Alpert, Bruce S; Quinn, David; Gallick, David
Oscillometric devices for the non-invasive estimation of blood pressure (BP) have become the "clinical standard" because of training requirements for determination of BP by auscultation, cost, and the phasing-out/banning of mercury in many states and countries. Analysis of recent publications reveals a lack of understanding of the "meaning" of oscillometric blood pressure (OBP) measurements by authors, journal editors, and clinicians. We were invited to submit a review of OBP methodology written for clinicians. We hope that the material contained herein will clarify how clinicians should interpret OBP values for their patients. PMID:25492837
Barbé, K.; Van Moer, W.; Lauwers, L.
In this paper, the oscillometric waveform measured by automatic non-invasive blood pressure meters (NIBP) is analyzed by transforming the data from the time domain to the frequency domain. The signal's spectrum of the oscillometric waveform is in current literature badly understood or explored. The only known link between the oscillometric waveform and the blood pressure is the maximum of the oscillometry's envelope equalling the mean arterial pressure (MAP). This link is established under the assumption that the oscillometry is an AM-signal. Unfortunately, computing the MAP is difficult in practice due to the non-sinusoidal nature of the actual measured signals. In this paper, we construct the best AM-signal approximation of the oscillometry and explore its use to compute the MAP.
Vachon, Catherine; Belanger, Marie C; Burns, Patrick M
Two non-invasive blood pressure (NIBP) devices (oscillometry and Doppler) were compared to invasive blood pressure using a Bland-Altman analysis, in anesthetized and conscious dogs. When considering the systolic arterial pressure only during general anesthesia, both NIBP devices slightly underestimated the systolic arterial blood pressure however the precision and the limits of agreement for the Doppler were of a greater magnitude. This indicates a worse clinical performance by the Doppler. The performance of both NIBP devices deteriorated as measured in conscious animals. In general, for the oscillometric device, determination of invasive diastolic and mean arterial pressures was better than the invasive systolic arterial pressure. Overall, the oscillometric device satisfied more of the criteria set by the American College of Veterinary Internal Medicine consensus statement. Based upon these results, the oscillometric device is more reliable than the Doppler in the determination of blood pressure in healthy medium to large breed dogs. PMID:24924217
Zheng, Dingchang; Di Marco, Luigi Yuri; Murray, Alan
Blood pressure (BP) measurement accuracy depends on consistent changes in Korotkoff sounds (KorS) for manual measurement and oscillometric pulses for automated measurement, yet little is known about the direct effect of respiration on these physiological signals. The aim of this research was to quantitatively assess the modulation effect of respiration on Korotkoff sounds and oscillometric pulses. Systolic and diastolic blood pressures were measured manually from 30 healthy subjects (age 41 ± 12 years). Three static cuff pressure conditions were studied for two respiratory rates. Cuff pressure [with oscillometric pulses (OscP)], ECG, chest motion respiration [respiration signal (Resp), from magnetometer] and Korotkoff sounds (KorS, from digital stethoscope) were recorded twice for 20 s. The physiological data were evenly resampled. Respiratory frequency was calculated from Resp (fR), OscP (fO) and KorS (fK) from peak spectral frequency. There was no statistically significant difference between fR and fO or fK. Respiratory modulation was observed in all subjects. OscP amplitude modulation changed significantly between the two respiratory rates (p < 0.05) and between the three cuff pressures (p < 0.0001), and decreased significantly with decreasing cuff pressure (p < 0.05). The phase shift between Resp and modulation of OscP was statistically significant with respiratory rates (p < 0.05), but not with cuff pressures. It is accepted that BP in individuals is variable and that this relates to respiration; we now show that this respiration modulates oscillometric pulse and Korotkoff sound amplitudes from which BP is measured. PMID:24668326
Maselli, Monica; Giantin, Valter; Corrado, Domenico; Franchin, Alessandro; Attanasio, Francesca; Pengo, Valentina; Tramontano, Alessandra; De Toni, Pietro; Perissinotto, Egle; Manzato, Enzo
The reliability of automated oscillometric blood pressure (BP) monitors in atrial fibrillation (AF) has been poorly investigated, only comparing different patients with AF and sinus rhythm (SR), and is a method influenced by individual characteristics. This study compared the reliability of the oscillometric device A&D TM-2430 (A&D Company, Tokyo, Japan) with that of a mercury sphygmomanometer in AF patients whose SR was restored after electric cardioversion (ECV). Three consecutive BP measurements were obtained on the day before and about 30 days after ECV in stable treatment conditions. Of the 100 patients studied, 63 reported an SR at follow-up, with a significant increase in systolic BP and a significant decrease in diastolic BP according to both devices. There were no significant differences between the systolic and diastolic biases before and after ECV using Bland Altman analysis (P > .05 each). The oscillometric device analyzed, using three repeated measurements, is reliable in measuring BP in AF patients. PMID:25855463
Rego Filho, E A; Mello, S F; Silva, C R; Vituri, D W; Bazoni, E; Gordan, L N
OBJECTIVE: The aim of this study is to analyze the substitution of the standard auscultatory method by the oscillometric blood pressure monitor, independently of the validity of the intraarterial blood pressure measurement. The accuracy of the automatic oscillometric monitor was compared to the auscultatory mercury manometer blood pressure measurement in apparently healthy school age children. METHODS: A device able to perform 3 simultaneous readings are used: one reading by the monitor and the others by two "blind" observers. We studied 72 school age children with the following characteristics: mean age 9.5 (6.1-16.1) and 39 males (54.2%). RESULTS: The difference for the systolic and diastolic blood pressure obtained by the monitor was in average + 6.2 mmHg and + 10.0 mmHg, respectively, when compared to the observer's readings. There was neither a good correlation nor a good agreement between the two observers and the monitor in the blood pressure determination. CONCLUSIONS: We concluded that the substitution of the standard auscultatory method for the non-invasive oscillometric method to measure blood pressure in school age children can not be generally recommended. PMID:14685547
Cao, Xiaoqin; Song, Chunhua; Guo, Leilei; Yang, Junxia; Deng, Songyuan; Xu, Yajuan; Chen, Xiaolin; Sapa, Wolde Bekalo; Wang, Kaijuan
This study aims to validate blood pressure (BP) values measured by an oscillometric BP monitor and seek possible calibration methods if discrepancies exist. Noninvasive BP measurement outcomes were determined using an oscillometric BP monitor (Omron HBP-1300) versus a mercury sphygmomanometer (standard device). Two percent of subjects enrolled in an epidemiological investigation were systematically sampled in this study. Intraclass correlation coefficient (ICC) was used to evaluate measurement reliability, paired t-test was used to evaluate trueness, and linear regression was used for calibration. The Association for the Advancement of Medical Instrumentation (AAMI) standards and British Hypertension Society (BHS) protocols were used for validation quality assessment. Both mercury sphygmomanometer (standard device) and oscillometric BP monitor (test device) displayed high reliability. A significant difference in systolic blood pressure (SBP) was observed between devices. SBP calibration was achieved by using an effective linear regression model (B = 0.803 and constant = 19.592, P < 0.001). The calibrated model was corroborated by verification samples (P = 0.120) and was found to pass AAMI standards and BHS protocol requirements. Calibrated SBP measurements from the Omron HBP-1300 device were valid. Use of a combination of statistical methods, such as ICC for reliability assessment as well as paired t-test for trueness evaluation can be used to validate data from the oscillometric BP monitors. PMID:26376388
Cao, Xiaoqin; Song, Chunhua; Guo, Leilei; Yang, Junxia; Deng, Songyuan; Xu, Yajuan; Chen, Xiaolin; Sapa, Wolde Bekalo; Wang, Kaijuan
Abstract This study aims to validate blood pressure (BP) values measured by an oscillometric BP monitor and seek possible calibration methods if discrepancies exist. Noninvasive BP measurement outcomes were determined using an oscillometric BP monitor (Omron HBP-1300) versus a mercury sphygmomanometer (standard device). Two percent of subjects enrolled in an epidemiological investigation were systematically sampled in this study. Intraclass correlation coefficient (ICC) was used to evaluate measurement reliability, paired t-test was used to evaluate trueness, and linear regression was used for calibration. The Association for the Advancement of Medical Instrumentation (AAMI) standards and British Hypertension Society (BHS) protocols were used for validation quality assessment. Both mercury sphygmomanometer (standard device) and oscillometric BP monitor (test device) displayed high reliability. A significant difference in systolic blood pressure (SBP) was observed between devices. SBP calibration was achieved by using an effective linear regression model (B = 0.803 and constant = 19.592, P < 0.001). The calibrated model was corroborated by verification samples (P = 0.120) and was found to pass AAMI standards and BHS protocol requirements. Calibrated SBP measurements from the Omron HBP-1300 device were valid. Use of a combination of statistical methods, such as ICC for reliability assessment as well as paired t-test for trueness evaluation can be used to validate data from the oscillometric BP monitors. PMID:26376388
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) and diastolic blood pressure (DBP) as displayed by the device. In this study we have analysed measured and calculated MAP, obtained by two different oscillometric BP measurement devices in two different patient cohorts. The first cohort included 242 healthy subjects (male 40.5%, 50+/-13 years). BP measurements were performed with a Welch Allyn 5300P device. We found a small but significant difference between measured MAP and calculated MAP (MAP(m-c:) -1.8 mmHg, range -5.7 to 12.9 mmHg, p < 0.001). MAP(m-c) showed a significant, but weak correlation with DBP and SBP. The second cohort included included 134 patients with glomerular diseases (male 63%, 50+/14 years). BP measurements were performed with a Dinamap 487210 device. In this group we also observed a small difference between measured MAP and calculated MAP (+1.7 mmHg, range -15.3 to 28.2 mmHg, p<0.001). MAP (m-c) correlated with age, all blood pressure indices and heart rate. An overall analysis showed that age, SBP, DBP, and type of device are all independently related to MAP (m-c). There is a significant difference between measured and calculated MAP. The difference is small on average; however, this MAP(m-c) can be large in the individual patient. Moreover, there are differences of reported MAP between devices. Our data suggest that calculated and measured MAP cannot be used interchangeably. PMID:19075313
Lim, Pooi Khoon; Ng, Siew-Cheok; Jassim, Wissam A.; Redmond, Stephen J.; Zilany, Mohammad; Avolio, Alberto; Lim, Einly; Tan, Maw Pin; Lovell, Nigel H.
We present a novel approach to improve the estimation of systolic (SBP) and diastolic blood pressure (DBP) from oscillometric waveform data using variable characteristic ratios between SBP and DBP with mean arterial pressure (MAP). This was verified in 25 healthy subjects, aged 28 ± 5 years. The multiple linear regression (MLR) and support vector regression (SVR) models were used to examine the relationship between the SBP and the DBP ratio with ten features extracted from the oscillometric waveform envelope (OWE). An automatic algorithm based on relative changes in the cuff pressure and neighbouring oscillometric pulses was proposed to remove outlier points caused by movement artifacts. Substantial reduction in the mean and standard deviation of the blood pressure estimation errors were obtained upon artifact removal. Using the sequential forward floating selection (SFFS) approach, we were able to achieve a significant reduction in the mean and standard deviation of differences between the estimated SBP values and the reference scoring (MLR: mean ± SD = −0.3 ± 5.8 mmHg; SVR and −0.6 ± 5.4 mmHg) with only two features, i.e., Ratio2 and Area3, as compared to the conventional maximum amplitude algorithm (MAA) method (mean ± SD = −1.6 ± 8.6 mmHg). Comparing the performance of both MLR and SVR models, our results showed that the MLR model was able to achieve comparable performance to that of the SVR model despite its simplicity. PMID:26087370
Schell, Kathleen; Morse, Kate; Waterhouse, Julie K
When patients' upper arms are not accessible and/or when cuffs do not fit large upper arms, the forearm site is often used for blood pressure (BP) measurement. The purpose of this study is to compare forearm and upper-arm BPs in 70 acutely ill adults, admitted to a community hospital's 14-bed ICU. Using Philips oscillometric monitors, three repeated measures of forearm and upper-arm BPs are obtained with head of bed flat and with head of bed elevated at 30 degrees. Arms are resting on the bed. Paired t tests show statistically significant differences in systolic BPs, diastolic BPs, and mean arterial pressures in the supine and head-elevated positions. Bland-Altman analyses indicate that forearm and upper-arm oscillometric BPs are not interchangeable in acutely ill adults. PMID:20581399
Doh, Il; Lim, Hyun Kyoon; Ahn, Bongyoung
Blood pressure is one of the most important vital signs used to monitor a patient’s medical condition and is widely measured in hospitals and at home. Automatic, non-invasive blood pressure (NIBP) monitoring devices measure systolic and diastolic blood pressures from the analysis of cuff pressure oscillations caused by periodic variations of blood pressure in an artery. Currently, clinical validation by comparing them to the auscultatory reference has been used to verify the performance of NIBP devices. However, there are presently no calibration methods for NIBP devices. Here, we propose an SI-traceable calibration method for oscillometric NIBP devices. The calibration system generates pressure-pulses at pre-determined cuff pressures, and with pre-determined amplitude, to the device-under-test. The uncertainty of each pulse is analyzed and used for the calculation of blood pressure (BP) uncertainty. The maximum uncertainty for systolic and diastolic BP using the newly developed calibration system is (0.74 and 0.60) mmHg (k = 2) depending on the pressure and amplitude of each pulse, as well as the number of pulses applied. The present method can be used for calibration of oscillometric NIBP devices.
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 < .0001) than Phase 1 (K1) systolic, 2) DynaPulse diastolic was 5 mm Hg lower (P < .0001) than Phase 4 (K4), and 3) is less than 1 mm Hg higher than Phase 5 (K5) diastolic (P < .0001), when compared with K-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. PMID:21269907
Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B
Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly
Rithalia, S V; Edwards, D
Non-invasive oscillometric blood pressure and pulse measured by an Omron HEM-703CP monitor were compared with arterial values obtained from direct measurements of the radial artery. An excellent correlation and agreement was found between the two methods (systolic r = 0.99; diastolic r = 0.97; pulse r = 0.99), although there was some variability among individual subjects. The range of difference between them was 0 to 10 mmHg for systolic and -6 to +5 mmHg for diastolic pressures. When tested on the bench using the Metron QA-1280 non-invasive blood pressure analyser the HEM-703CP monitor rarely exhibited errors exceeding 2-3 mmHg over a measurement range of 50-200 mmHg. PMID:7776359
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. PMID:22913792
Benmira, A; Perez-Martin, A; Schuster, I; Aichoun, I; Coudray, S; Bereksi-Reguig, F; Dauzat, M
The auscultatory technique remains the point of reference for the validation of non-invasive blood pressure measurement devices, although the exact origin of the Korotkoff sounds is still debated and comparison with intra-arterial measurement shows limits and pitfalls. Automatic oscillometric devices are now widely used by nurses, physicians, and patients. However, many available devices have not been duly validated. Moreover, they calculate systolic and diastolic blood pressures using undisclosed algorithms. Therefore, these devices are not interchangeable, and their reliability may be questionable in some clinical situations. Nevertheless, oscillometry is increasingly used, beside NIBP, for the assessment of central blood pressure and systemic arterial wall stiffness. Awareness of its limits and causes of error is all the more necessary. PMID:26641026
Pimentel, M A F; Santos, M D; Arteta, C; Domingos, J S; Maraci, M A; Clifford, G D
The presence of respiratory activity in the electrocardiogram (ECG), the pulse oximeter's photoplethysmo-graphic and continuous arterial blood pressure signals is a well-documented phenomenon. In this paper, we demonstrate that such information is also present in the oscillometric signal acquired from automatic non-invasive blood pressure monitors, and may be used to estimate the vital sign respiratory rate (RR). We propose a novel method that combines the information from the two respiratory-induced variations (frequency and amplitude) via frequency analysis to both estimate RR and eliminate estimations considered to be unreliable because of poor signal quality. The method was evaluated using data acquired from 40 subjects containing ECG, respiration and blood pressure waveforms, the latter acquired using an in-house built blood pressure device that is able to connect to a mobile phone. Results demonstrated a good RR estimation accuracy of our method when compared to the reference values extracted from the reference respiration waveforms (mean absolute error of 2.69 breaths/min), which is comparable to existing methods in the literature that extract RR from other physiological signals. The proposed method has been implemented in Java on the Android device for use in an mHealth platform. PMID:25570824
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. PMID:10980589
Riedel, W.; Mieke, S.; Seemann, R.; Ittermann, B.
