contribution is a comprehensive explanation of the mechanisms for these errors. This study may have important implications when using the fixed-ratio method, particularly in subjects with arterial disease.
Altunkan, Sekip; Yildiz, Sevil; Azer, Sabir
In this study, we compared two wrist blood pressure-measuring devices, the Omron RX and the Nissei WS-310, against a mercury manometer. A total of 152 subjects attending an out-patient hypertensive clinic were recruited from a randomized blood pressure survey, 87 patients (mean 44.4 +/- 14.5 years of age) being selected according to the Association for the Advancement of Medical Instrumentation/British Hypertension Society standards. Device validation was assessed through the use of sequential same-arm readings compared with readings taken using a mercury sphygmomanometer by the two trained observers. There were no differences between the observers and the monitors for diastolic readings (2.8 +/- 4.8 mmHg for the Omron and 4.2 +/- 6.4 mmHg for the Nissei) according to the Association for the Advancement of Medical Instrumentation standards. The largest standard deviations -- 8.3 mmHg for the Omron and 8.8 mmHg for the Nissei, respectively -- were seen for systolic readings recorded by the observers and the monitors. According to the British Hypertension Society standards, the Omron achieved an A grade for diastolic readings and a B grade for systolic readings within 5 and 10 mmHg. The Nissei monitor achieved an A grade for diastolic readings and a B grade for systolic readings within 5 and 10 mmHg. Patients found the wrist oscillometric devices that we tested to be comfortable and easy to use. These devices are appropriate for measuring diastolic blood pressure according to the standards, but the reliability of both devices decreased when measuring systolic blood pressure.
Zheng, Dingchang; Pan, Fan; Murray, Alan
The aim of this study was to investigate the effect of different mechanical behaviour of the brachial artery on blood pressure (BP) measurements during cuff inflation and deflation. BP measurements were taken from each of 40 participants, with three repeat sessions under three randomized cuff deflation/inflation conditions. Cuff pressure was linearly deflated and inflated at a standard rate of 2-3 mmHg/s and also linearly inflated at a fast rate of 5-6 mmHg/s. Manual auscultatory systolic and diastolic BPs, and pulse pressure (SBP, DBP, PP) were measured. Automated BPs were determined from digitally recorded cuff pressures by fitting a polynomial model to the oscillometric pulse amplitudes. The BPs from cuff deflation and inflation were then compared. Repeatable measurements between sessions and between the sequential order of inflation/deflation conditions (all P > 0.1) indicated stability of arterial mechanical behaviour with repeat measurements. Comparing BPs obtained by standard inflation with those from standard deflation, manual SBP was 2.6 mmHg lower (P deflation suggest different arterial mechanical behaviour between arterial opening and closing during BP measurement. We have shown that the mechanical behaviour of the brachial artery during BP measurement differs between cuff deflation and cuff inflation.
Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure
Holstein, P; Trap-Jensen, J; Bagger, H
in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured pO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood...... that 99Tcm is as suitable as the 131I- -labelled tracers in estimating the SPP. The SPP is significantly correlated to skin blood flow, to systolic blood pressure, to tc pO2 and to angiographic findings. Correction of SPP for systemic blood pressure changes can be made in proportion with the measured...... variations in systemic mean blood pressure, but only for groups of patients....
... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Types of Blood Pressure Medications Updated:Nov 6,2017 Prescription blood ... will find an overview of the classes of blood pressure medication. To expand the information on a type of medication, simply click on the subject tab. ...
Ryan, Jennifer M; Hensey, Owen; McLoughlin, Brenda; Lyons, Alan; Gormley, John
Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk. The aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP. This study included 55 ambulatory children with CP [mean (SD) age 11.3 (0.2) yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS) levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio) and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts) were calculated. Multiple regression analyses revealed that vigorous activity (β = 0.339, pactivity (β = 0.250, pactivity (β = 0.238, pactivity than children with middle fitness (pblood pressure (r2 = -0.306, pphysical activity, particularly at a vigorous intensity, is associated with high cardiorespiratory fitness in children with CP. Low cardiorespiratory fitness is associated with increased cardiometabolic risk.
Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl
Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...
Full Text Available ... system activity , and blood vessel structure and function. Biology and High Blood Pressure Researchers continue to study ... and Your Heart U.S. Department of Health and Human Services' 2008 Physical Activity Guidelines for Americans Maintaining ...
Full Text Available ... treatment plans for high blood pressure that include lifelong lifestyle changes and medicines to control high blood ... Managing and coping with stress To help make lifelong lifestyle changes, try making one healthy lifestyle change ...
Hypertension - diet ... diet is a proven way to help control high blood pressure . These changes can also help you lose weight ... DIET The low-salt Dietary Approaches to Stop Hypertension (DASH) diet is proven to help lower blood ...
Full Text Available ... the body’s salt balance by retaining sodium and water and excreting potassium. Imbalances in this kidney function ... pressure. Medicines to lower blood pressure include: Diuretics (Water or Fluid Pills): Flush excess sodium from your ...
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Débora C. Alavarce
Full Text Available A medida da pressão arterial faz parte do exame físico e deve ser realizada em toda consulta médica. Para avaliar se a pressão arterial é medida nas consultas médicas, foram consultados 500 prontuários de pacientes de primeira consulta ambulatorial, sendo 335 (67% provenientes de clínicas médicas e cirúrgicas e 165 (33% das clínicas ginecológica e obstétrica. A pressão arterial foi anotada em 39% das consultas realizadas (135±32/85±19 mm Hg, sendo que em 11% destas anotações a pressão diastólica estava acima de 90 mm Hg. Em relação ao diagnóstico prévio de hipertensão arterial verificou-se que: a em 62% dos prontuários não havia esta informação; b 20% referiram ter hipertensão, e em 79% destes a pressão arterial foi anotada; e c 18% referiram não ter hipertensão e 46% destes tiveram registro da pressão arterial. Portanto, a maior parte dos pacientes não teve sua pressão arterial anotada.The blood pressure measure is part of the physical exam and it should be accomplished in every medical consultation. To verify the blood pressure measured in the accomplished medical consultations record of first they were consulted it consults 500 patient's ambulatorial being 335 (67% coming of medical and surgical clinics and 165 (33% of the gynecological and obstetric clinics. The blood pressure was written down in 39% of the accomplished consultations (135+32 mm Hg 85+19 mm Hg, and 11% of this annotations the pressure diastólica was above 90 mm Hg. In relation to the previous diagnosis of hypertension it was verified that: a in 62% of the records there was not this information; b 20% referred to have hypertension, and in 79% of these the arterial pressure was scored; and c 18% referred not to have hypertension and 46% of these had registration of the arterial pressure. Therefore, most of the patients didn't have its logged arterial pressure.
Full Text Available Background: We examined the cross-sectional and longitudinal associations of objectively measured physical activity (step counts and blood pressure (BP among adults spanning 37countries.Methods: Across 37 countries, we used data from a pool of 9238 adult owners of Withings’ Pulse activity trackers, which measures steps taken each day, and Wireless Blood Pressure Monitor, which measures BP. Analyses were adjusted on age, sex, number of days where the tracker was worn, and number of BP measurements. Data was collected from 2009 to 2013.Results: Subjects had a mean ± standard deviation (SD age of 51.6 ± 11.3 years and a body mass index (BMI of 28.7±5.5 kg/m2. A 1-month increase of more than 3000 steps per day was associated with a decrease of systolic BP (SBP and diastolic BP (DBP among the obese (1.57mm Hg and 1.29 mm Hg respectively, both P<0.001 and the overweight population (0.79mm Hg and 0.84 mm Hg respectively, both P≤0.001, but not in the normal weight population(P=0.60 and P=0.36 respectively.Conclusion: One-month increases in daily step counts was associated with a decrease of SBP and DBP in a large obese and overweight free living population.
Lee, B K; Lee, G S; Stewart, W F; Ahn, K D; Simon, D; Kelsey, K T; Todd, A C; Schwartz, B S
Evidence suggests that lead and selected genes known to modify the toxicokinetics of lead--namely, those for the vitamin D receptor (VDR) and delta-aminolevulinic acid dehydratase (ALAD)--may independently influence blood pressure and hypertension risk. We report the relations among ALAD and VDR genotypes, three lead dose measures, and blood pressure and hypertension status in 798 Korean lead workers and 135 controls without occupational exposure to lead. Lead dose was assessed by blood lead,...
People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ... People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ...
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Controlling hypertension ... when you wake up. For people with very high blood pressure, this is when they are most at risk ... 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed ...
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Morrison, Shaun F.; Davis, Robert Patrick; Barman, Susan M.
5-Hydroxytryptamine (5-HT; serotonin) was discovered more than 60 years ago as a substance isolated from blood. The neural effects of 5-HT have been well investigated and understood, thanks in part to the pharmacological tools available to dissect the serotonergic system and the development of the frequently prescribed selective serotonin-reuptake inhibitors. By contrast, our understanding of the role of 5-HT in the control and modification of blood pressure pales in comparison. Here we focus on the role of 5-HT in systemic blood pressure control. This review provides an in-depth study of the function and pharmacology of 5-HT in those tissues that can modify blood pressure (blood, vasculature, heart, adrenal gland, kidney, brain), with a focus on the autonomic nervous system that includes mechanisms of action and pharmacology of 5-HT within each system. We compare the change in blood pressure produced in different species by short- and long-term administration of 5-HT or selective serotonin receptor agonists. To further our understanding of the mechanisms through which 5-HT modifies blood pressure, we also describe the blood pressure effects of commonly used drugs that modify the actions of 5-HT. The pharmacology and physiological actions of 5-HT in modifying blood pressure are important, given its involvement in circulatory shock, orthostatic hypotension, serotonin syndrome and hypertension. PMID:22407614
Midttun, M; Azad, B B S; Broholm, R
was poor (P = 0·333 and 0·685 for right and left 1. Toe, respectively) probably because not all measurements were performed under optimal conditions with maximally dilated arterioles and warm hands and feet. The patients already have maximally dilated arterioles to extract the maximal amount of oxygen from....... There was no statistical difference in the healthy controls, consistent with previous findings. These results may indicate that the heat-washout method can be used as an alternative to strain gauge blood pressure in the evaluation of peripheral artery disease and wound healing potentials. Furthermore, the heat...
Yang, Wen-Yi; Staessen, Jan A
A significant association of office diastolic blood pressure with low-level blood lead exposure was reported in a Brazilian adult population. However, caution should be taken to interpret these results. The multivariable-adjusted association with blood pressure was positive for diastolic blood pressure, but inverse for systolic blood pressure. The association sizes were infinitesimal without clinical relevance. The outcome measures, i.e. blood pressure and the prevalence of hypertension were analysed across categories of the blood lead distribution - not in relation to blood lead as continuous variable. Blood pressure was the average of two oscillometric office readings, whereas ambulatory monitoring is the state-of-the-art.
Taing, Kevin Y; Farkouh, Michael E; Moineddin, Rahim; Tu, Jack V; Jha, Prabhat
A determinant of blood pressure is adiposity; however, there are uncertainties surrounding whether general or central adiposity is the more important determinant of blood pressure. Further, inconsistent results exist for the relationships of anthropometric measures with blood pressure and hypertension, and whether these relationships differ substantially by age and sex is unclear. We aimed to elucidate the associations of anthropometric measures of general and central adiposity with blood pressure and hypertension, and determine the effect of age and sex on these relationships. We used cross-sectional data from the Centre for Global Health Research health check-up survey conducted during 2006-2007 of the general population in India (n = 7 601; age 18-59 years). We examined the associations of anthropometric measures (body mass index, waist circumference, hip circumference, waist-hip ratio, waist-height ratio) with blood pressure components (systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure, mid-blood pressure) and hypertension within four (18-29 years, 30-39 years, 40-49 years, 50-59 years) age groups, by sex. We adjusted all analyses for education and location, with further adjustments, variously, for either a measure of central (waist circumference) or general (body mass index) adiposity. On average, every 5 kg/m 2 greater body mass index or 10 cm wider waist circumference was associated with a 5 and 4 mmHg higher systolic blood pressure, respectively. When considered separately, each anthropometric measure was strongly and positively associated with most blood pressure components in all age groups, and for both sexes. However, with few exceptions, when considered jointly (body mass index adjusted for waist circumference), the associations of body mass index with blood pressure components and hypertension were greatly diminished for both sexes, and particularly in the ≥30 years age groups. By contrast, further adjustment
Bos, W. J.; van Goudoever, J.; van Montfrans, G. A.; Wesseling, K. H.
To evaluate the effect of blood pressure variability on Riva Rocci Korotkoff blood pressure determinations, we studied the intra-arterial pressure during Riva Rocci Korotkoff determinations in 25 patients. In 50 measurements with a cuff deflation rate of 2.5 mm Hg/sec, the systolic intra-arterial
Full Text Available Background/Aims: We compare conventional office blood pressure measurements with automated SPRINT-study type readings in kidney transplant recipients in order to determine the impact of the white coat effect in a prospective observational study. Methods: Adult patients with a functional renal transplant not dependent on dialysis were eligible. Readings were taken in the office in presence of the physician with an oscillometric method. Afterwards, readings were repeated with the patients resting alone in a quiet examination room with an automated blood pressure monitor. After 5 minutes of rest, 3 readings were taken at 1 minute intervals, with an average of these 3 readings calculated by the monitor. Results: 120 patients with an average age of 58.5±12.2 years were included. Mean time since transplantation was 7.95±6.48 years. Mean eGFR (CKD-EPI was 48.5±18.3 ml/min. SPRINT-study type readings were significantly lower than office readings (139.01±18.45 vs. 149.00±21.02 mmHg systolic, p<0.001; 80.88±11.63 mmHg vs. 84.35±12.41 mmHg diastolic, p <0.001. Correlation analysis for many potentially influencing factors (diabetes mellitus, transplant vintage, proteinuria, age, immunosuppression, donor type was not significant but obese women were significantly more prone to white coat hypertension. Conclusion: Automated office blood pressure measurements should be considered the method of choice in kidney transplant recipients.
Rock, Cheryl L; Flatt, Shirley W; Barkai, Hava-Shoshana; Pakiz, Bilge; Heath, Dennis D
Dietary strategies that help patients adhere to a weight reduction diet may increase the likelihood of weight loss maintenance and improved long-term health outcomes. Regular nut consumption has been associated with better weight management and less adiposity. The objective of this study was to compare the effects of a walnut-enriched reduced-energy diet to a standard reduced-energy-density diet on weight, cardiovascular disease risk factors, and satiety. Overweight and obese men and women (n = 100) were randomly assigned to a standard reduced-energy-density diet or a walnut-enriched (15% of energy) reduced-energy diet in the context of a behavioral weight loss intervention. Measurements were obtained at baseline and 3- and 6-month clinic visits. Participants rated hunger, fullness and anticipated prospective consumption at 3 time points during the intervention. Body measurements, blood pressure, physical activity, lipids, tocopherols and fatty acids were analyzed using repeated measures mixed models. Both study groups reduced body weight, body mass index and waist circumference (time effect p weight was -9.4 (0.9)% vs. -8.9 (0.7)% (mean [SE]), for the standard vs. walnut-enriched diet groups, respectively. Systolic blood pressure decreased in both groups at 3 months, but only the walnut-enriched diet group maintained a lower systolic blood pressure at 6 months. The walnut-enriched diet group, but not the standard reduced-energy-density diet group, reduced total cholesterol and low-density lipoprotein cholesterol (LDL-C) at 6 months, from 203 to 194 mg/dL and 121 to 112 mg/dL, respectively (p weight loss that is comparable to a standard reduced-energy-density diet in the context of a behavioral weight loss intervention. Although weight loss in response to both dietary strategies was associated with improvements in cardiovascular disease risk factors, the walnut-enriched diet promoted more favorable effects on LDL-C and systolic blood pressure. The trial
Goldberg, Lior; Bar-Aluma, Bat-El; Krauthammer, Alex; Efrati, Ori; Sharabi, Yehonatan
Familial dysautonomia (FD) is a rare genetic disease that involves extreme blood pressure fluctuations secondary to afferent baroreflex failure. The diurnal blood pressure profile, including the average, variability, and day-night difference, may have implications for long-term end organ damage. The purpose of this study was to describe the circadian pattern of blood pressure in the FD population and relationships with renal and pulmonary function, use of medications, and overall disability. We analyzed 24-h ambulatory blood pressure monitoring recordings in 22 patients with FD. Information about medications, disease severity, renal function (estimated glomerular filtration, eGFR), pulmonary function (forced expiratory volume in 1 s, FEV1) and an index of blood pressure variability (standard deviation of systolic pressure) were analyzed. The mean (± SEM) 24-h blood pressure was 115 ± 5.6/72 ± 2.0 mmHg. The diurnal blood pressure variability was high (daytime systolic pressure standard deviation 22.4 ± 1.5 mmHg, nighttime 17.2 ± 1.6), with a high frequency of a non-dipping pattern (16 patients, 73%). eGFR, use of medications, FEV1, and disability scores were unrelated to the degree of blood pressure variability or to dipping status. This FD cohort had normal average 24-h blood pressure, fluctuating blood pressure, and a high frequency of non-dippers. Although there was evidence of renal dysfunction based on eGFR and proteinuria, the ABPM profile was unrelated to the measures of end organ dysfunction or to reported disability.
Baumstark, Annette; Schmid, Christina; Pleus, Stefan; Haug, Cornelia; Freckmann, Guido
Background Partial pressure of oxygen (pO2) in blood samples can affect blood glucose (BG) measurements, particularly in systems that employ the glucose oxidase (GOx) enzyme reaction on test strips. In this study, we assessed the impact of different pO2 values on the performance of five GOx systems and one glucose dehydrogenase (GDH) system. Two of the GOx systems are labeled by the manufacturers to be sensitive to increased blood oxygen content, while the other three GOx systems are not. Methods Aliquots of 20 venous samples were adjusted to the following pO2 values: pO2 ~70 mmHg, which is considered to be similar to pO2 in capillary blood samples, and the mean BG result at pO2 pO2 pO2 ≥150 mmHg. For both pO2 levels, relative differences of all tested GOx systems were significant (p pO2 values pO2 variations lead to clinically relevant BG measurement deviations in GOx systems, even in GOx systems that are not labeled as being oxygen sensitive. PMID:24351177
Conclusion: This study demonstrates a positive correlation of blood pressure parameters with age, abdominal obesity, hypertriglyceridemia, hypercholesterolemia, thus the need for stakeholders to strengthen measures towards cardiovascular risk awareness and cardiovascular diseases (CVD) prevention in the general ...
Salazar, Martin R; Espeche, Walter G; Stavile, Rodolfo N; Balbín, Eduardo; Leiva Sisnieguez, Betty C; Leiva Sisnieguez, Carlos E; March, Carlos E; Cor, Susana; Eugenio Acero, Irma; Carbajal, Horacio A
Blood pressure (BP) was assessed by patients themselves in recently published trials. Self-measured office blood pressure (SMOBP) seems particularly interesting for limited health resources regions. The aim of our study was to evaluate the relationship between SMOBP values and those estimated by ambulatory blood pressure monitoring (ABPM). Six hundred seventy-seven patients were evaluated using both, SMOBP and ABPM. The differences between SMOBP and daytime ABPM were evaluated with paired "t" test. The correlations among SMOBP and ABPM were estimated using Pearson's r. The accuracy of SMOBP to identify abnormal ABPM was determined using area under ROC curve (AUC). Sensitivity, specificity, and positive and negative predictive values were calculated for different SMOBP cut-points. Using the average of three readings, systolic SMOBP was higher (3.7 (14.2) mmHg, p ABPM. Both BP estimates had a significant correlation, r = 0.67 and r = 0.75 (p ABPM; the AUC were 0.80 (0.77-0.84) and 0.78 (0.74-0.81) for daytime and 24 h hypertension, respectively. Diastolic SMOBP predicted diastolic hypertension, AUC 0.86 (0.83-0.88) for both daytime and 24 h hypertension. Neither correlations nor AUCs improved significantly using the average of five readings. SMOBP ≥ 160/90 mmHg was highly specific (>95%) to identify individuals with hypertension in the ABPM; SMOBP ABPM. In conclusion, a high proportion of individuals could be classified adequately using SMOBP, reducing the necessity of healthcare resources and supporting its utility for screening purposes.
van der Bel, René; Sliggers, Bart C; van Houwelingen, Marc J; van Lieshout, Johannes J; Halliwill, John R; van Hulst, Robert A; Krediet, C T Paul
It would be desirable to safely and continuously measure blood pressure noninvasively under hyperbaric and/or hyperoxic conditions, in order to explore haemodynamic responses in humans under these conditions. A systematic analysis according to 'failure mode and effects analysis' principles of a commercially available beat-by-beat non-invasive blood pressure monitoring device was performed using specifications provided by the manufacturer. Possible failure modes related to pressure resistance and fire hazard in hyperbaric and oxygen-enriched environments were identified and the device modified accordingly to mitigate these risks. The modified device was compared to an unaltered device in five healthy volunteers under normobaric conditions. Measurements were then performed under hyperbaric conditions (243 kPa) in five healthy subjects. Modifications required included: 1) replacement of the carbon brush motorized pump by pressurized air connected through a balanced pressure valve; 2) modification of the 12V power supply connection in the multiplace hyperbaric chamber, and 3) replacement of gas-filled electrolytic capacitors by solid equivalents. There was concurrence between measurements under normobaric conditions, with no significant differences in blood pressure. Measurements under pressure were achieved without problems and matched intermittent measurement of brachial arterial pressure. The modified system provides safe, stable, continuous non-invasive blood pressure trends under both normobaric and hyperbaric conditions.
Altunkan, Sekip; Ilman, Nevzat; Altunkan, Erkan
A variety of automatic blood measurement devices with diverse features have been introduced to the medical markets recently. Among these devices, models that measure at the wrist have become increasingly popular in self measurements. The objective of this study was to evaluate the accuracy of the Samsung SBM-100A and Microlife BP 3BU1-5 wrist blood pressure devices against the mercury sphygmomanometer in adults according to the International Protocol criteria. Fifty-four patients over 30 years of age were studied and classified based on the International Protocol range. Blood pressure measurements at the wrist with the Samsung SBM-100A and Microlife BP 3BU1-5 were compared with the results obtained by two trained observers using a mercury sphygmomanometer. Nine sequential blood pressure measurements were taken. A total of 33 participants with randomly distributed arm circumferences were selected for both of the validation studies. During each validation study, 99 measurements were obtained for comparison from 33 participants. The first phase was performed on 15 participants and if the device passed this phase, 18 more participants were selected. Mean discrepancies and standard deviations of the device-sphygmomanometer were 0.9+/-9.2 and -2.7+/-9.3 mmHg for systolic blood pressure and -1.4+/-8.0 mmHg and 1.4+/-5.7 for diastolic blood pressure in the Samsung and Microlife study groups, respectively. The Samsung SBM-100A passed Phase 1 in 15 participants. Despite the fact that Microlife BP 3BU1-5 passed Phase 1 for diastolic pressure, it failed according to the systolic pressure criteria. Eighteen patients were added and Phase 2 was continued, in which Samsung SBM-100A failed to meet the criteria of Phases 2.1 and 2.2 for adults in systolic and diastolic blood pressure. It was found that the Microlife BP 3BU1-5 does not meet the criteria of either of Phases 2.1 and 2.2 for systolic blood pressure and Phase 2.2 for diastolic blood pressure. In this study, Samsung SBM
Jennifer M Ryan
Full Text Available Children with cerebral palsy (CP have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk.The aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP.This study included 55 ambulatory children with CP [mean (SD age 11.3 (0.2 yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts were calculated.Multiple regression analyses revealed that vigorous activity (β = 0.339, p<0.01, sustained moderate-to-vigorous activity (β = 0.250, p<0.05 and total activity (β = 0.238, p<0.05 were associated with level achieved on the shuttle run test after adjustment for age, sex and GMFCS level. Children with high fitness spent more time in vigorous activity than children with middle fitness (p<0.05. Shuttle run test level was negatively associated with BMI (r2 = -0.451, p<0.01, waist circumference (r2 = -0.560, p<0.001, waist-height ratio (r2 = -0.560, p<0.001 and systolic blood pressure (r2 = -0.306, p<0.05 after adjustment for age, sex and GMFCS level.Participation in physical activity, particularly at a vigorous intensity, is
... High Blood Pressure (Hypertension) - 简体中文 (Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section High ...
Full Text Available ... to Aim for a Healthy Weight . Limiting Alcohol Intake Limit alcohol intake. Too much alcohol will raise your blood pressure ... physically active. Maintain a healthy weight. Limit alcohol intake. Other lifestyle changes can improve your overall health, ...
Full Text Available ... physical activity Drinking too much alcohol Stress Family History A family history of high blood pressure raises the risk of ... Genetic causes of this condition are why family history is a risk factor for this condition. Screening ...
... Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hypertension tends to worsen with age and you cannot ...
Wang, Qing; Zhao, Huadong; Chen, Wan; Li, Ni; Wan, Yi
The aim of this study was to validate the iHealth BP7 wireless wrist blood pressure monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. A total of 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained for validation. The ESH-IP revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. The device produced 66, 87, and 97 measurements within 5, 10, and 15 mmHg for systolic blood pressure (SBP) and 72, 93, and 99 mmHg for diastolic blood pressure (DBP), respectively. The mean±SD device-observer difference was -0.7±6.9 mmHg for SBP and -1.0±5.1 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 25 for SBP and 26 for DBP; furthermore, there were three participants for SBP and one participant for DBP, with none of the device-observer differences within 5 mmHg. On the basis of the validation results, the iHealth BP7 wireless wrist blood pressure monitor can be recommended for self-measurement in an adult population.
Salihbegovic, Eldina Malkic; Hadzigrahic, Nermina; Suljagic, Edin; Kurtalic, Nermina; Sadic, Sena; Zejcirovic, Alema; Mujacic, Almina
Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including high blood pressure. A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD= ±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. Average duration of psoriasis was 15,52 (SD=±12,54) years. Frequency of high blood pressure in those affected by psoriasis was 54,28%. Average age of the patients with psoriasis and high blood pressure was 53,79 year (SD=±14,15) and average duration of psoriasis was 17,19 years (SD=±13,51). Average values of PASI score were 16,65. Increase in values of PASI score and high blood pressure were statistically highly related (r=0,36, p=0,0001). Psoriasis was related to high blood pressure and there was a correlation between the severity of psoriasis and high blood pressure.
... cause of high blood pressure? Can anxiety cause high blood pressure? Answers from Sheldon G. Sheps, M.D. Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, ...
ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? African Americans in the U.S. have a higher prevalence of high blood pressure (HBP) ...
... For Consumers Consumer Information by Audience For Women High Blood Pressure--Medicines to Help You Share Tweet Linkedin Pin ... Click here for the Color Version (PDF 533KB) High blood pressure is a serious illness. High blood pressure is ...
Alcohol: Does it affect blood pressure? Does drinking alcohol affect your blood pressure? Answers from Sheldon G. Sheps, M.D. Drinking too much alcohol can raise blood pressure to unhealthy levels. Having ...
Chinnadurai, Sathya K; DeVoe, Ryan; Koenig, Amie; Gadsen, Nadia; Ardente, Amanda; Divers, Stephen J
The objective of this study was to compare an implanted direct blood pressure monitor and a non-invasive oscillometric unit for use in anesthetized and awake green iguanas. Prospective experimental trial. Four male and four female adult green iguanas (Iguana iguana) weighing 1833 +/- 534 g. For each animal, the carotid artery was surgically exposed and the catheter tip of the pressure transducer was placed in the aortic arch. Non-invasive blood pressure was measured using a cuff over the left femoral region. Pulse rate, respiratory rate and arterial blood pressure (ABP) measurements were taken every 5 minutes. Direct ABP measurements consisted of recording numerical values and graphic output. Simultaneous direct and indirect measurements were repeated in awake animals. The oscillometric device failed to provide a reading in over 80% of attempts, and failed to provide readings that correlated with direct measurements. The implanted direct transducer was capable of detecting blood pressures throughout all ABP ranges examined. The implantable transducer was a reliable means of determining blood pressure in this study, while the oscillometric device was unreliable and often failed to provide any reading. We do not recommend using the oscillometric device as described in a research or clinical setting for green iguanas. The advantages of an implantable device include the ability to monitor awake and anesthetized subjects remotely and continuously. These monitors are small, biocompatible and function across a wide range of ABP.
We have developed a non-invasive blood pressure measurement system using pulse transit time (PTT) from the heart to the common carotid artery, measured by using an electrocardiogram (ECG) R-wave and carotid arterial Doppler signals at the anterior neck. In this study, we examined the validity of our system by comparing PTT derived systolic blood pressure (Dopp_SBP) with invasive radial systolic arterial pressure (Inv_SBP) with calibration every 15 min in the ICU setting.Methods: 17 patients u...
Whittemore, Jacqueline C; Nystrom, Michael R; Mawby, Dianne I
OBJECTIVE To assess the effects of age, body condition score (BCS), and muscle condition score (MCS) on radial and coccygeal systolic arterial blood pressure (SAP) in cats. DESIGN Prospective randomized trial. ANIMALS 66 privately owned cats enrolled between May and December 2010. PROCEDURES BCS and MCS of cats were assessed by 2 investigators; SAP was measured via Doppler ultrasonic flow detector, with cats positioned in right lateral or sternal recumbency for measurements at the radial or coccygeal artery, respectively, with order of site randomized. Associations among variables were assessed through correlation coefficients, partial correlation coefficients, and ANCOVA. RESULTS Interrater reliability for BCS and MCS assessment was high (correlation coefficients, 0.95 and 0.83, respectively). No significant effect was identified for order of SAP measurement sites. Coccygeal and radial SAP were positively correlated (ρ = 0.45). The median difference in coccygeal versus radial SAP was 19 mm Hg, but differences were not consistently positive or negative. Radial SAP was positively correlated with age (ρ = 0.48) and negatively correlated with MCS (ρ = -0.30). On the basis of the correlation analysis, the association between radial SAP and MCS reflected the confounding influence of age. Coccygeal SAP was not significantly correlated with age, BCS, or MCS. CONCLUSIONS AND CLINICAL RELEVANCE Use of the coccygeal artery is recommended to reduce the confounding effects of age and sarcopenia on Doppler ultrasonographic SAP measurements in cats. Additionally, monitoring for changes in MCS is recommended for cats undergoing serial SAP measurement.
Angba, Tessy Onogimesike
The benefits of physical activities are universal for all, including those with intellectual disability. Individuals with intellectual disability are mostly neglected and hardly exercised. Hence, the opportunities for improved health and wellness are limited. Paucity of data that could guide ameliorative measures also presents another challenge.…
Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure
Holstein, P; Trap-Jensen, J; Bagger, H
), 131I- -antipyrine (131I- -a.p.) was compared to Na(131I-) and 99Tcm-pertechnetate (99Tcm). The average SPP by 131I- -a.p. and by 131I- were approximately equal, 57.0 mmHg (range 18-93) compared to 56.3 mmHg (range 13-88) (P greater than 0.1). The average SPP by 99Tcm was just slightly higher, 60.3 mm...... that 99Tcm is as suitable as the 131I- -labelled tracers in estimating the SPP. The SPP is significantly correlated to skin blood flow, to systolic blood pressure, to tc pO2 and to angiographic findings. Correction of SPP for systemic blood pressure changes can be made in proportion with the measured...
Tanaka, Gohichi; Sawada, Yukihiro; Kato, Yuichi; Yamakoshi, Ken-ichi; Matsumura, Kenta; Maeda, Kimihito; Horiguchi, Masami; Ohguro, Hiroshi
Stiffening of the small artery may be the earliest sign of arteriosclerosis. However, there is no adequate method for directly assessing small arterial stiffness. In this study, the finger arterial elasticity index (FEI) was defined as the parameter n which denotes the curvilinearity of an exponential model of pressure (P)–volume (V a ) relationship (V a = a − b exp (−nP)). For the original estimation, the FEI was calculated from a compliance index from the finger photoplethysmogram whilst occluding the finger. A simple estimation of the FEI was devised by utilizing normalized pulse volume instead of the compliance index. Both estimations yielded close agreement with the exponential model in healthy young participants (study 1: n = 19). Since the FEI was dependent on finger mean blood pressure, normalized finger arterial stiffness index (FSI) was defined as standardized residual from their relationship: mean and standard deviation (SD) of the FSI were 50 ± 10 (study 2: n = 174). The mean coefficient of variation of the FSI for four measurements was 5.72% (study 3: n = 6). The mean and SD of the FSI in seven arteriosclerotic patients were 100.0 ± 13.5. In conclusion, the FEI and FSI by simple estimation are valid and useful for arteriosclerosis research
Sehestedt, Thomas; Jeppesen, Jørgen; Hansen, Tine W
. RESULTS: During a median follow-up of 12.8 years, the composite endpoint (CEP) of cardiovascular death, nonfatal myocardial infarction and stroke occurred in 153 individuals, of whom 32 had high normal BP. Presence of high normal BP was associated with increased risk of CEP [hazard ratio, 1.8 (95...... plaques or urine albumin/creatinine ratio of at least the 90th percentile did not produce significantly worse results. Seventy-five percent of individuals with three or more traditional risk factors had SOD. CONCLUSION: In healthy individuals with high normal BP, measuring two of pulse wave velocities...
Mehlsen, Jesper; Wiinberg, Niels
The present study aimed at examining the interarm difference in blood pressure and its use as an indicator of peripheral arterial disease (PAD). Data were included from consecutive patients referred from their general practitioner to our vascular laboratory for possible PAD aged 50 years or older...... without known cardiac disease, renal disease, or diabetes mellitus. 824 patients (453 women) with mean age of 72 years (range: 50-101) were included. 491 patients had a diagnosis of hypertension and peripheral arterial disease (PAD) was present in 386 patients. Systolic blood pressure was 143 ± 24 mm......Hg and 142 ± 24 mmHg on the right and left arm, respectively (P = 0.015). The interarm difference was greater in patients with hypertension (P = 0.002) and PAD (P blood pressure was reproducible...
Sheppard, James P.; Holder, Roger; Nichols, Linda; Bray, Emma; Hobbs, F.D. Richard; Mant, Jonathan; Little, Paul; Williams, Bryan; Greenfield, Sheila; McManus, Richard J.
Objectives: Identification of people with lower (white-coat effect) or higher (masked effect) blood pressure at home compared to the clinic usually requires ambulatory or home monitoring. This study assessed whether changes in SBP with repeated measurement at a single clinic predict subsequent differences between clinic and home measurements. Methods: This study used an observational cohort design and included 220 individuals aged 35–84 years, receiving treatment for hypertension, but whose SBP was not controlled. The characteristics of change in SBP over six clinic readings were defined as the SBP drop, the slope and the quadratic coefficient using polynomial regression modelling. The predictive abilities of these characteristics for lower or higher home SBP readings were investigated with logistic regression and repeated operating characteristic analysis. Results: The single clinic SBP drop was predictive of the white-coat effect with a sensitivity of 90%, specificity of 50%, positive predictive value of 56% and negative predictive value of 88%. Predictive values for the masked effect and those of the slope and quadratic coefficient were slightly lower, but when the slope and quadratic variables were combined, the sensitivity, specificity, positive and negative predictive values for the masked effect were improved to 91, 48, 24 and 97%, respectively. Conclusion: Characteristics obtainable from multiple SBP measurements in a single clinic in patients with treated hypertension appear to reasonably predict those unlikely to have a large white-coat or masked effect, potentially allowing better targeting of out-of-office monitoring in routine clinical practice. PMID:25144295
Chang, Chia-Cheng; Kuwana, Nobumasa; Ito, Susumu; Ikegami, Tadashi
Measurement of cerebral blood flow (CBF) and computed tomography (CT) cisternography were performed in 37 patients with a tentative diagnosis of normal pressure hydrocephalus (NPH) to predict their surgical outcome. The mean CBF of the whole brain was measured quantitatively by single photon emission computed tomography with technetium-99m-hexamethylpropylene amine oxime before surgery. The results of CT cisternography were classified into four patients: type I, no ventricular stasis at 24 hours; type II, no ventricular stasis with delayed clearance of cerebral blush; type III, persistent ventricular stasis with prominent cerebral blush; type IV, persistent ventricular stasis with diminished cerebral blush and/or asymmetrical filling of the sylvian fissures. The mean CBF was significantly lower than that of age-matched controls (p<0.005). Patients with a favorable outcome had a significantly higher mean CBF than patients with an unfavorable outcome (p<0.005). Patients with the type I pattern did not respond to shunting. Some patients with type II and III patterns responded to shunting but improvement was unsatisfactory. Patients with type IV pattern responded well to shunting, and those with a mean CBF of 35 ml/100 g/min or over achieved a favorable outcome. The combination of CBF measurement and CT cisternography can improve the prediction of surgical outcome in patients with suspected NPH. (author)
Meyer, Olivier; Jenni, Roland; Greiter-Wilke, Andrea; Breidenbach, Alexander; Holzgrefe, Henry H
This study compared torcetrapib-induced blood pressure (BP) changes simultaneously obtained by high-definition oscillometry (HDO) and telemetry. Male beagles (n = 6) received single oral doses of vehicle or torcetrapib at 10 or 30 mg/kg; BP were acquired simultaneously by HDO and telemetry from 2 h before dosage until 7 h afterward. Systolic, diastolic, and mean arterial pressures (MAP) and heart rate were compared by using Altman-Bland agreement analysis. Dogs were allocated into subgroups according to temperament and baseline MAP (less than 110 mm Hg and 110 mm Hg or greater). Both methods demonstrated high precision. HDO recordings exhibited higher variability for all parameters (inclusive MAP SDs were 7.0 ± 2.7 mm Hg for HDO compared with 3.4 ± 1.9 mm Hg for telemetry), accompanied by a positive bias for all pressures (systolic, 10.4 mm Hg; diastolic, 5.7 mm Hg; MAP, 1.9 mm Hg). Both methods detected similar maximal increases in MAP with 30 mg/kg torcetrapib (HDO, 15.8 ± 10.4 mm Hg; telemetry, 15.8 ± 5.3 mm Hg). No significant effects were noted for heart rate. Torcetrapib elicited a dose-dependent increase in BP in dogs with baseline MAP of less than 110 mm Hg, whereas increases were maximal with 10 mg/kg in the other group, and dose-dependence was no longer observed. BP changes were influenced by animal temperament, demonstrating that HDO results must be interpreted with caution. HDO may provide a useful and accurate method for noninvasive BP measurements in canine studies. PMID:20819394
Wu, Lili; Jiao, Yinghui; Wang, Chengdong; Chen, Lei; Di, Dalin; Zhang, Haiyan
This study aimed to validate the Andon KD-5851 upper arm blood pressure (BP) monitor according to the European Society of Hypertension International Protocol (ESH-IP) revision 2010. A total of 33 eligible participants were included in the study. Sequential measurements of BPs were performed using a mercury sphygmomanometer and the device, and the data analysis was carried out following precisely the ESH-IP revision 2010. The device had 82, 98, and 99 measurements within 5, 10, and 15 mmHg for systolic blood pressure and 85, 95, and 99 measurements for diastolic blood pressure, respectively. The average device-observer difference was -0.53±4.00 mmHg for systolic blood pressure and -1.15±4.06 mmHg for diastolic blood pressure. The device passed all the criteria according to the ESH-IP revision 2010. According to the validation results on the basis of the ESH-IP revision 2010, the Andon KD-5851 upper arm BP monitor can be recommended for self/home measurement in adults. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Hinderliter Alan L
Full Text Available Abstract Background Ambulatory blood pressure monitoring (ABPM is increasingly used to measure blood pressure (BP in research studies. We examined ease of use, comfort, degree of disturbance, reported adverse effects, factors associated with poor tolerability, and association of poor tolerability with data acquisition of 24-hour ABPM using the Oscar 2 monitor in the research setting. Methods Sixty adults participating in a research study of people with a history of borderline clinic BP reported on their experience with ABPM on two occasions one week apart. Poor tolerability was operationalized as an overall score at or above the 75th percentile using responses to questions adapted from a previously developed questionnaire. In addition to descriptive statistics (means for responses to Likert-scaled "0 to 10" questions and proportions for Yes/No questions, we examined reproducibility of poor tolerability as well as associations with poor tolerability and whether poor tolerability was associated with removal of the monitor or inadequate number of BP measurements. Results The mean ambulatory BP of participants by an initial ABPM session was 148/87 mm Hg. After wearing the monitor the first time, the degree to which the monitor was felt to be cumbersome ranged from a mean of 3.0 to 3.8, depending on whether at work, home, driving, or other times. The most bother was interference with normal sleeping pattern (mean 4.2. Wearers found the monitor straightforward to use (mean 7.5. Nearly 67% reported that the monitor woke them after falling asleep, and 8.6% removed it at some point during the night. Reported adverse effects included pain (32%, skin irritation (37%, and bruising (7%. Those categorized as having poor tolerability (kappa = 0.5 between sessions, p = 0.0003 were more likely to report being in fair/poor health (75% vs 22%, p = 0.01 and have elevated 24-hour BP average (systolic: 28% vs 17%, p = 0.56; diastolic: 30% vs 17%, p = 0.37. They were
Kim, Kwang-Il; Nikzad, Nima; Quer, Giorgio; Wineinger, Nathan E; Vegreville, Matthieu; Normand, Alexis; Schmidt, Nicolas; Topol, Eric J; Steinhubl, Steven
Using the data from 56,365 individuals, from 185 countries, and a Nokia Health Wireless blood pressure (BP) monitor, we investigated real-world characteristics of BP variability (BPV). All included individuals self-measured and uploaded their BP using Bluetooth at least 20 times over a period of ≥1 month at a frequency and duration of their choosing. In total, 16,904,844 BP measurements were analyzed, with a median of 146 measurements per person (interquartile range [IQR] 73-321) over a median of 14 months (IQR 7-31). SD, coefficient of variation, maximum BP, and maximum minus minimum BP difference were all calculated as measures of BPV. BPV showed a distinct pattern, influenced by season of year, day of week, and time of day. BPV index was higher in females compared with males (P < 0.001) and increased with age (P < 0.001). Compared to the weekend, the weekday BPV index was significantly higher, and this finding was more prominent in females (P = 0.001). In multivariate analysis, BPV index were significantly associated with age, gender, geographic location, and mean BP values. Using the largest BP data set we are aware of, with the benefits and limitations of real-world measurement, we could show the pattern of BPV and provide reference values that may be helpful in understanding the nature of BPV as self-measurement at home becomes more common, and help guide individualized management. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: firstname.lastname@example.org
Kallioinen, Noa; Hill, Andrew; Horswill, Mark S.; Ward, Helen E.; Watson, Marcus O.
Background: To interpret blood pressure (BP) data appropriately, healthcare providers need to be knowledgeable of the factors that can potentially impact the accuracy of BP measurement and contribute to variability between measurements. Methods: A systematic review of studies quantifying BP measurement inaccuracy. Medline and CINAHL databases were searched for empirical articles and systematic reviews published up to June 2015. Empirical articles were included if they reported a study that was relevant to the measurement of adult patients’ resting BP at the upper arm in a clinical setting (e.g. ward or office); identified a specific source of inaccuracy; and quantified its effect. Reference lists and reviews were searched for additional articles. Results: A total of 328 empirical studies were included. They investigated 29 potential sources of inaccuracy, categorized as relating to the patient, device, procedure or observer. Significant directional effects were found for 27; however, for some, the effects were inconsistent in direction. Compared with true resting BP, significant effects of individual sources ranged from −23.6 to +33 mmHg SBP and −14 to +23 mmHg DBP. Conclusion: A single BP value outside the expected range should be interpreted with caution and not taken as a definitive indicator of clinical deterioration. Where a measurement is abnormally high or low, further measurements should be taken and averaged. Wherever possible, BP values should be recorded graphically within ranges. This may reduce the impact of sources of inaccuracy and reduce the scope for misinterpretations based on small, likely erroneous or misleading, changes. PMID:27977471
Nouwen, Elisabeth; Snijder, Marianne; van Montfrans, Gert; Wolf, Hans
Objective. Validation of two automatic blood pressure devices (Microlife 3BTO-A, Microlife, Taipei, Taiwan and Omron M7, OMRON, Kyoto, Japan) in preeclampsia. Methods. Women (n = 34) admitted to the obstetric department of the Academic Medical Center and the Onze Lieve Vrouwe Gasthuis, Amsterdam,
Introduction. Available data on the use of 24-hour ambulatory blood pressure recordings in private practice are limited. For this purpose we studied 39 consecutive hypertensive patients on treatment in a private practice. Method. Office blood pressure, 24-hour ambulatory blood pressure, daytime ambulatory blood pressure ...
Full Text Available Elevated blood pressure is an indicator of cardiovascular stress and increased risk of cardiovascular-related morbidity and mortality. There is emerging evidence suggesting air pollutants, including particulate matter (PM, could promote hypertension, thereby increasing cardiovascular disease risk. Repeated measurement analyses were conducted to examine the associations of three types of PM with systolic blood pressure (SBP, diastolic blood pressure (DBP, and pulse pressure (PP in 220 participants, (mean age = 58.5 years from the Community Assessment of Freeway Exposure and Health study (CAFEH, most of whom live near a major highway. Ambient levels of air pollutants including particle number concentration (PNC; a measure of ultrafine particle (UFP concentration, fine PM (PM2.5, Particle diameter <2.5 µm, and black carbon (BC were measured at a central site <7 km from the study areas. Central sites are good at capturing short-term temporal trends in pollution associated with meteorological changes over regional areas. Linear mixed-effect models that accounted for repeated measures within one person were used to examine the associations between blood pressure variables and daily average of ambient PNC, PM2.5, or BC, controlling for demographic characteristics and major confounders including temperature. Our PNC model predicted that a higher PNC of 10,000 particles/cm3 was associated with higher DBP of 2.40 mmHg (p = 0.03, independent of other factors in the model. There were no significant associations for PM2.5 or BC. Post hoc subgroup analyses by obesity status showed that positive associations of DBP with PNC were more pronounced among obese individuals than non-obese individuals. These results suggested that PNC levels are associated with increased blood pressure, which may contribute to cardiovascular disease risk. More research is needed to assess the relationship between PNC and blood pressure and to address possible residual confounding.
Kotovskaya, Yulia V; Kobalava, Zhanna D; Orlov, Artemy V
The objective of this study was to validate the novel integration of oscillometric (Vasotens(®)) technology into a BPLab(®) ambulatory blood pressure (BP) monitoring system to measure central BP, the aortic augmentation index, and pulse wave velocity (PWV) compared with the recommended and widely accepted tonometric method. The ARTERY Society guidelines for comparison of PWV measurement techniques were used as the basis for recruitment of 99 individuals (mean age 44±19 years, 52 males). The standard for comparison was the conventional "classic" SphygmoCor device. Accordance of the two methods was satisfactory (r=0.98, mean difference of 2.9±3.5 mmHg for central systolic BP; r=0.98, mean difference of -1.1±2.3 mmHg for central diastolic BP; r=0.83, mean difference of -2.6%±13% for aortic augmentation index; r=0.85, mean difference of 0.69±1.4 for PWV). The performance of Vasotens algorithms using an oscillometric ambulatory BP monitoring system is feasible for accurate diagnosis, risk assessment, and evaluation of the effects of antihypertensive drugs.
Stephanie L. Fitzpatrick
Full Text Available The purpose of this study was to assess the psychometric properties of a cardiovascular health knowledge measure for adolescents using item response theory. The measure was developed in the context of a cardiovascular lifestyle intervention for adolescents with elevated blood pressure. Sample consisted of 167 adolescents (mean age = 16.2 years who completed the Cardiovascular Health Knowledge Assessment (CHKA, a 34-item multiple choice test, at baseline and post-intervention. The CHKA was unidimensional and internal consistency was .65 at pretest and .74 at posttest. Rasch analysis results indicated that at pretest the items targeted adolescents with variable levels of health knowledge. However, based on results at posttest, additional hard items are needed to account for the increase in level of cardiovascular health knowledge at post-intervention. Change in knowledge scores was examined using Rasch analysis. Findings indicated there was significant improvement in health knowledge over time [t(119 = -10.3, p< .0001]. In summary, the CHKA appears to contain items that are good approximations of the construct cardiovascular health knowledge and items that target adolescents with moderate levels of knowledge. DOI: 10.2458/azu_jmmss.v3i1.16111
Ali Reza Khoshdel
Full Text Available Ali Reza Khoshdel1,2, Shane Carney2, Alastair Gillies21Faculty of Medicine, Aja University of Medical Science, Tehran, Iran; 2John Hunter Hospital, Faculty of Health, The University of Newcastle, Newcastle, NS W, AustraliaAbstract: Despite the increasing popularity of blood pressure (BP wrist monitors for self-BP measurement at home, device validation and the effect of arm position remains an issue. This study focused on the validation of the Omron HEM-609 wrist BP device, including an evaluation of the impact of arm position and pulse pressure on BP measurement validation. Fifty patients at high risk for cardiovascular disease were selected (age 65 ± 10 years. Each patient had two measurements with a mercury sphygmomanometer and three measurements with the wrist BP device (wrist at the heart level while the horizontal arm supported [HORIZONTAL], hand supported on the opposite shoulder [SHOULDER], and elbow placed on a desk [DESK], in random order. The achieved systolic BP (SBP and diastolic BP (DBP wrist-cuff readings were compared to the mercury device and the frequencies of the readings within 5, 10, and 15 mmHg of the gold standard were computed and compared with the British Hypertension Society (BHS and Association for the Advancement of Medical Instrumentation (AAMI protocols. The results showed while SBP readings with HORIZONTAL and SHOULDER positions were significantly different from the mercury device (mean difference = 7.1 and 13.3 mmHg, respectively; P < 0.05, the DESK position created the closest reading to mercury (mean difference = 3.8, P > 0.1. Approximately 71% of SBP readings with the DESK position were within ±10 mmHg, whereas it was 62.5% and 34% for HORIZONTAL and SHOULDER positions, respectively. Wrist DBP attained category D with BHS criteria with all three arm positions. Bland–Altman plots illustrated that the wrist monitor systematically underestimated SBP and DBP values. However a reading adjustment of 5 and 10 mm
In the U.S., nearly one third of the adult population have high blood pressure, the leading risk factor for heart disease and stroke - two of the nation's leading causes of death. Created: 10/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Date Released: 10/17/2012.
... our e-newsletter! Aging & Health A to Z High Blood Pressure Hypertension Unique to Older Adults This section provides information ... Pressure Targets are Different for Very Old Adults High blood pressure (also called hypertension) increases your chance of having ...
Blood pressure at rest is not predictive of roundthe- clock values. Blood pressure should therefore be measured during effort to evaluate hypertension and its response to treatment. The effect of sustained-release verapamil (240 mg taken once a day) on blood pressure at rest and during isometric effort was therefore ...
Knudsen, Søren Tang; Poulsen, Per Løgstrup; Hansen, Klavs Würgler
BACKGROUND: In nondiabetic subjects pulse pressure (PP) is an independent predictor of cardiovascular disease and microalbuminuria. Reduced circadian blood pressure (BP) variation is a potential risk factor for the development of diabetic complications. We investigated the association between...... retinopathy, nephropathy, macrovascular disease, PP, and diurnal BP variation in a group of type 2 diabetic patients. METHODS: In 80 type 2 diabetic patients we performed 24-h ambulatory BP (AMBP) and fundus photographs. Urinary albumin excretion was evaluated by urinary albumin/creatinine ratio. Presence...... and 3-6 had higher PP and blunted diurnal BP variation: night PP 55 +/- 10 mm Hg, 64 +/- 10 mm Hg, 61 +/- 15 mm Hg, P groups (45 normo-, 19 micro-, and 15...
Palade, D; Iliescu, D; Cotârleţ, Laura; Pandele, G I
Comparison of blood pressure values measured by two methods. 94 hypertensive patients (66 women and 28 men in relation to 2.36/1) were assessed classically and also by ABPM. For statistic evaluation we have used t - Student test, chi2 test, Pearson correlation coefficient and variation coefficient (cv%). It shows significant differences between mean values of systolic and diastolic blood pressure obtained by the 2 methods. ABPM measured values are more accurate compared to clinic, bringing also information on pattern hypertensive therapy.
Hoon Lim, Kyoung; Duck Shin, Young; Hi Park, Sang; Ho Bae, Jin; Jae Lee, Hong; Jung Kim, Seon; Yun Shin, Ji; Jin Choi, Young
Objective : Esophageal stethoscope has the advantage of being non-invasive, easily placed and capability to monitor the heart sound. This study was designed to determine whether the ratio of S1 to S2 analyzed by esophageal stethoscope and wireless bluetooth transmission can be accurate indicator that express the correlation with blood pressure. Total 33 adult male and female without cardiac disorder and with normal heart rhythm were selected randomly as the subjects of this Study. Two microphones were used with one for acquisition of heart sound by connecting it to the esophageal stethoscope while the other was used to measure the background noise in the operating room. After having transmitted the heart sound measured with the esophageal stethoscope to the receiver by using bluetooth module, it was saved in PC and outputted, following removal of noise in the operating room and the respiratory sound. S1 and S2 were measured with computation of the ratio of S1 to S2. Correlations between the systolic blood pressure with each of the S1, S2 and ratio of S1 to S2 were examined by using correlation analysis. The ratio of S1 to S2 displayed the highest correlation with the systolic blood pressure, with S1 and S2 also displaying positive correlation with the systolic blood pressure. As the result of analysis of the heart sound and the systolic blood pressure measured by using the esophageal stethoscope, the radio of S1 to S2 displayed greater correlation with the systolic blood pressure in comparison to the S1.
Tjelle, Torunn Elisabeth; Holtung, Linda; Bøhn, Siv Kjølsrud; Aaby, Kjersti; Thoresen, Magne; Wiik, Siv Åshild; Paur, Ingvild; Karlsen, Anette Solli; Retterstøl, Kjetil; Iversen, Per Ole; Blomhoff, Rune
Intake of fruits and berries may lower blood pressure (BP), most probably due to the high content of polyphenols. In the present study, we tested whether consumption of two polyphenol-rich juices could lower BP. In a randomised, double-blinded, placebo-controlled trial of 12 weeks, 134 healthy individuals, aged 50-70 years, with high normal range BP (130/85-139/89 mmHg, seventy-two subjects) or stage 1-2 hypertension (140/90-179/109 mmHg, sixty-two subjects), were included. They consumed 500 ml/d of one of either (1) a commercially available polyphenol-rich juice based on red grapes, cherries, chokeberries and bilberries; (2) a juice similar to (1) but enriched with polyphenol-rich extracts from blackcurrant press-residue or (3) a placebo juice (polyphenol contents 245·5, 305·2 and 76 mg/100 g, respectively). Resting BP was measured three times, with a 1 min interval, at baseline and after 6 and 12 weeks of intervention. Systolic BP significantly reduced over time (6 and 12 weeks, respectively) in the pooled juice group compared with the placebo group in the first of the three measurements, both for the whole study group (6·9 and 3·4 mmHg; P= 0·01) and even more pronounced in the hypertensive subjects when analysed separately (7·3 and 6·8 mmHg; P= 0·04). The variation in the BP measurements was significantly reduced in the pooled juice group compared with the placebo group (1·4 and 1·7 mmHg; P= 0·03). In conclusion, the present findings suggest that polyphenol-rich berry juice may contribute to a BP- and BP variability lowering effect, being more pronounced in hypertensive than in normotensive subjects.
Quinlan, Jacklyn; Pearson, Laurel N.; Mitchell, Miaisha M.; Boston, Qasimah; Gravlee, Clarence C.; Mulligan, Connie J.