A device was developed allowing to generate simulated human blood pressure signals for the purpose of testing the performance of automated noninvasive sphygmomanometers. The apparatus reproducibly generates blood-pressure oscillations synthesized from prerecorded measurements on human subjects. These real-life data allow for a much better evaluation of the accuracy of blood-pressure measurements than the existing simulators using artificial and thus less realistic waveforms. To assess the performance of a given sphygmomanometer under both stable and varying conditions, generated signals can be repeated in their original shape or distorted by well-defined artifacts. In comparison to clinical tests, the procedural influences on the performance testing of sphygmomanometers are largely reduced when the simulator is used.
Background White matter hyperintensities may contribute to depression by disrupting neural connections among brain regions that regulate mood. Orthostatic hypotension (OH) may be a risk factor for white matter hyperintensities and accumulating evidence, although limited suggests it may play a role in the development of late-life depression. The aim of this study was to examine the relationship between an oscillometric measure of orthostatic hypotension and depression in population based sample of older adults. Methods We analysed data on adults aged 60 and over from the first wave of The Irish Longitudinal Study on Ageing (TILDA). Depression was assessed using the Center for Epidemiologic Studies – Depression (CES–D) scale and OH was assessed by a sit-to-stand orthostatic stress test; two seated blood pressure measurements were followed by a single standing blood pressure measurement. Participants self reported whether they felt dizzy, light-headed or unsteady on standing. Results Participants with symptomatic OH (SOH, n=20) had the highest mean CES-D score (mean 8.6, SE 1.6) when compared to participants with asymptomatic OH (AOH) (mean 5.6, SE .48) and participants with no OH (mean 5.2, SE .14) and this difference was significant for both comparisons (p<0.001). Linear regression analysis adjusted for socio-demographic and clinical characteristics showed that SOH was associated with higher CES-D scores (unstandardised B coefficient = 2.24; 95% CI .301 - 4.79; p =0.05) compared to participants without OH. AOH was not associated with higher CES-D scores (unstandardised B coefficient =.162; 95% CI -.681, 1.00; p= 0.70). Conclusions Symptomatic orthostatic hypotension is associated with depression in older adults and needs to be considered in studies examining the relationship between vascular disease and depression in older adults. PMID:24138959
Urbina, Elaine M; Khoury, Philip R; McCoy, Connie E; Daniels, Stephen R; Dolan, Lawrence M; Kimball, Thomas R
Objective Hypertension (HT) is an important risk factor for target organ damage (TOD). New methods for measuring BP are replacing mercury sphygmomanometry in many clinics. We examined the utility of different BP measurement techniques in predicting subclinical TOD in adolescents and young adults. Methods Subjects in a study of the CV effects of obesity and type 2 diabetes (T2DM) were evaluated (N=677, 18 ± 3.3 years, 35% male, 60% non-Caucasian, 30% T2DM). We measured adiposity, lab, left ventricular mass, carotid intima-media thickness & pulse wave. BP was measured 3 times with mercury sphygmomanometery (BPm) an oscillometric device (BPo) and central aortic BP (BPc) was derived with arterial tonometry. Subjects were stratified as normotensive (N), pre-hypertensive (P) or hypertensive (H). Results The prevalence of HT this cohort with mean BMI of 31 was highest with BPo (16%), followed by BPm (11%) and BPc (9%), p≤0.001. BPm was most consistent in differentiating left ventricular mass and pulse wave velocity among subjects in the P group as compared to the N & H groups. Mercury BP was also more sensitive and specific in predicting greater left ventricular mass, pulse wave velocity and carotid thickness than the other BP measurement techniques in logistic regression. Conclusions We conclude that mercury sphygmomanometry should remain the gold standard for evaluation of HT and the risk for TOD in adolescents and young adults. PMID:25647284
Verberk, Willem J.; Cheng, Hao-min; Huang, Li-Chih; Lin, Chia-Ming; Teng, Yao-Pin; Chen, Chen-Huan
Accumulating evidence indicates that central blood pressure (CBP) is a better cardiovascular risk predictor than brachial blood pressure (BP). Although more additional benefits of CBP-based treatment above usual hypertension treatment are to be demonstrated, the demand for implementing CBP assessment in general clinical practice is increasing. For this, the measurement procedure must be noninvasive, easy to perform, and cost- and time-efficient. Therefore, oscillometric devices with the possibility to assess CBP seem the best option. Recently, such an oscillometric BP monitor, the Microlife WatchBP Office Central, was developed, which demonstrated its high accuracy in a validation study against invasive BP measurement. Calibration errors of this device are limited because the procedure is automated, standardized, and performed at the same place of and within 30 s from pulse wave assessment. The transformation from the peripheral pulse wave to CBP is done by means of an individual-based pulse wave analysis according to a theory of arterial compliance and wave reflections. In addition, the device has demonstrated to enable a more reliable diagnosis of hypertension by CBP than by peripheral BP, with a lower frequency of over- and underdiagnosis. Altogether, the available clinical evidence suggests that the Microlife WatchBP Office Central fulfills the criteria for general clinical use. PMID:27195242
Verberk, Willem J; Cheng, Hao-Min; Huang, Li-Chih; Lin, Chia-Ming; Teng, Yao-Pin; Chen, Chen-Huan
Accumulating evidence indicates that central blood pressure (CBP) is a better cardiovascular risk predictor than brachial blood pressure (BP). Although more additional benefits of CBP-based treatment above usual hypertension treatment are to be demonstrated, the demand for implementing CBP assessment in general clinical practice is increasing. For this, the measurement procedure must be noninvasive, easy to perform, and cost- and time-efficient. Therefore, oscillometric devices with the possibility to assess CBP seem the best option. Recently, such an oscillometric BP monitor, the Microlife WatchBP Office Central, was developed, which demonstrated its high accuracy in a validation study against invasive BP measurement. Calibration errors of this device are limited because the procedure is automated, standardized, and performed at the same place of and within 30 s from pulse wave assessment. The transformation from the peripheral pulse wave to CBP is done by means of an individual-based pulse wave analysis according to a theory of arterial compliance and wave reflections. In addition, the device has demonstrated to enable a more reliable diagnosis of hypertension by CBP than by peripheral BP, with a lower frequency of over- and underdiagnosis. Altogether, the available clinical evidence suggests that the Microlife WatchBP Office Central fulfills the criteria for general clinical use. PMID:27195242
Neuhauser, Hannelore K; Ellert, Ute; Thamm, Michael; Adler, Carolin
Oscillometric blood pressure (BP) measurement devices are increasingly replacing standard mercury sphygmomanometers and generalizability of validation studies to other environments, for example, national survey environments, is assumed. We compared BP measurements according to two highly standardized German national survey BP protocols: a standard mercury sphygmomanometer and an oscillometric device, Datascope Accutorr Plus, each with specific manufacturer-provided cuffs and cuff-selection rules. A sample of 105 adults were subjected to alternate same-arm BP measurements according to the principles of the International Protocol revision 2010 for the validation of BP-measuring devices in adults of the European Society of Hypertension. In all, 315 BP measurement pairs were obtained. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher by the standard mercury old protocol and increased with BP, age, and pulse pressure, and were associated with the ratios of the cuff width to the arm circumference. The mean systolic difference (datascope new protocol-standard mercury old protocol) in participants with old protocol: for SBP<120 was -3.5 ± 4.9 mmHg (n=162), for SBP 120-139 (n=108) was -6.4 ± 5.8 mmHg, and for SBP ≥ 140 (n=45) was -11.9 ± 7.2 mmHg. For DBP<80/80-89/≥ 90 in 230/67/18 participants, the differences were -1.9 ± 5.0/-6.8 ± 5.9/-7.6 ± 5.2 mmHg. A calibration formula for SBP derived from linear regression modeling includes SBP, sex, age, pulse pressure, and the difference in the cuff-width to arm-circumference ratios for the two devices (for DBP without age). Our study suggests that even in a highly standardized national survey environment, reported agreement from validation studies may not be replicable and comparisons in the specific clinical or research setting can be useful before replacing the mercury device completely. PMID:25144600
Jazbinsek, Vojko; Luznik, Janko; Mieke, Stephan; Trontelj, Zvonko
Most non-invasive blood pressure measurements are based on either the auscultatory or the oscillometric technique. In this study, we performed an extensive analysis of the signals, i.e., responses of a microphone implanted in the cuff and pressure changes in the cuff, which can be recorded during such measurements. We applied several methods to separate the cuff deflation from the arterial pressure pulses, as well as to separate the microphone data into an audible part (Korotkoff sounds) and a low frequency part. The oscillometric technique is based on some empirically derived criteria applied to the oscillometric index, which is defined as a certain characteristic physical property of pressure pulses. In addition to the pressure pulses, which are a typical physical property used for the oscillometric index, we also used in this study other properties such as a time derivative and an audible part of data measured by a microphone implanted in the cuff (Korotkoff sounds). We performed a case study of 23 healthy subjects to evaluate the influence of different presentations of the oscillometric index on known height-based and slope-based empirical algorithms for the automatic determination of the systolic and diastolic blood pressures. PMID:19953320
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
Jagomägi, K; Raamat, R; Talts, J; Ragun, U; Tähepõld, P
The Vasotrac monitor provides non-invasive near-continuous blood pressure monitoring and is designed to be an alternative to direct intra-arterial blood pressure (BP) measurement. As compared to radial artery invasive BP and upper arm non-invasive BP, Vasotrac readings have been found to have a good agreement with them. However, discrepancies have been reported when rapid changes in BP exist. In the present study we compared BP measured by the Vasotrac monitor on the radial artery with that recorded on the finger arteries by the differential oscillometric device allowing measurement on the beat-to-beat basis. Comparisons were performed on the mean arterial pressure (MAP) level. Special attention was paid to the signal conditioning before comparison of pressures of different temporal resolution. Altogether 383 paired MAP measurements were made in 14 healthy subjects. Based on all 383 paired measurements, the MAP values measured at the radial artery at rest were 4.8+/-6.0 mm Hg higher than those measured on fingers. The observed difference between the Vasotrac and differential oscillometric device can be explained by different measurement sites. This result is consistent with previous investigations, and the Vasotrac monitor can be considered to adequately track relatively rapid MAP changes on the radial artery. Attention should be paid to a proper signal conditioning before comparison of results obtained by different devices. PMID:20406039
Imai, Y; Sasaki, S; Minami, N; Munakata, M; Hashimoto, J; Sakuma, H; Sakuma, M; Watanabe, N; Imai, K; Sekino, H
The accuracy and performance of the A&D TM 2421, a new ambulatory blood pressure (BP) monitoring device using both the cuff-oscillometric method (O) and the Korotkoff sound method (K) were evaluated. The device was tested for accuracy under static and dynamic conditions by simultaneous comparison with two observers using a standard mercury column sphygmomanometer (standard method) and by the objective recording method (ORM). The performance of the device was also evaluated under ordinary ambulatory conditions. The mean differences in BP of standard method from K-method were -1.2 +/- 4.7 mm Hg systole and 1.3 +/- 4.7 mm Hg diastole (n = 323, mean +/- SD) and those of standard method from O-method were -0.4 +/- 5.3 mm Hg systole and 1.4 +/- 5.1 mm Hg diastole (n = 323). The agreement between each of the two methods of the device and the standard method was within 10 mm Hg for more than 90% of both systolic and diastolic readings. During bicycle exercise, the mean differences in BP of standard method from K-method were -3.4 +/- 4.8 mm Hg systole and 1.8 +/- 5.2 mm Hg diastole (n = 71) and those of standard method from O-method were -1.1 +/- 7.3 mm Hg systole and 1.7 +/- 7.8 mm Hg diastole (n = 67). There was a greater scatter in the individual comparisons of the device and the standard method during exercise, especially in diastolic BP. The relation between the device and ORM was almost similar to that between the device and the standard method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1418835
Gelido, G.; Angiletta, S.; Pujalte, A.; Quiroga, P.; Cornes, P.; Craiem, D.
Measurement of peripheral arterial pressure using the oscillometric method is commonly used by professionals as well as by patients in their homes. This non invasive automatic method is fast, efficient and the required equipment is affordable with a low cost. The measurement method consists of obtaining parameters from a calibrated decreasing curve that is modulated by heart beats witch appear when arterial pressure reaches the cuff pressure. Diastolic, mean and systolic pressures are obtained calculating particular instants from the heart beats envelope curve. In this article we analyze the envelope of this amplified curve to find out if its morphology is related to arterial stiffness in patients. We found, in 33 volunteers, that the envelope waveform width correlates to systolic pressure (r=0.4, p<0.05), to pulse pressure (r=0.6, p<0.05) and to pulse pressure normalized to systolic pressure (r=0.6, p<0.05). We believe that the morphology of the heart beats envelope curve obtained with the oscillometric method for peripheral pressure measurement depends on arterial stiffness and can be used to enhance pressure measurements.
Normal blood pressure is important for proper blood flow to the body’s organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both ...
Normal blood pressure is important for proper blood flow to the body’s organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart ...
Gu, Liangling; Yang, Yongming; Yu, Chengbo; Guo, Qiaohui; Zhu, Gang
Blood pressure reflects a person's health.It is proposed here that the method of detecting blood pressure may be the key to improving the precision of blood pressure measurements. The oscillometric blood pressure measurement technique is widely used in automatic blood pressure measurement instruments correctly. A method of blood pressure measurement by oscillometric method is first presented. In the oscillometric method, the basic principle of the "feature point" method and the "amplitude characteristic ratios" method is also explained and discussed here. A new method of blood pressure measurement, namely the coefficient difference comparative method, is proposed here,which is based on the feature point method and amplitude characteristic ratios method. The method is proved both effective and reliable through the analysis of many cases and clinical tests. Utilizing Visual C++, software for this new and novel method was developed and passed criterion simulation apparatus test. When applied in hospital situation, its error was +/-5%. It is concluded that the oscillometric blood pressure measurement method can provide better means of blood pressure measurements reference for doctors.