Sequencing of the human genome and decades of genetic association and linkage studies have dramatically improved our understanding of the etiology of many diseases. However, the multiple causes of complex diseases are still not well understood, in part because genetic and sociocultural risk factors are not typically investigated concurrently. Hypertension is a leading risk factor for cardiovascular disease and afflicts more African Americans than any other racially defined group in the US. Few genetic loci for hypertension have been replicated across populations, which may reflect population-specific differences in genetic variants and/or inattention to relevant sociocultural factors. Discrimination is a salient sociocultural risk factor for poor health and has been associated with hypertension. Here we use a biocultural approach to study blood pressure (BP) variation in African Americans living in Tallahassee, Florida by genotyping over 30,000 single nucleotide polymorphisms (SNPs) and capturing experiences of discrimination using novel measures of unfair treatment of self and others (n = 157). We perform a joint admixture and genetic association analysis for BP that prioritizes regions of the genome with African ancestry. We only report significant SNPs that were confirmed through our simulation analyses, which were performed to determine the false positive rate. We identify eight significant SNPs in five genes that were previously associated with cardiovascular diseases. When we include measures of unfair treatment and test for interactions between SNPs and unfair treatment, we identify a new class of genes involved in multiple phenotypes including psychosocial distress and mood disorders. Our results suggest that inclusion of culturally relevant stress measures, like unfair treatment in African Americans, may reveal new genes and biological pathways relevant to the etiology of hypertension, and may also improve our understanding of the complexity of gene
Zhou, Bin; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundstrom, Johan; Smeeth, Liam; Soric, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al Raddadi, Rajaa; Al Woyatan, Rihab; Ali, Mohamed M.; Alkerwi, Ala'a; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Angquist, Lars; Anjana, Ranjit Mohan; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araujo, Joana; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Aryal, Krishna; Arveiler, Dominique; Assah, Felix K.; Assuncao, Maria Cecilia F.; Avdicova, Maria; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Bandosz, Piotr; Banegas, Jose R.; Barbagallo, Carlo M.; Barcelo, Alberto; Barkat, Amina; Barros, Aluisio J. D.; Barros, Mauro V.; Bata, Iqbal; Batieha, Anwar M.; Baur, Louise A.; Beaglehole, Robert; Ben Romdhane, Habiba; Benet, Mikhail; Benson, Lowell S.; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bi, Yufang; Bikbov, Mukharram; Bjerregaard, Peter; Bjertness, Espen; Bjokelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bongard, Vanina; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Bruno, Graziella; Bueno-de-Mesquita, H. B. (as); Bugge, Anna; Burns, Con; Bursztyn, Michael; de Leon, Antonio Cabrera; Cameron, Christine; Can, Gunay; Candido, Ana Paula C.; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan-Pablo; Caserta, Carmelo A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Ching-Yu; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chiolero, Arnaud; Chiou, Shu-Ti; Chirita-Emandi, Adela; Cho, Belong; Cho, Yumi; Chudek, Jerzy; Cifkova, Renata; Claessens, Frank; Clays, Els; Concin, Hans; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crujeiras, Ana B.; Cruz, Juan J.; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; de Backer, Guy; de Gaetano, Giovanni; de Henauw, Stefaan; de Smedt, Delphine; Deepa, Mohan; Dehghan, Abbas; Delisle, Helene; Deschamps, Valerie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Do, Ha T. P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Doering, Angela; Doua, Kouamelan; Drygas, Wojciech; Dulskiene, Virginija; Dzakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eggertsen, Robert; Ekelund, Ulf; El Ati, Jalila; Ellert, Ute; Elosua, Roberto; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Escobedo-de la Pena, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernandez-Berges, Daniel; Ferrante, Daniel; Ferrari, Marika; Ferreccio, Catterina; Ferrieres, Jean; Finn, Joseph D.; Fischer, Krista; Foeger, Bernhard; Foo, Leng Huat; Forslund, Ann-Sofie; Forsner, Maria; Fortmann, Stephen P.; Fouad, Heba M.; Francis, Damian K.; Franco, Maria do Carmo; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Gavrila, Diana; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Ghimire, Anup; Giampaoli, Simona; Gianfagna, Francesco; Giovannelli, Jonathan; Goldsmith, Rebecca A.; Goncalves, Helen; Gonzalez Gross, Marcela; Gonzalez Rivas, Juan P.; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dusan; Grajda, Aneta; Gregor, Ronald D.; Grodzicki, Tomasz; Grontved, Anders; Gruden, Grabriella; Grujic, Vera; Guan, Ong Peng; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc; Gupta, Prakash C.; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Halkjaer, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Harikumar, Rachakulla; Hata, Jun; Hayes, Alison J.; He, Jiang; Hendriks, Marleen Elisabeth; Henriques, Ana; Hernandez Cadena, Leticia; Herqutanto, N. N.; Herrala, Sauli; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Dinc, Gonul Horasan; Hormiga, Claudia M.; Horta, Bernardo L.; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Hu, Yonghua; Maria Huerta, Jose; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, M. Mohsen; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ivkovic, Vanja; Iwasaki, Masanori; Jacobs, Jeremy M.; Jafar, Tazeen; Jamrozik, Konrad; Janszky, Imre; Jasienska, Grazyna; Jelakovic, Bojan; Jiang, Chao Qiang; Johansson, Mattias; Jonas, Jost B.; Jorgensen, Torben; Joshi, Pradeep; Juolevi, Anne; Jurak, Gregor; Juresa, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinanen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C. G.; Kersting, Mathilde; Key, Timothy; Khader, Yousef Saleh; Khalili, Davood; Khang, Young-Ho; Khaw, Kay-Tee; Kiechl, Stefan; Killewo, Japhet; Kim, Jeongseon; Klumbiene, Jurate; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Koskinen, Seppo; Kouda, Katsuyasu; Koziel, Slawomir; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kula, Krzysztof; Kulaga, Zbigniew; Kumar, R. Krishna; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Lachat, Carl; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Le, Nguyen Bao Khanh; Le, Tuyen D.; Leclercq, Catherine; Lee, Jeannette; Lee, Jeonghee; Lehtimaki, Terho; Lekhraj, Rampal; Leon-Munoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Fernanda Lima-Costa, M.; Lin, Hsien-Ho; Lin, Xu; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Lorbeer, Roberto; Lotufo, Paulo A.; Eugenio Lozano, Jose; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L. L.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Marques-Vidal, Pedro; Marrugat, Jaume; Martorell, Reynaldo; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mbanya, Jean Claude N.; Posso, Anselmo J. Mc Donald; McFarlane, Shelly R.; McGarvey, Stephen T.; McLachlan, Stela; McLean, Rachael M.; McNulty, Breige A.; Khir, Amir Sharifuddin Md; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Meshram, Indrapal I.; Metspalu, Andres; Mi, Jie; Mikkel, Kairit; Miller, Jody C.; Francisco Miquel, Juan; Jaime Miranda, J.; Misigoj-Durakovic, Marjeta; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Yusoff, Muhammad Fadhli Mohd; Moller, Niels C.; Molnar, Denes; Momenan, Amirabbas; Monyeki, Kotsedi Daniel K.; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mostafa, Aya; Mota, Jorge; Motlagh, Mohammad Esmaeel; Motta, Jorge; Muiesan, Maria L.; Mueller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musil, Vera; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Namsna, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Maria Navarrete-Munoz, Eva; Ndiaye, Ndeye Coumba; Neal, William A.; Nenko, Ilona; Nervi, Flavio; Nguyen, Nguyen D.; Nguyen, Quang Ngoc; Nieto-Martinez, Ramfis E.; Niiranen, Teemu J.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Oh, Kyungwon; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ordunez, Pedro; Osmond, Clive; Ostojic, Sergej M.; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Panda-Jonas, Songhomitra; Panza, Francesco; Papandreou, Dimitrios; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Pelletier, Catherine; Peltonen, Markku; Pereira, Alexandre C.; Marina Perez, Rosa; Peters, Annette; Petkeviciene, Janina; Pham, Son Thai; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Plans-Rubio, Pedro; Polakowska, Maria; Polasek, Ozren; Porta, Miquel; Portegies, Marileen L. P.; Pourshams, Akram; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Raitakari, Olli; Raj, Manu; Rao, Sudha Ramachandra; Ramos, Elisabete; Rampal, Sanjay; Rangel Reina, Daniel A.; Rasmussen, Finn; Redon, Josep; Reganit, Paul Ferdinand M.; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; de Wit, Tobias F. Rinke; Ritti-Dias, Raphael M.; Robinson, Sian M.; Robitaille, Cynthia; Rodriguez-Artalejo, Fernando; Rodriguez-Villamizar, Laura A.; Rojas-Martinez, Rosalba; Rosengren, Annika; Rubinstein, Adolfo; Rui, Ornelas; Sandra Ruiz-Betancourt, Blanca; Russo Horimoto, Andrea R. V.; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Sakarya, Sibel; Salanave, Benoit; Salazar Martinez, Eduardo; Salmeron, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sanchez-Abanto, Jose; Sans, Susana; Santos, Diana; Santos, Ina S.; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Margolis, Giselle Sarganas; Sarrafzadegan, Nizal; Saum, Kai-Uwe; Savva, Savvas C.; Scazufca, Marcia; Schargrodsky, Herman; Schneider, Ione J.; Schultsz, Constance; Schutte, Aletta E.; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Siantar, Rosalynn; Sibai, Abla M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A.; Sjotrom, Michael; Skovbjerg, Sine; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smith, Margaret C.; Snijder, Marieke B.; So, Hung-Kwan; Sobngwi, Eugene; Soderberg, Stefan; Solfrizzi, Vincenzo; Sonestedt, Emily; Song, Yi; Sorensen, Thorkild I. A.; Jerome, Charles Sossa; Soumare, Aicha; Staessen, Jan A.; Starc, Gregor; Stathopoulou, Maria G.; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stoeckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Sun, Chien-An; Sung, Yn-Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Tai, E. Shyong; Tammesoo, Mari-Liis; Tamosiunas, Abdonas; Tang, Line; Tang, Xun; Tanser, Frank; Tao, Yong; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne; Theobald, Holger; Thijs, Lutgarde; Thuesen, Betina H.; Tjonneland, Anne; Tolonen, Hanna K.; Topbas, Murat; Topor-Madry, Roman; Jose Tormo, Maria; Torrent, Maties; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T. H.; Trivedi, Atul; Tshepo, Lechaba; Tulloch-Reid, Marshall K.; Tuomainen, Tomi-Pekka; Turley, Maria L.; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M. T.; Valdivia, Gonzalo; Valvi, Damaskini; van der Schouw, Yvonne T.; van Herck, Koen; van Rossem, Lenie; van Valkengoed, Irene G. M.; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. M. Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vollenweider, Peter; Vrdoljak, Ana; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Walton, Janette; Mohamud, Wan Nazaimoon Wan; Wang, Ming-Dong; Wang, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas; Wederkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wiecek, Andrzej; Wijga, Alet H.; Wilks, Rainford J.; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong, Tien Yin; Wong-McClure, Roy A.; Woo, Jean; Wu, Aleksander Giwercman; Wu, Frederick C.; Wu, Shou Ling; Xu, Haiquan; Yan, Weili; Yang, Xiaoguang; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoshihara, Akihiro; Younger-Coleman, Novie O.; Yusoff, Ahmad F.; Zambon, Sabina; Zdrojewski, Tomasz; Zeng, Yi; Zhao, Dong; Zhao, Wenhua; Zheng, Yingffeng; Zhu, Dan; Zimmermann, Esther; Zuniga Cisneros, Julio
Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood
Zhou, B.; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundström, Johan; Smeeth, Liam; Sorić, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gómez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al Raddadi, Rajaa; Al Woyatan, Rihab; Ali, Mohamed M.; Alkerwi, Ala'a; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Ängquist, Lars; Anjana, Ranjit Mohan; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araújo, Joana; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Aryal, Krishna; Arveiler, Dominique; Assah, Felix K.; Assunção, Maria Cecília F.; Avdicová, Mária; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Bandosz, Piotr; Banegas, José R.; Barbagallo, Carlo M.; Barceló, Alberto; Barkat, Amina; Barros, Aluisio J.D.; Barros, Mauro V.; Bata, Iqbal; Batieha, Anwar M.; Baur, Louise A.; Beaglehole, Robert; Romdhane, Habiba Ben; Benet, Mikhail; Benson, Lowell S.; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bi, Yufang; Bikbov, Mukharram; Bjerregaard, Peter; Bjertness, Espen; Björkelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bongard, Vanina; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Bruno, Graziella; Bueno-de-Mesquita, H B As; Bugge, Anna; Burns, Con; Bursztyn, Michael; de León, Antonio Cabrera; Cacciottolo, Joseph; Cameron, Christine; Can, Günay; Cândido, Ana Paula C.; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan-Pablo; Caserta, Carmelo A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Yu Ching; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chiolero, Arnaud; Chiou, Shu Ti; Chirita-Emandi, Adela; Cho, Belong; Cho, Yumi; Chudek, Jerzy; Cifkova, Renata; Claessens, Frank; Clays, Els; Concin, Hans; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crujeiras, Ana B.; Cruz, Juan J.; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Danaei, Goodarz; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; De Backer, Guy; De Bacquer, Dirk; de Gaetano, Giovanni; De Henauw, Stefaan; De Smedt, Delphine; Deepa, Mohan; Dehghan, Abbas; Delisle, Hélène; Deschamps, Valérie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Do, Ha T.P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Döring, Angela; Doua, Kouamelan; Drygas, Wojciech; Dulskiene, Virginija; Džakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eggertsen, Robert; Ekelund, Ulf; El Ati, Jalila; Ellert, Ute; Elliott, Paul; Elosua, Roberto; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Escobedo-de la Peña, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernández-Bergés, Daniel; Ferrante, Daniel; Ferrari, Marika; Ferreccio, Catterina; Ferrieres, Jean; Finn, Joseph D.; Fischer, Krista; Föger, Bernhard; Foo, Leng Huat; Forslund, Ann Sofie; Forsner, Maria; Fortmann, Stephen P.; Fouad, Heba M.; Francis, Damian K.; do Carmo Franco, Maria; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Gavrila, Diana; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Ghimire, Anup; Giampaoli, Simona; Gianfagna, Francesco; Giovannelli, Jonathan; Goldsmith, Rebecca A.; Gonçalves, Helen; Gross, Marcela Gonzalez; González Rivas, Juan P.; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dušan; Grajda, Aneta; Gregor, Ronald D.; Grodzicki, Tomasz; Grøntved, Anders; Gruden, Grabriella; Grujic, Vera; Gu, Dongfeng; Guan, Ong Peng; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc J.; Gupta, Prakash C.; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Halkjær, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Harikumar, Rachakulla; Hata, Jun; Hayes, Alison J.; He, Jiang; Hendriks, Marleen Elisabeth; Henriques, Ana; Cadena, Leticia Hernandez; Herrala, Sauli; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Dinc, Gonul Horasan; Hormiga, Claudia M.; Horta, Bernardo Lessa; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Hu, Yonghua; Huerta, José María; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, M. Mohsen; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ivkovic, Vanja; Iwasaki, Masanori; Jackson, Rod T.; Jacobs, Jeremy M.; Jafar, Tazeen; Jamrozik, Konrad; Janszky, Imre; Jasienska, Grazyna; Jelakovic, Bojan; Jiang, Chao Qiang; Joffres, Michel; Johansson, Mattias; Jonas, Jost B; Jørgensen, Torben; Joshi, Pradeep; Juolevi, Anne; Jurak, Gregor; Jureša, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinänen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C.G.; Kengne, Andre Pascal; Kersting, Mathilde; Key, Timothy J.; Khader, Yousef Saleh; Khalili, Davood; Khang, Young Ho; Khaw, Kay Tee; Kiechl, Stefan; Killewo, Japhet; Kim, Jeongseon; Klumbiene, Jurate; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Koskinen, Seppo; Kouda, Katsuyasu; Koziel, Slawomir; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kula, Krzysztof; Kulaga, Zbigniew; Krishna Kumar, R.; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Laatikainen, Tiina; Lachat, Carl; Lam, Tai Hing; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Laxmaiah, Avula; Le Nguyen Bao, Khanh; Le, Tuyen D.; Leclercq, Catherine; Lee, Jeannette; Lee, Jeonghee; Lehtimäki, Terho; Lekhraj, Rampal; León-Muñoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Lima-Costa, M. Fernanda; Lin, Hsien Ho; Lin, Xu; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Lorbeer, Roberto; Lotufo, Paulo A.; Lozano, José Eugenio; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L.L.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Marques-Vidal, Pedro; Marrugat, Jaume; Martorell, Reynaldo; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mbanya, Jean Claude N.; McDonald Posso, Anselmo J.; McFarlane, Shelly R.; McGarvey, Stephen T.; McLachlan, Stela; McLean, Rachael M.; McNulty, Breige A.; MdKhir, Amir Sharifuddin; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Meshram, Indrapal I.; Metspalu, Andres; Mi, Jie; Mikkel, Kairit; Miller, Jody C.; Miquel, Juan-Francisco; Mišigoj-Durakovic, Marjeta; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Mohd Yusoff, Muhammad Fadhli; Møller, Niels C.; Molnár, Dénes; Momenan, Amirabbas; Mondo, Charles K.; Monyeki, Kotsedi Daniel K.; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mota, Jorge; Mostafa, Aya; Motlagh, Mohammad Esmaeel; Motta, Jorge; Muiesan, Maria L.; Müller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musil, Vera; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Námešná, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Navarrete-Muñoz, Eva Maria; Ndiaye, Ndeye Coumba; Neal, William A.; Nenko, Ilona; Nervi, Flavio; Nguyen, Nguyen D.; Nguyen, Quang Ngoc; Nieto-Martínez, Ramfis E.; Niiranen, Teemu J.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Oh, Kyungwon; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ordunez, Pedro; Osmond, Clive; Ostojic, Sergej M.; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Panda-Jonas, Songhomitra; Panza, Francesco; Papandreou, Dimitrios; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Pelletier, Catherine; Peltonen, Markku; Pereira, Alexandre C.; Pérez, Rosa Marina; Peters, Annette; Petkeviciene, Janina; Pham, Son Thai; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Plans-Rubió, Pedro; Polakowska, Maria; Polašek, Ozren; Porta, Miquel; Portegies, Marileen L.P.; Pourshams, Akram; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Raitakari, Olli T.; Raj, Manu; Rao, Sudha Ramachandra; Ramachandran, Ambady; Ramos, Elisabete; Rampal, Sanjay; Rangel Reina, Daniel A.; Rasmussen, Finn; Redon, Josep; Reganit, Paul Ferdinand M.; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; Rinke de Wit, Tobias F.; Ritti-Dias, Raphael M.; Robinson, Sian M.; Robitaille, Cynthia; Rodríguez-Artalejo, Fernando; del Cristo Rodriguez-Perez, María; Rodríguez-Villamizar, Laura A.; Rojas-Martinez, Rosalba; Rosengren, Annika; Rubinstein, Adolfo; Rui, Ornelas; Ruiz-Betancourt, Blanca Sandra; Russo Horimoto, Andrea R.V.; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Sakarya, Sibel; Salanave, Benoit; Martinez, Eduardo Salazar; Salmerón, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sánchez-Abanto, Jose; Sans, Susana; Santos, Diana; Santos, Ina S.; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Margolis, Giselle Sarganas; Sarrafzadegan, Nizal; Saum, Kai Uwe; Savva, Savvas C.; Scazufca, Marcia; Schargrodsky, Herman; Schneider, Ione J.; Schultsz, Constance; Schutte, Aletta E.; Schutte, Aletta E.; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Siantar, Rosalynn; Sibai, Abla M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A; Sjöström, Michael; Skovbjerg, Sine; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smith, Margaret C.; Snijder, Marieke B.; So, Hung Kwan; Sobngwi, Eugène; Söderberg, Stefan; Solfrizzi, Vincenzo; Sonestedt, Emily; Song, Yi; Sørensen, Thorkild I A; Soric, Maroje; Jérome, Charles Sossa; Soumare, Aicha; Staessen, Jan A.; Starc, Gregor; Stathopoulou, Maria G.; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stöckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Sun, Chien An; Sung, Yn Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Tai, E. Shyong; Tammesoo, Mari Liis; Tamosiunas, Abdonas; Tang, Line; Tang, Xun; Tao, Yong; Tanser, Frank; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne; Theobald, Holger; Thijs, Lutgarde; Thuesen, Betina Heinsbek; Tjonneland, Anne; Tolonen, Hanna K.; Tolstrup, Janne S.; Topbas, Murat; Topór-Madry, Roman; Tormo, María José; Torrent, Maties; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T.H.; Trivedi, Atul; Tshepo, Lechaba; Tulloch-Reid, Marshall K.; Tuomainen, Tomi-Pekka; Tuomilehto, Jaakko; Turley, Maria L.; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M.T.; Valdivia, Gonzalo; Valvi, Damaskini; van der Schouw, Yvonne T.; Van Herck, Koen; van Rossem, Lenie; Van Valkengoed, Irene G M; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. M.Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vollenweider, Peter; Voutilainen, Sari; Vrdoljak, Ana; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Walton, Janette; Wan Mohamud, Wan Nazaimoon; Wang, Ming Dong; Wang, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas J.; Wederkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wijga, Alet H; Wiecek, Andrzej; Wilks, Rainford J.; Willeit, Johann; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong, Tien-Yin; Wong-McClure, Roy A.; Woo, Jean; Woodward, Mark; Woodward, Mark; Wu, Aleksander Giwercman; Wu, Frederick C.; Wu, Shou Ling; Xu, Haiquan; Yan, Weili; Yang, Xiaoguang; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoshihara, Akihiro; Younger-Coleman, Novie O.; Yusoff, Ahmad F.; Yusoff, Muhammad Fadhli M.; Zambon, Sabina; Zdrojewski, Tomasz; Zeng, Yi-Xin; Zeng, Yi-Xin; Zhao, Dong; Zhao, Wenhua; Zheng, Yingffeng; Zimmermann, Esther; Cisneros, Julio Zuñiga; Zhu, Dan
Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood
Zhou, Bin; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali M; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre-Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundstrom, Johan; Smeeth, Liam; Soric, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen Me; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al-Raddadi, Rajaa; Al Woyatan, Rihab; Karamat Ali, Mohamed Hanief; Alkerwi, Ala'a; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Angquist, Lars; Anjana, Ranjit Mohan; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araujo, Joana; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Aryal, Krishna; Arveiler, Dominique; Assah, Felix K.; Assuncao, Maria Cecilia F.; Avdicova, Maria; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Bandosz, Piotr; Banegas, Jose R.; Barbagallo, Carlo M.; Barcelo, Alberto; Barkat, Amina; Barros, Aluisio J. D.; Barros, Mauro V.; Bata, Iqbal; Batieha, Anwar M.; Baur, Louise A.; Beaglehole, Robert; Ben Romdhane, Habiba; Benet, Mikhail; Benson, Lowell S.; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bi, Yufang; Bikbov, Mukharram; Bjerregaard, Peter; Bjertness, Espen; Bjokelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bongard, Vanina; Bovet, Pascal; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Bruno, Graziella; Bueno-de-Mesquita, H. B(as).; Bugge, Anna; Burns, Con; Bursztyn, Michael; de Leon, Antonio Cabrera; Cameron, Christine; Can, Gunay; Candido, Ana Paula C.; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casanueva, Felipe F.; Casas, Juan Pablo; Caserta, Carmelo A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Yu-Ching; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chiolero, Arnaud; Chiou, Shu-Ti; Chirita-Emandi, Adela; Cho, Belong; Cho, Yumi; Chudek, Jerzy; Cifkova, Renata; Claessens, Frank; Clays, Els; Concin, Hans; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris T.; Craig, Cora L.; Crujeiras, Ana B.; Cruz Moreno, Juan; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Danaei, Goodarz; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; De Backer, Guy; de Gaetano, Giovanni; De Henauw, Stefaan; De Smedt, Delphine; Deepa, Mohan; Dehghan, Abbas; Delisle, Helene; Deschamps, Valerie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Djalalinia, Shirin; Do, Ha T. P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Doering, Angela; Doua, Kouamelan; Drygas, Wojciech; Dulskiene, Virginija; Dzakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eggertsen, Robert; Ekelund, Ulf; El Ati, Jalila; Ellert, Ute; Elliott, Paul; Elosua, Roberto; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Escobedo-de la Pena, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernandez-Berges, Daniel; Ferrante, Daniel; Ferrari, Marika; Ferreccio, Catterina; Ferrieres, Jean; Finn, Joseph D.; Fischer, Krista; Foeger, Bernhard; Foo, Leng Huat; Forslund, Ann-Sofie; Forsner, Maria; Fortmann, Stephen P.; Fouad, Heba M.; Francis, Damian K.; Franco, Maria do Carmo; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Gavrila, Diana; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Ghimire, Anup; Giampaoli, Simona; Gianfagna, Francesco; Giovannelli, Jonathan; Goldsmith, Rebecca A.; Goncalves, Helen; Gonzalez Gross, Marcela; Gonzalez Rivas, Juan P.; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dusan; Grajda, Aneta; Gregor, Ronald D.; Grodzicki, Tomasz; Grontved, Anders; Gruden, Grabriella; Grujic, Vera; Gu, Dongfeng; Guan, Ong Peng; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc; Gupta, Prakash C.; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Halkjaer, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Harikumar, Rachakulla; Hata, Jun; Hayes, Alison J.; He, Jiang; Hendriks, Marleen Elisabeth; Henriques, Ana; Hernandez Cadena, Leticia; Herqutanto,; Herrala, Sauli; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Dinc, Gonul Horasan; Hormiga, Claudia M.; Horta, Bernardo Lessa; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Hu, Yonghua; Maria Huerta, Jose; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, M. Mohsen; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ivkovic, Vanja; Iwasaki, Masanori; Jackson, Rod T.; Jacobs, Jeremy M.; Jafar, Tazeen H.; Jamrozik, Konrad; Janszky, Imre; Jasienska, Grazyna; Jelakovic, Bojan; Jiang, Chao Qiang; Johansson, Mattias; Jonas, Jost B; Jorgensen, Torben; Joshi, Pradeep; Juolevi, Anne; Jurak, Gregor; Juresa, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinanen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C. G.; Kengne, Andre-Pascal; Kersting, Mathilde; Key, Timothy; Khader, Yousef Saleh; Khalili, Davood; Khang, Young-Ho; Khaw, Kay Tee; Kiechl, Stefan; Killewo, Japhet; Kim, Jeongseon; Klumbiene, Jurate; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Koskinen, Seppo; Kouda, Katsuyasu; Koziel, Slawomir; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kula, Krzysztof; Kulaga, Zbigniew; Kumar, R. Krishna; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Laatikainen, Tiina; Lachat, Carl; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Laxmaiah, Avula; Khanh Le Nguyen Bao,; Le, Tuyen D.; Leclercq, Catherine; Lee, Jeannette Jen-Mai; Lee, Jeonghee; Lehtimaki, Terho; Lekhraj, Rampal; Leon-Munoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Fernanda Lima-Costa, M.; Lin, Hsien-Ho; Lin, Xu; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Liu, Jing; Lorbeer, Roberto; Lotufo, Paulo A.; Eugenio Lozano, Jose; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L. L.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Marques-Vidal, Pedro; Marrugat, Jaume; Martorell, Reynaldo; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mbanya, Jean Claude N.; Posso, Anselmo J. Mc Donald; McFarlane, Shelly R.; McFarlane, Shelly R.; McGarvey, Stephen Theodore; McLachlan, Stela; McLean, Rachael M.; McNulty, Breige A.; Khir, Amir Sharifuddin Md; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Meshram, Indrapal I.; Metspalu, Andres; Mi, Jie; Mikkel, Kairit; Miller, Jody C.; Francisco Miquel, Juan; Jaime Miranda, J.; Misigoj-Durakovic, Marjeta; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Yusoff, Muhammad Fadhli Mohd; Moller, Niels C.; Molnar, Denes; Momenan, Amirabbas; Mondo, Charles K.; Monyeki, Kotsedi Daniel K.; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mostafa, Aya; Mota, Jorge; Motlagh, Mohammad Esmaeel; Motta, Jorge; Muiesan, Maria L.; Mueller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musil, Vera; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Namsna, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Maria Navarrete-Munoz, Eva; Ndiaye, Ndeye Coumba; Neal, William A.; Nenko, Ilona; Nervi, Flavio; Neuhauser, Hannelore K.; Nguyen, Nguyen D.; Quang Ngoc Nguyen,; Nieto-Martinez, Ramfis E.; Niiranen, Teemu J.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Oh, Kyungwon; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ordunez, Pedro; Osmond, Clive; Ostojic, Sergej M.; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Panda-Jonas, Songhomitra; Panza, Francesco; Papandreou, Dimitrios; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Pelletier, Catherine; Peltonen, Markku; Pereira, Alexandre C.; Marina Perez, Rosa; Peters, Annette; Petkeviciene, Janina; Peykari, Niloofar; Son Thai Pham,; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Plans-Rubio, Pedro; Polakowska, Maria; Polasek, Ozren; Porta, Miquel; Portegies, Marileen L. P.; Pourshams, Akram; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Raitakari, Olli; Raj, Manu; Rao, Sudha Ramachandra; Ramos, Elisabete; Rampal, Sanjay; Rangel Reina, Daniel A.; Rasmussen, Finn; Redon, Josep; Reganit, Paul Ferdinand M.; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; de Wit, Tobias F. Rinke; Ritti-Dias, Raphael M.; Robinson, Sian M.; Robitaille, Cynthia; Rodriguez-Artalejo, Fernando; Rodriguez-Villamizar, Laura A.; Rojas-Martinez, Rosalba; Rosengren, Annika; Rubinstein, Adolfo; Rui, Ornelas; Sandra Ruiz-Betancourt, Blanca; Russo Horimoto, Andrea R. V.; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Sakarya, Sibel; Salanave, Benoit; Salazar Martinez, Eduardo; Salmeron, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sanchez-Abanto, Jose; Sans, Susana; Santos, Diana; Santos, Ina S.; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Margolis, Giselle Sarganas; Sarrafzadegan, Nizal; Saum, Kai-Uwe; Savva, Savvas C.; Scazufca, Marcia; Schargrodsky, Herman; Schneider, Ione J. C.; Schultsz, Constance; Schutte, Aletta E.; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Siantar, Rosalynn; Sibai, Abla M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A.; Sjotrom, Michael; Skovbjerg, Sine; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smeeth, Liam; Smith, Margaret C. M.; Snijder, Marieke B.; So, Hung-Kwan; Sobngwi, Eugene; Soderberg, Stefan; Solfrizzi, Vincenzo; Sonestedt, Emily; Song, Yi; Sorensen, Thorkild I. A.; Soric, Maroje; Jerome, Charles Sossa; Soumare, Aicha; Staessen, Jan A.; Starc, Gregor; Stathopoulou, Maria G.; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stoeckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Sun, Chien-An; Sundstrom, Johan; Sung, Yn-Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Tai, E-Shyong; Tammesoo, Mari-Liis; Tamosiunas, Abdonas; Tang, Line; Tang, Xun; Tanser, Frank; Tao, Yong; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne W.; Theobald, Holger; Thijs, Lutgarde; Thuesen, Betina H.; Tjonneland, Anne; Tolonen, Hanna K.; Topbas, Murat; Topor-Madry, Roman; Jose Tormo, Maria; Torrent, Maties; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T. H.; Trivedi, Atul; Tshepo, Lechaba; Tulloch-Reid, Marshall K.; Tuomainen, Tomi-Pekka; Turley, Maria L.; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M. T.; Valdivia, Gonzalo; Valvi, Damaskini; van der Schouw, Yvonne T.; Van Herck, Koen; van Rossem, Lenie; van Valkengoed, Irene G. M.; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vollenweider, Peter; Vrdoljak, Ana; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Walton, Janette; Mohamud, Wan Nazaimoon Wan; Wang, Ming-Dong; Wang, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas; Wederkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wiecek, Andrzej; Wijga, Alet H.; Wilks, Rainford J.; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan J.; Wong, Tien-Yin; Wong-McClure, Roy A.; Woo, Jean; Woodward, Mark; Wu, Aleksander Giwercman; Wu, Frederick C.; Wu, Shou Ling; Xu, Haiquan; Yan, Weili; Yang, Xiaoguang; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoshihara, Akihiro; Younger-Coleman, Novie O.; Yusoff, Ahmad F.; Zambon, Sabina; Zdrojewski, Tomasz; Zeng, Yi; Zhao, Dong; Zhao, Wenhua; Zheng, Yingffeng; Zhu, Dan; Zimmermann, Esther; Zuniga Cisneros, Julio
Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood
Herrejón, A; Inchaurraga, I; Palop, J; Ponce, S; Peris, R; Terrádez, M; Blanquer, R
To evaluate the usefulness of transcutaneous carbon dioxide pressure (TcPCO2) monitoring in patients hospitalized for respiratory disease. We used a SenTec TcPCO2 monitor that also determines transcutaneous oxygen saturation (SpO2) by means of a sensor placed behind the ear lobe at a temperature of 42 degrees C. We compared arterial blood gas measurements--PaCO2 and arterial oxygen saturation (SaO2)--with transcutaneous measurements and analyzed the correlation, regression line, and agreement between the 2 methods. Thirty patients (20 men and 10 women) with various respiratory diseases and a mean (SD) age of 71 (13) years were included in the study. The median TcPCO2 was 43.25 mm Hg and the median PaCO2 was 42.6 mm Hg with no significant differences between the 2 measurements. The correlation was significant (rho=0.979; PTcPCO2=-2.475+1.058 PaCO2. The mean difference was 0.16 mm Hg (95% confidence interval [CI], --0.74 to 1.06). The lower limit of agreement (mean -1.96 SD) was -4.64 mm Hg, and the upper limit (mean +1.96 SD) was 4.96 mm Hg. For SaO2, the median was 94% and for SpO2, 95%. The difference between the 2 medians was significant (P< .004). The correlation was also significant (rho=0.822; P< .0001) with SpO2=4.427+0.97 SaO2. The mean difference was 1.14% (95% CI, 0.381% to 1.899%). The lower limit of agreement (mean -1.96 SD) was --2.93% and the upper limit (mean +1.96 SD) was 5.21% Transcutaneous determination of carbon dioxide pressure and oxygen saturation is useful for patients hospitalized for respiratory disease in view of its good correlation and agreement, although SpO2 does tend to overestimate SaO2.
Saud A. AlAnazi
Full Text Available AIM: To investigate the number of hypertensive patients, the optometrist is able to identify by routinely taking blood pressure (BP measurements for patients in “at-risk” groups, and to sample patients’ opinions regarding in-office BP measurement. Many of the optometrists in Saudi Arabia practice in optical stores. These stores are wide spread, easily accessible and seldom need appointments. The expanding role of the optometrist as a primary health care provider (PHCP and the increasing global prevalence of hypertension, highlight the need for an integrated approach towards detecting and monitoring hypertension.METHODS:Automated BP measurements were made twice (during the same session at five selected optometry practices using a validated BP monitor (Omron M6 to assess the number of patients with high BP (HBP -in at-risk groups-visiting the eye clinic routinely. Prior to data collection, practitioners underwent a two-day training workshop by a cardiologist on hypertension and how to obtain accurate BP readings. A protocol for BP measurement was distributed and retained in all participating clinics. The general attitude towards cardiovascular health of 480 patients aged 37.2 (±12.4y and their opinion towards in-office BP measurement was assessed using a self-administered questionnaire.RESULTS: A response rate of 83.6% was obtained for the survey. Ninety-three of the 443 patients (21.0% tested for BP in this study had HBP. Of these, (62 subjects 66.7% were unaware of their HBP status. Thirty of the 105 subjects (28.6% who had previously been diagnosed with HBP, still had HBP at the time of this study, and only 22 (73.3% of these patients were on medication. Also, only 25% of the diagnosed hypertensive patients owned a BP monitor.CONCLUSION: Taking BP measurements in optometry practices, we were able to identify one previously undiagnosed patient with HBP for every 8 adults tested. We also identified 30 of 105 previously diagnosed patients
Improving the accuracy of blood pressure measurement: the influence of the European Society of Hypertension International Protocol (ESH-IP) for the validation of blood pressure measuring devices and future perspectives.
Stergiou, George S; Asmar, Roland; Myers, Martin; Palatini, Paolo; Parati, Gianfranco; Shennan, Andrew; Wang, Jiguang; O'Brien, Eoin
The European Society of Hypertension (ESH) International Protocol (ESH-IP) for the validation of blood pressure (BP) measuring devices was published in 2002, with the main objective of simplifying the validation procedures, so that more BP monitors would be subjected to independent validation. This article provides an overview of the international impact of the ESH-IP and of the lessons learned from its use, to be able to justify further developments in validation protocols. A review of published (PubMed) validation studies from 2002 to 2017 was performed. One hundred and seventy-seven validation studies using the ESH-IP, 59 using the British Hypertension Society protocol, 46 using the Association for the Advancement of Medical Instrumentation (AAMI) standard and 23 using the International Organization for Standardization (ISO) standard were identified. Lists of validated office-clinic, home and ambulatory BP monitors are provided. Of the ESH-IP studies, 93% tested oscillometric devices, 80% upper arm, 71% home, 25% office and 7% ambulatory monitors (some had more than one function). The original goal of the ESH-IP has been fulfilled in that in the last decade the number of published validation studies has more than doubled. It is now recognized that the provision of accurate devices would be best served by having a universal protocol. An international initiative has been put in place by AAMI, ESH and ISO experts aiming to reach consensus for a universal validation protocol to be accepted worldwide, which will allow a more thorough evaluation of the accuracy and performance of future BP monitors.
Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.
The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality
Boshuizen, H.C.; Lanti, M.; Menotti, A.; Moschandreas, J.; Tolonen, H.; Nissinen, A.; Nedeljkovic, S.; Kafatos, A.; Kromhout, D.
The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality
Paige, Ellie; Barrett, Jessica; Pennells, Lisa; Sweeting, Michael; Willeit, Peter; Angelantonio, Emanuele Di; Gudnason, Vilmundur; Nordestgaard, Børge G.; Psaty, Bruce M.; Goldbourt, Uri; Best, Lyle G; Assmann, Gerd; Salonen, Jukka T.; Nietert, Paul J; Verschuren, Wm Monique; Brunner, Eric J.; Kronmal, Richard A; Salomaa, Veikko; Bakker, Stephan JL; Dagenais, Gilles R; Sato, Shinichi; Jansson, Jan Håkan; Willeit, Johann; Onat, Altan; de la Cámara, Agustin Gómez; Roussel, Ronan; Völzke, Henry; Dankner, Rachel; Tipping, Robert W; Meade, Tom W; Donfrancesco, Chiara; Kuller, Lewis H; Peters, Annette; Gallacher, John; Kromhout, Daan; Iso, Hiroyasu; Knuiman, Matthew W; Casiglia, Edoardo; Kavousi, Maryam; Palmieri, Luigi; Sundström, Johan; Davis, Barry R.; Njølstad, Inger; Couper, David J; Danesh, John; Thompson, Simon G.; Wood, Angela M.
The added value of incorporating information from repeated measurements of blood pressure and cholesterol for cardiovascular disease (CVD) risk prediction has not been rigorously assessed. We used data from the Emerging Risk Factors Collaboration on 191,445 adults (38 cohorts from across 17
van der Bel, René; Sliggers, Bart C.; van Houwelingen, Marc J.; van Lieshout, Johannes J.; Halliwill, John R.; van Hulst, Robert A.; Krediet, C. T. Paul
It would be desirable to safely and continuously measure blood pressure noninvasively under hyperbaric and/or hyperoxic conditions, in order to explore haemodynamic responses in humans under these conditions. A systematic analysis according to 'failure mode and effects analysis' principles of a
Pastelín Hernández, Gustavo; Rosas Peralta, Martín
Inflammatory status is involved in the pathophysiology of several cardiovascular disorders and in the genesis of high blood pressure. In this disease inflammation results from the activity of several hematological cells as well as the presence of chemotactic factors, immunological reactivity and hyperactivity of vasoconstrictor systems as that of the renin-angiotensin. Clinical evaluation of hypertension recommends secreening of several proinflammatory substances in hypertensive patients in order to evaluate their level of cardiovascular risk. Interleukin-6 and C reactive protein have been considered the most usual risk biomarkers. Interleukin 6 is a potent proinflammatory compound which participates in the acute fase of the tissular reaction to lesions associated to immunological, ischemic or oxidative stress. C reactive protein participates during inflammation activating the first component of complement with disorganization of the phospholipidic array of the endothelial sarcolemmal membrane and the consequent endothelial dysfunction related to the genesis of high blood pressure.
Full Text Available Objective: The prevalence of hypertension in childhood and adolescence is gradually increasing. We aimed to investigate the blood pressure (BP values of children aged 7-18 years. Methods: This study was conducted in a total of 3375 (1777 females, 1598 males children from 27 schools. Blood pressures of children were measured using sphygmomanometer appropriate to arm circumference. Results: A positive relationship was found between systolic blood pressure (SBP and diastolic blood pressure (DBP and the body weight, height, age and body mass index (BMI in male and female children. SBP was higher in males than females after the age of 13. DBP was higher in males than the females after the age of 14. The mean annual increase of SBP was 2.06 mmHg in males and 1.54 mmHg in females. The mean annual increase of DBP was 1.52 mmHg in males and 1.38 mmHg in females. Conclusion: In this study, we identified the threshold values for blood pressure in children between the age of 7 and 18 years in Erzurum province. It is necessary to combine and evaluate data obtained from various regions for the identification of BP percentiles according to the age, gender and height percentiles of Turkish children.
... AQ FREQUENTLY ASKED QUESTIONS FAQ034 PREGNANCY Preeclampsia and High Blood Pressure During Pregnancy • What is high blood pressure? • What is chronic hypertension? • What is gestational hypertension? • ...
To find out, the Medical Service's nurses are organising A HIGH BLOOD PRESSURE SCREENING AND PREVENTION CAMPAIGN from Monday, 26th to Thursday, 29th March 2007 at the Infirmary - Building 57 - ground floor A blood pressure test, advice, information and, if necessary, referral for specialist medical treatment will be offered to any person working on the CERN site. High blood pressure is a silent threat to health. So come and get your blood pressure checked.
To find out, the Medical Service's nurses are organising A HIGH BLOOD PRESSURE SCREENING AND PREVENTION CAMPAIGN from Monday, 26th to Thursday, 29th March 2007 at the Infirmary - Building 57 - ground floor A blood pressure test, advice, information and, if necessary, referral for specialist medical treatment will be offered to any person working on the CERN site. High blood pressure is a stealth threat to health. So come and get your blood pressure checked.
Conclusions: The prevalence of undiagnosed raised blood pressure and elevated blood sugar was high in Ethiopia and only very small percentage of people had been aware of their high blood pressure and elevated blood sugar. Policy makers in the health sector including other health development partners need to ...
that 24-hour ambulatory and daytime ambulatory blood pressure values were lower than office blood pressure values in hypertensive patients in a private practice. REFERENCES. 1. The fifth report of the Joint National Committee on detection, evaluation and treatment of high blood pressure (JNC V). Arch Intern Med 1993; ...
A method and apparatus are described for measuring the pressure of a fluid having characteristics that make it unsuitable for connection directly to a pressure gauge. The method is particularly suitable for the periodic measurement of the pressure of a supply of liquid Na to Na-lubricated bearings of pumps for pumping Na from a reservoir to the bearing via a filter, the reservoir being contained in a closed vessel containing an inert blanket gas, such as Ar, above the Na. (UK)
Full Text Available Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP. An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion, moderate (∼100 mmHg, saline, or high levels (∼160 mmHg, angiotensin II of mean arterial pressure (MAP, n = 5-10 per group were subjected to IOP challenge (10-120 mmHg, 5 mmHg steps every 3 minutes. Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave and inner retinal function (scotopic threshold response or STR. Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow.
Rodrigues, S L; Souza Júnior, P R; Pimentel, E B; Baldo, M P; Malta, D C; Mill, J G; Szwarcwald, C L
High salt intake is related to an increase in blood pressure and development of hypertension. However, currently, there are no national representative data in Brazil using the gold standard method of 24-h urine collection to measure sodium consumption. This study aimed to determine salt intake based on 24-h urine collection in a sample of 272 adults of both genders and to correlate it with blood pressure levels. We used a rigorous protocol to assure an empty bladder prior to initiating urine collection. We excluded subjects with a urine volume salt intake was 10.4±4.1 g/day (d), and 94% of the participants (98% of men and 90% of women) ingested more than the recommended level of 5 g/d. We found a positive association between salt and body mass index (BMI) categories, as well as with salt and blood pressure, independent of age and BMI. The difference in systolic blood pressure reached 13 mmHg between subjects consuming less than 6 g/d of salt and those ingesting more than 18 g/d. Subjects with hypertension had a higher estimated salt intake than normotensive subjects (11.4±5.0 vs 9.8±3.6 g/d, Psalt consumption in the general population.
Sindrup, J H; Kastrup, J; Christensen, H
Subcutaneous adipose tissue blood flow rate, together with systemic arterial blood pressure and heart rate under ambulatory conditions, was measured in the lower legs of 15 normal human subjects for 12-20 h. The 133Xe-washout technique, portable CdTe(Cl) detectors, and a portable data storage unit...... were used for measurement of blood flow rates. An automatic portable blood pressure recorder and processor unit was used for measurement of systolic blood pressure, diastolic blood pressure, and heart rate every 15 min. The change from upright to supine position at the beginning of the night period...... was associated with a 30-40% increase in blood flow rate and a highly significant decrease in mean arterial blood pressure and heart rate (P less than 0.001 for all). Approximately 100 min after the subjects went to sleep an additional blood flow rate increment (mean 56%) and a simultaneous significant decrease...
Full Text Available Abstract Background Prediabetes (PreDM in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV. Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S rats (n = 19 after weaning were fed either an American (AD or a standard (SD diet. The AD (high-glycemic-index, high-fat simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG, adipokines (leptin and adiponectin, and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1 and tumor necrosis factor-α (TNF-α] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP and heart rate (HR were recorded by telemetry every 5 minutes during both sleep (day and active (night periods. Pulse pressure (PP was calculated (PP = SBP-DBP. Results [mean(SEM]: The AD fed group displayed significant increase in body weight (after 90 days; p Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental basis for examining the relationship between dysglycemia and perturbation of the underlying mechanisms (adipose tissue dysfunction induced local and systemic inflammation, insulin resistance and alteration of adipose tissue precursors for the renin-aldosterone-angiotensin system which generate abnormal CBPV.
Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C
Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.
Conlay, L. A.; Maher, T. J.; Wurtman, R. J.
The effect of L-alanine administration on blood pressure (BP) during haemorrhagic shock was investigated using anesthetized rats whose left carotid arteries were cannulated for BP measurement, blood removal, and drug administration. It was found that L-alanine, in doses of 10, 25, 50, 100, and 200 mg/kg, increased the systolic BP of hypotensive rats by 38 to 80 percent (while 100 mg/kg pyruvate increased BP by only 9.4 mmhg, not significantly different from saline). The results suggest that L-alanine might influence cardiovascular function.
Fokkema, Dirk S.; Koolhaas, Jaap M.; Meulen, Jan van der; Schoemaker, Regien
A large amplitude blood pressure oscillation occurs during social defeat in a territorial fight between male rats, and during the application of a psychosocial stimulus associated with this defeat. Synchronous recording of blood pressure, intrathoracic pressure and diaphragm activity shows that the
Marrone, A.; Polosa, A. D.; Scioscia, G.; Stramaglia, S.; Zenzola, A.
We describe the multiresolution wavelet analysis of blood pressure waves in vasovagal syncope-affected patients compared with those in healthy people, using Haar and Gaussian bases. A comparison between scale-dependent and scale-independent measures discriminating the two classes of subjects is made. What emerges is a sort of equivalence between these two methodological approaches, that is, both methods reach the same statistical significance of separation between the two classes.
Power, M; Stout, R W
As post-prandial hypotension may be a cause of falls in older people, blood pressure was measured for one hour following a test meal in 22 elderly patients. There was a small fall in both systolic and diastolic blood pressure but no change in heart rate. Although the changes were small and no symptoms occurred, post-prandial hypotension might be important in elderly patients who had other abnormalities in blood pressure regulation. PMID:3811013
Power, M; Stout, R W
As post-prandial hypotension may be a cause of falls in older people, blood pressure was measured for one hour following a test meal in 22 elderly patients. There was a small fall in both systolic and diastolic blood pressure but no change in heart rate. Although the changes were small and no symptoms occurred, post-prandial hypotension might be important in elderly patients who had other abnormalities in blood pressure regulation.
Full Text Available Systemic arterial blood pressures were measured in 30 dogs with acute babesiosis, 10 each with mild uncomplicated, severe uncomplicated and complicated disease. Ten healthy dogs were used as controls. Hypotension was defined as more than 3 standard deviations below the control mean. Normal mean pressures (Â±SD were: systolic arterial pressure 151 (Â±11 mm Hg, diastolic arterial pressure 89 (Â±8 mm Hg and mean arterial pressure 107 (Â±10 mmHg. Hypotension was the most frequent abnormality, and increased strikingly in incidence as disease severity increased, with 5/10 dogs in the complicated group being hypotensive for systolic, diastolic and mean arterial pressures, compared with 2/10 in the severe uncomplicated group and 0/10 in the mild uncomplicated group. Systolic, diastolic and mean arterial pressures in the complicated group and severe uncomplicated group, and systolic pressure in the mild uncomplicated group, were significantly lower than in the controls. There were no significant relationships between arterial pressures and age, pulse rate, respiratory rate, temperature, mucous membrane colour or haematocrit. There was a significant negative correlation between arterial pressures and white cell and immature neutrophil counts. Arterial pressures differed significantly between dogs that were clinically collapsed and those that were not, but not between survivors and non-survivors. Pulse pressure (systolic - diastolic was low in 7/10 complicated, 1/10 mild uncomplicated, and 1/10 severe uncomplicated cases, and differed significantly between the complicated and control groups. The high incidence of hypotension in clinically severe babesiosis has important implications for therapy.
Almeida, Daniel; Barletta, Michele; Mathews, Lindsey; Graham, Lynelle; Quandt, Jane
Monitoring blood pressure under general anesthesia in animals is important to prevent hypotension and poor tissue perfusion. Thirteen sheep were enrolled to evaluate the accuracy of the petMAP, a portable non-invasive blood pressure (NIBP) monitor. Animals were anesthetized with midazolam, fentanyl, ketamine, propofol and maintained with isoflurane in oxygen for ovariectomy. Invasive and non-invasive (petMAP) blood pressure measurements were recorded simultaneously every 5 minutes. Agreement between IBP and NIBP was assessed by evaluation of bias and 95% limits of agreement (LOA) using the Bland-Altman method and correlation coefficient. None of the measurements met the criteria for good agreement between invasive and non-invasive readings established by the Association for the Advancement of Medical Instrumentation. Systolic blood pressure readings obtained at the left thoracic limb site and mean blood pressure at the right pelvic limb site met the bias and LOA criteria established by the American College of Veterinary Internal Medicine. Copyright © 2014 Elsevier Ltd. All rights reserved.
... Your diastolic pressure is 100 or higher For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender. People with diabetes or chronic kidney disease should keep their blood pressure below 130/80. ...
Kanbak, Güngör; Uzuner, Kubilay; Kuşat Ol, Kevser; Oğlakçı, Ayşegül; Kartkaya, Kazım; Şentürk, Hakan
Abstract We aim to study the effect of low-dose aspirin and kefir on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet. Forty adult male Sprague-Dawley rats were divided into five groups: control, high-salt (HS) (8.0% NaCl), HS+aspirin (10 mg/kg), HS+kefir (10.0%w/v), HS+aspirin +kefir. We measured sistolic blood pressure (SBP), mean arterial pressure (MAP), diastolic pressure, pulse pressure in the rats. Cathepsin B, L, DNA fragmentation and caspase-3 activities were determined from rat kidney tissues and rats clearance of creatinine calculated. Although HS diet increased significantly SBP, MAP, diastolic pressure, pulse pressure parameters compared the control values. They were not as high as accepted hypertension levels. When compared to HS groups, kefir groups significantly decrease Cathepsin B and DNA fragmentation levels. Caspase levels were elevated slightly in other groups according to control group. While, we also found that creatinine clearance was higher in HS+kefir and HS+low-dose aspirin than HS group. Thus, using low-dose aspirin had been approximately decreased of renal function damage. Kefir decreased renal function damage playing as Angiotensin-converting enzyme inhibitor. But, low-dose aspirin together with kefir worsened rat renal function damage. Cathepsin B might play role both apoptosis and prorenin-processing enzyme. But not caspase pathway may be involved in the present HS diet induced apoptosis. In conclusion, kefir and low-dose aspirin used independently protect renal function and renal damage induced by HS diet in rats.
Rabiei, Samira; Shakerhosseini, Rahebeh; Saadat, Navid
Increase in prevalence of obesity and type 2 diabetes which are of the main risk factors of metabolic syndrome, is not only the result of changes in genetic, diet or physical activity, but also an imbalance of micro flora may play an important role. Therefore, alteration of micro flora using pre/probiotic is considered as a new strategy for treatment of metabolic disorders. The current study is a triple blind randomized controlled trial. 46 patients from both sexes, who fulfilled inclusion criteria, randomly categorized into intervention or placebo group. The intervention and placebo groups consumed 2 probiotic capsules or 2 placebo capsules during 3 months, respectively. Both groups received a weight loss diet, according to their adjusted ideal body weight. Anthropometric, body composition, blood pressure and nutritional measurements were done in the beginning, at 6th week, and at the end of the study. T-test and paired-t test were used for statistical analysis. 40 patients completed the study. BMI, WC, HC, fat mass, lean mass and blood pressure were reduced in all participants (p< 0.05). Systolic blood pressure in symbiotic group was less than placebo group, significantly (p< 0.05). The trend of weight loss in symbiotic group continued at least for 12 weeks while it was stopped at week 6 in placebo group. Symbiotic supplement with the weight loss diet had synergistic effects on improvement in systolic blood pressure and anthropometric measurements. Based on our findings, symbiotic can postpone plateau phase of weight loss and it may prevent resistance to further weight loss.
De León-Robert, Arleen; Hidalgo-García, Isabel; Gascón-Cánovas, Juan; Antón-Botella, José; López-Alegría, Carmen; Campusano Castellanos, Heidi
To identify the most efficient measurement pattern of home blood pressure monitoring (HBPM) for the follow-up of hypertensive patients in primary care. Validation study of a diagnostic test. Primary care team in Murcia, Spain. One hundred and fifty three hypertensive patients younger than 80 years who met the inclusion criteria, who used HBPM and ambulatory blood pressure monitoring. Performing HBPM for 24hours. The HBPM protocol consisted of recording 2 measurements in the morning and 2 in the evening for 7 days. With the records obtained, the different HBPM patterns were established (7, 6, 5, 4, 3 days). The ROC curves were used for the analysis, together with the correlation coefficients and the Bland-Altman plots. The best areas under the curve for the systolic pressure of the different HBPM patterns corresponded to the 4-day pattern: 0.837 (0.77-0.90); and the 3 day one: 0.834 (0.77-0.90). As for diastolic pressure, the 7-day pattern had an area under the curve of 0.889 (0.84-0.94); followed by the 3 and 4 days patterns, which had the same statistical result both: 0.834 (0.83-0.94). There were no significant differences between correlation coefficients for systolic and diastolic blood pressures. The 3-day pattern showed a lower dispersion in the Bland-Altman plots. The 3 days HBPM pattern is proposed for the follow-up of the hypertensive patient, since it does not have an inferior efficiency to the other patterns. Copyright © 2018 The Author. Publicado por Elsevier España, S.L.U. All rights reserved.
... Sheps, M.D. Blood pressure has a daily pattern. Blood pressure is normally lower at night while you' ... begins dropping again. Having an abnormal blood pressure pattern, such as high blood pressure during the night or early in the ...
Khe, A. K.; Cherevko, A. A.; Chupakhin, A. P.; Krivoshapkin, A. L.; Orlov, K. Yu
In this paper an endovascular measurement system used for intraoperative cerebral blood flow monitoring is described. The system is based on a Volcano ComboMap Pressure and Flow System extended with analogue-to-digital converter and PC laptop. A series of measurements performed in patients with cerebrovascular pathologies allows us to introduce “velocity-pressure” and “flow rate-energy flow rate” diagrams as important characteristics of the blood flow. The measurement system presented here can be used as an additional instrument in neurosurgery for assessment and monitoring of the operation procedure. Clinical data obtained with the system are used for construction of mathematical models and patient-specific simulations. The monitoring of the blood flow parameters during endovascular interventions was approved by the Ethics Committee at the Meshalkin Novosibirsk Research Institute of Circulation Pathology and included in certain surgical protocols for pre-, intra- and postoperative examinations.
Elias, Merrill F; Torres, Rachael V; Davey, Adam
Randomized controlled trials of blood pressure (BP) lowering and antihypertensive medication use on cognitive outcomes have often been disappointing, reporting mixed findings and small effect sizes. We evaluate the extent to which cognitive assessment protocols used in these trials approach state-of-the-art. Overall, we find that a primary focus on cognition and the systematic selection of cognitive outcomes across trials take a backseat to other trial goals. Twelve trials investigating change in cognitive functioning were examined and none met criteria for state-of-the-art assessment, including use of at least 4 tests indexing 2 cognitive domains. Four trials investigating incident dementia were also examined. Each trial used state-of-the-art diagnostic criteria to assess dementia, although follow-up periods were relatively short, with only 2 trials lasting for at least 3 years. Weaknesses in each trial may act to obscure or weaken the positive effects of BP lowering on cognitive functioning. Improving trial designs in terms of cognitive outcomes selected and length of follow-up periods employed could lead to more promising findings. We offer logical steps to achieve state-of-the-art assessment protocols, with examples, in hopes of improving future trials.
Issa, Zeinab; Seely, Ellen W; Rahme, Maya; El-Hajj Fuleihan, Ghada
Although hormone therapy remains the most efficacious option for the management of vasomotor symptoms of menopause, its effects on blood pressure remain unclear. This review scrutinizes evidence of the mechanisms of action of hormone therapy on signaling pathways affecting blood pressure and evidence from clinical studies. Comprehensive Ovid MEDLINE searches were conducted for the terms "hypertension" and either of the following "hormone therapy and menopause" or "selective estrogen receptor modulator" from year 2000 to November 2013. In vitro and physiologic studies did not reveal a clear deleterious effect of hormone therapy on blood pressure. The effect of oral therapy was essentially neutral in large trials conducted in normotensive women with blood pressure as primary outcome. Results from all other trials had several limitations. Oral therapy had a neutral effect on blood pressure in hypertensive women. Transdermal estrogen and micronized progesterone had a beneficial effect on blood pressure in normotensive women and, at most, a neutral effect on hypertensive women. In general, tibolone and raloxifene had a neutral effect on blood pressure in both hypertensive and normotensive women. Large randomized trials are needed to assess the effect of oral hormone therapy on blood pressure as a primary outcome in hypertensive women and the effect of transdermal preparations on both normotensive and hypertensive women. Transdermal preparations would be the preferred mode of therapy for hypertensive women, in view of their favorable physiologic and clinical profiles. The decision regarding the use of hormone therapy should be individualized, and blood pressure should be monitored during the course of treatment.
... individuals. American Journal of Physiology. Heart and Circulatory Physiology. 2016;311:H1024. Carlson DJ, et al. Isometric exercise training for blood pressure management: A systematic review ...
Mooney, Allison P; Mawby, Dianne I; Price, Joshua M; Whittemore, Jacqueline C
The purpose of this study was to assess the effects of age, body condition score (BCS) and muscle condition score (MCS) on indirect radial and coccygeal Doppler systolic arterial blood pressure (SAP) measurements in dogs. Sixty-two privately-owned dogs were enrolled between June and July 2016. The BCS and MCS were determined by two investigators. Blood pressure was measured per published guidelines and using headphones, and the order of measurement site was randomized. Dogs were positioned in right lateral recumbency for radial measurements and sternal recumbency or standing for coccygeal measurements. Associations between SAP and other variables were assessed by correlation coefficients and analysis of covariance. Radial and coccygeal SAP measurements were moderately correlated ( r = 0.45, P < 0.01). Radial SAP measurements were higher than coccygeal SAP measurements (mean difference 9 mmHg, P < 0.01), but discordance occurred in both directions. No difference was observed between the first measurement taken, the average of measurements 2-6, or the average of all 6 measurements for either the radial (128, 129, and 129 mmHg; P = 0.36) or coccygeal (121, 122, and 122 mmHg; P = 0.82) site. Associations were not found between SAP measurements for either site and age, weight, BCS, MCS, anxiety score, or cuff size. Heart rate decreased significantly from the start of acclimation to the end of the first data collection series regardless of site ( P < 0.01). Initial measurement site can be based on patient and operator preference given lack of associations with patient variables, but the same site should be used for serial SAP measurements given discordant results between sites.
Allison P. Mooney
Full Text Available Objective The purpose of this study was to assess the effects of age, body condition score (BCS and muscle condition score (MCS on indirect radial and coccygeal Doppler systolic arterial blood pressure (SAP measurements in dogs. Methods Sixty-two privately-owned dogs were enrolled between June and July 2016. The BCS and MCS were determined by two investigators. Blood pressure was measured per published guidelines and using headphones, and the order of measurement site was randomized. Dogs were positioned in right lateral recumbency for radial measurements and sternal recumbency or standing for coccygeal measurements. Associations between SAP and other variables were assessed by correlation coefficients and analysis of covariance. Results Radial and coccygeal SAP measurements were moderately correlated (r = 0.45, P < 0.01. Radial SAP measurements were higher than coccygeal SAP measurements (mean difference 9 mmHg, P < 0.01, but discordance occurred in both directions. No difference was observed between the first measurement taken, the average of measurements 2–6, or the average of all 6 measurements for either the radial (128, 129, and 129 mmHg; P = 0.36 or coccygeal (121, 122, and 122 mmHg; P = 0.82 site. Associations were not found between SAP measurements for either site and age, weight, BCS, MCS, anxiety score, or cuff size. Heart rate decreased significantly from the start of acclimation to the end of the first data collection series regardless of site (P < 0.01. Conclusions and Clinical Relevance Initial measurement site can be based on patient and operator preference given lack of associations with patient variables, but the same site should be used for serial SAP measurements given discordant results between sites.
Full Text Available Automatic detection of ectopic beats has become a thoroughly researched topic, with literature providing manifold proposals typically incorporating morphological analysis of the electrocardiogram (ECG. Although being well understood, its utilization is often neglected, especially in practical monitoring situations like online evaluation of signals acquired in wearable sensors. Continuous blood pressure estimation based on pulse wave velocity considerations is a prominent example, which depends on careful fiducial point extraction and is therefore seriously affected during periods of increased occurring extrasystoles. In the scope of this work, a novel ectopic beat discriminator with low computational complexity has been developed, which takes advantage of multimodal features derived from ECG and pulse wave relating measurements, thereby providing additional information on the underlying cardiac activity. Moreover, the blood pressure estimations’ vulnerability towards ectopic beats is closely examined on records drawn from the Physionet database as well as signals recorded in a small field study conducted in a geriatric facility for the elderly. It turns out that a reliable extrasystole identification is essential to unsupervised blood pressure estimation, having a significant impact on the overall accuracy. The proposed method further convinces by its applicability to battery driven hardware systems with limited processing power and is a favorable choice when access to multimodal signal features is given anyway.