Hasan, M A; Thomas, T A; Prys-Roberts, C
We have compared two non-invasive methods of arterial pressure (AP) measurement used in labour wards: an automatic oscillometric measurement obtained by Dinamap 1846, and a conventional auscultatory measurement obtained by midwives. A total of 369 AP measurements were recorded, involving 28 normotensive and hypertensive pregnant women during labour, with or without extradural analgesia. Compared with the midwife group, the Dinamap group had a greater systolic AP, by 2.7 mm Hg (P < 0.01) and smaller diastolic AP, by 9.8 mm Hg (P < 0.01). The correlations between the two methods were highly significant, but the limits of agreement were relatively wide for both systolic and diastolic AP measurements. We conclude that a clinically important difference exists in diastolic AP measurements. Dinamap diastolic AP must be corrected using a regression equation, or simply by adding 10 mm Hg, before being compared with the available normal and hypertensive AP values. PMID:8435255
... version High Blood Pressure Overview What is blood pressure? Blood pressure is the amount of force that your ... called your blood pressure. What is high blood pressure? High blood pressure (also called hypertension) occurs when your blood ...
Soueidan, Karen; Chen, Silu; Dajani, Hilmi R; Bolic, Miodrag; Groza, Voicu
Current noninvasive blood pressure (BP) measurement methods, such as the oscillometric method, estimate the systolic and diastolic blood pressure (SBP and DBP) at two random instants in time and do not take into account the natural variability in BP. The standard for automated BP devices sets a maximum allowable system error of ±5 mmHg, even though natural BP variability often exceeds these limits. This paper proposes a new approach using simultaneous recordings of the oscillometric and continuous arterial pulse waveforms to augment the conventional noninvasive measurement by providing (1) the mean SBP and DBP over the measurement interval and the associated confidence intervals of the mean, (2) the standard deviation of SBP and DBP over the measurement interval, which indicates the degree of fluctuation in BP and (3) an indicator as to whether or not the oscillometric reading is an outlier. Recordings with healthy subjects demonstrate the potential utility of this approach to characterize BP, to detect outlier measurements, and that it does not suffer from bias relative to the conventional oscillometric method. PMID:22551623
Vega, Jorge; Romaní, Sebastián; Garcipérez, Francisco J; Vicente, Lucia; Pacheco, Nazaret; Zamorano, José; Gómez-Barrado, José J; Sánchez Muñoz-Torrero, Juan F
Relatively little is known on how the Doppler method compares with oscillometric measurement using a conventional automatic blood pressure device to determine the ankle-brachial index, when determinations are performed by physicians with little experience. To assess the diagnostic efficacy of both methods in this professional group, we calculated their sensitivity, specificity, and positive and negative predictive value in 158 legs of 85 patients with symptoms of intermittent claudication. Angiography was used as the gold standard. Of the legs examined, 131 showed significant arterial obstruction. The oscillometric method showed 97% sensitivity, 89% specificity, 98% positive predictive value, and 86% negative predictive value. The Doppler method showed 95% sensitivity, 56% specificity, 91% positive predictive value, and 68% negative predictive value. This study suggests that the automatic blood pressure equipment has greater diagnostic accuracy when the test is performed by physicians not specifically trained to use the Doppler probe. Full English text available from: www.revespcardiol.org. PMID:21435772
Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... your health care provider will wrap the blood pressure cuff snugly around your upper arm. The lower ...
Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The ...
Gains, M J; Grodecki, K M; Jacobs, R M; Dyson, D; Foster, R A
The precision and accuracy of an indirect oscillometric blood pressure measurement technique (Dinamap 8100) was assessed in 11 anesthetized Beagle dogs weighing 8 to 11.5 kg. Direct blood pressure measurements were made by catheterization of the lingual artery, and simultaneous indirect measurements were determined by placing a cuff over the median artery (midradial area). Blood pressure measurements at 2 different planes of anesthesia (light and deep) were recorded in triplicate. At a light plane of anesthesia, the Dinamap 8100 underestimated diastolic and mean arterial pressure, and at a deep anesthetic plane overestimated systolic pressure. The indirect technique had good repeatability of systolic pressures. Regression analysis for the 2 techniques showed excellent correlation (r = 0.93). The results indicate that the indirect oscillometric blood pressure measurement technique provides a good estimate of systolic, diastolic, and mean arterial pressure in dogs weighing 8-11.5 kg. PMID:8521360
... Pressure Tools & Resources Stroke More Understanding Blood Pressure Readings Updated:Aug 17,2016 Blood pressure is typically ... Your doctor should evaluate unusually low blood pressure readings. How is high blood pressure diagnosed? Your healthcare ...
Doh, Il; Lim, Hyun Kyoon; Ahn, Bongyoung
This research aimed to develop a simulator capable of oscillometric pressure pulses recorded from the participants for the validation of oscillometric noninvasive blood pressure (NIBP) devices. The simulator generates the pressure pulses to the cuff connected to NIBP devices depending on the oscillometric waveforms obtained from the participants. Device readings were compared with auscultatory references (systolic and diastolic blood pressures) of the participants. A total of 94 oscillometric waveforms from participants were used in the simulator for the validation of two automated NIBP devices (Omron HEM-7221 and UA-787Plus). For Omron HEM-7221, the differences between device readings and auscultation references for systolic and diastolic blood pressures were 2.82±7.27 and -4.74±6.73 mmHg, respectively. UA-787Plus showed differences of 3.26±5.69 and -3.53±6.61 mmHg, respectively. Although the number of individual measurements did not fulfill the ISO 81060-2 requirement for clinical validation, criterion 1, where the average of the difference and SD should be lower than ±5 and -8 mmHg, was fulfilled. Although the simulator still needs extensive comparative studies to be verified, it could be a potential candidate for a simple and robust tool for the validation and quality control of NIBP devices. PMID:26745850
... High Blood Pressure Tools & Resources Stroke More Low Blood Pressure Updated:Aug 30,2016 To know if you ... to learn more about blood pressure . If my blood pressure stays around 85/55, do I have a ...
Porter, K B; O'Brien, W F; Kiefert, V; Knuppel, R A
Often, obstetric patients are not evaluated in preliminary studies during the development of new medical devices. The purpose of this study was to compare the Finapres digital probe with oscillometric and arterial line devices for recording blood pressures in low- and high-risk pregnant women. A total of 38 women were studied, including 24 with pregnancy-induced hypertension, two with chronic hypertension, two with cardiac disease, and ten who had no risk factors but requested epidural catheter placement. The comparison of Finapres or oscillometric recordings with direct arterial values confirmed that systolic recordings were imprecise for both devices (r = 0.80 and r = 0.64, respectively). Diastolic recordings (Korotkoff sound, phase 4) from the Finapres were accurate compared with the arterial values (r = 0.84). The Finapres performed at least as reliably as the oscillometric monitor in assessing blood pressure in our pregnant population and provided continuous measurements. When very accurate systolic recordings are needed, arterial catheter placement may be necessary. PMID:1876379
Bachmann, K; Wortmann, A; Engels, G
Indirect arterial blood pressure measurement has not changed substantially since its introduction by Riva-Rocci in 1986, Korotkoff in 1905 and Recklinghausen in 1906. Random measurements in the clinic or practice reflect only incompletely the dynamic nature of the blood pressure. Blood pressure recordings by patients themselves have provided more information through better temporal resolution, however, exact characterization of the pressure response throughout the entire day and, in particular, during physical exertion are not enabled; the latter are especially important with regard to diagnosis and treatment of hypertension. In 1966, therefore, radiotelemetric transmission of direct, continuously-measured arterial blood pressure was developed which enabled beat-to-beat registration of blood pressure, outside the laboratory, during normal daily life and sport activities. The initial results showed a marked variability of the blood pressure during the course of the day (Figure 1). Excessive blood pressure increases were observed during exposure to cold, static and dynamic exercise and to a lesser degree during automobile driving and exposure to heat (Figure 3). Recording of the pressure curves via transmission by radiotelemetry shows a high degree of accuracy and temporal resolution, spatial and situational freedom but is invasive and costly in terms of personnel. The same holds true for direct continuous blood pressure registration and storage on a portable tape recorder. Portable, automatic blood pressure measuring units for ambulatory monitoring employ indirect auscultatory or oscillometric recording with a cuff. As compared with the radiotelemetric direct continuous blood pressure measuring method, the indirect method has subordinate temporal resolution, that is, the measurements are only intermittent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2676813
Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...
Hypertension - infants ... and blood vessels The health of the kidneys High blood pressure in infants may be due to kidney or ... Bronchopulmonary dysplasia Renal artery stenosis In newborn babies, high blood pressure is often caused by a blood clot in ...
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics . ...
... 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 ...
... this page: //medlineplus.gov/ency/article/000468.htm High blood pressure To use the sharing features on ... body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as ...
... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...
Song, Han Wook; Lee, SungJun; Park, Yon Kyu; Choi, In Mook; Woo, Sam Yong
Blood pressure is defined as the amount of force at unit area which the blood exerts on a wall of a blood vessel. The BP has a clinical importance as the basic index in the medical examination of patients. Especially, the percentage of the hypertensive is more than 15% in an adult population of Korea and hypertension is notorious as 'a silent killer' because it has no prior symptoms. The most important thing in the diagnosis, treatment and prognosis of hypertension is the accurate measurement of the BP. In this study, we developed the blood pressure simulator for the monitoring of oscillometric BP devices and compared this KRISS simulator with commercial simulators. Finally, we tested the commercial oscillometric BP devices (6 models from 5 manufacturers) using the KRISS simulator. The KRISS simulator has the repeatability error below 0.1% for the pressure generation and we expected to develop the BP simulator for Korean by the collection of clinical data from Koreans. PMID:19163409
... page from the NHLBI on Twitter. Description of High Blood Pressure Español High blood pressure is a common disease ... defines high blood pressure severity levels. Stages of High Blood Pressure in Adults Stages Systolic (top number) Diastolic (bottom ...
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Hypotension; Blood pressure - low; Postprandial hypotension; Orthostatic hypotension; Neurally mediated hypotension; NMH ... Blood pressure varies from one person to another. A drop as little as 20 mmHg, can cause problems for ...
High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, heart failure, ... failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight and ...
... pressure to live. Without it, blood can't flow through our bodies and carry oxygen to our vital organs. But when blood pressure gets too high — a condition called hypertension — it can lead to ...
Hypotension; Blood pressure - low; Postprandial hypotension; Orthostatic hypotension; Neurally mediated hypotension; NMH ... Blood pressure varies from one person to another. A drop as little as 20 mmHg, can cause ...
... blood pressure with the development of a practical method to measure it. Physicians began to note associations between hypertension and risk of heart failure, stroke, and kidney failure. Although scientists had yet to prove that lowering blood pressure ...
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... more often referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated ... flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope ...
Woo, Sung Hun; Choi, Yun Young; Kim, Dae Jung; Bien, Franklin; Kim, Jae Joon
Accurate continuous direct measurement of the blood pressure is currently available thru direct invasive methods via intravascular needles, and is mostly limited to use during surgical procedures or in the intensive care unit (ICU). Non-invasive methods that are mostly based on auscultation or cuff oscillometric principles do provide relatively accurate measurement of blood pressure. However, they mostly involve physical inconveniences such as pressure or stress on the human body. Here, we introduce a new non-invasive mechanism of tissue-informative measurement, where an experimental phenomenon called subcutaneous tissue pressure equilibrium is revealed and related for application in detection of absolute blood pressure. A prototype was experimentally verified to provide an absolute blood pressure measurement by wearing a watch-type measurement module that does not cause any discomfort. This work is supposed to contribute remarkably to the advancement of continuous non-invasive mobile devices for 24-7 daily-life ambulatory blood-pressure monitoring. PMID:25331013
Woo, Sung Hun; Choi, Yun Young; Kim, Dae Jung; Bien, Franklin; Kim, Jae Joon
Accurate continuous direct measurement of the blood pressure is currently available thru direct invasive methods via intravascular needles, and is mostly limited to use during surgical procedures or in the intensive care unit (ICU). Non-invasive methods that are mostly based on auscultation or cuff oscillometric principles do provide relatively accurate measurement of blood pressure. However, they mostly involve physical inconveniences such as pressure or stress on the human body. Here, we introduce a new non-invasive mechanism of tissue-informative measurement, where an experimental phenomenon called subcutaneous tissue pressure equilibrium is revealed and related for application in detection of absolute blood pressure. A prototype was experimentally verified to provide an absolute blood pressure measurement by wearing a watch-type measurement module that does not cause any discomfort. This work is supposed to contribute remarkably to the advancement of continuous non-invasive mobile devices for 24-7 daily-life ambulatory blood-pressure monitoring.
Engineering Development Laboratory developed a system for the cardiovascular study of weightless astronauts. This was designed to aid people with congestive heart failure and diabetes. While in space, astronauts' blood pressure rises, heart rate becomes unstable, and there are sometimes postflight lightheadedness or blackouts. The Baro-Cuff studies the resetting of blood pressure. When a silicone rubber chamber is strapped to the neck, the Baro-Cuff stimulates the carotid arteries by electronically controlled pressure application. Blood pressure controls in patients may be studied.
Cuce, Antonino; Di Guardo, Mario; Sicurella, Gaetano
In this paper, an intelligent system for blood pressure measurement is posed together with a possible implementation using an eight bit fuzzy processor. The system can automatically determine the ideal cuff inflation level eliminating the discomfort and misreading caused by incorrect cuff inflation. Using statistics distribution of the systolic and diastolic blood pressure, in the inflation phase, a fuzzy rule system determine the pressure levels at which checking the presence of heart beat in order to exceed the systolic pressure with the minimum gap. The heart beats, characterized through pressure variations, are recognized by a fuzzy classifier.
An estimated 30 million people in the United States have high blood pressure, or hypertension. But a great many of them are unaware of it because hypertension, in its initial stages, displays no symptoms. Thus, the simply-operated blood pressure checking devices now widely located in public places are useful health aids. The one pictured above, called -Medimax 30, is a direct spinoff from NASA technology developed to monitor astronauts in space. For manned space flights, NASA wanted a compact, highly-reliable, extremely accurate method of checking astronauts' blood pressure without the need for a physician's interpretive skill. NASA's Johnson Space Center and Technology, Inc., a contractor, developed an electronic sound processor that automatically analyzes blood flow sounds to get both systolic (contracting arteries) and diastolic (expanding arteries) blood pressure measurements. NASA granted a patent license for this technology to Advanced Life Sciences, Inc., New York City, manufacturers of Medimax 30.
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... on its own. The screen will show a digital readout of your systolic and diastolic blood pressure. After showing your blood pressure, the cuff will deflate on its own. ... again. A digital blood pressure monitor will not be as accurate ...
... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...
The Vital-2 unit pictured is a semi-automatic device that permits highly accurate blood pressure measurement, even by untrained personnel. Developed by Meditron Instrument Corporation, Milford, New Hampshire, it is based in part on NASA technology found in a similar system designed for automatic monitoring of astronauts' blood pressure. Vital-2 is an advancement over the familiar arm cuff, dial and bulb apparatus customarily used for blood pressure checks. In that method, the physician squeezes the bulb to inflate the arm cuff, which restricts the flow of blood through the arteries. As he eases the pressure on the arm, he listens, through a stethoscope, to the sounds of resumed blood flow as the arteries expand and contract. Taking dial readings related to sound changes, he gets the systolic (contracting) and diastolic (expanding) blood pressure measurements. The accuracy of the method depends on the physician's skill in interpreting the sounds. Hospitals sometimes employ a more accurate procedure, but it is "invasive," involving insertion of a catheter in the artery.
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White, W B; Lund-Johansen, P; McCabe, E J
The Colin ABPM 630 is a silent, gas-powered (CO2) ambulatory blood pressure monitor which uses both ausculatory and/or oscillometric methods to measure blood pressure. We compared simultaneous, same-arm blood pressures obtained with the monitor with those made by two blinded, skilled clinicians using a mercury column and teaching stethoscope. In a second study, the monitor readings were also compared with opposite-arm intra-arterial recordings of blood pressure. The group mean systolic blood pressures obtained by the Colin monitor via the Korotkoff mode were almost identical to the mercury column readings (127.8 +/- 19.4 versus 128.1 +/- 19.3 mmHg, P = NS) and the limit of agreement (2 standard deviations) for the differences in the two methods was +/- 9 mmHg. The diastolic blood pressure obtained by the Colin monitor was significantly lower than the clinician's readings (-6.0 +/- 5.9 mmHg, P less than 0.0001). Similar findings were obtained with the oscillometric mode, however, the mean systolic blood pressure given by the monitor was slightly higher than that given by the mercury column (1.9 +/- 4.5 mmHg, P less than 0.001). In contrast to the mercury column comparisons, the mean diastolic blood pressure obtained with the monitor was nearly the same as the mean intra-arterial diastolic blood pressure for both the Korotkoff (0.1 +/- 5.6 mmHg) and the oscillometric modes (1.2 +/- 6.3 mmHg). During 100-watt bicycle exercise, there was a considerably greater scatter in the individual comparisons of the monitor and intra-arterial blood pressure than that seen in the measurements at rest, but the group means were again similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2778314
Barthélémy, J C; Geyssant, A; Auboyer, C; Antoniadis, A; Berruyer, J; Lacour, J R
This study was designed to discriminate, according to their accuracy, between three ambulatory pressurometers (Diasys 200R, Novacor; P IV, Del Mar Avionics; SpaceLab 90202, SpaceLab). The evaluation was performed against invasive arterial reference measurements. Accuracy was assessed by calculating the error on pressure (EOP) as the difference between invasive and non-invasive measurement of arterial blood pressure. For the systolic values, accuracy (mean of EOP differences) and uncertainty (SD of these differences) were -0.9 +/- 9.7, -4.3 +/- 10.1 and -16.7 +/- 10.1 mmHg for, respectively, Diasys, PIV and SpaceLab. For diastolic values, they were, respectively, 5.9 +/- 6.7, 6.8 +/- 8.5 and 9.1 +/- 6.6 mmHg. EOP was then separated in two different types of errors: (i) the error of dispersion appreciated by the index of homogeneity calculated by a Lehmann analysis and leading to a statistical classification (ii) the error due to the drift of EOP with the reference value, this last error being easier to correct. Two different behaviours were observed for the EOP: (i) the drift of EOP of systolic values was significantly larger for the oscillometric (SpaceLab) than for the auscultatory (Diasys and P IV) method, with no difference between Diasys and P IV (ii) the homogeneity index was not statistically different among these three devices. These data suggest that, in case the correction of the drift of EOP is carried out, there is no statistical significant difference in accuracy between these three pressurometers. However, in our experimental conditions, the two ambulatory pressurometers recording the Korotkoff sounds have a better accuracy than the one using the oscillometric approach. PMID:1947731
McGrath, Barry P
Summary 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. Home monitoring has good reproducibility, is well tolerated and relatively inexpensive. It is superior to blood pressure taken in the clinic in predicting cardiovascular events and mortality. Twice-daily measurements are recommended, usually in the morning and evening for a minimum of five days. The threshold for defining hypertension is an average home blood pressure of 135/85 mmHg or above. Patients are engaged with their management when they monitor their own blood pressure. This results in increased adherence to therapy and lower blood pressure. PMID:26648605
Engineering Development Lab., Inc.'s E-2000 Neck Baro Reflex System was developed for cardiovascular studies of astronauts. It is regularly used on Space Shuttle Missions, and a parallel version has been developed as a research tool to facilitate studies of blood pressure reflex controls in patients with congestive heart failure, diabetes, etc. An advanced version, the PPC-1000, was developed in 1991, and the technology has been refined substantially. The PPC provides an accurate means of generating pressure for a broad array of laboratory applications. An improved version, the E2010 Barosystem, is anticipated.
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.
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Your blood pressure can be measured at many places, including: Home Your doctor's office Your local fire station Some pharmacies Your doctor may ask you to keep track of your blood pressure at home. Make ...
... above. Confirming High Blood Pressure A blood pressure test is easy and painless and can be done ... provider’s office or clinic. To prepare for the test: Don’t drink coffee or smoke cigarettes for ...
... 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 ...
Altintas, Ersin; Takoh, Kimiyasu; Ohno, Yuji; Abe, Katsumi; Akagawa, Takeshi; Ariyama, Tetsuri; Kubo, Masahiro; Tsuda, Kenichiro; Tochikubo, Osamu
We propose a highly wearable, upper-arm type, oscillometric-based blood pressure monitoring technology with low-stress. The low-stress is realized by new developments in the hardware and software design. In the hardware design, conventional armband; cuff, is almost halved in volume thanks to a flexible plastic core and a liquid bag which enhances the fitness and pressure uniformity over the arm. Reduced air bag volume enables smaller motor pump size and battery leading to a thinner, more compact and more wearable unified device. In the software design, a new prediction algorithm enabled to apply less stress (and less pain) on arm of the patient. Proof-of-concept experiments on volunteers show a high accuracy on both technologies. This paper mainly introduces hardware developments. The system is promising for less-painful and less-stressful 24-hour blood pressure monitoring in hypertension managements and related healthcare solutions. PMID:26737405
Both monotherapy and combination therapy options are appropriate for antihypertensive therapy according to the 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines. Most patients require more than one agent to achieve blood pressure (BP) control, and adding a second agent is more effective than doubling the dose of existing therapy. The addition of a third agent may be required to achieve adequate BP reductions in some patients. Single-pill fixed-dose combinations (FDCs) allow multiple-drug regimens to be delivered without any negative impact on patient compliance or persistence with therapy. FDCs also have documented beneficial clinical effects and use of FDCs containing two or three agents is recommended by the 2013 ESH/ESC guidelines. PMID:26002423
... the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... can increase your risk for developing high blood pressure. Age Blood pressure tends to rise with age. About 65 ...
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 ...
... MANUAL BLOOD PRESSURE MONITORS Manual devices include a cuff that wraps around your arm, a rubber squeeze ... needle moves around and the pressure in the cuff rises or falls. When used correctly, manual devices ...
Chamontin, B; Amar, J; Chollet, F; Rouge, P; Bonetti-d'Esteve, L; Guittard, J; Salvador, M
Blood pressure (BP) elevations may correspond to different clinical situations. Hypertensives emergencies are situations that require immediate reduction in BP because of acute or rapidly progressing target organ damage: accelerated malignant hypertension, hypertensive encephalopathy, acute myocardial infarction, acute aortic dissection, acute left ventricular failure, and eclampsia. Hypertensive urgencies are those with marked elevated BP in which it is desirable to reduce BP progressively within few hours, such as severe hypertension, progressive target organ damage, perioperative hypertension. Cerebrovascular accidents have to be individualized. In most patients in the immediate post-stroke period, BP should not be lowered. Caution is advised in lowering BP in these patients because excessive falls may precipitate cerebral ischemia. In situations without symptoms or progressive target organ it is necessary to exclude proximate causes of elevated BP such as pain and elevated BP alone rarely requires antihypertensive treatment. Among parenteral antihypertensive (AH) drugs labetalol, nicardipine, urapidil, and nitroprussiate are generally used, and the choice of AH drug depends on the clinical situation. It is not required to normalize BP immediately but to reduce mean BP no more than 25%, then toward 160/100 mmHg as recommended by JNC VI, in order to avoid an impairment of renal, cerebral or coronary ischemia. Oral long-acting dihydropyridines are often subsequently administrated, except in myocardial ischemia. Therapeutic attitudes vary considerably according to the clinical situation: abstention, immediate decrease or progressive decrease in BP have to be decided. PMID:11190294
Myers, Martin G; Godwin, Marshall
Manual blood pressure (BP) is gradually disappearing from clinical practice with the mercury sphygmomanometer now considered to be an environmental hazard. Manual BP is also subject to measurement error on the part of the physician/nurse and patient-related anxiety which can result in poor quality BP measurements and office-induced (white coat) hypertension. Automated office (AO) BP with devices such as the BpTRU (BpTRU Medical Devices, Coquitlam, BC) has already replaced conventional manual BP in many primary care practices in Canada and has also attracted interest in other countries where research studies using AOBP have been undertaken. The basic principles of AOBP include multiple readings taken with a fully automated recorder with the patient resting alone in a quiet room. When these principles are followed, office-induced hypertension is eliminated and AOBP exhibits a much stronger correlation with the awake ambulatory BP as compared with routine manual BP measurements. Unlike routine manual BP, AOBP correlates as well with left ventricular mass as does the awake ambulatory BP. AOBP also simplifies the definition of hypertension in that the cut point for a normal AOBP (< 135/85 mm Hg) is the same as for the awake ambulatory BP and home BP. This article summarizes the currently available evidence supporting the use of AOBP in routine clinical practice and proposes an algorithm in which AOBP replaces manual BP for the diagnosis and management of hypertension. PMID:22265230
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
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 ...
Mather, C M
One percent of children have appreciably and consistently raised arterial blood pressure. A 7-year-old girl admitted for routine tonsillectomy, had unrecognised hypertension which put her at increased risk. Should anaesthetic practice take more note of paediatric blood pressures? PMID:2035786
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 ...
Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.
Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J
Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance. PMID:15611362
Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.
Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J
Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance. PMID:15699287
Hypertensive retinopathy is damage to the retina from high blood pressure. The retina is the layer of tissue at ... High blood pressure can damage blood vessels in the retina. The higher the blood pressure and the longer it ...
Al-Jumaily, A M; Lan, H; Stergiopulos, N
Theoretically the auscultatory method using Korotkoff sounds is more related to the maximum artery closure status, while the oscillometric method is more related to the overall artery closure status under the cuff. Therefore, the latter is less accurate than the former. This work introduces a new method, which is more accurate than the oscillometric method and suitable for automatic devices. To monitor the maximum artery closure status, a piezoelectric film sensor is attached to the skin just above the brachial artery and under the central section of the cuff where maximum cuff pressure is transferred to the arm. Using the waveform features obtained by this sensor, measurement errors of 0.7±2.5 and 1.27±4.53 mmHg were obtained for the systolic and diastolic pressure, respectively. These reflect small deviations from auscultatory clinical data. PMID:23149078
Yates, F E; Benton, L A
We obtained multiple ambulatory blood pressure monitoring (ABPM) records over five years from two trained, normotensive subjects experienced in wearing the apparatus. The resulting time series data on systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were used to suggest optimal parameters for monitoring by two instruments (Colin Medical Instruments ABPM-630 and Del Mar Avionics Pressurometer) and to compare two indirect methods (auscultatory and oscillometric). A 10-min sampling interval day and night provided sufficient density of data to support spectral analysis for ultradian rhythms in the frequency range of one cycle per hour to one cycle per 9 h on a 24-h record. Rhythms with major periods of approximately 3, 6, and 9 h were variously found in 94 normotensive subjects, aged 20 to 95 years, including the two trained subjects. When the monitoring period was extended to 72 h, the circadian (approximately 24 h) rhythm could be more sharply defined, as well as a 12-h harmonic. In some studies the two trained subjects wore two monitors, one on each arm, set to read simultaneously. From the simultaneous measurements on both arms, it was shown that averaging across three points (30 min of record) reduced the coefficient of variation between the two simultaneous records to 6% or less. Auscultatory and oscillometric methods were equally reliable. Echocardiographic data were obtained in five normotensive subjects and compared to their ABPM data. The ABPM records provided additional information about cardiovascular function not merely duplicating that obtained by acute stress tests, such as exercise or cold pressor responses, or echocardiography. Standards for ABPM are suggested. PMID:2221507
Badeli, Hamidreza; Assadi, Farahnak
Errors in blood pressure (BP) measurement are common in the clinical practice. Inaccurate measurements of BP may lead to misdiagnosis and inappropriate treatment of hypertension. The preferred method of BP measurement in the clinical setting is auscultation, using the first and the fifth Korotkoff sounds. However, the use of mercury sphygmomanometer is declining. Automated oscillometric devices are an acceptable alternative method of BP measurements if the proper cuff size is used. Aneroid devices are suitable, but they require frequent calibration. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. At 24 h ambulatory monitoring is also useful for diagnosing white-coat hypertension and resistance hypertension. There is increasing evidence that lack of nocturnal BP dipping during the night may be associated with increased cardiovascular event. This report attempts to address the need for accurate BP measurements in children and adolescents by reducing human and equipment errors and providing clinicians with the accurate measurement of BP, which is essential to classify individuals, to ascertain BP-related CV risks and to guide management. PMID:24791186
Sukor, J Abdul; Redmond, S J; Chan, G S H; Lovell, N 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
... 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 ...
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... than 230 researchers across 6 continents scanned the genomes of over 200,000 European people to identify ... blood pressure. They followed up by analyzing the genomes of 70,000 people of East Indian, South ...
Hum, L.; Cole, C. E.
Design and performance of a blood pressure recording device for pediatric use are reported. A strain gage transducer with a copper-beryllium strip as force sensing element is used to monitor skin movements and to convert them into electrical signals proportional to those displacements. Experimental tests with this device in recording of force developed above the left femoral artery of a dog accurately produced a blood pressure curve.
Daskalopoulou, Stella S; Rabi, Doreen M; Zarnke, Kelly B; Dasgupta, Kaberi; Nerenberg, Kara; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; McKay, Donald W; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Ramesh Prasad, G V; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Brian Penner, S; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Stone, James A; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Fournier, Anne; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Benoit, Geneviève; Feber, Janusz; Harris, Kevin C; Poirier, Luc; Padwal, Raj S
The Canadian Hypertension Education Program reviews the hypertension literature annually and provides detailed recommendations regarding hypertension diagnosis, assessment, prevention, and treatment. This report provides the updated evidence-based recommendations for 2015. This year, 4 new recommendations were added and 2 existing recommendations were modified. A revised algorithm for the diagnosis of hypertension is presented. Two major changes are proposed: (1) measurement using validated electronic (oscillometric) upper arm devices is preferred over auscultation for accurate office blood pressure measurement; (2) if the visit 1 mean blood pressure is increased but < 180/110 mm Hg, out-of-office blood pressure measurements using ambulatory blood pressure monitoring (preferably) or home blood pressure monitoring should be performed before visit 2 to rule out white coat hypertension, for which pharmacologic treatment is not recommended. A standardized ambulatory blood pressure monitoring protocol and an update on automated office blood pressure are also presented. Several other recommendations on accurate measurement of blood pressure and criteria for diagnosis of hypertension have been reorganized. Two other new recommendations refer to smoking cessation: (1) tobacco use status should be updated regularly and advice to quit smoking should be provided; and (2) advice in combination with pharmacotherapy for smoking cessation should be offered to all smokers. The following recommendations were modified: (1) renal artery stenosis should be primarily managed medically; and (2) renal artery angioplasty and stenting could be considered for patients with renal artery stenosis and complicated, uncontrolled hypertension. The rationale for these recommendation changes is discussed. PMID:25936483
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Raamat, R; Jagomägi, K; Talts, J; Mäger, I
We investigated finger beat-to-beat blood pressure responses to a series of successive hand elevations in 14 normal volunteers. By passive elevation of the hand by 40 cm and lowering it again after a minute, calibrated hydrostatic pressure changes were induced in the finger arteries of the subjects. Three successive procedures with a 2-min interval between them were performed. Transitions between positions were completed smoothly over a 10-s period. Non-invasive beat-to-beat mean arterial pressure (MAP) in the finger arteries was measured by applying the servo-oscillometric physiograph (University of Tartu, Estonia). A good agreement between the evoked MAP changes during all the three hand elevations (-31.2, -30.4 and -30.0 mmHg, respectively) and the calculated hydrostatic pressure change (-31.0 mmHg) was obtained. The height difference of approximately 40 cm and rate of 4-5 cm/s can be recommended for the hand elevation test, greater postural changes and higher rates may diminish agreement between the measured blood pressure response and the corresponding hydrostatic pressure change. The applied hydrostatic test may be helpful for assessing the accuracy of beat-to-beat finger blood pressure measurement. PMID:19027338
... Pressure (Hypertension) (Food and Drug Administration) Also in Spanish High Blood Pressure (Hypertension) (Mayo Foundation for Medical Education and Research) Questions and Answers about High Blood ...