Pflugradt, Maik; Geissdoerfer, Kai; Goernig, Matthias; Orglmeister, Reinhold
Automatic detection of ectopic beats has become a thoroughly researched topic, with literature providing manifold proposals typically incorporating morphological analysis of the electrocardiogram (ECG). Although being well understood, its utilization is often neglected, especially in practical monitoring situations like online evaluation of signals acquired in wearable sensors. Continuous blood pressure estimation based on pulse wave velocity considerations is a prominent example, which depends on careful fiducial point extraction and is therefore seriously affected during periods of increased occurring extrasystoles. In the scope of this work, a novel ectopic beat discriminator with low computational complexity has been developed, which takes advantage of multimodal features derived from ECG and pulse wave relating measurements, thereby providing additional information on the underlying cardiac activity. Moreover, the blood pressure estimations’ vulnerability towards ectopic beats is closely examined on records drawn from the Physionet database as well as signals recorded in a small field study conducted in a geriatric facility for the elderly. It turns out that a reliable extrasystole identification is essential to unsupervised blood pressure estimation, having a significant impact on the overall accuracy. The proposed method further convinces by its applicability to battery driven hardware systems with limited processing power and is a favorable choice when access to multimodal signal features is given anyway. PMID:28098831
Lewis, Cora E.; Diaz, Keith M.; Carson, April P.; Kim, Yongin; Calhoun, David; Yano, Yuichiro; Viera, Anthony J.; Shimbo, Daichi
BACKGROUND Several ambulatory blood pressure monitoring (ABPM) measures have been associated with increased cardiovascular disease risk independent of clinic blood pressure (BP). African Americans have higher clinic BP compared with Whites but few data are available on racial differences in ABPM measures. METHODS We compared ABPM measures between African American (n = 178) and White (n = 103) participants at the Year 5 Coronary Artery Risk Development in Young Adults study visit. BP was measured during a study visit and the second and third measurements were averaged. ABPM was conducted over the following 24 hours. RESULTS Mean ± SD age of participants was 29.8±3.8 years and 30.8±3.5 years for African Americans and Whites, respectively. Mean daytime systolic BP (SBP) was 3.90 (SD 1.18) mm Hg higher among African Americans compared with Whites (P ABPM was higher among African Americans compared with Whites. CONCLUSIONS These data suggest racial differences in several ABPM measures exist. PMID:25376639
Background: There is a lot of controversy on the prognostic value of admission blood pressures in acute ischaemic stroke, but in Nigeria, there is no information on this. Objective: The objective of this study was to correlate the effect of blood pressures measured on admission with 30-day mortality and neurological handicap ...
Nielsen, P.E.; Myschetzky, P; Andersen, A R
Out-patient clinic blood pressure (OPC-BP) was compared to home blood pressure (Home-BP) measured three times daily during a two week period in 122 consecutively referred hypertensive subjects. A semi-automatic device (TM-101) including a microphone for detection of Korotkoff-sounds, self...
In this thesis we have explored different aspects of blood pressure measurement and related it to the risk of cardiovascular disease. In the first part we showed that when the arm is positioned under heart level, for example when the arm is placed on a desk or a chair support, the blood pressure and
The effect of malaria on blood pressure, heart rate, electrocardiogram and the cardiovascular responses to postural change were studied in malaria patients. Blood pressure was measured by the sphygmomanometric-auscultatory method. Standard ECG machine was used to record the electrocardiogram. Heart rate was ...
Nielsen, P.E.; Myschetzky, P; Andersen, A R
Out-patient clinic blood pressure (OPC-BP) was compared to home blood pressure (Home-BP) measured three times daily during a two week period in 122 consecutively referred hypertensive subjects. A semi-automatic device (TM-101) including a microphone for detection of Korotkoff-sounds, self-deflation...
Satoh, Michihiro; Asayama, Kei; Kikuya, Masahiro; Inoue, Ryusuke; Metoki, Hirohito; Hosaka, Miki; Tsubota-Utsugi, Megumi; Obara, Taku; Ishiguro, Aya; Murakami, Keiko; Matsuda, Ayako; Yasui, Daisaku; Murakami, Takahisa; Mano, Nariyasu; Imai, Yutaka; Ohkubo, Takayoshi
The prognostic significance of white-coat hypertension (WCHT) is controversial, and different findings on self-measured home measurements and 24-h ambulatory monitoring make identifying WCHT difficult. We examined whether individuals with partially or completely defined WCHT, as well as masked hypertension, as determined by different out-of-office blood pressure measurements, have a distinct long-term stroke risk. We followed 1464 participants (31.8% men; mean age, 60.6±10.8 years) in the general population of Ohasama, Japan, for a median of 17.1 years. A first stroke occurred in 212 subjects. Using sustained normal blood pressure (events/n=61/776) as a reference, adjusted hazard ratios for stroke (95% confidence intervals; events/n) were 1.38 (0.82-2.32; 19/137) for complete WCHT (isolated office hypertension), 2.16 (1.36-3.43; 29/117) for partial WCHT (either home or ambulatory normotension with office hypertension), 2.05 (1.24-3.41; 23/100) for complete masked hypertension (both home and ambulatory hypertension with office normotension), 2.08 (1.37-3.16; 38/180) for partial masked hypertension (either home or ambulatory hypertension with office normotension), and 2.46 (1.61-3.77; 42/154) for sustained hypertension. When partial WCHT and partial masked hypertension groups were further divided into participants only with home hypertension and those only with ambulatory hypertension, all subgroups had a significantly higher stroke risk (adjusted hazard ratio ≥1.84, P≤0.04). In conclusion, impacts of partial WCHT as well as partial masked hypertension for long-term stroke risk were comparable to those of complete masked hypertension or sustained hypertension. We need both home and 24-h ambulatory blood pressure measurements to evaluate stroke risk accurately. © 2015 American Heart Association, Inc.
Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael
This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the
Wang, Lulu; Zhao, Mingming; Liu, Wenjin; Li, Xiurong; Chu, Hong; Bai, Youwei; Sun, Zhuxing; Gao, Chaoqing; Zheng, Lemin; Yang, Junwei
Mechanisms underlying elevated blood pressure in dialysis patients are complex as a variety of non-traditional factors are involved. We sought to explore the association of circulating betaine, a compound widely distributed in food, with blood pressure in dialysis patients. We used baseline data of an ongoing cohort study involving patients on hemodialysis. Plasma betaine was measured by high performance liquid chromatography in 327 subjects. Blood pressure level was determined by intradialytic ambulatory blood pressure monitoring. The mean age of the patients was 52.6 ± 11.9 years, and 58.4% were male. Average interdialytic ambulatory systolic and diastolic blood pressure were 138.4 ± 22.7 mm Hg and 84.4 ± 12.5 mm Hg, respectively. Mean plasma betaine level was 37.6 μmol/L. Multiple linear regression analysis revealed significant associations of betaine with both systolic blood pressure (β = -3.66, P = .003) and diastolic blood pressure (β = -2.00, P = .004). The associations persisted even after extensive adjustment for cardiovascular covariates. Subgroup analysis revealed that the association between betaine and blood pressure was mainly limited to female patients. Our data suggest that alteration of circulating betaine possibly contributes to blood pressure regulation in these patients. ©2018 Wiley Periodicals, Inc.
Eisner, Alvin; Samples, John R.
The study had two main purposes: (1) to determine whether the foveal visual sensitivities of people treated for high blood pressure (vascular hypertension) differ from the sensitivities of people who have not been diagnosed with high blood pressure and (2) to understand how visual adaptation is related to standard measures of systemic cardiovascular function. Two groups of middle-aged subjects-hypertensive and normotensive-were examined with a series of test/background stimulus combinations. All subjects met rigorous inclusion criteria for excellent ocular health. Although the visual sensitivities of the two subject groups overlapped extensively, the age-related rate of sensitivity loss was, for some measures, greater for the hypertensive subjects, possibly because of adaptation differences between the two groups. Overall, the degree of steady-state sensitivity loss resulting from an increase of background illuminance (for 580-nm backgrounds) was slightly less for the hypertensive subjects. Among normotensive subjects, the ability of a bright (3.8-log-td), long-wavelength (640-nm) adapting background to selectively suppress the flicker response of long-wavelength-sensitive (LWS) cones was related inversely to the ratio of mean arterial blood pressure to heart rate. The degree of selective suppression was also related to heart rate alone, and there was evidence that short-term changes of cardiovascular response were important. The results suggest that (1) vascular hypertension, or possibly its treatment, subtly affects visual function even in the absence of eye disease and (2) changes in blood flow affect retinal light-adaptation processes involved in the selective suppression of the flicker response from LWS cones caused by bright, long-wavelength backgrounds.
Bragin, Denis E; Statom, Gloria L; Yonas, Howard; Dai, Xingping; Nemoto, Edwin M
The lower limit of cerebral blood flow autoregulation is the critical cerebral perfusion pressure at which cerebral blood flow begins to fall. It is important that cerebral perfusion pressure be maintained above this level to ensure adequate cerebral blood flow, especially in patients with high intracranial pressure. However, the critical cerebral perfusion pressure of 50 mm Hg, obtained by decreasing mean arterial pressure, differs from the value of 30 mm Hg, obtained by increasing intracranial pressure, which we previously showed was due to microvascular shunt flow maintenance of a falsely high cerebral blood flow. The present study shows that the critical cerebral perfusion pressure, measured by increasing intracranial pressure to decrease cerebral perfusion pressure, is inaccurate but accurately determined by dopamine-induced dynamic intracranial pressure reactivity and cerebrovascular reactivity. Cerebral perfusion pressure was decreased either by increasing intracranial pressure or decreasing mean arterial pressure and the critical cerebral perfusion pressure by both methods compared. Cortical Doppler flux, intracranial pressure, and mean arterial pressure were monitored throughout the study. At each cerebral perfusion pressure, we measured microvascular RBC flow velocity, blood-brain barrier integrity (transcapillary dye extravasation), and tissue oxygenation (reduced nicotinamide adenine dinucleotide) in the cerebral cortex of rats using in vivo two-photon laser scanning microscopy. University laboratory. Male Sprague-Dawley rats. At each cerebral perfusion pressure, dopamine-induced arterial pressure transients (~10 mm Hg, ~45 s duration) were used to measure induced intracranial pressure reactivity (Δ intracranial pressure/Δ mean arterial pressure) and induced cerebrovascular reactivity (Δ cerebral blood flow/Δ mean arterial pressure). At a normal cerebral perfusion pressure of 70 mm Hg, 10 mm Hg mean arterial pressure pulses had no effect on
Objective: To establish whether systolic blood pressure management outlined in hospital guidelines for the management of severe pre-eclampsia and eclampsia is in ... There was considerable variation in the level of blood pressure used as a target during treatment with antihypertensive medication and 32 (43.8%) of the ...
Steen, M.S. van der; Lenders, J.W.M.; Thien, Th.
OBJECTIVE: To study the experiences and complaints of patients who underwent 24 h blood pressure monitoring. METHODS: Two groups of hypertensive patients of a tertiary outpatient clinic were asked to fill in a nine-item questionnaire about the side effects of ambulatory blood pressure monitoring
The pattern of blood pressure in a cross-section of urban apparently healthy Nigerian adolescents aged 13 to 18 years as well as the prevalence of elevated blood pressure (hypertension) in the group is presented. Four hundred and forty three (443) students attending two secondary schools in the city of Calabar formed ...
... Thromboembolism Aortic Aneurysm More Managing Stress to Control High Blood Pressure Updated:Jan 29,2018 The importance of stress ... heart . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...
BMI) and waist-hip ratio (WHR) were calculated, and the blood pressure of the ... Contraceptive use was significantly associated with BMI classification (P=0.000), blood pressure classification (P=0.000) and history of hypertension among the ...
Manabe, Yasuhiro; Kono, Syoichiro; Tanaka, Tomotaka; Narai, Hisashi; Omori, Nobuhiko
This study aimed to evaluate the prognostic value of acute phase blood pressure in patients with acute ischemic stroke by determining whether or not it contributes to clinical outcome. We studied 515 consecutive patients admitted within the first 48 hours after the onset of ischemic strokes, employing systolic and diastolic blood pressure measurements recorded within 36 hours after admission. High blood pressure was defined when the mean of at least 2 blood pressure measurements was ≥200 mmHg systolic and/or ≥110 mmHg diastolic at 6 to 24 hours after admission or ≥180 mmHg systolic and/or ≥105 mmHg diastolic at 24 to 36 hours after admission. The high blood pressure group was found to include 16% of the patients. Age, sex, diabetes mellitus, hypercholesterolemia, atrial fibrillation, ischemic heart disease, stroke history, carotid artery stenosis, leukoaraiosis, NIH Stroke Scale (NIHSS) on admission and mortality were not significantly correlated with either the high blood pressure or non-high blood pressure group. High blood pressure on admission was significantly associated with a past history of hypertension, kidney disease, the modified Rankin Scale (mRS) on discharge and the length of stay. On logistic regression analysis, with no previous history of hypertension, diabetes mellitus, atrial fibrillation, and kidney disease were independent risk factors associated with the presence of high blood pressure [odds ratio (OR), 1.85 (95% confidence interval (CI): 1.06-3.22), 1.89 (95% CI: 1.11-3.22), and 3.31 (95% CI: 1.36-8.04), respectively]. Multi-organ injury may be presented in acute stroke patients with high blood pressure. Patients with high blood pressure had a poor functional outcome after acute ischemic stroke.
Full Text Available Abstract Background Insufficient blood pressure control is a frequent problem despite the existence of effective treatment. Insufficient adherence to self-monitoring as well as to therapy is a common reason. Blood pressure self-measurement at home (Home Blood Pressure Measurement, HBPM has positive effects on treatment adherence and is helpful in achieving the target blood pressure. Only a few studies have investigated whether adherence to HBPM can be improved through simple measures resulting also in better blood pressure control. Objective Improvement of self-monitoring and improved blood pressure control by using a new colour-coded blood pressure diary. Outcome Primary outcome: Change in systolic and/or diastolic blood pressure 6 months after using the new colour-coded blood pressure diary. Secondary outcome: Adherence to blood pressure self-measurement (number of measurements/entries. Methods/Design Randomised controlled study. Population: 138 adult patients in primary care with uncontrolled hypertension despite therapy. The control group uses a conventional blood pressure diary; the intervention group uses the new colour-coded blood pressure diary (green, yellow, red according a traffic light system. Expected results/conclusion The visual separation and entries in three colour-coded areas reflecting risk (green: blood pressure in the target range ≤ 140/≤ 90 mmHg, yellow: blood pressure >140/>90 mmHg, red: blood pressure in danger zone > 180 mmHg/>110 mmHg lead to better self-monitoring compared with the conventional (non-colour-coded blood pressure booklet. The colour-coded, visualised information supports improved perception (awareness and interpretation of blood pressure and triggers correct behaviour, in the means of improved adherence to the recommended treatment as well as better communication between patients and doctors resulting in improved blood pressure control. Trial registration ClinicalTrials.gov ID NCT01013467
Defective blood pressure responses to standing, exercise and epinephrine infusions have been demonstrated in diabetic patients with autonomic neuropathy. The circulatory mechanisms underlying blood pressure responses to exercise and standing up in these patients are well characterized: In both...... which may contribute to exercise hypotension in these patients. During hypoglycemia, blood pressure regulation seems intact in patients with autonomic neuropathy. This is probably due to release of substantial amounts of catecholamines during these experiments. During epinephrine infusions a substantial...... blood pressure fall ensues in patients with autonomic neuropathy, probably due to excessive muscular vasodilation. It is unresolved why blood pressure regulation is intact during hypoglycemia and severely impaired--at similar catecholamine concentrations--during epinephrine infusions....
Blood pressure is the pressure exerted by circulating blood upon the walls of blood vessels. Accuracy in blood pressure meters is of essence to health, especially in blood pressure monitoring and treatment. The aim of this research was to compare the readings and the sensitivities of some blood pressure monitors in use ...
Ahadi, Z; Qorbani, M; Kelishadi, R; Ardalan, G; Motlagh, M E; Asayesh, H; Zeynali, M; Chinian, M; Larijani, B; Shafiee, G; Heshmat, R
The aim of this study is to assess the association between breakfast intake with anthropometric measurements and blood pressure among Iranian children and adolescents. The second goal is to investigate the correction of breakfast consumption with other food consumption behaviors. In this national survey, 13,486 children and adolescents, aged 6-18 years, were selected by multistage, cluster sampling method from rural and urban areas of 31 provinces of Iran (2011-2012). Physical measurements included height, weight, waist circumference, and blood pressure. Food habits were assessed by self-reported questionnaire. Breakfast frequency was defined as skippers (eating breakfast 0-2 days/week), semi-skippers (eating breakfast 3-4 days/week) and non-skippers (eating breakfast 5-7 days/week). The data were analyzed by the STATA package. Of the participants, 18.9%, 13.2% and 67.9%, were breakfast skippers, semi-skippers and non-skippers respectively. The prevalence of overweight and obesity among breakfast skippers were higher than non-skippers counterparts (P-value breakfast skippers and non-skippers group were 22.6% (CI 95%: 21-24.3) and 17.9% (CI 95%: 17-18.6), respectively. Blood pressure did not significantly differ between non-skippers students and breakfast skippers (P-value = 0.1). Non-skipping adolescents ate more fresh fruits, dried fruits, vegetables and drank milk more frequently compared with breakfast skipper; while the skippers showed a higher intake of salty snack, soft drinks, packed fruit juice and fast foods (all P-value breakfast consumption is significantly associated with lower body fatness and healthier dietary habits but that further study, using controlled intervention trials, is required to test whether this represents a causal relationship. Copyright © 2015. Published by Elsevier Ltd.
Ferns, S. P.; Schneiders, J. J.; Siebes, M.; van den Berg, R.; van Bavel, E. T.; Majoie, C. B.
Hemodynamics is thought to play a role in the growth and rupture of intracranial aneurysms. In 4 patients, we obtained local pressure and BFV by using a dual-sensor pressure and Doppler velocity wire within and in vessels surrounding unruptured aneurysms. Local BFVs can serve as boundary conditions
Formiga, Francesc; Ferrer, Assumpta; Sobrino, Javier; Coca, Antonio; Riera, Antoni; Pujol, Ramón
The objective of the study is to investigate ambulatory blood pressure monitoring (ABPM) in a sample of Spanish nonagenarians. We also analyzed the misdiagnosis of hypertension and investigated blood pressure (BP) control in treated hypertensive nonagenarians. Twenty-four-hour ABPM was undertaken in a group of 42 nonagenarians. The 24-h mean, daytime BP, nighttime BP and heart rate (HR) were extracted from the ABPM. Sociodemographic data, the ability to perform basic daily activities, measured by the Barthel index (BI) or instrumental activities revealed by the Lawton and Brody index (LI), cognition, and comorbidity were evaluated. Thirty-one subjects were receiving antihypertensive drug treatment. Twenty-four hour, daytime and sleeping pressures averaged 130/65, 131/68 and 128/63mmHg, respectively. Seventeen (40.5%) of the 42 patients had a daytime BP of 135/85 or higher. In terms of the BP pattern, 8 (19%) subjects were dippers, 19 (45%) non-dippers, and 15 (36%) were risers. Five (45.46%) out of 11 patients with no evidence of hypertension (normotensive patients) had a daytime BP of 135/85 or higher. The mean daytime BP was 135/85 or higher in 12 (38.7%) out of 31 nonagenarians who had previously received therapy for hypertension. In, conclusion a high prevalence of hypertension, misdiagnosis and inadequate BP control was found in nonagenarians treated for hypertension.
Blood pressure and heart rate response to posteriorly directed pressure applied to the cervical spine in young, pain-free individuals: a randomized, repeated-measures, double-blind, placebo-controlled study.
Yung, Emmanuel; Wong, Michael; Williams, Haddie; Mache, Kyle
Randomized clinical trial. Objectives To compare the blood pressure (BP) and heart rate (HR) response of healthy volunteers to posteriorly directed (anterior-to-posterior [AP]) pressure applied to the cervical spine versus placebo. Manual therapists employ cervical spine AP mobilizations for various cervical-shoulder pain conditions. However, there is a paucity of literature describing the procedure, cardiovascular response, and safety profile. Thirty-nine (25 female) healthy participants (mean ± SD age, 24.7 ± 1.9 years) were randomly assigned to 1 of 2 groups. Group 1 received a placebo, consisting of light touch applied to the right C6 costal process. Group 2 received AP pressure at the same location. Blood pressure and HR were measured prior to, during, and after the application of AP pressure. One-way analysis of variance and paired-difference statistics were used for data analysis. There was no statistically significant difference between groups for mean systolic BP, mean diastolic BP, and mean HR (P >.05) for all time points. Within-group comparisons indicated statistically significant differences between baseline and post-AP pressure HR (-2.8 bpm; 95% confidence interval: -4.6, -1.1) and between baseline and post-AP pressure systolic BP (-2.4 mmHg; 95% confidence interval: -3.7, -1.0) in the AP group, and between baseline and postplacebo systolic BP (-2.6 mmHg; 95% confidence interval: -4.2, -1.0) in the placebo group. No participants reported any adverse reactions or side effects within 24 hours of testing. AP pressure caused a statistically significant physiologic response that resulted in a minor drop in HR (without causing asystole or vasodepression) after the procedure, whereas this cardiovascular change did not occur for those in the placebo group. Within both groups, there was a small but statistically significant reduction in systolic BP following the procedure.
Laverman, Gozewijn Dirk; Andersen, Steen; Rossing, Peter
BACKGROUND: AT1-receptor blockade dose dependently lowers blood pressure (BP) and albuminuria. Reduction of BP and albuminuria are independent treatment targets for renoprotection, but whether this requires similar dose titration is unknown. METHODS: We tested this in two studies designed to find...... arterial pressure (MAP) were measured. Patients were divided into "good" and "poor" BP responders (BP+, BP-) according to BP response above or below group median. RESULTS: Baseline MAP in the BP- groups was 102 (97, 104) mm Hg in DM (median, 95% CI) and 91 (80, 108) mm Hg in ND. The top of the dose...... response for BP (obtained at losartan 100 mg) in the BP- groups was -2 (-4, 3) mm Hg in DM and -1 (-6, 2) mm Hg in ND, versus -15 (-18, -12) mm Hg and -16 (-26, -18) mm Hg in BP+ groups (both P
Mortensen, Rikke Nørmark; Gerds, Thomas Alexander; Jeppesen, Jørgen Lykke
Aims: To determine the added value of (i) 24-h ambulatory blood pressure relative to office blood pressure and (ii) night-time ambulatory blood pressure relative to daytime ambulatory blood pressure for 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events. Methods...... and results: A total of 7927 participants were included from the International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes. We used cause-specific Cox regression to predict 10-year person-specific absolute risks of fatal and non-fatal cardiovascular events....... Discrimination of 10-year outcomes was assessed by time-dependent area under the receiver operating characteristic curve (AUC). No differences in predicted risks were observed when comparing office blood pressure and ambulatory blood pressure. The median difference in 10-year risks (1st; 3rd quartile) was -0...
Full Text Available ... ounces of liquor Managing and Coping With Stress Learning how to manage stress, relax, and cope with ... goes down. Central Acting Agents: Act in the brain to decrease nerve signals that narrow blood vessels, ...
Full Text Available ... management techniques include: Being physically active Listening to music or focusing on something calm or peaceful Performing ... multidisciplinary researchers on June 10, 2016, to share current scientific k... View all events on High Blood ...
Cortés, Yamnia I; Catov, Janet M; Brooks, Maria; Harlow, Siobán D; Isasi, Carmen R; Jackson, Elizabeth A; Matthews, Karen A; Thurston, Rebecca C; Barinas-Mitchell, Emma
Adverse pregnancy outcomes, such as preterm birth (PTB), have been associated with elevated risk of maternal cardiovascular disease, but their effect on late midlife blood pressure (BP) and subclinical vascular measures remains understudied. We conducted a cross-sectional analysis with 1220 multiethnic parous women enrolled in SWAN (Study of Women's Health Across the Nation) to evaluate the impact of self-reported history of adverse pregnancy outcomes (PTB, small-for-gestational-age, stillbirth), on maternal BP, mean arterial pressure, and subclinical vascular measures (carotid intima-media thickness, plaque, and pulse wave velocity) in late midlife. We also examined whether these associations were modified by race/ethnicity. Associations were tested in linear and logistic regression models adjusting for sociodemographics, reproductive factors, cardiovascular risk factors, and medications. Women were on average aged 60 years and 255 women reported a history of an adverse pregnancy outcome. In fully adjusted models, history of PTB was associated with higher BP (systolic: β=6.40; SE, 1.62 [ P history of PTB is associated with higher BP and mean arterial pressure in late midlife. Adverse pregnancy outcomes were not significantly related to subclinical cardiovascular disease when excluding women with prevalent hypertension. Future studies across the menopause transition may be important to assess the impact of adverse pregnancy outcomes on midlife progression of BP. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Aleixandre, A; Miguel, M
In the past few years, new strategies to control blood pressure levels are emerging by developing new bioactive components of foods. Fiber has been linked to the prevention of a number of cardiovascular diseases and disorders. β-Glucan, the main soluble fiber component in oat grains, was initially linked to a reduction in plasma cholesterol. Several studies have shown afterward that dietary fiber may also improve glycaemia, insulin resistance and weight loss. The effect of dietary fiber on arterial blood pressure has been the subject of far fewer studies than its effect on the above-mentioned variables, but research has already shown that fiber intake can decrease arterial blood pressure in hypertensive rats. Moreover, certain fibers can improve arterial blood pressure when administered to hypertensive and pre-hypertensive subjects. The present review summarizes all those studies which attempt to establish the antihypertensive effects of dietary fiber, as well as its effect on other cardiovascular risk factors.
Aourell, Moa; Skoog, Martina; Carleson, J
Swedish massage technique includes mechanically activated muscular tissue and also skin, tendons, fascias, and connected tissue, which indirectly regulates the tonus of the autonomous nervous system. This study set out to examine the effects of Swedish massage on blood pressure. Healthy males were given massage treatment at the Karolinska Hospital, Stockholm, Sweden. Treatment was over a 12-week period divided into three parts, each consisting of 4 weeks. Two treatment periods contained massage treatment either on back, neck and chest (BNC), or leg, arm and face (LAF), with an in between washout period. The first treatment period with massage decreased systolic blood pressure directly after treatment (BNC: Pmassage decreased systolic (Pmassage (Pmassage on the BNC resulted in a minor decrease in blood pressure possibly due to sympathetic inhibition. It may be suggested that massage may be tried as a complementary therapy in patients suffering from increased blood pressure due to stress.
Ji, A-L; Chen, W-W; Huang, W-J
We investigated the effects of oral administration of enteric coated aspirin (ASA) on blood pressure and blood pressure variability of hypertension patients before sleep. We observed 150 hypertension cases, classified as Grade 1-2, from September 2006 to March 2008. They are divided into a control group with 30 cases, ASA I group with 60 cases and ASA II group with 60 cases randomly. Subjects in the control group had proper diets, were losing weight, exercising and maintaining a healthy mentality and were taking 30 mg Adalat orally once a day. Based on the treatment of control group, patients in ASA I group were administered 0.1 g Bayaspirin (produced by Bayer Company) at drought in the morning. Also, based on the treatment of control group, patients in ASA II group were administered 0.1 g Bayaspirin at draught before sleep. The course of treatment is 3 months and then after the treatment, decreasing blood pressure and blood pressure variability conditions in three groups will be compared. Through the comparison of ASA II group with the control group, they have differences in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), decreasing range of blood pressure and blood pressure variability (p sleep has synergistic effects on decreasing blood pressure of hypertension patients and improving blood pressure variability.
The hidden magnitude of raised blood pressure and elevated blood glucose in Ethiopia: A call for initiating community based NCDs risk factors screening program. Abebe Bekele1, Terefe Gelibo1, Kassahun Amenu1, Theodros Getachew1, Atkure Defar1, Habtamu Teklie1,. Tefera Taddele1, Girum Taye1, Misrak Getnet1, ...
and only very small percentage of people had been aware of their high blood pressure and elevated blood sugar. Policy makers in the health sector including other health development partners need to strengthen health system and design nation-wide population based strategy to establish community based screening ...
Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging
Gideon, P; Thomsen, C; Gjerris, F
PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopathic...... intracranial hypertension (IIH). RESULTS: Mean blood flow was 443 ml/min in healthy volunteers with a tendency towards reduced blood flow with increasing age. In NPH patients significantly lower superior sagittal sinus blood flow values were found, but this difference was no longer significant when patients...
Bauduceau, B; Mayaudon, H; Chanudet, X; Lecoules, S; Agrumi, C; Dupuy, O; Larroque, P
The evaluation of the real blood pressure in the diabetic population has a major interest. Arterial blood pressure measure during standardised exercise test could be a supplementary aid in this field of research. This retrospective work is based on 134 diabetic patients compared with age, sex and body mass index matched controls. All of them were tested with a standardised protocol of bicycle ergometer. In the diabetic group, 62 patients present a microalbuminuria over 30 mg/day. The heart rate and arterial pressure do not differ between diabetics and controls before, during, and after the exercise. The registered parameters at the top of the effort are exactly the same for the pulse the systolic and the diastolic blood pressure. Systolic blood pressure gradient during effort is not different between the two groups. The presence of microalbuminuria into the diabetic group do not provoke any modification of cardiac frequency or pressure during the effort. Nevertheless a decrease in systolic blood pressure gradient is noted into the microalbuminuria group despite their older age is in favour of an increase in this parameter. Exercise test has a main place to track down coronary disease and the field of interest is the same that non diabetic patients to find white coat hypertension, to value arterial pressure reactivity during effort of hypertensive athletes or border line hypertensives. The signification and interest of the modification of systolic blood pressure gradient should to be evaluated by other works.