Eckert, S; Gleichmann, S; Gleichmann, U
Automatic 24 h Ambulatory Blood Pressure Monitoring (ABPM) has become an established method in the diagnosis and treatment control of arterial hypertension. Fully automatic blood pressure devices for blood pressure self-measurement (BPSM) in the upper arm and in the wrist using the oscillometric measuring technique have been available in Germany for several years. After evaluating the blood pressure devices boso Oscillomat (upper arm) and Omron HEM-601 (wrist) by means of simultaneous invasive measurements, we studied the suitability of this new method for the control of treated hypertension. Using the device Space Labs 90207, we had ABPM carried out in 100 men (aged 58 +/- 8 years) with mild to moderate hypertension. They recorded hourly blood pressure measurements in the wrist between 6 a.m. and 6 p.m., in the same arm as the blood pressure monitoring using the device Omron HEM-601, or in the other arm using the device boso Oscillomat. The values of systolic and diastolic blood pressure were measured using both methods. Since the random samples probably consisted of non-standard distribution differences, we applied the Wilcoxon matched pairs signed rank test for statistical analysis. No significant differences were recorded between the daily mean systolic (p < .07) and diastolic (p < .97) blood pressure values determined by ABPM and by frequent blood pressure self-measurement. Multiple blood pressure readings obtained using blood pressure self-measurement in the upper arm as well as in the wrist are an alternative to the established, automatic 24-h, ambulatory blood pressure measurement for the treatment control of arterial hypertension, that nightly blood pressure measurement can be omitted. It has advantage of unrestricted and desired frequent use under standardized conditions. PMID:8896310
... Pressure High Blood Pressure Tools & Resources Stroke More High Blood Pressure and Metabolic Syndrome Updated:Aug 12,2014 Metabolic ... content was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) Introduction What ...
Song, Bo Mi; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil
Background and Objectives We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. Subjects and Methods A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. Results The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Conclusion Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure. PMID:27275174
Meyer-Sabellek, W; Schulte, K L; Gotzen, R
Automatic 24-h indirect ambulatory monitoring of blood pressure and heart rate was performed in 758 patients. The blood pressure profiles of 1105 subjects were evaluated for 5 years using seven different monitors: Pill (Del Mar Avionics), PHYSIOPORT (Natic), Accutracker (Oxford), BDS (Medizintechnik), SL 5200, SL 90202 and SL 90207 (Spacelabs). The monitors were equipped with auscultatory and/or oscillometric devices, provided accurate readings and were repeatedly used up to eight times in some patients. Up to 100 data points per 24 h provided circadian blood pressure profiles for over 91% of the patients in clinical and non-clinical situations. Early identification of borderline hypertensives at risk and detailed information on the efficacy of different antihypertensive regimens may in part justify the high costs of the monitors. Although sleep disturbance continued in more than 24% of investigated patients, the new lighter, quieter monitors (e.g. SL 90207, 380 g) were well received by patients and nurses. In the future, simultaneous registration with 24-h ECG may help in identifying the effects of different antihypertensive therapies on blood pressure variability and rhythmicity of the heart rate. PMID:2760714
Meyer-Sabellek, W; Schulte, K L; Gotzen, R
Non-invasive automatic 24-h indirect ambulatory monitoring of blood pressure and the heart rate was performed in 2010 subjects at the Department of Internal Medicine, Klinikum Steglitz, Free University of Berlin, Germany, from 1983 to 1990. Blood pressure profiles were obtained using seven different monitors, Pressurometer III (Del Mar Avionics), Physioport (Natic), Accutracker (Oxford), Blutdrucksystem (Medizintechnik), SL 5200, SL 90202 and SL 90207 (SpaceLabs). The monitors were equipped with auscultatory and/or oscillometric devices, provided accurate readings and were repeatedly used up to eight times in some patients. Up to 100 data points per 24 h provided diurnal blood pressure profiles for over 91% of the patients in clinical and non-clinical situations. Early identification of borderline hypertensives at risk of cardiovascular disease and detailed information on the efficacy of different antihypertensive regimens may in part justify the high costs of the monitors. Although disturbance to sleep remained a problem in more than 20% of the patients investigated, the new, lighter, quieter monitors (e.g. SpaceLabs 90207 at 380 g) were well received by patients and nurses. In the future, simultaneous registration with 24-h ECG may help in identifying the effects of different antihypertensive therapies on blood pressure variability and the periodicity of the heart rate. PMID:2081997
Nolte, R. W.
The Blood Pressure Measuring System is described. It measures blood pressure by the noninvasive Korotkoff sound technique on a continual basis as physical stress is imposed during experiment M092, Lower Body Negative Pressure, and experiment M171, Metabolic Activity.
Huang, Q-F; Sheng, C-S; Kang, Y-Y; Zhang, L; Wang, S; Li, F-K; Cheng, Y-B; Guo, Q-H; Li, Y; Wang, J-G
We investigated the association of plasma AGE (advanced glycation end product) concentration with central and peripheral blood pressures and central-to-brachial blood pressure amplification in a Chinese population. The study subjects were from a newly established residential area in the suburb of Shanghai. Using the SphygmoCor system, we recorded radial arterial waveforms and derived aortic waveforms by a generalized transfer function and central systolic and pulse pressure by calibration for brachial blood pressure measured with an oscillometric device. The central-to-brachial pressure amplification was expressed as the central-to-brachial systolic blood pressure difference and pulse pressure difference and ratio. Plasma AGE concentration was measured by the enzyme-linked immunosorbent assay method and logarithmically transformed for statistical analysis. The 1051 participants (age, 55.1±13.1 years) included 663 women. After adjustment for sex, age and other confounding factors, plasma AGE concentration was associated with central but not peripheral blood pressures and with some of the pressure amplification indexes. Indeed, each 10-fold increase in plasma AGE concentration was associated with 2.94 mm Hg (P=0.04) higher central systolic blood pressure and 2.39% lower central-to-brachial pulse pressure ratio (P=0.03). In further subgroup analyses, the association was more prominent in the presence of hypercholesterolemia (+8.11 mm Hg, P=0.008) for central systolic blood pressure and in the presence of overweight and obesity (-4.89%, P=0.009), diabetes and prediabetes (-6.26%, P=0.10) or current smoking (-6.68%, P=0.045) for central-to-brachial pulse pressure ratio. In conclusion, plasma AGE concentration is independently associated with central systolic blood pressure and pulse pressure amplification, especially in the presence of several modifiable cardiovascular risk factors. PMID:26084655
Nakamura, Kaori; Kikuya, Masahiro; Hara, Azusa; Hirose, Takuo; Obara, Taku; Metoki, Hirohito; Asayama, Kei; Inoue, Ryusuke; Ohkubo, Takayoshi; Totsune, Kazuhito; Imai, Yutaka
To validate the FM-800 device (Fukuda Denshi Co., Ltd., Tokyo, Japan) for ambulatory blood pressure monitoring (ABPM), this validation study was performed based on the European Society of Hypertension (ESH) protocol and the Association for the Advancement of Medical Instrumentation (AAMI) criteria. Thirty-three participants were included (15 in phase 1 and an additional 18 in phase 2) in the ESH protocol. The device was tested on 85 participants according to the AAMI criteria, which require a mean device-observers discrepancy within 5 ± 8 mmHg. The tested device passed all the criteria for both systolic blood pressure (SBP) and diastolic blood pressure (DBP), and for the Korotkoff and oscillometric methods according to the ESH protocol. The test device also fulfilled the AAMI accuracy criteria for the 85 participants; the mean ± SD of the SBP/DBP differences between the tested device and the mean of the observer readings were -1.1 ± 4.2/-0.8 ± 4.2 mmHg for the Korotkoff method and 2.3 ± 3.9/-2.3 ± 3.9 mmHg for the oscillometric method. The FM-800 device for ABPM passed all the validation criteria of the ESH and AAMI and can, therefore, be recommended for clinical use in an adult population. PMID:21091358
Cornélissen, G.; Halberg, F.; Bakken, E. E.; Wang, Z.; Tarquini, R.; Perfetto, F.; Laffi, G.; Maggioni, C.; Kumagai, Y.; Homolka, P.; Havelková, A.; Dušek, J.; Svačinová, H.; Siegelová, J.; Fišer, B.
BIOCOS, the project aimed at studying BIOlogical systems in their COSmos, has obtained a great deal of expertise in the fields of blood pressure (BP) and heart rate (HR) monitoring and of marker rhythmometry for the purposes of screening, diagnosis, treatment, and prognosis. Prolonging the monitoring reduces the uncertainty in the estimation of circadian parameters; the current recommendation of BIOCOS requires monitoring for at least 7 days. The BIOCOS approach consists of a parametric and a non-parametric analysis of the data, in which the results from the individual subject are being compared with gender- and age-specified reference values in health. Chronobiological designs can offer important new information regarding the optimization of treatment by timing its administration as a function of circadian and other rhythms. New technological developments are needed to close the loop between the monitoring of blood pressure and the administration of antihypertensive drugs. PMID:19122770
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Duke-Novakovski, Tanya; Carr, Anthony
Blood pressure monitoring and management is a vital part of the perianesthetic period. Disturbances in blood pressure, especially hypotension, can have significant impacts on the well-being of small animal patients. There are a variety of mechanisms present to control blood pressure, including ultra-short-, short-, and long-term mechanisms. Several conditions can contribute to decreased blood pressure, including anesthetics, tension pneumothorax, intermittent positive pressure ventilation, hypoxemia, hypercapnia, surgical positioning, and abdominal distension. If hypotension is encountered, the initial response is to provide appropriate fluid therapy. If this is inadequate, other interventions can be used to increase blood pressure and thereby increase perfusion. PMID:26076581
Pressure within blood vessel is measured by new cufflike device without penetration of vessel. Device continuously monitors blood pressure for up to 6 months or longer without harming vessel. Is especially useful for vessels smaller than 4 or 5 millimeters in diameter. Invasive methods damage vessel wall, disturb blood flow, and cause clotting. They do not always give reliable pressure measurements over prolonged periods.
Chia, F; Ang, A T; Wong, T W; Tan, K W; Fung, K P; Lee, J; Khin, K
Four hundred thirty-one paired sets of readings of systolic and diastolic blood pressure and 438 paired sets of readings of mean arterial BP from 49 ill newborns, including 21 very low birth weight infants, were analyzed for the extent and pattern of agreement and the linear relationship between the Dinamap oscillometric monitor and the direct intraarterial blood pressure readings. Agreement between the two methods was measured by the intraclass correlation, whereas the linear relationship was assessed by the product-moment correlation. The intraclass correlations for systolic, diastolic and mean blood pressures were 0.696, 0.766, and 0.781, respectively. The product-moment correlations for systolic, diastolic and mean blood pressures were 0.706, 0.768, and 0.786, respectively. BP measurements by the Dinamap monitor showed reasonably close agreement to those obtained by the intraarterial mean arterial pressure ranges above 40 mmHg. For mean arterial pressure of 40 mmHg and lower, BP readings by the Dinamap monitor tended to be higher than those obtained by the intraarterial method. These findings appeared to be consistent regardless of the birth weight of the newborn. PMID:2340688
Horton, Rachel Avery; Rose, Kathryn M.
Background: Industrial swine operations emit odorant chemicals including ammonia, hydrogen sulfide (H2S), and volatile organic compounds. Malodor and pollutant concentrations have been associated with self-reported stress and altered mood in prior studies. Objectives: We conducted a repeated-measures study of air pollution, stress, and blood pressure in neighbors of swine operations. Methods: For approximately 2 weeks, 101 nonsmoking adult volunteers living near industrial swine operations in 16 neighborhoods in eastern North Carolina sat outdoors for 10 min twice daily at preselected times. Afterward, they reported levels of hog odor on a 9-point scale and measured their blood pressure twice using an automated oscillometric device. During the same 2- to 3-week period, we measured ambient levels of H2S and PM10 at a central location in each neighborhood. Associations between systolic and diastolic blood pressure (SBP and DBP, respectively) and pollutant measures were estimated using fixed-effects (conditional) linear regression with adjustment for time of day. Results: PM10 showed little association with blood pressure. DBP [β (SE)] increased 0.23 (0.08) mmHg per unit of reported hog odor during the 10 min outdoors and 0.12 (0.08) mmHg per 1-ppb increase of H2S concentration in the same hour. SBP increased 0.10 (0.12) mmHg per odor unit and 0.29 (0.12) mmHg per 1-ppb increase of H2S in the same hour. Reported stress was strongly associated with BP; adjustment for stress reduced the odor–DBP association, but the H2S–SBP association changed little. Conclusions: Like noise and other repetitive environmental stressors, malodors may be associated with acute blood pressure increases that could contribute to development of chronic hypertension. PMID:23111006
Vick, H. A.
Blood pressure reprogramming adapter separates the two components of a blood pressure signal, a dc pressure signal and an ac Korotkoff sounds signal, so that the Korotkoff sounds are recorded on one channel as received while the dc pressure signal is converted to FM and recorded on a second channel.
Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.
A complex but crucial relationship exists between blood volume and blood pressure in human subjects; it has been recognized that in essential hypertension, renovascular hypertension, and pheochromocytoma, the relationship between plasma volume and diastolic blood pressure is an inverse one. This phenomenon has not been studied in individuals with low normal and reduced blood pressures. Orthostatic intolerance is a commonly encountered abnormality in blood pressure regulation often associated with tachycardia in the standing position. Most of these patients have varying degrees of reduced blood volume. We tested the hypothesis that the relationship previously found between plasma volume and diastolic blood pressure in pressor states would also hold in orthostatic intolerance. We studied 16 patients with a history of symptomatic orthostatic intolerance associated with an elevation in plasma norepinephrine in the upright posture and hypovolemia in 9 patients and normovolemia in 7 patients. Our studies demonstrate an inverse relationship between plasma volume and diastolic blood pressure in patients with orthostatic intolerance. This finding also holds for the change in diastolic blood pressure in response to upright posture. In this relationship, patients with orthostatic intolerance with high plasma norepinephrine resemble those with essential hypertension, renovascular hypertension, and pheochromocytoma. We conclude that in a variety of conditions at both ends of the blood pressure spectrum, the seemingly paradoxical association of hypovolemia and diastolic blood pressure is preserved.
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
Shahriari, Majid; Rotenberg, Daniel Kaminski; Nielsen, Jesper Kent; Wiinberg, Niels; Nielsen, Poul Ebbe
Five different semiautomatic manometers were tested, where oscillometry is the measuring principle. Three of the manometers (Omron R4, A&D UB 322 and Braun) were wrist manometers, where the occluding cuff is placed around the volar surface of the wrist. Two of the manometers (A&D UA 777 and Omron M4) measure on the upper arm. The investigation included 72 patients with systolic blood pressure (SBP) ranging between 110 and 200, and diastolic blood pressure (DBP) between 62 and 114 mmHg. Forty-five of the subjects were on antihypertensive medication when the manometer tests were carried out. Each of the manometers was tested with double measurements of blood pressure against 2 x 2 auscultatory measurements done before and after the semiautomatic readings. The auscultatory measurements are all performed by the same observer, who was blinded for the measurements with semiautomatic manometers. The mean difference between the oscillometric recordings compared to auscultatory measurements varied from +1.2 to -8.5 mmHg for SBP and from -0.5 to -8.3 mmHg for DBP. However, the interindividual differences varied considerable with standard deviation of the difference varying from 8 to 18 mmHg for SBP with the highest values for wrist manometers. Concerning DBP, the standard deviation of difference for all five manometers was between 6 and 8 mmHg, with the highest values for wrist manometers. None of the tested manometers fulfilled the criteria for grading A or B in the previously introduced grading by the British Hypertension Society. To conclude, the upper-arm manometers have a measuring accuracy for SBP a little higher than that of the wrist manometers, while there is no bigger difference in the measuring accuracy of DBP. The most important point is that the measuring accuracy in a single patient is unpredictable. If home readings are prepared, a test of the accuracy against auscultatory recordings should be done in every single patient. In the clinical wards, it is
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.
Poghosyan, Armen; Mouradian, Vahram; Hovhannisyan, Levon
We are presenting a novel photoplethysmographic (PPG) optical sensor and device with ambient optical, electrical and electromagnetic noises cancellation, thus allowing only the useful optical signals to be received by the health monitoring device. We are also presenting a new processing technique for canceling the ambient noises contributed by optical, electrical and electromagnetic artifacts in the measured PPG signals. Such a device and method allow the enhancement of the performance of the PPG sensors compared to conventional apparatus and methods. The presented sensor and methodology have been integrated into a prototype standalone device for noninvasive, continuous, wearable, remote and mobile monitoring of blood pressure and other human vital signs, such as heart rate, oxygen saturation, respiration rate, etc This small device allows the user to read, store, process and transmit all the measurements made using the PPG optical sensor and the electronic unit to a remote location.
Pierin, Angela M. G.; Ignez, Edna C.; Filho, Wilson Jacob; Barbato, Alfonso Júlio Guedes; Mion, Décio
OBJECTIVE To compare blood pressure measurements taken at home by physicians, nurses, and patients with office blood pressure measurement , ambulatory blood pressure monitoring and home blood pressure measurement. METHODS A total of 44 patients seen by a home care program were studied. Protocol 1 a) blood pressure was measured by the patient, a physician and a nurse during a regular home visit (Home1); b) home blood pressure measurement was measured for 4 days (HBPM1); c) office blood pressure measurement was measured by a physician, a nurse, and the patient; and by 24-hour ambulatory blood pressure monitoring. Protocol 2 blood pressure was measured by the patient, a physician, and a nurse during a special home visit in the presence of a physician and a nurse only (Home2); and b) home blood pressure measurement was taken for the second time (HBPM2). Echocardiography, guided by a two-dimensional echocardiograph, was performed. RESULTS Protocol 1: a) office blood pressure measurement and Home1 were significantly higher than ambulatory blood pressure monitoring, except for systolic and diastolic office blood pressure measurement taken by the patient or a family member, systolic blood pressure taken by a nurse, and diastolic blood pressure taken by a physician. b) ambulatory blood pressure monitoring and HBPM1 were similar. Protocol 2: a) HBPM2 and Home2 were similar. b) Home2 was significantly lower than Home1, except for diastolic blood pressure taken by a nurse or the patient. There were significant relationships between: a) diastolic blood pressure measured by the patient and the thickness of the interventricular septum, posterior wall, and left ventricular mass; and b) ambulatory and HBPM2 diastolic and systolic blood pressure taken by a physician (home2) and left ventricular mass. Therefore, the data indicate that home blood pressure measurement and ambulatory blood pressure monitoring had good prognostic values relative to “office measurement.” CONCLUSION
Rabbia, F; Del Colle, S; Testa, E; Naso, D; Veglio, F
Blood pressure measurement is the cornerstone for the diagnosis, the treatment and the research on arterial hypertension, and all of the decisions about one of these single aspects may be dramatically influenced by the accuracy of the measurement. Over the past 20 years or so, the accuracy of the conventional Riva-Rocci/Korotkoff technique of blood pressure measurement has been questioned and efforts have been made to improve the technique with automated devices. In the same period, recognition of the phenomenon of white coat hypertension, whereby some individuals with an apparent increase in blood pressure have normal, or reduced, blood pressures when measurement is repeated away from the medical environment, has focused attention on methods of measurement that provide profiles of blood pressure behavior rather than relying on isolated measurements under circumstances that may in themselves influence the level of blood pressure recorded. These methodologies have included repeated measurements of blood pressure using the traditional technique, self-measurement of blood pressure in the home or work place, and ambulatory blood pressure measurement using innovative automated devices. The purpose of this review to serve as a source of practical information about the commonly used methods for blood pressure measurement: the traditional Riva-Rocci method and the automated methods. PMID:17016412
Rothman, Neil S.
Device measures time-averaged component of absolute blood pressure in artery. Includes compliant cuff around artery and external monitoring unit. Ceramic construction in monitoring unit suppresses ebb and flow of pressure-transmitting fluid in sensor chamber. Transducer measures only static component of blood pressure.
Müller, Jan; Meyer, Joanna; Elmenhorst, Julia; Oberhoffer, Renate
Cardiopulmonary fitness benefits cardiovascular health. Various studies have shown a strong negative correlation between exercise capacity and arterial stiffness in adults. However, evidence for this connection in children and adolescents is scarce. About 320 healthy children and adolescents (252 male, 14.0±2.1 years) were evaluated with regard to their demographic, anthropometric and hemodynamic parameters, and their peak oxygen uptake. Peripheral and central systolic blood pressures were measured with patients in a supine position using an oscillometric device. Peak oxygen uptake was assessed by cardiopulmonary exercise testing. In multivariate regression, only peripheral systolic blood pressure (β=0.653, P<.001) and body weight (β=0.284, P<.001) emerged as independent determinants for central systolic blood pressure. Body weight therefore determines central systolic blood pressure in children and adolescents rather than measures of cardiorespiratory fitness. The prevention of overweight in childhood is necessary to reduce stiffening of the arteries and delay the onset of cardiovascular disease. PMID:26689169
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Sadler, Ryan A; Hall, Natalie H; Kass, Philip H; Citino, Scott B
Two indirect blood pressure measurement techniques, Doppler (DOP) sphygmomanometry and oscillometry, applied at the ventral coccygeal artery were compared with simultaneous direct blood pressure measurements at the dorsal pedal artery in 10 anesthetized, captive cheetahs (Acinonyx jubatus). The DOP method was moderately accurate, with relatively little bias (mean difference 3.8 mmHg) and 88.6% of the DOP systolic arterial pressure measurements being within 10 mmHg of the direct systolic arterial measurement. With the oscillometric (OM) method, 89.2% of the mean arterial pressure measurements were within 10 mmHg of the direct measurement and had the least bias (mean difference 2.3 mmHg), 80.7% of the systolic measurements were within 10 mmHg of the direct measurement and had the second least bias (mean difference 2.3 mmHg), and 59% of the diastolic measurements were within 10 mmHg of the direct measurement and had significant bias (mean difference 7.3 mmHg). However, DOP showed relatively poor precision (SD 11.2 mmHg) compared with OM systolic (SD 8.0 mmHg), diastolic (SD 8.6 mmHg), and mean (SD 5.7 mmHg). Both techniques showed a linear relationship with the direct technique measurements over a wide range of blood pressures. The DOP method tended to underestimate systolic measurements below 160 mmHg and overestimate systolic measurements above 160 mmHg. The OM method tended to underestimate mean pressures below 160 mm Hg, overestimate mean pressures above 160 mmHg, underestimate systolic pressures below 170 mmHg, overestimate systolic pressures above 170 mmHg, and underestimate diastolic pressures throughout the measured blood pressure range. Indirect blood pressure measurement using the ventral coccygeal artery, particularly when using an OM device for mean and systolic arterial pressure, may be useful in the clinical assessment of cheetahs when monitoring trends over time, but caution should be taken when interpreting individual values. PMID:24450051
Rischell, Robert E.
Additional uses found for equipment described in "Implanted Blood-Pressure-Measuring Device" (GSC-13042). Implanted with device electronic circuitry that measures, interprets, and transmits data via inductive link through patient's skin to external receiver. Receiver includes audible alarm generator activated when patient's blood pressure exceeds predetermined threshold. Also included in receiver a blood-pressure display, recorder, or both, for use by patient or physician.
Ivy, Jessica R; Bailey, Matthew A
The regulation of extracellular fluid volume by renal sodium excretion lies at the centre of blood pressure homeostasis. Renal perfusion pressure can directly regulate sodium reabsorption in the proximal tubule. This acute pressure natriuresis response is a uniquely powerful means of stabilizing long-term blood pressure around a set point. By logical extension, deviation from the set point can only be sustained if the pressure natriuresis mechanism is impaired, suggesting that hypertension is caused or sustained by a defect in the relationship between renal perfusion pressure and sodium excretion. Here we describe the role of pressure natriuresis in blood pressure control and outline the cascade of biophysical and paracrine events in the renal medulla that integrate the vascular and tubular response to altered perfusion pressure. Pressure natriuresis is impaired in hypertension and mechanistic insight into dysfunction comes from genetic analysis of blood pressure disorders. Transplantation studies in rats show that blood pressure is determined by the genotype of the kidney and Mendelian hypertension indicates that the distal nephron influences the overall natriuretic efficiency. These approaches and the outcomes of genome-wide-association studies broaden our view of blood pressure control, suggesting that renal sympathetic nerve activity and local inflammation can impair pressure natriuresis to cause hypertension. Understanding how these systems interact is necessary to tackle the global burden of hypertension. PMID:25107929
Sharp, D.S.; Osterloh, J.; Becker, C.E.; Bernard, B.; Smith, A.H.; Fisher, J.M.; Syme, S.L.; Holman, B.L.; Johnston, T.
San Francisco bus drivers have an increased prevalence of hypertension. This study examined relationships between blood lead concentration and blood pressure in 342 drivers. The analysis reported in this study was limited to subjects not on treatment for hypertension (n = 288). Systolic and diastolic pressure varied from 102 to 173 mm Hg and from 61 to 105 mm Hg, respectively. The blood lead concentration varied from 2 to 15 ..mu..g/dL. The relationship between blood pressure and the logarithm of blood lead concentration was examined using multiple regression analysis. Covariates included age, body mass index, sex, race, and caffeine intake. The largest regression coefficient relating systolic blood pressure and blood lead concentration was 1.8 mm Hg/ln (..mu..g/dL). The coefficient for diastolic blood pressure was 2.5 mm Hg/ln (..mu..g/dL). These findings suggest effects of lead exposure at lower blood lead concentrations than those concentrations that have previously been linked with increases in blood pressure.
Fixler, D E; Wallace, J M; Thornton, W E; Dimmitt, P
The purpose of this study was to determine the ability of ambulatory blood pressure monitoring to identify youths with chronic blood pressure elevation. Nineteen adolescent boys were studied, ten had 5-year average systolic or diastolic pressures above the 95th percentile, nine had normal pressure. A Del Mar Avionics Pressurometer III system recorded an average of 121 readings on each subject. The coefficients of variation for pressure were similar for hypertensive and normotensive individuals. During classes, eight of the ten hypertensive youths had elevated pressures in over half of the measurements. Also during these classes eight of ten hypertensive boys had average systolic or diastolic pressure above the 95th percentile, whereas only one of nine normotensive boys had average pressures above this level. We suggest that schooltime ambulatory pressures may be most useful in classifying the blood pressure trend in a youth. PMID:2346634
Meng, Xianghu; Zang, Guanghui; Fan, Longchang; Zheng, Lei; Dai, Jinzhen; Wang, Xueren; Xia, Wei; Liu, Jihong; Zhang, Chuanhan
The Philips Intellivue MP50 monitor provides a method for non-invasive, near-continuous blood pressure (BP) monitoring and is designed to be an alternative to direct intra-arterial BP (IABP) measurement. However, no studies have specifically compared non-invasive and invasive BP measurements using the monitor. The present retrospective study observed 515 patients undergoing surgery with general anesthesia, whose invasive (intra-radial, femoral or dorsalis pedis artery) and non-invasive (oscillometric) BP (NIBP) were monitored simultaneously using the monitor. These data were analyzed using correlations, regressions and Bland-Altman plots. The patients were placed in a supine position during surgery. The correlation data for invasive BP and NIBP measurements were: for intra-radial measurements, r(2)=0.51 (bias and precision, 11.04±15.22 and 14.76±11.64 mmHg, respectively) for systolic BP (SBP) and r(2)=0.27 (6.17±11.95 and 9.77±9.25 mmHg, respectively) for diastolic BP (DBP); for intra-femoral measurements: r(2)=0.57 (14.79±14.55 and 17.15±11.68 mmHg, respectively) for SBP and r(2)=0.45 (4.12±9.70 and 7.49±7.40 mmHg, respectively) for DBP; and for intra-dorsalis pedis measurements: r(2)=0.33 (13.00±16.81 and 17.34±12.28 mmHg, respectively) for SBP and r(2)=0.30 (0.17±11.27 and 8.44±7.46 mmHg, respectively) for DBP. According to this data, the NIBP measured by the Philips Intellivue MP50 monitor showed low positive correlations and poor agreement with the IABP, as calculated by Bland-Altman analysis. Therefore, the use of oscillometric BP measured by the monitor in surgery patients under general anesthesia is not generally recommended. PMID:23935710
Hasan, Md. Mahmud-Ul; Islam, Md. Kafiul; Shawon, Mehedi Azad; Nowrin, Tasnuva Faruk
A more efficient newer algorithm of detecting systolic and diastolic pressure of human body along with a complete package of an effective user-friendly embedded programmable blood pressure monitoring system has been proposed in this paper to reduce the overall workload of medical personals as well as to monitor patient's condition more conveniently and accurately. Available devices for measuring blood pressure have some problems and limitations in case of both analog and digital devices. The sphygmomanometer, being analog device, is still being used widely because of its reliability and accuracy over digital ones. But it requires a skilled person to measure the blood pressure and obviously not being automated as well as time consuming. Our proposed system being a microcontroller based embedded system has the advantages of the available digital blood pressure machines along with a much improved form and has higher accuracy at the same time. This system can also be interfaced with computer through serial port/USB to publish the measured blood pressure data on the LAN or internet. The device can be programmed to determine the patient's blood pressure after each certain interval of time in a graphical form. To sense the pressure of human body, a pressure to voltage transducer is used along with a cuff in our system. During the blood pressure measurement cycle, the output voltage of the transducer is taken by the built-in ADC of microcontroller after an amplifier stage. The recorded data are then processed and analyzed using the effective software routine to determine the blood pressure of the person under test. Our proposed system is thus expected to certainly enhance the existing blood pressure monitoring system by providing accuracy, time efficiency, user-friendliness and at last but not the least the 'better way of monitoring patient's blood pressure under critical care' all together at the same time.