Chen, Can; Shang, Fujun; Wang, Jiepin; Chen, Jianghong; Ji, Na; Wan, Yi
This study aimed to evaluate the performance of the iHealth BP3 upper-arm blood pressure monitor, which is designed for clinic use and self-measurement of blood pressure using Apple touch devices as an interface. The European Society of Hypertension International Protocol (ESH-IP) revision 2010 for the validation of blood pressure measuring devices in adults was followed precisely. Ninty-nine couples of test device and reference blood pressure measurements were obtained during the study (three pairs for each of the 33 participants). The 33 participants, age 47.1±12.3 years (age range 27-69 years) and arm circumference 30.0±4.4 cm, had a mean systolic blood pressure (SBP) of 143.9±27.4 mmHg and a mean diastolic blood pressure (DBP) of 90.1±18.3 mmHg. The device passed all of the requirements fulfilling the standards of the protocol, and the mean±SD device-observer difference was 2.8±4.2 mmHg for SBP and -0.4±3.5 mmHg for DBP. According to the results of the validation study on the basis of the ESH-IP revision 2010, the iHealth BP3 can be recommended for clinic use and self-measurement in an adult population. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Madsen, Søren Aalbæk; Fomsgaard, Jonna Storm; Jensen, Rigmor
Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals. Treatment of low CSF pressure headache consists...... of non-invasive/conservative measures and invasive measures with epidural blood patch providing the cornerstone of the invasive measures. In the present pilot study we therefore aimed to evaluate the treatment efficacy of epidural blood patch (EBP) in treatment-refractory low-pressure headache. Our...
Sosner, P; Gremeaux, V; Bosquet, L; Herpin, D
High blood pressure is a frequent pathology with many cardiovascular complications. As highlighted in guidelines, the therapeutic management of hypertension relies on non-pharmacological measures, which are diet and regular physical activity, but both patients and physicians are reluctant to physical activity prescription. To acquire the conviction that physical activity is beneficial, necessary and possible, we can take into account some fundamental and clinical studies, as well as the feedback of our clinical practice. Physical inactivity is a major risk factor for cardiovascular morbidity and mortality, and hypertension contributes to increase this risk. Conversely, regular practice of physical activity decreases very significantly the risk by up to 60%. The acute blood pressure changes during exercise and post-exercise hypotension differs according to the dynamic component (endurance or aerobic and/or strength exercises), but the repetition of the sessions leads to the chronic hypotensive benefit of physical activity. Moreover, physical activity prescription must take into account the assessment of global cardiovascular risk, the control of the hypertension, and the opportunities and desires of the patient in order to promote good adherence and beneficial lifestyle change. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide
High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.
Wang, Yang; Liu, Zhiwen; Ma, Shaodong
This paper proposes an unobtrusive blood pressure (BP) measurement system design with a motion artifact (MA) compensation strategy as a potential surrogate to the traditional cuff-based sphygmomanometer for self-monitoring in a less restricted environment. A dual-channel photoplethysmographic signal acquisition system is designed and implemented for cuff-less BP measurement based on the peripheral pulse transit time (PPTT) acquired from the forearm and wrist. Comprising a motion decision, singular spectrum analysis, PPTT calculation and BP measurement, a novel approach is proposed to realize BP measurements and suppress MA interference. Compared with the reference BP recorded by a cuff-based sphygmomanometer, our preliminary examinations on 30 subjects found that the correlation coefficients for systolic BP estimation and diastolic BP estimation were 0.75 and 0.78, and the mean absolute differences were 7.61 mmHg and 6.82 mmHg, respectively. Meanwhile, the proposed approach was compared with the other most widely used pulse transit time (PTT) measuring methods and BP-PTT models. All the results indicate that our work was highly effective in realizing the BP measurement. The proposed system and approach have resulted in remarkable progress in cuff-less BP measurements with MA removal, and have great potential value in wearable applications without environmental restrictions.
Blood pressure, blood viscosity and plasma fibrinogen and nutrient intake were determined before and during intervention. The complementary fruits and vegetables included in the normal dietary regimen of the patients during the 10 weeks study increased the levels of potassium, calcium, phosphorus, antioxidants and ...
Santiago, Luiz Miguel; Simões, Ana Rita; Ricardo Miranda, Paula; Matias, Catarina; Rosendo, Inês; Constantino, Liliana; Santos, Tiago; Neto, Maria da Glória; Francisco, Maria dos Prazeres
Central blood pressure (CBP) is the pressure exerted by the blood column at any given moment on the aortic and carotid artery walls, which is a close proxy for the blood pressure inside the brain and the heart, and is thus a better marker of cardiovascular morbidity and mortality than peripheral blood pressure (PBP). To assess how the augmentation index (AI), peripheral pulse pressure (pPP), central pulse pressure (cPP) and subendocardial viability ratio (SEVR) vary in hypertensive patients according to level of control of CBP and PBP. We performed an observational, cross-sectional study in a convenience sample from a general practice in Central Portugal over a period of four days in May 2010. Measurements were taken after a four-minute resting period. The following values were considered to reflect controlled pressures: PBP <140/90 mmHg, CBP <130/80 mmHg, pPP <55 mmHg and cPP <45 mmHg. The sample included 92 patients, 38 male (41.3%), mean age 62.3±11.1 years, with no significant difference in gender distribution. PBP was controlled in 55 (59.8%), and CBP in 53 (57.6%). Both PBP and CBP were controlled in 50 patients (54.3%) and neither was controlled in 34 (37.9%). pPP and cPP were significantly lower in those with controlled PBP (p<0.001) and CBP (p<0.001). AI was non-significantly lower in those with controlled PBP (78±9 vs. 80.7) and those with controlled CBP (78±9 vs.81±7) (p=0.02). SEVR was within the desirable range in 92 patients (92.2%). 78.4% of individuals were taking drugs acting on the renin angiotensin aldosterone system (RAAS). In a convenience sample of 92 patients, PBP and CBP were controlled in 59.8% and 57.6%, respectively. Those with controlled PBP had significantly better peripheral systolic and diastolic blood pressure, CBP, pPP and cPP; the same was true of those with controlled CBP, who also had a significantly better AI. The percentage of the cardiac cycle in diastole had a desirable value for 92,2% of the subjects. Copyright © 2011
Stryker, Trina; Wilson, Merne; Wilson, Thomas W
To evaluate the accuracy of automated digital blood pressure monitoring devices and operators in the community. Also, we tested the effects of a simple education program, and looked for arm-arm differences. Subjects who had bought their own automated digital blood pressure monitor were recruited via an advertisement in the local newspaper. On arrival, they were asked to record their blood pressure exactly as they would at home. The investigator noted any technique deficiencies then corrected them. Blood pressures were then recorded by the investigator and the subject, on opposite arms, simultaneously, and repeated with the arms switched. Finally, subjects recorded their blood pressure again. The subjects' readings were compared to the average of monitor and mercury readings using Bland-Altman methods. A total of 80 subjects were tested. Before educating, subjects' systolic blood pressure (SBP) readings were +5.8+/-6.4 (standard deviation) mmHg greater than the mean of all readings, and diastolic blood pressure (DBP) were +1.3+/-4.0 mmHg; after educating they were +1.3+/-4.0 and -1.3+/-2.7 respectively. The monitors, as a group, were accurate, and met British Hypertension Society and AAMI highest standards. We found no differences among monitors that had been validated (n=26) and those that had not. There were differences between the arms: 5.3+/-5.2 mmHg for SBP and 3.4+/-3.3 mmHg for DBP. Most patients had never been informed by anyone of proper blood pressure measuring techniques. We conclude that home blood pressure measurement, as practiced in our community, is prone to error, mostly due to mistakes by the operator. These can easily be corrected, so that readings become more accurate. Attention should be paid to arm-arm differences.
Choi, Jae Chan; Lee, Jong-Hyuk; Lee, Young-Don; Kim, Soon Yul; Chang, Sei-Jin
During shoulder surgery, blood pressure is frequently measured at the ankle. Anesthetic complications may result when ankle blood pressure is higher than brachial blood pressure and anesthesiologists misinterpret ankle blood pressure as brachial blood pressure. Therefore, we investigated whether ankle blood pressure is significantly higher than brachial blood pressure before anesthesia induction, during induction, after tracheal intubation, before beach chair position, and in the beach chair position. Thirty patients requiring general anesthesia for shoulder surgery were included in this study. Ankle and brachial blood pressure were simultaneously measured before induction, during induction, after intubation, before beach chair position, and in the beach chair position. Ankle blood pressure was higher than brachial blood pressure before induction, during induction, after intubation, before beach chair position, and in the beach chair position. Ankle-brachial blood pressure differences in the beach chair condition were much higher than in four other conditions. The correlation coefficient between mean ankle-brachial blood pressure differences before the beach chair position and mean ankle-brachial blood pressure differences in the beach chair position was 0.616. Brachial systolic blood pressure could be predicted by regression equations (R(2) = 0.306-0.771). These results suggest that anesthesiologists should consider these ankle-brachial blood pressure differences when monitoring anesthesia in the beach chair position.
den Heijer, T; Skoog, [No Value; Oudkerk, M; de Leeuw, FE; de Groot, JC; Hofman, A; Breteler, MMB
The relation between blood pressure level and degree of global brain atrophy is equivocal. We evaluated past and present blood pressure levels and change in blood pressure over 20 years in relation to the degree of cortical atrophy on magnetic resonance imaging (MRI). In 1995-1996, we measured blood
Heijer, T.; Skoog, I.; Oudkerk, M.; Leeuw, H.F. de; Groot, J.C. de; Hofman, A.W.I.M.; Breteler, M.H.M.
The relation between blood pressure level and degree of global brain atrophy is equivocal. We evaluated past and present blood pressure levels and change in blood pressure over 20 years in relation to the degree of cortical atrophy on magnetic resonance imaging (MRI). In 1995-1996, we measured blood
... blood pressure drugs? Is it true that calcium supplements may interact with blood pressure medications? Answers from ... Sheps, M.D. Yes. In large amounts, calcium supplements may interact with some blood pressure medications. Interactions ...
Measurement of blood flow in the superior sagittal sinus in healthy volunteers, and in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension with phase-contrast cine MR imaging
Gideon, P; Thomsen, C; Gjerris, F
PURPOSE: To measure blood flow and velocity in the superior sagittal ++sinus. MATERIAL AND METHODS: MR velocity mapping was used to examine 14 healthy volunteers, 15 patients with normal pressure hydrocephalus (NPH), 3 patients with high pressure hydrocephalus (HPH), and 11 patients with idiopath...
Dimeo, Fernando; Pagonas, Nikolaos; Seibert, Felix; Arndt, Robert; Zidek, Walter; Westhoff, Timm H
Regular physical exercise is broadly recommended by current European and American hypertension guidelines. It remains elusive, however, whether exercise leads to a reduction of blood pressure in resistant hypertension as well. The present randomized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension. Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents. Fifty subjects with resistant hypertension were randomly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program (target lactate, 2.0±0.5 mmol/L). Blood pressure was assessed by 24-hour monitoring. Arterial compliance and cardiac index were measured by pulse wave analysis. The training program was well tolerated by all of the patients. Exercise significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg, respectively (P=0.03 each). Regular exercise reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves. Arterial compliance and cardiac index remained unchanged. Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment. It should be included in the therapeutic approach to resistant hypertension.
Full Text Available To compare the therapeutic efficacy of acupuncture, massage, and Tachibana-Ryojutsu (one of Japanese traditional body balance therapy techniques (SEITAI, on stiff shoulders, the subjects’ muscle firmness, blood pressure, pulse, VAS, and body temperature were measured before and after the treatment. Forty-seven volunteer subjects gave written informed consent to participate in this study. The subjects were randomly divided into three groups to receive acupuncture, massage, or Tachibana-Ryojutsu. Each therapy lasted for 90 seconds. The acupuncture treatment was applied by a retaining-needle at GB-21, massage was conducted softly on the shoulders, and Tachibana-Ryojutsu treated only the muscles and joints from the legs to buttocks without touching the shoulders or backs. The study indicated that the muscle firmness and VAS of the Tachibana-Ryojutsu group decreased significantly in comparison with the acupuncture and massage groups after treatment.
Blum, V.; Carrière, E.G.J.; Kolsters, W.; Mosterd, W.L.; Schiereck, P.; Wesseling, K.H.
The purpose of this study was to compare aortic blood pressure (AOR) to peripheral measurements by the Riva-Rocci/Korotkov (RRK) and Finapres continuous finger pressure (FIN) methods during dynamic and static exercise. A tip manometer was introduced in the ascending aorta after coronary angiography
Thuesen, Betina H; Toft, Ulla; Buhelt, Lone
BACKGROUND: Excessive salt intake causes increased blood pressure which is considered the leading risk for premature death. One major challenge when evaluating associations between daily salt intake and markers of non-communicable diseases is that a high daily salt intake correlates with obesity......, which is also a well described risk factor for poor cardiometabolic outcome. The aim of this study was to evaluate the relationship of estimated daily salt intake with blood pressure and blood lipids and to investigate the effect of taking different measures of obesity into account. METHODS: We included...... of estimated 24-hour sodium excretion with blood pressure and blood lipids were evaluated by linear regression models. RESULTS: The daily mean estimated intake of salt was 10.80 g and 7.52 g among men and women, respectively. Daily salt intake was significantly associated with blood pressure (β-estimates 1...
Full Text Available Hemodialysis-induced hypotension is still a common complication in spite of the progress achieved in hemodialysis (HD treatment. Due to its multifactorial nature, dialysis-induced hypotension cannot be reliably prevented by conventional profiling of ultrafiltration in open-loop systems since they are unable to adapt themselves to actual decreases in blood pressure. A blood pressure guided closed-loop system for prevention of dialysis-induced hypotension by biofeedback-controlled profiling of ultrafiltration was clinically tested in 94 HD treatments of four patients prone to hypotension. Automatic profiling of ultrafiltration was based on frequent measurements of blood pressure at intervals of five minutes. Proper adaptation of control features to patients′ conditions was provided by the lower limit of systolic pressure which was individually set by the physician at the beginning of each treatment. During the initial and medium phases of the HD sessions, ultrafiltration rates up to 200% of the average rates were applied as long as this was tolerated. The additional ultrafiltrate volume was used for blood pressure stabilization by lowering the ultrafiltration rates in the final phase of HD session. Biofeedback-controlled profiling of ultrafiltration provides reliable blood pressure stabilization in all phases of HD. During the first half of treatment, the frequency of hypotensive episodes remained below that with conventional therapy although ultrafiltration rates up to 200% were used. During the second half of treatment, blood pressure guided reduction of ultrafiltration rate provided a decreasing frequency of hypotensive episodes in contrast to the increasing trend during conventional therapy. Stable blood pressure trends during the last hour of HD were achieved in 91% of biofeedback-controlled treatments in comparison with only 32% of conventional treatments. Ultrafiltration rates of 150%-200% and blood pressure measurements at intervals of
Johnson, Philip K; Ferguson, Michael A; Zachariah, Justin P
Since younger patients have low pretest probability of hypertension and are susceptible to reactive and masked hypertension, ambulatory blood pressure monitoring (ABPM) can be useful. To better target use in referred patients, we sought to define in-clinic systolic blood pressure (SBP) measures that predicted normal ABPM and target end organ damage. Data were collected on consecutive patients referred for high BP undergoing an ambulatory BP monitor from 2010 to 2013 (n = 248, 33.9% female, mean age 15.5 ± 3.6 years). Candidate in-clinic predictors were systolic maximum, minimum, or average BPs obtained by auscultative, oscillometric, or both. Multivariable logistic regression models were used to determine the prediction of normal ABPM by in-clinic BP predictors. Separate models considered predicting left ventricular hypertrophy (LVH) by in-clinic SBP vs. ABPM-defined hypertension. Identified predictor utility was tested with receiver operator characteristic curves. Maximum (OR 0.97 [95% CI 0.94-0.99]; P = .047), minimum (0.96 [0.94-0.99]; P = .002), and average (0.97 [0.95-1.00]; P = .04) in-clinic auscultative SBP predicted normal ABPM. Each had a c-statistic of 0.58. LVH was associated with in-clinic auscultative minimum SBP treated continuously (1.05, [1.01-1.10], P = .01) or dichotomized at the 90th percentile (8.23, [1.48-45.80], P = .02), as well as ABPM-defined hypertension (3.31, [1.23-8.91], P = .02). Both predictors had poor sensitivity and specificity. In youth, normal auscultative in-clinic systolic blood pressure indices weakly predicted normal ambulatory blood pressure and target end organ damage. © 2016 Wiley Periodicals, Inc.
Jantsje H Pasma
Full Text Available OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment. MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197 and continuously (subsample, n = 58 before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1 the ability to maintain standing balance; 2 self-reported impaired standing balance; and 3 history of falls, adjusted for age and sex. RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements. CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.
Kjellgren, K I; Svensson, S; Ahlner, J; Säljö, R
To investigate hypertensive patients' understanding of the circulatory system, in particular high blood pressure. Semi-structured audio-taped interviews of patients immediately after a regular follow-up appointment with their physician. A primary health care centre and a specialist clinic (hypertension unit) in southern Sweden. 33 hypertensive patients, consecutively selected. Focus was set on the exploration of patients' understanding/knowledge. In spite of a long history of hypertensive care, on average ten years, patients had a less than satisfactory understanding of their condition. Most patients knew their blood pressure values, but very few were able to give an account of what high blood pressure implies in functional terms. Knowledge of high blood pressure seems mainly to be derived from sources other than the health care system, in particular from the mass media. Knowledge of the risks associated with hypertension was quite good, as was the insight into how these risks could be managed. An assessment of patient knowledge of high blood pressure ought to be a starting point for educational strategies that aim to deepen patients' understanding of their state of health.
El Hafidi, Mohammed; Pérez, Israel; Baños, Guadalupe
Glycine, a non-essential amino acid, has been found to protect against oxidative stress in several pathological situations, and it is required for the biosynthesis of structural proteins such as elastin. As hypertension is a disease in which free radicals and large vessel elasticity are involved, this article will examine the possible mechanisms by which glycine may protect against high blood pressure. The addition of glycine to the diet reduces high blood pressure in a rat model of the metabolic syndrome. Also, glycine supplemented to the low protein diet of rat dams during pregnancy has a beneficial effect on blood pressure in their offspring. The mechanism by which glycine decreases high blood pressure can be attributed to its participation in the reduction of the generation of free radicals, increasing the availability of nitric oxide. In addition, as glycine is required for a number of critical metabolic pathways, such as the synthesis of the structural proteins collagen and elastin, the perturbation of these leads to impaired elastin formation in the aorta. This involves changes in the aorta's elastic properties, which would contribute to the development of hypertension. The use of glycine to lower high blood pressure could have a significant clinical impact in patients with the metabolic syndrome and with limited resources. On the other hand, more studies are needed to explore the beneficial effect of glycine in other models of hypertension and to investigate possible side-effects of treatment with glycine.
Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil
. Interventions: Treatment of hypertension to a systolic blood pressure goal of 120 mm Hg (intensive management) or 140 mm Hg (standard management). Main Outcomes and Measures: Lifetime costs and quality-adjusted life-years (QALYs), discounted at 3% annually. Results: Standard management yielded 9.6 QALYs......Importance: Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events....... Objective: To evaluate the incremental cost-effectiveness of intensive blood pressure management compared with standard management. Design, Setting, and Participants: This cost-effectiveness analysis conducted from September 2015 to August 2016 used a Markov cohort model to estimate cost...
Lund Rasmussen, Charlotte; Nielsen, Line; Linander Henriksen, Marie
PURPOSE: High occupational physical activity (OPA) is shown to increase the risk for elevated blood pressure, cardiovascular diseases and mortality. Conversely, aerobic exercise acutely lowers the blood pressure up to 25 h post exercise. However, it is unknown if this beneficial effect also apply...... for workers exposed to high levels of OPA. Cleaners constitute a relevant occupational group for this investigation because of a high prevalence of OPA and cardiovascular disease. Accordingly, the objective was to investigate the acute effects on ambulatory blood pressure from a single aerobic exercise...... session among female cleaners. METHODS: Twenty-two female cleaners were randomised to a cross-over study with a reference and an aerobic exercise session. Differences in 24-h, work hours, leisure time, and sleep ambulatory blood pressure (ABP) were evaluated using repeated measure 2 × 2 mixed...
Kato, Yoji; Domoto, Tokio; Hiramitsu, Masanori; Katagiri, Takao; Sato, Kimiko; Miyake, Yukiko; Aoi, Satomi; Ishihara, Katsuhide; Ikeda, Hiromi; Umei, Namiko; Takigawa, Atsusi; Harada, Toshihide
Background. Recent studies suggest that the daily intake of lemon (Citrus limon) has a good effect on health, but this has not been confirmed in humans. In our previous studies, it was observed that people who are conscious of their health performed more lemon intake and exercise. An analysis that took this into account was required. Methodology. For 101 middle-aged women in an island area in Hiroshima, Japan, a record of lemon ingestion efforts and the number of steps walked was carried out for five months. The change rates (Δ%) of the physical measurements, blood test, blood pressure, and pulse wave measured value during the observation period were calculated, and correlations with lemon intake and the number of steps walked were considered. As a result, it was suggested that daily lemon intake and walking are effective for high blood pressure because both showed significant negative correlation to systolic blood pressure Δ%. Conclusions. As a result of multiple linear regression analysis, it was possible that lemon ingestion is involved more greatly with the blood citric acid concentration Δ% and the number of steps with blood pressure Δ%, and it was surmised that the number of steps and lemon ingestion are related to blood pressure improvement by different action mechanisms.
Full Text Available Background. Recent studies suggest that the daily intake of lemon (Citrus limon has a good effect on health, but this has not been confirmed in humans. In our previous studies, it was observed that people who are conscious of their health performed more lemon intake and exercise. An analysis that took this into account was required. Methodology. For 101 middle-aged women in an island area in Hiroshima, Japan, a record of lemon ingestion efforts and the number of steps walked was carried out for five months. The change rates (Δ% of the physical measurements, blood test, blood pressure, and pulse wave measured value during the observation period were calculated, and correlations with lemon intake and the number of steps walked were considered. As a result, it was suggested that daily lemon intake and walking are effective for high blood pressure because both showed significant negative correlation to systolic blood pressure Δ%. Conclusions. As a result of multiple linear regression analysis, it was possible that lemon ingestion is involved more greatly with the blood citric acid concentration Δ% and the number of steps with blood pressure Δ%, and it was surmised that the number of steps and lemon ingestion are related to blood pressure improvement by different action mechanisms.
Ried, Karin; Fakler, Peter; Stocks, Nigel P
High blood pressure is an important risk factor for cardiovascular disease, contributing to about 50% of cardiovascular events worldwide and 37% of cardiovascular-related deaths in Western populations. Epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. Flavanols found in cocoa have been shown to increase the formation of endothelial nitric oxide which promotes vasodilation and therefore blood pressure reduction. Here we update previous meta-analyses on the effect of cocoa on blood pressure. To assess the effects on blood pressure of chocolate or cocoa products versus low-flavanol products or placebo in adults with or without hypertension when consumed for two weeks or longer. This is an updated version of the review initially published in 2012. In this updated version, we searched the following electronic databases from inception to November 2016: Cochrane Hypertension Group Specialised Register, CENTRAL, MEDLINE and Embase. We also searched international trial registries, and the reference lists of review articles and included trials. Randomised controlled trials (RCTs) investigating the effects of chocolate or cocoa products on systolic and diastolic blood pressure in adults for a minimum of two weeks duration. Two review authors independently extracted data and assessed the risks of bias in each trial. We conducted random-effects meta-analyses on the included studies using Review Manager 5. We explored heterogeneity with subgroup analyses by baseline blood pressure, flavanol content of control group, blinding, age and duration. Sensitivity analyses explored the influence of unusual study design. Thirty-five trials (including 40 treatment comparisons) met the inclusion criteria. Of these, we added 17 trials (20 treatment comparisons) to the 18 trials (20 treatment comparisons) in the previous version of this updated review.Trials provided participants with 30 to 1218 mg of flavanols (mean = 670 mg) in 1.4 to 105
A. Hofman (Albert)
textabstractHigh arterial blood pressure takes a heavy toll in western populations (1 ). Its causes are still largely unknown, but its sequelae, a variety of cardiovascular and renal diseases, have been referred to as "a modern scourge" (2). High blood pressure of unknown cause, or
Garner, Rochelle E; Levallois, Patrick
Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. Men had higher mean systolic (114.8 vs. 110.8mmHg, pcadmium levels (0.48 vs. 0.38µg/L, pcadmium were associated with increased systolic (0.70mmHg, 95% confidence interval [CI]=0.25-1.16, pcadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44-0.85, pcadmium levels, blood pressure and hypertension. However, the significance and direction of this association differs by sex, smoking status, and body mass index category. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.
Validation of the Andon KD-5917 automatic upper arm blood pressure monitor, for clinic use and self-measurement, according to the European Society of Hypertension International Protocol revision 2010.
Guo, Wan-Gang; Li, Bing-Ling; He, Yong; Xue, Yu-Sheng; Wang, Hai-Yan; Zheng, Qiang-Sun; Xiang, Ding-Cheng
To validate the Andon KD-5917 automatic upper arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Sequential same-left-arm measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained in 33 participants using the mercury sphygmomanometer and the test device. According to the validation protocol, 99 pairs of test device and reference blood pressure measurements (three pairs for each of the 33 participants) were obtained in the study. The device produced 73, 98, and 99 measurements within 5, 10, and 15 mmHg for SBP and 86, 98, and 99 for DBP, respectively. The mean ± SD device-observer difference was 3.07 ± 3.68 mmHg for SBP and -0.89 ± 3.72 mmHg for DBP. The number of patients with two or three of the device-observer difference within 5 mmHg was 26 for SBP and 29 for DBP, and no patient had a device-observer difference within 5 mmHg. The Andon KD-5917 automatic upper arm blood pressure monitor can be recommended for clinical use and self-measurement in an adult population on the basis of the European Society of Hypertension International Protocol revision 2010.
Hansen, Tine W; Li, Yan; Boggia, José
of conclusive evidence proving that nondipping is a reversible risk factor, the option whether or not to restore the diurnal blood pressure profile to a normal pattern should be left to the clinical judgment of doctors and should be individualized for each patient. Current guidelines on the interpretation......Numerous studies addressed the predictive value of the nighttime blood pressure (BP) as captured by ambulatory monitoring. However, arbitrary cutoff limits in dichotomized analyses of continuous variables, data dredging across selected subgroups, extrapolation of cross-sectional studies...
A K Lipatenkova
Full Text Available Реферат по материалам статей 1. Gilbert K, Nian H, Yu C, Luther JM, Brown NJ. Fenofibrate lowers blood pressure in salt-sensitive but not salt-resistant hypertension. J Hypertens. 2013 Apr;31(4:820-9. doi: 10.1097/HJH.0b013e32835e8227. 2. Kwang K. K. Does Fenofibrate Lower Blood Pressure? Hypertension. 2013 Mar;61(3:e27. doi: 10.1161/HYPERTENSIONAHA.111.00792.
Material and Methods ― Remote BP monitoring was organized on the basis of computer system which automatically in text messages send requests about BP level to Htn patients. Obtained BP results were stored in the system and automatically worked. A doctor corrected a patient’s therapy if necessary based on this information. To evaluate the effectiveness of a new technology one year observation of 97 Htn patients was organized (54.6% – male aged 49±11 years. Patients regularly responded to automated SMS requests the computer system about the level of blood pressure. The effectiveness was evaluated with the help of the following hypertension guidelines performance measures: 1 a part of patients with four or more BP results during the previous 12 months; 2 a part of patients with BP above the goal level who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 3 a part of patients with BP above the goal level 140/90 mm Hg who prescribed two or more antihypertensive drugs on the last visit during the previous 12 months; 4 a part of patients with goal blood pressure (less than 140/90 mmHg on the last visit during the previous 12 months. To evaluate a performance of these measures before BP monitoring the data extracted from patients’ ambulatory cards were used. Results ― 62 patients completed one-year BP monitoring A part of patients with four or more BP results during the previous 12 months increased from 21% to 100% (p<0.001. From 70% to 82% increased the part of patients who were prescribed two or more antihypertensive drugs (p=0.091. From 31% to 15% reduced the part of hypertensives with uncontrolled BP who were prescribed less than two antihypertensive drugs on the last visit (p=0.044. After one-year monitoring a goal BP was registered in 77% of Htn patients versus 13% at the start of the observation (p<0.001. Conclusion ― Htn guidelines performance measures allowed evaluate quantitatively the positive influence
Hoffmann-Petersen, Nikolai; Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard
Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). Using the Civil Registration System, we invited citizens aged 55-64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55-64 years had an abnormally high HBP, and one fourth either had WCH or MH. ClinicalTrials.gov identification number: NCT02355392. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: email@example.com.
Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard
BACKGROUND Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). METHODS Using the Civil Registration System, we invited citizens aged 55–64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. RESULTS We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. CONCLUSIONS This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55–64 years had an abnormally high HBP, and one fourth either had WCH or MH. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number: NCT02355392 PMID:26208671
Cheung, Carol Y; Tay, Wan T; Mitchell, Paul; Wang, Jie J; Hsu, Wynne; Lee, Mong L; Lau, Qiangfeng P; Zhu, Ai L; Klein, Ronald; Saw, Seang M; Wong, Tien Y
The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs. Retinal photographs from the Singapore Malay Eye Study, a population-based cross-sectional study of 3280 (78.7% response) persons aged 40-80 years, were analyzed. Quantitative changes in the retinal vasculature (branching angle, vascular tortuosity, fractal dimension, and vascular caliber) were measured using a semi-automated computer-based program. Qualitative signs, including focal arteriolar narrowing (FAN), arteriovenous nicking (AVN), opacification of the arteriolar wall (OAW), and retinopathy (e.g., microaneurysms, retinal hemorrhages), were assessed from photographs by trained technicians. After excluding persons with diabetes and ungradable photographs, 1913 persons provided data for this analysis. In multivariable linear regression models controlling for age, sex, BMI, use of antihypertensive medication, and other factors, retinal arteriolar branching asymmetry ratio, arteriolar tortuosity, venular tortuosity, fractal dimension, arteriolar caliber, venular caliber, FAN, AVN, and retinopathy were independently associated with mean arterial blood pressure. In contrast, arteriolar/venular branching angle, venular branching asymmetry ratio and OAW were not related to blood pressure. Retinal arteriolar caliber (sβ = -0.277) and FAN (sβ = 0.170) had the strongest associations with mean arterial blood pressure, and higher blood pressure levels were associated with increasing number of both quantitative and qualitative retinal vascular signs (P trend qualitative retinal vascular signs, with the number of signs increasing with higher blood pressure levels.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood pressure...
Blood pressure and pulse rate are two of the vital signs of humans and it is imperative that the chronically ill and the elderly patients need to have their blood pressure and pulse rate checked from time to time. This paper describes the use of the Omron 790it blood pressure monitor to check the blood pressure and the pulse ...
Gillman, M W; Hood, M Y; Moore, L L; Nguyen, U S; Singer, M R; Andon, M B
To evaluate the effect of calcium supplementation on blood pressure in children. Randomized, double-masked, placebo-controlled trial. One hundred one fifth-grade students in one inner-city school. Each child consumed 480 ml of juice beverages, containing either no calcium or 600 mg calcium (as calcium citrate malate) daily for 12 weeks. At baseline we obtained nutrient data from three sets of 2-day food records on each subject. We measured blood pressure four times on each of three weekly sittings at baseline and at follow-up. Using multiple linear regression analysis, we compared mean blood pressure change in the intervention group with that in the placebo group. There were 50 girls and 51 boys; 61 subjects were black. At baseline, mean age was 11.0 years, systolic and diastolic blood pressures were 101.7 and 57.7 mm Hg, daily total energy intake was 1966 kcal, and calcium intake was 827 mg. With control for age, height, hours of television watched, and baseline blood pressure, systolic blood pressure increased 1.0 mm Hg in the intervention group and 2.8 mm Hg in the placebo group (effect estimate = -1.8 mm Hg; 95% confidence interval -4.0, 0.3). In black subjects the intervention effect estimate was -2.0 mm Hg (95% confidence interval -4.4, 0.4). From lowest to highest quartile of baseline calcium intake (per 1000 kcal), the intervention effect estimates were -3.5, -2.8, -1.3, and 0.0 mm Hg (p for trend = 0.009). There was little effect on diastolic blood pressure. These data suggest a blood pressure-lowering effect of calcium supplementation in children, especially in subjects with low baseline calcium intake.
Modiri, A R; Fredrickson, M G; Gillberg, P G; Alberts, P
The aim of this study was to test alpha-adrenergic reference agonists for tissue selectivity in the urethra and to pharmacologically characterize the functional alpha-adrenoceptor type of the female rabbit urethra in vivo. The effect of alpha-adrenergic agonists and antagonists on the urethral pressure was compared with that on blood pressure and heart rate measured simultaneously in the anaesthetized female rabbit. Oxymetazoline, NS-49, phenylephrine and phenylpropanolamine enhanced the urethral pressure in a dose-dependent manner. Phenylephrine and phenylpropanolamine also enhanced the blood pressure with significantly lower ED50 (dose that gives half of the maximal enhancing effect) values than for the urethral pressure. This was in contrast to oxymetazoline and NS-49. The ED50 values for oxymetazoline on urethral pressure, and systolic and diastolic blood pressure were 0.00067, 0.0030 and 0.0020 mg/kg, respectively. The ED50 values for NS-49 on urethral pressure, and systolic and diastolic blood pressure were 0.019, 0.21 and 0.18 mg/kg, respectively. Clonidine and UK 14,304 had no effect on urethral or blood pressure. The oxymetazoline-evoked increase in urethral pressure was inhibited by WB-4101 with an ID50 (dose that gives half of the inhibitory effect) significantly lower than that for rauwolscine. The results suggest that in the female rabbit in vivo activation of alpha1-adrenoceptors increased the urethral pressure. Phenylephrine and phenylpropanolamine, in contrast to oxymetazoline and NS-49, selectively enhanced blood pressure as compared with urethral pressure. Provided that the present results also have validity in humans, it would seem possible to develop urethra-selective drugs for treatment of stress incontinence with few or no cardiovascular side-effects.
Wijsman, Liselotte W.; Richard, Edo; Cachucho, Ricardo; de Craen, Anton J. M.; Jongstra, Susan; Mooijaart, Simon P.
Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. In this proof-of-principle study, we evaluated the feasibility of home BP monitoring using mobile
Wijsman, L.W.; Richard, E.; Cachucho, R.; Craen, A.J. de; Jongstra, S.; Mooijaart, S.P.
BACKGROUND: Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. OBJECTIVE: In this proof-of-principle study, we evaluated the feasibility of home BP monitoring
Al-Shehri, Ahmed M.
Objective was to assess blood pressure BP control in patients with diabetes mellitus type 2 DM type treated in primary health care. A cross-sectional study was conducted in primary health care at King Fahd Military Complex Hospital in Dhahran, Kingdom of Saudi Arabia, between August 2003 and February 2004, to assess blood control in type 2 diabetics. A sample of 403 medical records of type 2 diabetic patients was selected using systematic random sampling after ordering the medical record numbers. The data were collected through the pre-coded checklist. Hypertension was found in 57.8% of diabetic patients with no statistically significant difference between males and females. The mean age of diabetic patients was significantly highly in hypertensive than non-hypertensive p=0.001. The mean duration of hypertension was significantly higher in females p=0.02. There were only 14.2% of hypertensive diabetic patients in whom blood pressure was controlled. Poor control was significantly associated with obesity and a high rate of complications. Blood pressure control correlated positively and significantly with the age of patients and negatively with duration of diabetes and hypertension. The most commonly prescribed antihypertensive were angiotensin converting enzyme inhibitors in 29.3%, followed by angiotensin receptors blockers in 24.1%, and the least prescribed drug was thiazide diuretic. Blood pressure in diabetic patients needs to be given particular attention from all health care professionals, especially primary care family physicians, who should follow the new guideline for better control of blood pressure, and fewer complications. Patient's awareness should be increased, through continuous health education with different modalities. (author)
Raichle, Christina J; Eckstein, Jens; Lapaire, Olav; Leonardi, Licia; Brasier, Noé; Vischer, Annina S; Burkard, Thilo
Hypertensive disorders are one of the leading causes of maternal death worldwide. Several smartphone apps claim to measure blood pressure (BP) using photoplethysmographic signals recorded by smartphone cameras. However, no single app has been validated for this use to date. We aimed to validate a new, promising smartphone algorithm. In this subgroup analysis of the iPARR trial (iPhone App Compared With Standard RR Measurement), we tested the Preventicus BP smartphone algorithm on 32 pregnant women. The trial was conducted based on the European Society of Hypertension International Protocol revision 2010 for validation of BP measuring devices in adults. Each individual received 7 sequential BP measurements starting with the reference device (Omron-HBP-1300) and followed by the smartphone measurement, resulting in 96 BP comparisons. Validation requirements of the European Society of Hypertension International Protocol revision 2010 were not fulfilled. Mean (±SD) systolic BP disagreement between the test and reference devices was 5.0 (±14.5) mm Hg. The number of absolute differences between test and reference device within 5, 10, and 15 mm Hg was 31, 53, and 64 of 96, respectively. A Bland-Altman plot showed an overestimation of smartphone-determined systolic BP in comparison with reference systolic BP in low range but an underestimation in medium-range BP. The Preventicus BP smartphone algorithm failed the accuracy criteria for estimating BP in pregnant women and was thus not commercialized. Pregnant women should be discouraged from using BP smartphone apps, unless there are algorithms specifically validated according to common protocols. URL: https://www.clinicaltrials.gov. Unique identifier: NCT02552030. © 2018 American Heart Association, Inc.
Stress and high blood pressure: What's the connection? Stress and long-term high blood pressure may not be linked, but taking steps to reduce your stress can improve your general health, including your blood ...
Thuesen, Betina H; Toft, Ulla; Buhelt, Lone P; Linneberg, Allan; Friedrich, Nele; Nauck, Matthias; Wallaschofski, Henri; Jørgensen, Torben
Excessive salt intake causes increased blood pressure which is considered the leading risk for premature death. One major challenge when evaluating associations between daily salt intake and markers of non-communicable diseases is that a high daily salt intake correlates with obesity, which is also a well described risk factor for poor cardiometabolic outcome. The aim of this study was to evaluate the relationship of estimated daily salt intake with blood pressure and blood lipids and to investigate the effect of taking different measures of obesity into account. We included 3294 men and women aged 18-69 years from a general population based study in Copenhagen, Denmark. Estimated 24-hour sodium excretion was calculated by measurements of creatinine and sodium concentration in spot urine in combination with information of sex, age, height and weight. The relations of estimated 24-hour sodium excretion with blood pressure and blood lipids were evaluated by linear regression models. The daily mean estimated intake of salt was 10.80 g and 7.52 g among men and women, respectively. Daily salt intake was significantly associated with blood pressure (β-estimates 1.18 mm Hg/g salt (systolic) and 0.74 mm Hg/g salt (diastolic), p lipids were highly affected by adjustment for obesity. Associations of estimated daily salt intake with blood pressure and blood lipids were highly affected by adjustment for obesity. © The European Society of Cardiology 2014.
Full Text Available The increased secretion of thyroid gland hormones affects the cardiovascular system by increasing heart rate and often by increasing systolic and diastolic blood pressure. We examined the influence of elevated thyroid hormone on blood pressure. Blood pressure monitoring was performed prior to the introduction of therapy in people with increased FT4 and on therapy when FT4 was in the normal range. We analyzed 32 people, of which 26 women had normal blood pressure values measured by blood pressure monitoring. Average age 45 and body mass index 27 kg/m2. Blood pressure was measured by monitoring blood pressure for 24 hours. On average, before the introduction of the therapy, it was 133/83 mmHg P 96 / min. The blood pressure on average on therapy with tireosuppressive was 128/82 mmHg P 74 / min. The Wilcoxon-Mann-Whitney paired test shows a significant P <0.05 higher systolic blood pressure and pulse rate during the day and night before the treatment, when FT4 was higher, than the time when medication was taking, when the FT4 was in the normal range. No significant difference was found for diastolic blood pressure before the introduction of therapy and during therapy with tireosuppressives. When values of FT4 are increased, monitoring of blood pressure shows significantly higher values of systolic blood pressure and pulse during day and night compared to systolic blood pressure and pulse values when FT4 is in the normal range.
Background: Despite of the recommendations to use population specific blood pressure (BP) references which consider time, ethnicity and environmental factors, there is limited information regarding BP profile among Tanzanians. This cross sectional study was done to determine casual BP profile among healthy volunteer ...
Laverman, GD; Andersen, S; Rossing, P; Navis, G; de Zeeuw, D; Parving, HH
Background. AT1-receptor blockade dose dependently lowers blood pressure (BP) and albuminuria. Reduction of BP and albuminuria are independent treatment targets for renoprotection, but whether this requires similar dose titration is unknown. Methods. We tested this in two studies designed to find
Wang, Xiaoling; Xu, Xiaojing; Su, Shaoyong; Snieder, Harold
There is growing concern about elevated blood pressure (BP) in children. The evidence for familial aggregation of childhood BP is substantial. Twin studies have shown that a large part of the familial aggregation of childhood BP is due to genes. The first part of this review provides the latest
This podcast is based on the September 2012 CDC Vital Signs report. A team-based approach by patients, health care systems, and health care providers is one of the best ways to treat uncontrolled high blood pressure. Created: 9/4/2012 by Centers for Disease Control and Prevention (CDC). Date Released: 9/4/2012.
Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert
Purpose: To examine the extent to which neighborhood disadvantage accounts for variation in blood pressure. Methods: Demographic, biometric, and self-reported data from 19,261 health screenings were used. Addresses of participants were geocoded and located within census block groups (n = 14,510, 75.3%). Three hierarchical linear models were…
Background: Hypertension and proteinuria are known risk factors for cardiovascular disease and renal impairment. Early detection and treatment will reduce morbidity and mortality associated with them. Objective: To determine the prevalence of asymptomatic proteinuria with or without elevated blood pressure among ...
Objective: To observe blood pressure (BP) pattern and its correlates in primary school children of northern Nigeria. Design: Sitting BP and pulse were measured in quadruplicate, then repeated after four weeks in 1,721 healthy children aged five to 16 years. Body weight and height were also measured in their school ...
Judith A Whitworth
Full Text Available Judith A WhitworthJohn Curtin School of Medical Research, Australian National University, Canberra, ACT, AustraliaAbstract: Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO – International Society of Hypertension (ISH 2003 statement on management of hypertension.Keywords: blood pressure, hypertension, cardiovascular risk, treatment
Klarskov, Pia; Bang, Lia E; Schultz-Larsen, Peter
To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting. Randomized controlled parallel group trial with 12-month follow-up. One hundred and ten general practices in all regions of Denmark....... One thousand forty-eight patients with essential hypertension. Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent...... to the usual group, and 533 (51%) to the intensive group. The reductions in day- and night-time 24-hour ambulatory blood pressure were similar (usual group: 4.6 ± 13.5/2.8 ± 82 mmHg; intensive group: 5.6 ± 13.0/3.5 ± 8.2 mmHg; P = 0.27/P = 0.20). Cardiovascular risk scores were reduced in both groups at follow...
Madsen, Søren Aalbæk; Fomsgaard, Jonna Storm; Jensen, Rigmor
Once believed an exceedingly rare disorder, recent evidence suggests that low cerebrospinal fluid (CSF) pressure headache has to be considered an important cause of new daily persistent headaches, particularly among young and middle-aged individuals. Treatment of low CSF pressure headache consists...... of non-invasive/conservative measures and invasive measures with epidural blood patch providing the cornerstone of the invasive measures. In the present pilot study we therefore aimed to evaluate the treatment efficacy of epidural blood patch (EBP) in treatment-refractory low-pressure headache. Our...... reduction in frequency. An increase in days with use of medication was found. Increased awareness of low CSF pressure headache is emphasized and a controlled larger randomized study is needed to confirm the results. However the present results, allows us to conclude that EBP in treatment-refractory low CSF...
Indirect blood pressure and heart rate measured quickly without observer bias using a semi-automatic machine (auto-manometer)--response to isometric exercise in normal healthy males and its modification by beta-adrenoceptor blockade.
1 In a double-blind crossover study, six volunteers performed sustained handgrip at 50% of maximal voluntary contraction before and 90 min following oral administration of 0.25 and 100 mg metoprolol tartrate, a beta1 selective adrenoceptor blocking agent. Blood pressure and heart rate were measured with the Auto-Manometer, an electronic semi-automatic device based on the principles of the London School of Hygiene and Tropical Medicine sphygmomanometer. It eliminates observer and digital bias completely, and also records heart rate at the same time as blood pressure is recorded. 2 Resting heart rate fell 15% after 25 mg, 21% after 100 mg and was unchanged after placebo. Systolic blood pressure fell 6% on both doses and was unchanged on placebo. Diastolic pressure did not change with any of the doses. 3 At 1 min of handgrip, heart rate was significantly lower after 25 and 100 mg than before drug or after placebo. There was no difference between the blood pressure levels attained before or after any of the dose levels. The rise of heart rate tended to be somewhat dampened after 100 mg only. The rise in blood pressure was unchanged after any dose compared with before. Images Figure 1 PMID:901695
Keavney, B; Bird, R; Caiazza, A; Casadei, B; Conway, J
We have evaluated under laboratory validation conditions and in an extensive field trial the behaviour of an ambulatory monitoring device that is capable of recording both by the Korotkoff-sound and oscillometric methods in a single cuff deflation (TM2421: A&D Co, Tokyo, Japan). The effects of subject age and blood pressure (BP) level on the accuracy and field reliability of the two methods implemented in the device have been determined. In the validation phase, automatic BP measurements were compared with readings by two trained observers in 96 subjects, and the results compared with the AAMI criteria for automatic BP monitors. In the field trial phase, the performances of Korotkoff-sound and oscillometric methods over a 24-h period of ambulatory BP monitoring were compared in 515 subjects, with analysis of the agreement between the two methods in patients where both provided satisfactory recordings. In the validation phase, the Korotkoff-sound method gave satisfactory results for both systolic and diastolic BP, but the oscillometric technique narrowly failed to meet the AAMI criteria for the measurement of either systolic or diastolic BP. In the field trial, the K-sound method failed to record BP accurately in 12% of subjects whereas the oscillometric method was successful in all of these. Where both methods provided technically adequate records, agreement between mean values for each method was close. In 18% of patients, the availability of the oscillometric measurement as a 'back-up' method for the K-sound method significantly improved the number of available measurements in the monitoring period, which should result in improved accuracy and reproducibility of the ambulatory mean values.
Mente, Andrew; O'Donnell, Martin J; Rangarajan, Sumathy; McQueen, Matthew J; Poirier, Paul; Wielgosz, Andreas; Morrison, Howard; Li, Wei; Wang, Xingyu; Di, Chen; Mony, Prem; Devanath, Anitha; Rosengren, Annika; Oguz, Aytekin; Zatonska, Katarzyna; Yusufali, Afzal Hussein; Lopez-Jaramillo, Patricio; Avezum, Alvaro; Ismail, Noorhassim; Lanas, Fernando; Puoane, Thandi; Diaz, Rafael; Kelishadi, Roya; Iqbal, Romaina; Yusuf, Rita; Chifamba, Jephat; Khatib, Rasha; Teo, Koon; Yusuf, Salim
Higher levels of sodium intake are reported to be associated with higher blood pressure. Whether this relationship varies according to levels of sodium or potassium intake and in different populations is unknown. We studied 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen and were used as surrogates for intake. We assessed the relationship between electrolyte excretion and blood pressure, as measured with an automated device. Regression analyses showed increments of 2.11 mm Hg in systolic blood pressure and 0.78 mm Hg in diastolic blood pressure for each 1-g increment in estimated sodium excretion. The slope of this association was steeper with higher sodium intake (an increment of 2.58 mm Hg in systolic blood pressure per gram for sodium excretion >5 g per day, 1.74 mm Hg per gram for 3 to 5 g per day, and 0.74 mm Hg per gram for 55 years of age, 2.43 mm Hg per gram at 45 to 55 years of age, and 1.96 mm Hg per gram at <45 years of age; P<0.001 for interaction). Potassium excretion was inversely associated with systolic blood pressure, with a steeper slope of association for persons with hypertension than for those without it (P<0.001) and a steeper slope with increased age (P<0.001). In this study, the association of estimated intake of sodium and potassium, as determined from measurements of excretion of these cations, with blood pressure was nonlinear and was most pronounced in persons consuming high-sodium diets, persons with hypertension, and older persons. (Funded by the Heart and Stroke Foundation of Ontario and others.).
Robillard, Rébecca; Lanfranchi, Paola A; Prince, François; Filipini, Daniel; Carrier, Julie
To determine how aging affects the impact of sleep deprivation on blood pressure at rest and under orthostatic challenge. Subjects underwent a night of sleep and 24.5 h of sleep deprivation in a crossover counterbalanced design. Sleep laboratory. Sixteen healthy normotensive men and women: 8 young adults (mean 24 years [SD 3.1], range 20-28 years) and 8 elderly adults (mean 64.1 years [SD 3.4], range 60-69 years). Sleep deprivation. Brachial cuff arterial blood pressure and heart rate were measured in semi-recumbent and upright positions. These measurements were compared across homeostatic sleep pressure conditions and age groups. Sleep deprivation induced a significant increase in systolic and diastolic blood pressure in elderly but not young adults. Moreover, sleep deprivation attenuated the systolic blood pressure orthostatic response in both age groups. Our results suggest that sleep deprivation alters the regulatory mechanisms of blood pressure and might increase the risk of hypertension in healthy normotensive elderly.
Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical...... was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution...
Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul
Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1,007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for blood pressure on HBPM, blood pressure on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for blood pressure on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality. PMID:26822864
Di Daniele, Nicola; Fegatelli, Danilo Alunni; Rovella, Valentina; Castagnola, Veronica; Gabriele, Marco; Scuteri, Angelo
Hypertension is a major risk factor for chronic kidney disease (CKD), and CKD progression is associated with suboptimal blood pressure (BP) control. Here we evaluate the impact of CKD on the attainment of BP control and the circadian BP profile in older subjects. In this observational study, we studied 547 patients referred to the hypertension clinic, of whom 224 (40.9%) had CKD. Blood pressure (BP) control and circadian BP patterns were evaluated by 24-hour ambulatory BP monitoring. Circadian BP variability was measured as the within-subject SD of BP, the percentage of measurements exceeding normal values, hypotension, and dipping status. The attainment of adequate BP control was similar in subjects with or without CKD (around 31%). Logistic regression analysis indicated that CKD was not a determinant of adequate BP control (OR 1.004; 95% CI 0.989-1.019; p = 0.58). Patients with CKD presented as twice as higher prevalence of reverse dipper (night-time peak) for systolic BP and episodes of hypotension during daytime, independently of BP control. Knowledge of the circadian pattern of BP in hypertensive subjects with CKD could inform better than attainment of BP target about risky condition for CKD progression and cognitive decline and allow a more personalized antihypertensive treatment. Copyright © 2017 Elsevier B.V. All rights reserved.
Wright, Joel David; Kritz-Silverstein, Donna; Morton, Deborah J; Wingard, Deborah L; Barrett-Connor, Elizabeth
It has been proposed that pet ownership improves cardiovascular health. This study examines the relation of pet ownership with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and hypertension in a large sample of older men and women. Participants were 1179 community-dwelling men (n = 498) and women (n = 681) age 50-95 years. Participants responded to a 1991-1992 mailed questionnaire ascertaining pet ownership, and they attended a 1992-1996 clinic visit at which systolic (SBP) and diastolic (DBP) blood pressures were measured and use of antihypertensive medication was validated. Pulse pressure was calculated as SBP minus DBP. Mean arterial pressure was calculated as (SBP+DBP)/2. Body mass index, waist-hip ratio, and information on other potential confounders were obtained. Average age of participants was 70.4 +/- 10.8 years; 30.0% reported current pet ownership. Mean SBP was 137.5 +/- 21.4 mm Hg, and DBP was 76.1 +/- 9.3 mm Hg; 55.6% were hypertensive (SBP >or= 140, DBP >or= 90 or taking hypertension medication). Pet owners were younger and slightly more overweight and they exercised less than nonowners; owners were somewhat more likely to have diabetes and to use beta-blockers. In unadjusted analyses, pet owners had lower SBP, pulse pressure, and mean arterial pressure, and a reduced risk of hypertension (odds ratio = 0.62; 95% confidence interval = 0.49-0.80). However, after adjustment for age and other confounders, pet ownership was not associated with systolic or diastolic blood pressure, pulse pressure, mean arterial pressure or risk of hypertension. Results suggest that pet ownership is not independently associated with blood pressure, vascular reactivity, or hypertension.
Nelson, Joan M; Cook, Paul F; Ingram, Jennifer C
To evaluate constructs from the theory of planned behavior (TPB, Ajzen 2002) - attitudes, sense of control, subjective norms and intentions - as predictors of accuracy in blood pressure monitoring. Despite numerous initiatives aimed at teaching blood pressure measurement techniques, many healthcare providers measure blood pressures incorrectly. Descriptive, cohort design. Medical assistants and licensed practical nurses were asked to complete a questionnaire on TPB variables. These nursing staff's patients had their blood pressures measured and completed a survey about techniques used to measure their blood pressure. We correlated nursing staff's responses on the TBP questionnaire with their intention to measure an accurate blood pressure and with the difference between their actual blood pressure measurement and a second measurement taken by a researcher immediately after the clinic visit. Patients' perceptions of MAs' and LPNs' blood pressure measurement techniques were examined descriptively. Perceived control and social norm predicted intention to measure an accurate blood pressure, with a negative relationship between knowledge and intention. Consistent with the TPB, intention was the only significant predictor of blood pressure measurement accuracy. Theory of planned behavior constructs predicted the healthcare providers' intention to measure blood pressure accurately and intention predicted the actual accuracy of systolic blood pressure measurement. However, participants' knowledge about blood pressure measurement had an unexpected negative relationship with their intentions. These findings have important implications for nursing education departments and organisations which traditionally invest significant time and effort in annual competency training focused on knowledge enhancement by staff. This study suggests that a better strategy might involve efforts to enhance providers' intention to change, particularly by changing social norms or increasing
Castro, Ana; Mattos, Sandra S; Coimbra, Miguel T
Heart sound characteristics are linked to blood pressure, and its interpretation is important for detection of cardiovascular disease. In this study, heart sounds' auscultation, acquired from children patients (27 patients, 10.2±3.9 years, 35.7±20.8 kg, 132.3±25.5 cm), were automatically segmented to extract the two main components: the first sound (S1) and the second sound (S2). Following, a set of time, frequency, and wavelet based features, were extracted from the S2, and analyzed in relation to the noninvasive cuff-based measures of blood pressure (mean blood pressure of 78±8.8 mmHg). A multivariate regression analysis was performed for each S2 feature set to determine which features better related to the blood pressure measurements. The best results, in the leave-one-out evaluation, were obtained using the frequency features set, with a MAE of 6.08 mmHg, a MAPE of 7.85%, and a ME of 0.31 mmHg, in the estimation of the mean blood pressure.
Lee, Kyu Rae; Ko, Ki Dong; Hwang, In Cheol; Suh, Heuy Sun; Kim, Kyoung Kon
The Korea National Health and Nutrition Examination Survey (KNHANES) has been performed every 3 years in Korea to help prevent cardiovascular mortality in the general population. Previous studies showed an association between blood lead levels and cardiovascular mortality. In order to assess the relationship between blood lead concentration and blood pressure in the healthy general population, we investigated whether blood lead levels were related to blood pressure in a non-smoking healthy population without any known medical diseases in the 2013 KNHANES. 896 (mean age 40.55±13.83 years; body mass index 23.06±3.33 kg/m 2 ) subjects who had no known diseases were included among 8018 subjects. Exclusion criteria were: hypertension, diabetes, hyperlipidaemia, cerebrovascular events, renal insufficiency, liver cirrhosis, thyroid dysfunction, any cardiovascular or renal disease, and any malignancy. Blood pressures were measured three times by sphygmomanometers, 5 min apart. Blood pressures were then expressed as the average between the second and third values. Height, weight, waist circumferences and blood pressure, as well as total cholesterol, high density lipoprotein cholesterol, triglycerides, low density lipoprotein cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), white blood cell count and blood lead levels were measured. In addition, dietary components were analysed by 24 hour recall. The association between log blood lead levels and systolic/diastolic pressure was stronger after it was controlled for age, sex, education, body mass index (BMI), waist circumference and fasting plasma glucose (FPG) (p=0.048, 0.002). Furthermore, the association between log blood lead levels and systolic pressure (p=0.048) and diastolic pressure (p=0.002) was more evident when controlled for age, sex, education, BMI, waist circumference, FPG, AST and ALT. Blood lead levels are significant determinants of systolic and diastolic blood pressure
Garner, Rochelle E.; Levallois, Patrick
Background: Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. Methods: The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. Results: Men had higher mean systolic (114.8 vs. 110.8 mmHg, p<0.01) and diastolic (74.0 vs. 69.6 mmHg, p<0.01) blood pressure compared to women. Although, geometric mean blood (0.46 vs. 0.38 µg/L, p<0.01) and creatinine-adjusted standardized urinary cadmium levels (0.48 vs. 0.38 µg/L, p<0.01) were higher among those with hypertension, these differences were no longer significant after adjustment for age, sex and smoking status. In overall regression models, increases in blood cadmium were associated with increased systolic (0.70 mmHg, 95% confidence interval [CI]=0.25–1.16, p<0.01) and diastolic blood pressure (0.74 mmHg, 95% CI=0.30–1.19, p<0.01). The associations between urinary cadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44–0.85, p<0.01), particularly female current smokers (OR=0.52, 95% CI=0.32–0.85, p=0.01). Conclusion: This study provides evidence of a significant association between cadmium levels, blood pressure
Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial.