Sirtori, Cesare R; Arnoldi, Anna; Cicero, Arrigo F G
Significant effects on blood pressure (BP) have been reported from large nutritional interventions, particularly the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet. In more recent years, numerous studies have investigated the possible BP-lowering effect of different nutraceuticals; these range from specific foods to minerals, lipids, whole proteins, peptides, amino acids, probiotics, and vitamins. While a very large body of evidence supports the use of potassium, L-arginine, vitamins C and D, cocoa flavonoids, beetroot juice, some probiotics, coenzyme Q10, controlled-release melatonin, aged garlic extract, and coffee, the use of other nutraceuticals, such as green tea, flaxseed, and resveratrol, has not as yet been supported by adequate evidence. In some cases, e.g. proteins/peptides, the responsible component needs also to be fully uncovered. Finally, while for most of the products only short-term studies are available, with no specific end-points, an ongoing very large prospective study on chocolate flavanols will answer the question whether this may reduce cardiovascular risk. Thus, in addition to data on long-term safety, further clinical research is advisable in order to identify, among active nutraceuticals, those with the best cost-effectiveness and risk-benefit ratio for a wide use in the general population with a raised cardiovascular risk consequent to uncomplicated hypertension. PMID:26362125
Benes, Jan; Simanova, Alena; Tovarnicka, Tereza; Sevcikova, Silvie; Kletecka, Jakub; Zatloukal, Jan; Pradl, Richard; Chytra, Ivan; Kasal, Eduard
Intermittent blood pressure (BP) monitoring is the standard-of-care during low and intermediate risk anaesthesia, yet it could lead to delayed recognition of BP fluctuations. Perioperative hypotension is known to be associated with postoperative complications. Continuous, non-invasive methods for BP monitoring have been developed recently. We have tested a novel non-invasive, continuous monitor (using the volume clamp method) to assist with maintaining BP in safe ranges for patients undergoing surgery in a beach chair position. Forty adult patients undergoing thyroid gland surgery in an upright position were included in this prospective randomised controlled trial. Patients were equally allocated to the group with continuous monitoring of BP using the CNAP® Monitor and to the control group managed using an intermittent oscillometric BP cuff. The absolute and proportional time spent outside the range of ±20% of the target BP along with other hemodynamic and clinical parameters were evaluated. The continuous monitoring decreased the anaesthesia time spent below -20% pressure range [absolute: 12 min (4-20) vs. 27 min (16-34); p=0.001; relative to procedure length: 14% (7-20) vs. 33.5% (17.5-53); p=0.003]. No significant differences were observed in postoperative morbidity or in hospital length of stay. Continuous non-invasive BP monitoring via the CNAP® Monitor allows for better BP management in patients undergoing surgery in a beach chair position. In our randomised trial the time spent in hypotension was significantly shorter using continuous monitoring. PMID:24841333
Coulehan, John L.; And Others
Among 580 Navajo adolescents, 11.1 percent of males and 1.6 percent of females had high blood pressure. Blood pressure was related to age in males and to body mass index in females but was not related to level of acculturation or traditionality. Contains 17 references. (SV)
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Pu, Jia; Chewning, Betty A; Johnson, Heather M; Vanness, David J; Young, Henry N; Kreling, David H
Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA) repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (p<0.05). We found no evidence of differences in health behavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing blood pressure
Lee, Yong Jin
This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes. Photoplethysmography, which measures changes in arterial blood volume, is commonly used to obtain heart rate and blood oxygen saturation. The digitized PPG signals are used as inputs into the beat-to-beat blood
Blood pressure measurement in the diagnosis and management of hypertension, including the technique required for ambulatory blood pressure monitoring and home blood pressure monitoring, will be reviewed in this article. Home and ambulatory measurements are widely used, both to confirm the diagnosis and to improve adherence to therapy. The major advantage of out-of-office blood pressure monitoring is that it provides a large number of blood pressure measurements away from the medical environment, which represents a more reliable assessment of actual blood pressure than office blood pressure. The advantage of ambulatory blood pressure monitoring is its unique ability to measure nocturnal blood pressure. Although not fully validated in large-scale clinical trials, ambulatory blood pressure monitoring appears to correlate best with prognosis. Ambulatory blood pressure monitoring and home blood pressure monitoring provide somewhat different information on the subject's blood pressure status, and the two methods should thus be regarded as complementary, rather than competitive or alternative. PMID:25019016
Kollias, Anastasios; Stergiou, George S
1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives. PMID:23647092
The Leg Volume Measuring System is used to measure leg calf girth changes that occur during exposure to lower body negative pressure as a result of pooling of blood and other fluids in the lower extremities.
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. PMID:26923351
... Information Center National Kidney Foundation Smokefree.gov MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Alternate Language URL Español High Blood Pressure and Kidney Disease Page Content On this page: What is ...
... in New York City. Until published in a peer-reviewed medical journal, the results should be considered preliminary. One-third of U.S. adults have high blood pressure, also called hypertension. It contributes to more than ...
Edvardsson, Vidar O; Steinthorsdottir, Sandra D; Eliasdottir, Sigridur B; Indridason, Olafur S; Palsson, Runolfur
A large body of literature suggests an inverse relationship between birth weight and blood pressure in children, adolescents and adults. The most persistent findings have been observed in children with a history of low birth weight or intrauterine growth restriction, while a large number of studies carried out in populations with normally distributed birth weight have shown conflicting results. A recently reported strong direct association between high birth weight and blood pressure, and the significant positive effect of postnatal growth on blood pressure suggests that the fetal origins of adult disease hypothesis should be expanded to include the role of excessive fetal and postnatal growth. In this paper, we review recent studies on the relationship between birth weight and blood pressure in childhood, with a focus on confounding variables that may explain the conflicting results of published work in this field. PMID:23054892
... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... when the sounds disappear. When a blood pressure reading is taken, the higher number represents the systolic ...
... nih.gov/medlineplus/news/fullstory_158828.html Booze, High Blood Pressure a Dangerous Mix Study links moderate drinking to heart damage in people with hypertension To use the sharing features on this page, ...
Ogedegbe, Gbenga; Pickering, Thomas
Although the mercury sphygmomanometer is widely regarded as the “gold standard” for office blood pressure measurement, the ban on use of mercury devices continues to diminish their role in office and hospital settings. To date, mercury devices have largely been phased out in US hospitals. This has led to the proliferation of non-mercury devices and has changed (probably for ever) the preferable modality of blood pressure measurement in clinic and hospital settings. In this article, the basic techniques of blood pressure measurement and the technical issues associated with measurements in clinical practice are discussed. The devices currently available for hospital and clinic measurements and their important sources of error are presented. Practical advice is given on how the different devices and measurement techniques should be used. Blood pressure measurements in different circumstances and in special populations such as infants, children, pregnant women, elderly persons, and obese subjects are discussed. PMID:20937442
Melby, Christopher L.; And Others
This cross-sectional study determined which anthropometric, dietary, and physical fitness variables were the best predictors of blood pressure in 323 white elementary school children. Results are discussed. (Author/MT)
... fullstory_158731.html Blood Pressure Patterns May Predict Stroke Risk Odds increase with rapid rise in middle ... overall pattern to predict a patient's risk of stroke or early death, new research suggests. "Our study ...
... at Erasmus University Medical Center in Rotterdam, the Netherlands. High blood pressure is the number one risk ... of epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Andrew Rogove, M.D., Ph.D., medical director, ...
Sharman, James E.; Blizzard, Leigh; Kosmala, Wojciech; Nelson, Mark R.
PURPOSE Twenty-four–hour ambulatory blood pressure (ABP) is the reference standard of blood pressure control. Home blood pressure (HBP) is superior to clinic blood pressure for assessing control, but a barrier to its use is the need for physicians to calculate average blood pressure from patient diaries. We sought to develop a quick and pragmatic method to assess blood pressure control from patients’ HBP diaries. METHODS Seven-day HBP and 24-hour ABP were measured in 286 patients with uncomplicated treated hypertension (aged 64 ± 8 years; 53% female). We determined the optimal ratio of home systolic blood pressure readings above threshold (≥135 mm Hg) for the last 10 recorded that would best predict elevated 24-hour ABP. Uncontrolled blood pressure was defined as 24-hour ABP systolic blood pressure ≥130 mm Hg or 24-hour ABP daytime systolic blood pressure ≥135 mm Hg. Validation by corroborative evidence was tested by association with markers of end-organ disease. RESULTS The best predictor of 24-hour ABP systolic blood pressure above treatment/target threshold was having 3 or more (≥30%) of the last 10 home systolic blood pressure readings ≥135 mm Hg (area under the receiver operating characteristic curve = 0.71). Importantly, patients meeting this criterion had evidence of target organ disease, with significantly higher aortic stiffness, left ventricular relative wall thickness, and left atrial area, and lower left ventricular ejection fraction, compared with those who did not meet this criterion. CONCLUSIONS To facilitate uptake of HBP monitoring, we propose that physicians can determine the percentage of the last 10 home systolic blood pressure values ≥135 mm Hg for a patient and tailor management accordingly. PMID:26755785
ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? The prevalence of high blood pressure in African Americans is among the highest in ...
... fullstory_158860.html Wearable Monitor Helps Spot 'Masked' High Blood Pressure Black people with undetected problem twice as likely ... doctors spot black people with "masked," or undetected, high blood pressure, a new study suggests. "Masked" high blood pressure ...
Palatini, P; Mormino, P; Martina, S; Businaro, R; Penzo, M; Racioppa, A; Guzzardi, G; Anaclerio, M; Pessina, A C
Purpose of the study was to investigate whether and to what extent blood pressure variability and average night-time blood pressure are related to cardiovascular complications in hypertension. To this aim 60 normotensive and 462 hypertensive subjects were studied by means of non-invasive 24 hour blood pressure monitoring, using either the Avionics, or the ICR Spacelabs, or the Takeda system. Each subject was attributed a target organ damage score on the basis of 12-lead electrocardiogram, chest X-ray and fundoscopy, starting from 0 (no damage) up to 5 (maximum degree of damage). The 522 subjects were subsequently subdivided into 5 classes of increasing average daytime diastolic blood pressure. In each class a higher degree of cardiovascular complications was present in the subjects with the higher blood pressure variability and the higher average night-time blood pressure. From these results it may be inferred that both blood pressure variability and night-time blood pressure are related to the degree of target organ damage in hypertension. This stresses the importance of recording blood pressure throughout the 24 hours. PMID:2147124
Kim, Su-A; Kim, Jang Young; Park, Jeong Bae
There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings. PMID:27310982
Lee, Yong Jin
This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes.
... mean? Blood pressure is measured by two numbers. systolic pressure 120 80 diastolic pressure Your provider will ... 120 over 80” The first (or top) number—“systolic”—is the pressure in your blood vessels when ...
Alstrøm, Preben; Eguíluz, Victor M.; Gustafsson, Finn; Holstein-Rathlou, Niels-Henrik
A new Rayleigh-type instability is proposed to explain the `sausage-string' pattern of alternating constrictions and dialtations formed in blood vessels at high blood pressure conditions. Our theory involves the nonlinear stress-strain characteristics of the vessel wall, and provides predictions for the conditions under which the normal cylindrical geometry of a blood vessel becomes unstable. The theory explains key features observed experimentally, e.g. the limited occurrence of the sausage-string pattern to small arteries and large arterioles, and only in those with small wall-to-lumen ratios.