Ruschitzka, Frank; Borer, Jeffrey S; Krum, Henry; Flammer, Andreas J; Yeomans, Neville D; Libby, Peter; Lüscher, Thomas F; Solomon, Daniel H; Husni, M Elaine; Graham, David Y; Davey, Deborah A; Wisniewski, Lisa M; Menon, Venu; Fayyad, Rana; Beckerman, Bruce; Iorga, Dinu; Lincoff, A Michael; Nissen, Steven E
Non-steroidal anti-inflammatory drugs (NSAIDs), both non-selective and selective cyclooxygenase-2 (COX-2) inhibitors, are among the most widely prescribed drugs worldwide, but associate with increased blood pressure (BP) and adverse cardiovascular (CV) events. PRECISION-ABPM, a substudy of PRECISION was conducted at 60 sites, to determine BP effects of the selective COX-2 inhibitor celecoxib vs. the non-selective NSAIDs naproxen and ibuprofen. In this double-blind, randomized, multicentre non-inferiority CV-safety trial, 444 patients (mean age 62 ± 10 years, 54% female) with osteoarthritis (92%) or rheumatoid arthritis (8%) and evidence of or at increased risk for coronary artery disease received celecoxib (100-200 mg bid), ibuprofen (600-800 mg tid), or naproxen (375-500 mg bid) with matching placebos in a 1: 1: 1 allocation, to assess the effect on 24-h ambulatory BP after 4 months. The change in mean 24-h systolic BP (SBP) in celecoxib, ibuprofen and naproxen-treated patients was -0.3 mmHg [95% confidence interval (CI), -2.25, 1.74], 3.7 (95% CI, 1.72, 5.58) and 1.6 mmHg (95% CI, -0.40, 3.57), respectively. These changes resulted in a difference of - 3.9 mmHg (P = 0.0009) between celecoxib and ibuprofen, of - 1.8 mmHg (P = 0.12) between celecoxib and naproxen, and of - 2.1 mmHg (P = 0.08) between naproxen and ibuprofen. The percentage of patients with normal baseline BP who developed hypertension (mean 24-h SBP ≥ 130 and/or diastolic BP ≥ 80 mmHg) was 23.2% for ibuprofen, 19.0% for naproxen, and 10.3% for celecoxib (odds ratio 0.39, P = 0.004 and odds ratio 0.49, P = 0.03 vs. ibuprofen and naproxen, respectively). In PRECISION-ABPM, allocation to the non-selective NSAID ibuprofen, compared with the COX-2 selective inhibitor celecoxib was associated with a significant increase of SBP, and a higher incidence of new-onset hypertension. gov number NCT00346216. Published on behalf of the European
Yoon, Sung Sug; Gu, Qiuping; Nwankwo, Tatiana; Wright, Jacqueline D; Hong, Yuling; Burt, Vicki
The aim of this study is to describe trends in the awareness, treatment, and control of hypertension; mean blood pressure; and the classification of blood pressure among US adults 2003 to 2012. Using data from the National Health and Nutrition Examination Survey 2003 to 2012, a total of 9255 adult participants aged ≥18 years were identified as having hypertension, defined as measured blood pressure ≥140/90 mm Hg or taking prescription medication for hypertension. Awareness and treatment among hypertensive adults were ascertained via an interviewer administered questionnaire. Controlled hypertension among hypertensive adults was defined as systolic blood pressure blood pressure Blood pressure was categorized as optimal blood pressure, prehypertension, and stage I and stage II hypertension. Between 2003 and 2012, the percentage of adults with controlled hypertension increased (P-trend Hypertensive adults with optimal blood pressure and with prehypertension increased from 13% to 19% and 27% to 33%, respectively (P-trend hypertensive adults who were taking antihypertensive medication, uncontrolled hypertension decreased from 38% to 30% (P-trend blood pressure was observed (P-trend blood pressure remained unchanged. The trend in the control of blood pressure has improved among hypertensive adults resulting in a higher percentage with blood pressure at the optimal or prehypertension level and a lower percentage in stage I and stage II hypertension. Overall, mean systolic blood pressure decreased as did the prevalence of uncontrolled hypertension among the treated hypertensive population. © 2014 American Heart Association, Inc.
Chandrasekaran, Vikram; Dantu, Ram; Jonnada, Srikanth; Thiyagaraja, Shanti; Subbu, Kalyan Pathapati
Smart phones today have become increasingly popular with the general public for their diverse functionalities such as navigation, social networking, and multimedia facilities. These phones are equipped with high-end processors, high-resolution cameras, and built-in sensors such as accelerometer, orientation-sensor, and light-sensor. According to comScore survey, 26.2% of U.S. adults use smart phones in their daily lives. Motivated by this statistic and the diverse capability of smart phones, we focus on utilizing them for biomedical applications. We present a new application of the smart phone with its built-in camera and microphone replacing the traditional stethoscope and cuff-based measurement technique, to quantify vital signs such as heart rate and blood pressure. We propose two differential blood pressure estimating techniques using the heartbeat and pulse data. The first method uses two smart phones whereas the second method replaces one of the phones with a customized external microphone. We estimate the systolic and diastolic pressure in the two techniques by computing the pulse pressure and the stroke volume from the data recorded. By comparing the estimated blood pressure values with those measured using a commercial blood pressure meter, we obtained encouraging results of 95-100% accuracy.
AlSalloum, Abdullah A.; El Mouzan, Mohammad I.; AlHerbish, Abdullah S.; AlOmar, Ahmad A.; Qurashi, Mansour M.
Blood pressure levels may vary in children because of genetic, ethnic and socioeconomic factors. To date, there have been no large national studies in Saudi Arabia on blood pressure in children. Therefore, we sought to establish representative blood pressure reference centiles for Saudi Arabian children and adolescents. We selected a sample of children and adolescents aged from birth to 18 years by multi-stage probability sampling of the Saudi population. The selected sample represented Saudi children from the whole country. Data were collected through a house-to-house survey of all selected households in all 13 regions in the country. Data were analyzed to study the distribution pattern of systolic (SBP) and diastolic blood pressure (DBP) and to develop reference values. The 90th percentile of SBP and DBP values for each age were compared with values from a Turkish and an American study. A total of 16 226 Saudi children and adolescents from birth to 18 years were studied. Blood pressure rose steadily with age in both boys and girls. The average annual increase in SBP was 1.66 mm Hg for boys and1.44 mm Hg for girls. The average annual increase in DBP was 0.83 mm Hg for boys and 0.77 mm Hg for girls. DBP rose sharply in boys at the age of 18 years. Values for the 90th percentile of both SBP and DBP varied in Saudi children from their Turkish and American counterparts for all age groups. Blood pressure values in this study differed from those from other studies in developing countries and in the United States, indicating that comparison across studies is difficult and from that every population should use their own normal standards to define measured blood pressure levels in children. (author)
Kamiński, Marek; Cieślik-Guerra, Urszula I; Kotas, Rafał; Mazur, Piotr; Marańda, Witold; Piotrowicz, Maciej; Sakowicz, Bartosz; Napieralski, Andrzej; Trzos, Ewa; Uznańska-Loch, Barbara; Rechciński, Tomasz; Kurpesa, Małgorzata
Atmospheric pressure is the most objective weather factor because regardless of if outdoors or indoors it affects all objects in the same way. The majority of previous studies have used the average daily values of atmospheric pressure in a bioclimatic analysis and have found no correlation with blood pressure changes. The main objective of our research was to assess the relationship between atmospheric pressure recorded with a frequency of 1 measurement per minute and the results of 24-h blood pressure monitoring in patients with treated hypertension in different seasons in the moderate climate of the City of Łódź (Poland). The study group consisted of 1662 patients, divided into 2 equal groups (due to a lower and higher average value of atmospheric pressure). Comparisons between blood pressure values in the 2 groups were performed using the Mann-Whitney U test. We observed a significant difference in blood pressure recorded during the lower and higher range of atmospheric pressure: on the days of the spring months systolic (p = 0.043) and diastolic (p = 0.005) blood pressure, and at nights of the winter months systolic blood pressure (p = 0.013). A significant inverse relationship between atmospheric pressure and blood pressure during the spring days and, only for systolic blood pressure, during winter nights was observed. Int J Occup Med Environ Health 2016;29(5):783-792. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Blood pressure was also recorded according to the standard method. Systolic and diastolic blood pressure to height ratio were then calculated. Receiver operating curves was used to assess the ability of systolic blood and diastolic blood pressure height ratio to discriminate childhood prehypertension and hypertension.
Klarskov, Pia; Bang, Lia E; Schultz-Larsen, Peter; Gregers Petersen, Hans; Benee Olsen, David; Berg, Ronan M G; Abrahamsen, Henrik; Wiinberg, Niels
To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting. Randomized controlled parallel group trial with 12-month follow-up. One hundred and ten general practices in all regions of Denmark. One thousand forty-eight patients with essential hypertension. Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring. Mean day- and night-time systolic and diastolic 24-hour ambulatory blood pressure. Change in systolic and diastolic office blood pressure and change in cardiovascular risk profile. Of the patients, 515 (49%) were allocated to the usual group, and 533 (51%) to the intensive group. The reductions in day- and night-time 24-hour ambulatory blood pressure were similar (usual group: 4.6 ± 13.5/2.8 ± 82 mmHg; intensive group: 5.6 ± 13.0/3.5 ± 8.2 mmHg; P = 0.27/P = 0.20). Cardiovascular risk scores were reduced in both groups at follow-up, but more so in the intensive than in the usual group (P = 0.02). An intensive blood pressure monitoring strategy led to a similar blood pressure reduction to conventional monitoring. However, the intensive strategy appeared to improve patients' cardiovascular risk profile through other effects than a reduction of blood pressure. Clinical Trials NCT00244660. © The Author 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Susan M. Wall
Full Text Available Type B and non-A, non-B intercalated cells are found within the connecting tubule and the cortical collecting duct. Of these cell types, type B intercalated cells are known to mediate Cl⁻ absorption and HCO₃⁻ secretion largely through pendrin-dependent Cl⁻/HCO₃⁻ exchange. This exchange is stimulated by angiotensin II administration and is also stimulated in models of metabolic alkalosis, for instance after aldosterone or NaHCO₃ administration. In some rodent models, pendrin-mediated HCO₃⁻ secretion modulates acid-base balance. However, the role of pendrin in blood pressure regulation is likely of more physiological or clinical significance. Pendrin regulates blood pressure not only by mediating aldosterone-sensitive Cl⁻ absorption, but also by modulating the aldosterone response for epithelial Na⁺ channel (ENaC-mediated Na⁺ absorption. Pendrin regulates ENaC through changes in open channel of probability, channel surface density, and channels subunit total protein abundance. Thus, aldosterone stimulates ENaC activity through both direct and indirect effects, the latter occurring through its stimulation of pendrin expression and function. Therefore, pendrin contributes to the aldosterone pressor response. Pendrin may also modulate blood pressure in part through its action in the adrenal medulla, where it modulates the release of catecholamines, or through an indirect effect on vascular contractile force. This review describes how aldosterone and angiotensin II-induced signaling regulate pendrin and the contributory role of pendrin in distal nephron function and blood pressure.
SARI, Aysel; SELİM, Nevzat; DİLEK, Melda; AYDOĞDU, Turkan; ADIBELLİ, Zelal; BÜYÜKKAYA, Piltan; AKPOLAT, Tekin
Lemon juice has commonly been used by hypertensive patients in order to lower blood pressure (BP) acutely when BP is raised or as an alternative/complementary therapy for expectation of chronic improvement. Grapefruit, a citrus fruit like lemon, causes clinically significant interactions with a variety of drugs including calcium antagonists. The aims of this study were to investigate acute and chronic effects of lemon juice on BP among hypertensive patients. Ninty-eight patients were included...
Leer, van E.M.
Trends in blood pressure, prevalence and treatment of hypertension were studied in 30,000 men and women aged 37-43 years during the period 1974-1980, in 80,000 men aged 33-37 years during the period 1981-1986 and 36,000 in men and women aged 20-59 years during the period 1987-1991. Between
Full Text Available A growing body of evidence supports the concept of fetal programming in cardiovascular disease in man, which asserts that an insult experienced in utero exerts a long-term influence on cardiovascular function, leading to disease in adulthood. However, this hypothesis is not universally accepted, hence animal models may be of value in determining potential physiological mechanisms which could explain how fetal undernutrition results in cardiovascular disease in later life. This review describes two major animal models of cardiovascular programming, the in utero protein-restricted rat and the cross-fostered spontaneously hypertensive rat. In the former model, moderate maternal protein restriction during pregnancy induces an increase in offspring blood pressure of 20-30 mmHg. This hypertensive effect is mediated, in part, by fetal exposure to excess maternal glucocorticoids as a result of a deficiency in placental 11-ß hydroxysteroid dehydrogenase type 2. Furthermore, nephrogenesis is impaired in this model which, coupled with increased activity of the renin-angiotensin system, could also contribute to the greater blood pressure displayed by these animals. The second model discussed is the cross-fostered spontaneously hypertensive rat. Spontaneously hypertensive rats develop severe hypertension without external intervention; however, their adult blood pressure may be lowered by 20-30 mmHg by cross-fostering pups to a normotensive dam within the first two weeks of lactation. The mechanisms responsible for this antihypertensive effect are less clear, but may also involve altered renal function and down-regulation of the renin-angiotensin system. These two models clearly show that adult blood pressure is influenced by exposure to one of a number of stimuli during critical stages of perinatal development.
Maryam sadat Amirkalali sijavandi
Full Text Available Introduction: Ramadan is a holy month for Muslims during which avoid from eating, drinking and sexual intercourse for about 13-17 hours. The aim of this study was surveying the effects of Islamic fasting in Ramadan on lipid profile and blood pressure.Materials and Methods: we designed this study in two phases, a week before and a week after Ramadan month. Eighty nine healthy subjects with 20-50 years old were participated in this study. Blood sampling for lipid profile measurement was done in the morning and blood pressure was measured in the afternoon with digital sphygmomanometer. Statistical analysis was performed with SPSS version 16.0 software.Results: In a week after Ramadan, body weight and body mass index (BMI decreased in both sexes, comparing with the week before Ramadan measurements (p
Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.
Eisenberg, Tobias; Abdellatif, Mahmoud; Zimmermann, Andreas; Schroeder, Sabrina; Pendl, Tobias; Harger, Alexandra; Stekovic, Slaven; Schipke, Julia; Magnes, Christoph; Schmidt, Albrecht; Ruckenstuhl, Christoph; Dammbrueck, Christopher; Gross, Angelina S.; Herbst, Viktoria; Carmona-Gutierrez, Didac; Pietrocola, Federico; Pieber, Thomas R.; Sigrist, Stephan J.; Linke, Wolfgang A.; Mühlfeld, Christian; Sadoshima, Junichi; Dengjel, Joern; Kiechl, Stefan; Kroemer, Guido; Sedej, Simon; Madeo, Frank
ABSTRACT Loss of cardiac macroautophagy/autophagy impairs heart function, and evidence accumulates that an increased autophagic flux may protect against cardiovascular disease. We therefore tested the protective capacity of the natural autophagy inducer spermidine in animal models of aging and hypertension, which both represent major risk factors for the development of cardiovascular disease. Dietary spermidine elicits cardioprotective effects in aged mice through enhancing cardiac autophagy and mitophagy. In salt-sensitive rats, spermidine supplementation also delays the development of hypertensive heart disease, coinciding with reduced arterial blood pressure. The high blood pressure-lowering effect likely results from improved global arginine bioavailability and protection from hypertension-associated renal damage. The polyamine spermidine is naturally present in human diets, though to a varying amount depending on food type and preparation. In humans, high dietary spermidine intake correlates with reduced blood pressure and decreased risk of cardiovascular disease and related death. Altogether, spermidine represents a cardio- and vascular-protective autophagy inducer that can be readily integrated in common diets. PMID:28118075
Are blood pressure values compatible with medication adherence in hypertensive patients? ... The patients with BP measurements completed the Medication Adherence Self‑Efficacy Scale‑Short Form 13 and the World Health Organization‑5 (WHO‑5) well‑being index. A Holter device was attached, and 24 h BP monitoring ...
Polderman, Jorinde; Gurgel, Ricardo Queiroz; Barreto-Filho, José Augusto S.; Roelofs, Rik; Ramos, Ricardo Emanoel de O.; de Munter, Jeroen S.; Wendte, Johannes F.; Agyemang, Charles
Objective: To assess the prevalence of high blood pressure (BP) and the association of overweight and obesity with high BP among adolescents in Aracaju, Brazil. Design: Cross-sectional study. The main outcome measure was the proportion of adolescents with high BP (sex-, age- and height-specific >=
The aim of this study was to determine the prevalence of obesity and hypertension among bankers in Lagos State, Nigeria. Methods: Blood pressure, body mass index (BMI) and waist circumference were measured in 260 professional bankers from 56 bank branches in Lagos. Results: The mean age of the respondents was ...
Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie
Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...
Rasmussen, Susanne; Hansen, Tine; Frimodt-Møller, Marie
Central blood pressure (BP) estimates the true load imposed on the left ventricle to a higher degree than does brachial BP. Increased aortic pulse wave velocity (aPWV) and central BP are risk markers for cardiovascular disease. Both can be measured by simple and noninvasive methods. Guidelines...
Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N
Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial
Diana V. Do
Full Text Available BACKGROUND: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure.OBJECTIVES: The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes.METHODS:Search methods: We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria: We included in this review randomized controlled trials (RCTs in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis: Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We
Cohen, Jordana B.; Cohen, Debbie L.
Guidelines for the diagnosis and monitoring of hypertension were historically based on in-office blood pressure measurements. However, the United States Preventive Services Task Force recently expanded their recommendations on screening for hypertension to include out-of-office blood pressure measurements to confirm the diagnosis of hypertension. Out-of-office blood pressure monitoring, including ambulatory blood pressure monitoring and home blood pressure monitoring, are important tools in distinguishing between normotension, masked hypertension, white-coat hypertension, and sustained (including uncontrolled or drug-resistant) hypertension. Compared to in-office readings, out-of-office blood pressures are a greater predictor of renal and cardiac morbidity and mortality. There are multiple barriers to the implementation of out-of-office blood pressure monitoring which need to be overcome in order to promote more widespread use of these modalities. PMID:27677895
Viera, Anthony J.; Shimbo, Daichi
Ambulatory blood pressure monitoring offers the ability to collect blood pressure readings several times an hour across a 24-hour period. Ambulatory blood pressure monitoring facilitates the identification of white-coat hypertension, the phenomenon whereby certain individuals who are not on antihypertensive medication show elevated blood pressure in a clinical setting but show non-elevated blood pressure averages when assessed by ambulatory blood pressure monitoring. Additionally, readings can be segmented into time windows of particular interest, e.g., mean daytime and nighttime values. During sleep, blood pressure typically decreases, or dips, such that mean sleep blood pressure is lower than mean awake blood pressure. A non-dipping pattern and nocturnal hypertension are strongly associated with increased cardiovascular morbidity and mortality. Approximately 70% of individuals dip ≥10% at night, while 30% have non-dipping patterns, when blood pressure remains similar to daytime average, or occasionally rises above daytime average. The various blood pressure categorizations afforded by ambulatory blood pressure monitoring are valuable for clinical management of high blood pressure since they increase accuracy for diagnosis and the prediction of cardiovascular risk. PMID:25107387
Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.
The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 ( 133 Xe) clearance technique, which uses an intravenous bolus of 133 Xe, an external chest detector to estimate arterial 133 Xe concentration, eight external cranial detectors to measure cephalic 133 Xe clearance curves, and a two-compartmental analysis of the cephalic 133 Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications
Cook, C.W.; Ames, E.S.
A fluid coupled plate (FCP) gage was designed which allows pressure measurements to be made in harsh environments (including debris) using conventional pressure transducers. The pressure transducer is isolated by means of a rigid force plate which is supported by a bellows having one corrugation. This portion of the gage is machined from a single piece of material. The interior of the gage is filled with a phenol fluid which has a low compressibility
Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul
Hypertension, a common cardiovascular disease (CVD) risk factor, is usually diagnosed and treated based on blood pressure readings obtained in the clinic setting. Blood pressure may differ considerably when measured in the clinic versus outside of the clinic setting. Over the past several decades, evidence has accumulated on two approaches for measuring out-of-clinic blood pressure: ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). Blood pressure measures on ABPM and HBPM each have a stronger association with CVD outcomes than clinic blood pressure. Controversy exists whether ABPM or HBPM is superior for estimating CVD risk, and under what circumstances these methods should be used in clinical practice for assessing out-of-clinic blood pressure. This review describes ABPM and HBPM procedures, the blood pressure phenotypic measures that can be ascertained, and the evidence that supports the use of each approach to measure out-of-clinic blood pressure. This review also describes barriers to the successful implementation of ABPM and HBPM in clinical practice, proposes core competencies for the conduct of these procedures, and highlights important areas for future research. PMID:26457954
Get the most out of home blood pressure monitoring Checking your blood pressure at home is an important part of managing ... monitors might not give you an accurate reading. Most pharmacies, medical supply stores and some websites sell ...
... What's the connection? Is there a connection between menopause and high blood pressure? Answers from Shannon K. ... Tommaso, M.D. Blood pressure generally increases after menopause. Some doctors think this increase suggests that hormonal ...
... also can cause disrupted breathing while you sleep (sleep apnea), which further raises your blood pressure. Weight loss is one of the most effective lifestyle changes for controlling blood pressure. Losing even a small amount of weight if you' ...
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Podell, Richard N.
Some physicians wonder if high blood pressure can be controlled without the use of drugs and their potential side effects. Current findings concerning nutrition and high blood pressure are presented. (RM)
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... please visit this page: About CDC.gov . Home Blood Pressure: Make Control Your Goal Infographic Recommend on Facebook ... Compartir Copy the code below to use the Blood Pressure Infographic on your web page or social media ...
... medications: Can they raise my triglycerides? Can some blood pressure medications cause an increase in triglycerides? Answers from Sheldon G. Sheps, M.D. Yes, some blood pressure medications can affect triglyceride and cholesterol levels. Hydrochlorothiazide ...
Full Text Available A Alex Ilechie, Sandra TettehDepartment of Optometry, University of Cape Coast, GhanaBackground: Energy drinks contain a wide variety of ingredients including caffeine, for which there have been conflicting reports regarding its effects on intraocular pressure (IOP and blood pressure. The aim of this study was to investigate the acute effects of an energy drink (Red Bull® on the IOP and blood pressure of healthy young adults.Methods: Thirty healthy university students of either gender, aged 18–30 (mean 23.20 ± 2.81 years were randomly selected to participate in this study. The subjects were randomly divided into two groups (experimental and control and were asked to abstain from caffeine for 48 hours prior to and during the study. Baseline IOP and blood pressure were measured. The experimental group (n = 15 consumed one can of the energy drink (containing 85 mg of caffeine in 250 mL and measurements were repeated at 30, 60, and 90 minutes, while the control group drank 250 mL of water and were tested over the same time period.Results: When compared with baseline, a significant decrease (P < 0.05 in mean IOP at 60 and 90 minutes was observed in the experimental group. There was no corresponding change in systolic or diastolic blood pressure.Conclusion: Our results suggest that energy drinks (ie, Red Bull produce a significant reduction in IOP but have no effect on blood pressure. These findings may be interpreted as reflecting the effect of the combination of caffeine and taurine in the Red Bull energy drink. This effect may result from the known hypotensive effect of taurine, and warrants further study.Keywords: acute effect, intraocular pressure, blood pressure, glaucoma, caffeine, taurine
Divisón Garrote, J A
It is clear that clinical measurements of blood pressure can lead to errors in the diagnostic process and follow-up of patients with hypertension. Scientific societies recommend other measurement methods, such as home measurements and outpatient monitoring. Outpatient monitoring might be the golden standard but, nowadays has an important limitation-its availability. Home measurements solve 80-90% of the doubts of the diagnostic process and follow-up of patients with hypertension, and its higher availability and acceptance by the patient are clear. Home measurements should be used in the diagnostic process of arterial hypertension as a screening test for white coat hypertension and masked hypertension. They should be used as a screening test for resistant hypertension in the follow-up of patients with high blood pressure. Besides, in the follow-up of patients with hypertension home measurements have shown that they can contribute to treatment adherence, reduce clinical inertia and make data teletransmission possible, aspects that have proven to help improve the degree of control of hypertensive patients. Therefore, home measurements would be the treatment of choice for the diagnosis and follow-up of most patients with hypertension. We should consider home measurements and outpatient monitoring as complementary methods for the diagnosis and follow-up of patients with high blood pressure. Copyright © 2016. Publicado por Elsevier España, S.L.U.
Full Text Available This work deals with the development and characterization of a potentially implantable blood pressure telemetry system, based on an active Radio-Frequency IDentification (RFID tag, International Organization for Standardization (ISO 15693 compliant. This approach aims to continuously measure the average, systolic and diastolic blood pressure of the small/medium animals. The measured pressure wave undergoes embedded processing and results are stored onboard in a non-volatile memory, providing the data under interrogation by an external RFID reader. In order to extend battery lifetime, RFID energy harvesting has been investigated. The paper presents the experimental characterization in a laboratory and preliminary in-vivo tests. The device is a prototype mainly intended, in a future engineered version, for monitoring freely moving test animals for pharmaceutical research and drug safety assessment purposes, but it could have multiple uses in environmental and industrial applications.
Asrin, M; Nessa, A; Hasan, M I; Das, R K
Obesity is increasing in developed as well as in developing countries. This analytical cross sectional study was carried out to document the relation between blood pressure, serum creatinine and body mass index in female and to assess potential health differences among obese female and normal weight female. This study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2012 to June 2013. Seventy female persons volunteered as subjects. Among them 35 were within normal weight (BMI 18.5-24.9kg/m²) and 35 were obese (BMI≥30kg/m²). Non probability purposive type of sampling technique was used to select the subjects. Measurement of body mass index and blood pressure were done as per procedure. Serum creatinine level was estimated by enzymatic colorimetric method. The results were calculated and analyzed by using SPSS (statistical package for social science, version 17.0), scientific electronic calculator and simultaneously with a computer assisted program like Microsoft excel. Unpaired 't' test was applied to find the significance of difference regarding serum creatinine and blood pressure levels in obese female. The value of p was 1% to indicate highly significant and 5% to indicate simply significant or statistically significant. The mean±SE of systolic blood pressure, diastolic blood pressure and serum creatinine levels were 135.71±1.58mmHg, 88.74±0.95mmHg and 1.03±0.01mg/dl respectively; significant at 1% level for obese group of BMI (pserum creatinine & blood pressure in obese female which indicate the obese subjects are prone to cardiovascular & metabolic risk.
Steinhorst, Ana P; Gonçalves, Sandro C; Oliveira, Ana T; Massierer, Daniela; Gus, Miguel; Fuchs, Sandra C; Moreira, Leila B; Martinez, Denis; Fuchs, Flávio D
Obstructive sleep apnea (OSA) is a risk factor for the development of hypertension and cardiovascular disease. Apnea overloads the autonomic cardiovascular control system and may influence blood pressure variability, a risk for vascular damage independent of blood pressure levels. This study investigates the hypothesis that blood pressure variability is associated with OSA. In a cross-sectional study, 107 patients with hypertension underwent 24-h ambulatory blood pressure monitoring and level III polysomnography to detect sleep apnea. Pressure variability was assessed by the first derivative of blood pressure over time, the time rate index, and by the standard deviation of blood pressure measurements. The association between the apnea-hypopnea index and blood pressure variability was tested by univariate and multivariate methods. The 57 patients with apnea were older, had higher blood pressure, and had longer duration of hypertension than the 50 patients without apnea. Patients with apnea-hypopnea index (AHI) ≥ 10 had higher blood pressure variability assessed by the standard deviation than patients with AHI variability assessed by the time rate index presented a trend for association during sleep (P = 0.07). Daytime blood pressure variability was not associated with the severity of sleep apnea. Sleep apnea increases nighttime blood pressure variability in patients with hypertension and may be another pathway linking sleep abnormalities to cardiovascular disease.
Korshøj, Mette; Clays, Els; Lidegaard, Mark
PURPOSE: Cardiovascular disease is prevalent among workers with high levels of occupational physical activity. The increased risk may be due to a high relative aerobic workload, possibly leading to increased blood pressure. However, studies investigating the relation between relative aerobic...... workload and ambulatory blood pressure (ABP) are lacking. The aim was to explore the relationship between objectively measured relative aerobic workload and ABP. METHODS: A total of 116 cleaners aged 18-65 years were included after informed consent was obtained. A portable device (Spacelabs 90217......) was mounted for 24-h measurements of ABP, and an Actiheart was mounted for 24-h heart rate measurements to calculate relative aerobic workload as percentage of relative heart rate reserve. A repeated-measure multi-adjusted mixed model was applied for analysis. RESULTS: A fully adjusted mixed model...
Abdi, Hamid; Tayefi, Maryam; Moallem, Seyed Reza; Zhao, Baxiao; Fayaz, Mojtaba; Ardabili, Hossein Mohaddes; Razavi, Akram-Alsadat; Darbandi, Mahsa; Darbandi, Sara; Abbasi, Parisa; Ferns, Gordon A; Ghayour-Mobarhan, Majid
Hypertension is an important risk factor of cardiovascular disease (CVD), which is associated with premature death, myocardial infarction, stroke, peripheral vascular disease, and renal disease. The goal of the present study was to use a randomized controlled clinical trial to explore and compare the effectiveness of abdominal and auricular acupuncture on blood pressure in 440 subjects with and without obesity. Four hundred participants were recruited and randomized to one of four groups: cases and controls receiving auricular acupuncture (204 subjects) and cases and controls receiving abdominal electroacupuncture (196 subjects). Blood pressure and anthropometric parameters were measured before and after the intervention period. In order to match the initial diet of the groups, participants were required to follow an isocaloric diet for two weeks before the trial, and a low-calorie diet for 6 weeks during the intervention period. We observed a significant time dependent improvement in the systolic blood pressure measurements in the abdominal intervention group, although this improvement was more pronounce in the first period of study. Of note, in the auricular intervention group, a significant increasing in the level of SBP was detected. Importantly no statistically significant changes were found in the corresponding sham groups. Our findings demonstrated that abdominal electro-acupuncture for 6 weeks reduced both systolic and diastolic blood pressure and auricular acupuncture had a short-term adverse effect on both SBP and DBP. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ezzati, Majid; Geleijnse, J.M.
Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic
lifting and supporting weights) and have an important influence on blood pressure, it is essential to evaluate blood pressure response to iso- metric effort. This test can reveal high blood pressure that might otherwise not be detected. Only a few ...
Background: High blood pressure is often said to be associated with poor outcome in stroke. However, there remains some uncertainly about the relationship of blood pressure to mortality in stroke. Objective: This study seeks to determine the influence of admission blood pressure on early mortality of stroke patients at the ...
... Is it true that sleep deprivation can cause high blood pressure? Answers from Sheldon G. Sheps, M.D. Possibly. It's thought ... night may be at higher risk of developing high blood pressure or worsening already high blood pressure. There's also ...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an inelastic...
Benjamins, C.; Schuurs, A.H.; Asscheman, H.; Hoogstraten, J.
Assessed dental anxiety and blood pressure immediately prior to a dental appointment in 24 patients attending a university dental clinic or a clinic for anxious dental patients in the Netherlands. Blood pressure was assessed by 2 independent methods, and the interchangeability of the blood-pressure