Špan, Matjaž; Geršak, Gregor; Millasseau, Sandrine C; Meža, Marko; Košir, Andrej
In occidental countries, peripheral arterial disease (PAD) is an important health issue; however, most subjects are asymptomatic (~50%) and therefore undiagnosed and untreated. Current guidelines recommend screening for PAD in primary care setting using ankle brachial index (ABI) in all patients with cardiovascular risks. This is, however, not performed strictly because the standard Doppler method is cumbersome and time-consuming. Here, we evaluate the accuracy and reproducibility of ABI measurements obtained by an improved automated oscillometric device, the MESI ABPI MD(®) device, and the standard Doppler method. ABI was measured in random order in a general practice with Doppler probes by two operators separately (ABI_dop) and twice with the MESI ABPI MD device (ABI_mesi). ABI_dop was calculated dividing the highest systolic blood pressure from both tibial and dorsalis pedis arteries by the highest systolic blood pressure of both brachial arteries. ABI_mesi was obtained automatically with simultaneous measurements on three extremities. According to ABI_dop, PAD was present in 10% of the 136 screened subjects (68.2±7.4 years). Interoperator coefficient of variation was 5.5% for ABI_dop, while the intrasubject coefficient of variation for ABI_mesi was 3.0%. ABI_mesi was correlated with ABI_dop (R=0.61, P<0.0001). The difference between the two techniques was 0.06±0.14 with ABI_mesi providing slightly higher values (P<0.0001) and negligible bias across the range (R=0.19, P<0.0001). Therefore, ABI_mesi ≤1 had a sensitivity of 85% and specificity of 96% to detect ABI_dop ≤0.9 and hence PAD. Doppler measurements took seven times longer than MESI ABPI MD measurements to be performed. In conclusion, MESI improved automated oscillometric method and offered a faster and repeatable measurement of ABI with only a small, clinically irrelevant overestimation of ABI value. The tested MESI ABPI MD-improved oscillometric system can be used as a screening tool for patients
Špan, Matjaž; Geršak, Gregor; Millasseau, Sandrine C; Meža, Marko; Košir, Andrej
In occidental countries, peripheral arterial disease (PAD) is an important health issue; however, most subjects are asymptomatic (~50%) and therefore undiagnosed and untreated. Current guidelines recommend screening for PAD in primary care setting using ankle brachial index (ABI) in all patients with cardiovascular risks. This is, however, not performed strictly because the standard Doppler method is cumbersome and time-consuming. Here, we evaluate the accuracy and reproducibility of ABI measurements obtained by an improved automated oscillometric device, the MESI ABPI MD® device, and the standard Doppler method. ABI was measured in random order in a general practice with Doppler probes by two operators separately (ABI_dop) and twice with the MESI ABPI MD device (ABI_mesi). ABI_dop was calculated dividing the highest systolic blood pressure from both tibial and dorsalis pedis arteries by the highest systolic blood pressure of both brachial arteries. ABI_mesi was obtained automatically with simultaneous measurements on three extremities. According to ABI_dop, PAD was present in 10% of the 136 screened subjects (68.2±7.4 years). Interoperator coefficient of variation was 5.5% for ABI_dop, while the intrasubject coefficient of variation for ABI_mesi was 3.0%. ABI_mesi was correlated with ABI_dop (R=0.61, P<0.0001). The difference between the two techniques was 0.06±0.14 with ABI_mesi providing slightly higher values (P<0.0001) and negligible bias across the range (R=0.19, P<0.0001). Therefore, ABI_mesi ≤1 had a sensitivity of 85% and specificity of 96% to detect ABI_dop ≤0.9 and hence PAD. Doppler measurements took seven times longer than MESI ABPI MD measurements to be performed. In conclusion, MESI improved automated oscillometric method and offered a faster and repeatable measurement of ABI with only a small, clinically irrelevant overestimation of ABI value. The tested MESI ABPI MD-improved oscillometric system can be used as a screening tool for patients
Parkinson, D K; Hodgson, M J; Bromet, E J; Dew, M A; Connell, M M
Recent community studies have suggested that low level lead exposure is significantly associated with blood pressure in the general population. This finding is inconsistent with the results of recent occupational studies of lead exposed workers, although the occupational studies contained serious methodological weaknesses. The present study examined the relation between occupational lead exposure and diastolic and systolic blood pressure in randomly selected samples of 270 exposed and 158 non-exposed workers. Four exposure indicators were examined: employment at a lead battery plant nu a control plant, current blood lead value, current zinc protoporphyrin value, and time weighted average blood lead value. After controlling for other known risk factors such as age, education, income, cigarette usage, alcohol consumption, and exercise, the associations between exposure and blood pressure were small and non-significant. In the absence of a biologically feasible hypothesis regarding the mechanism by which low level lead exposure would influence blood pressure the present findings challenge the validity of the general population association. PMID:3689706
Banach, Maciej; Aronow, Wilbert S; Serban, Maria-Corina; Rysz, Jacek; Voroneanu, Luminita; Covic, Adrian
The most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2015 were reviewed. In lipid research, the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial revalidated the concept "lower is better" for low density lipoprotein (LDL)-cholesterol as a target for therapy, increasing the necessity of treatment the high-risk patients to achieve LDL-C goals. After these results, ezetimibe might become the preferred additional drug in the combination therapy of lipid disorders because of oral dosage form and lower acquisition cost. However, for the statin-intolerant patients and those patients requiring essential reductions in LDL-C to achieve their goals, new therapies, including PCSK9 inhibitors remain promising drugs. In blood pressure research, American Heart Association (AHA)/American College of Cardiology (ACC) 2015 guidelines recommended a target for blood pressure below 140/90 mmHg in stable or unstable coronary artery disease patients and below 150/90 mmHg in patients older than 80 years of age, however the recent results of the Systolic Blood Pressure Intervention Trial (SPRINT) trial have suggested that there might be significant benefits, taking into account cardiovascular risk, for hypertensive patients over 50 without diabetes and blood pressure levels <120/80. In kidney research, reducing the progression of chronic kidney disease and related complications such as anemia, metabolic acidosis, bone and mineral diseases, acute kidney injury and cardiovascular disease is still a goal for clinicians. PMID:26718096
Introduction. Noninvasive blood pressure (NIBP) monitoring methods are widely used in critically ill patients despite poor evidence of their accuracy. The erroneous interpretations of blood pressure (BP) may lead to clinical errors. Objectives. To test the accuracy and reliability of aneroid (ABP) and oscillometric (OBP) devices compared to the invasive BP (IBP) monitoring in an ICU population. Materials and Methods. Fifty adult patients (200 comparisons) were included in a randomized crossover trial. BP was recorded simultaneously by IBP and either by ABP or by OBP, taking IBP as gold standard. Results. Compared with ABP, IBP systolic values were significantly higher (mean difference ± standard deviation 9.74 ± 13.8; P < 0.0001). Both diastolic (−5.13 ± 7.1; P < 0.0001) and mean (−2.14 ± 7.1; P=0.0033) IBP were instead lower. Compared with OBP, systolic (10.80 ± 14.9; P < 0.0001) and mean (5.36 ± 7.1; P < 0.0001) IBP were higher, while diastolic IBP (−3.62 ± 6.0; P < 0.0001) was lower. Bland-Altman plots showed wide limits of agreement in both NIBP-IBP comparisons. Conclusions. BP measurements with different devices produced significantly different results. Since in critically ill patients the importance of BP readings is often crucial, noninvasive techniques cannot be regarded as reliable alternatives to direct measurements. PMID:24616624
Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An
Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0
Shimbo, Daichi; Pickering, Thomas G.; Spruill, Tanya M.; Abraham, Dennis; Schwartz, Joseph E.; Gerin, William
Background Home blood pressure (HBP) monitoring plays an increasingly important role in the diagnosis and treatment of hypertension. We evaluated the independent value of HBP compared to ambulatory blood pressure (ABP) and office blood pressure (OBP) in the prediction of cardiovascular end-organ damage in normotensive subjects and untreated patients with mild hypertension. Methods 163 subjects underwent measurements of OBP, HBP, ABP, and echocardiography. A physician using a mercury column sphygmomanometer performed three OBP measurements. ABP was recorded using a noninvasive ambulatory monitor (mean 35.4 awake readings per subject). Participants took HBP readings with an automatic, oscillometric device over a 10-week period (mean 277.9 readings per subject). Left ventricular mass index (LVMI) was calculated from measurements obtained from 2-dimensionally guided M-mode or linear tracings on echocardiography. Results For systolic and diastolic blood pressures (SBP/DBP), the correlation coefficients of LVMI with OBP, awake ABP, and HBP were .29/.27, .41/.26, and .47/.35 respectively (all ps<.01). In a multivariate regression analysis in which age, sex, body mass index, OBP, awake ABP, and HBP were included, only age, sex, and HBP were significant predictors of LVMI. When only the first 12 home readings were used, the superiority of HBP was no longer evident. Conclusions In contrast to OBP and ABP, HBP measurements, when averaged over a 10-week period, are independently related to LVMI. HBP adds prognostic information over and above OBP and ABP in the prediction of cardiovascular end-organ damage, but this relation appears to depend on the number of readings taken. PMID:17485006
Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R
Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594
Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.
A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
Moss, Arthur J.
In infants the flush and Doppler methods of blood pressure measurement are usually used. The flush method measures mean pressure; the Doppler method, systolic and diastolic pressures. Normal flush values from 1 to 12 months of age do not exceed 100 mm of mercury; Doppler systolic levels do not exceed 113 mm of mercury. Data concerning normal limits for children and adolescents are conflicting. For practical purposes, a persistent pressure of 140 mm of mercury systolic or 90 mm of mercury diastolic in patients more than 10 years of age is indicative of hypertension. In those younger than 10 years, systolic pressure does not normally exceed 130 mm of mercury and diastolic pressure does not normally exceed 85 mm of mercury. Primary hypertension is relatively infrequent in pediatric patients and diagnosis should be made with deliberation and caution. Antihypertensive drug therapy is indicated only for severe hypertension and in selected cases of moderate hypertension. PMID:7245735
The Search for High-Impact Diagnostic and Management Tools for Low- and Middle-Income Countries: A Self-Powered Low-Cost Blood Pressure Measurement Device Powered by a Solid-State Vibration Energy Harvester.
Bilgen, Onur; Kenerson, John G; Akpinar-Elci, Muge; Hattery, Rebecca; Hanson, Lisbet M
The World Health Organization has established recommendations for blood pressure measurement devices for use in low-resource venues, setting the "triple A" expectations of Accuracy, Affordability, and Availability. Because of issues related to training and assessment of proficiency, the pendulum has swung away from manual blood pressure devices and auscultatory techniques towards automatic oscillometric devices. As a result of power challenges in the developing world, there has also been a push towards semiautomatic devices that are not dependent on external power sources or batteries. Beyond solar solutions, disruptive technology related to solid-state vibrational energy harvesting may be the next iterative solution to attain the ultimate goal of a self-powered low-cost validated device that is simple to use and reliable. PMID:25913774
Wu, Hongjun; Wang, Bingjian; Zhu, Xinpu; Chu, Guang; Zhang, Zhi
Abstract The widely used oscillometric automated blood pressure (BP) monitor was continuously questioned on its accuracy. A novel BP kit named Accutension which adopted Korotkoff auscultation method was then devised. Accutension worked with a miniature microphone, a pressure sensor, and a smartphone. The BP values were automatically displayed on the smartphone screen through the installed App. Data recorded in the phone could be played back and reconfirmed after measurement. They could also be uploaded and saved to the iCloud. The accuracy and consistency of this novel electronic auscultatory sphygmomanometer was preliminarily verified here. Thirty-two subjects were included and 82 qualified readings were obtained. The mean differences ± SD for systolic and diastolic BP readings between Accutension and mercury sphygmomanometer were 0.87 ± 2.86 and −0.94 ± 2.93 mm Hg. Agreements between Accutension and mercury sphygmomanometer were highly significant for systolic (ICC = 0.993, 95% confidence interval (CI): 0.989–0.995) and diastolic (ICC = 0.987, 95% CI: 0.979–0.991). In conclusion, Accutension worked accurately based on our pilot study data. The difference was acceptable. ICC and Bland–Altman plot charts showed good agreements with manual measurements. Systolic readings of Accutension were slightly higher than those of manual measurement, while diastolic readings were slightly lower. One possible reason was that Accutension captured the first and the last korotkoff sound more sensitively than human ear during manual measurement and avoided sound missing, so that it might be more accurate than traditional mercury sphygmomanometer. By documenting and analyzing of variant tendency of BP values, Accutension helps management of hypertension and therefore contributes to the mobile heath service. PMID:27512876
Jerez, S J; Coviello, A
The purpose of this study was to evaluate alcohol consumption among adolescents from Tucuman, Argentina, and to determine its possible relationship with increased levels of blood pressure. Three hundred fifty-six students aged 13-18 included in the study were asked to answer questionnaires anonymously. Two blood pressures measures were then taken. Differences between both sexes were found in quantity and frequency of alcohol consumption. Enjoyment was determined to be the main reason for drinking. There was an association between frequency and alcohol-related problems, and smoking habits. There were also differences in blood pressure among males and females. A weak, but significant, relationship between quantity/frequency index and diastolic blood pressure was found. A greater prevalence of hypertension in male heavy drinkers was noted as well. Because this addiction implies multiple social problems and it also accounts for a hypertension risk factor, the importance of aiming at developing prevention strategies for alcohol abuse among adolescents is stressed. PMID:9650629
Farkas, A. J.
System is described that employs solid state circuitry to transmit visual display of patient's blood pressure. Response of sphygmomanometer cuff and microphone provide input signals. Signals and their amplitudes, from turn-on time to turn-off time, are continuously fed to data transmitter which transmits to display device.
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…
... Karanja N, Lin PH; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH)diet. DASH-Sodium Collaborative Research Group. N Engl J Med . 2001 Jan 4;344( ...
... Español You Are Here: Home → Latest Health News → Article URL of this page: https://www.nlm.nih.gov/medlineplus/news/fullstory_158878.html Could Spuds Be Bad for Blood Pressure? Eating potatoes 4 or more ...
Hodgkinson, James A; Tucker, Katherine L; Martin, Una; Beesley, Louise; McManus, Richard J
Measurement of ambulatory blood pressure is recommended by the National Institute for Health and Care Excellence guidelines to confirm the diagnosis of hypertension in the UK. This article describes the use of ambulatory devices, and discusses the benefits and disadvantages of their use in clinical practice. PMID:26551492
Central aortic blood pressure (CBP) is increasingly considered a better cardiovascular prognostic marker than conventional cuff brachial blood pressure. Because CBP cannot be directly measured noninvasively, it has to be estimated from peripheral pressure pulses. To assess estimated CBP appropriately, the accuracy and features of the estimation method should be considered. The aim of this review is to provide basic knowledge and information useful for interpreting and assessing estimated CBP from a methodological point of view. Precise peripheral pressure pulse recording has been enabled by the introduction of arterial applanation tonometry, for which the radial artery may be the optimal site. An automated tonometry device utilizing a sensor array is preferable in terms of reproducibility and objectivity. Calibration of a peripheral pressure waveform has unresolved problems for any estimation method, due to imperfect brachial sphygmomanometry. However, if central and peripheral pressure calibrations are equivalent, two major methods to estimate CBP—those based on generalized pressure transfer function or radial late systolic pressure—may be comparable in their accuracy of CBP parameter estimation. PMID:22866025
Zhu, Yongjian; Bo, Yacong; Wang, Xi; Lu, Wenjie; Wang, Xule; Han, Zhanying; Qiu, Chunguang
Abstract The findings of clinical studies concerning the association between anthocyanins supplementation and blood pressure (BP) are inconsistent. In order to provide a more precise estimate of the overall effect of anthocyanins on systolic blood pressure (SBP) and diastolic blood pressure (DBP), we conducted a meta-analysis of clinical trials about anthocyanins supplementation and BP. PubMed, Web of Science, Wanfang Database, and China National Knowledge Infrastructure (CNKI) (until October 2015) were searched to identify potential studies with information on anthocyanins extract supplementation and arterial BP. The weighted mean difference (WMD) and 95% confidence interval (CI) were used as a summary statistic. Net changes in SBP and DBP between anthocyanins supplementation and placebo groups were calculated by subtracting the values at end of follow-up from those at baseline. Meta regression was used to explore the potential moderators of effect size. The publication bias was assessed using Begger's Funnel plots and Egger's tests; P < 0.05 was considered to be statistically significant. Finally, 6 clinical studies with 472 participants for the effect of anthocyanins consumption on BP were included in the present meta-analysis. There is no significant effect on either SBP (WMD: 1.15 mm Hg, 95% CI: −3.17 to 5.47, I2 = 56%) or DBP (WMD: 1.06 mm Hg, 95% CI: −0.71 to 2.83, I2 = 0%) following supplementation with anthocyanins. In summary, results from this meta-analysis do not favor any clinical efficacy of supplementation with anthocyanins in improving blood pressure. Further well-designed large randomized controlled trials (RCTs) with long follow-up period are needed to verify the association of anthocyanins supplementation and blood pressure. PMID:27082604
He, Zheng; Nguyen, Christine T. O.; Armitage, James A.; Vingrys, Algis J.; Bui, Bang V.
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. PMID:22359566
Orchard, T J; Rodgers, M; Hedley, A J; Mitchell, J R
A total of 625 adolescents from three general practices participated in a cross-sectional study of cardiovascular disease risk factors. The girls had higher serum total and high density lipoprotein (HDL) cholesterol concentrations than the boys, while the boys had higher serum triglyceride concentrations. Smoking (equally prevalent in both sexes) was associated with lower HDL cholesterol concentrations, particularly in boys, while in girls use of oral contraceptives was associated with higher total cholesterol and lower HDL cholesterol concentrations showed striking associations with age, height, and sexual maturation in boys, but not in girls. Triglyceride concentrations were associated with age in boys. Systolic blood pressure and serum urate concentrations were higher in boys and rose steeply with age, but no age association was seen for urate concentrations or systolic blood pressure in girls or for diastolic pressures in either sex. Girls, however, had higher diastolic pressures. There was a strong association between urate concentration and the other cardiovascular disease risk factors, especially HDL cholesterol. Adolescence is associated with considerable changes in cardiovascular disease risk factors, and there are striking sex differences in these changes. PMID:6968612
... 21 Food and Drugs 8 2014-04-01 2014-04-01 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...
... 21 Food and Drugs 8 2011-04-01 2011-04-01 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...
... 21 Food and Drugs 8 2013-04-01 2013-04-01 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...
... 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...
... 21 Food and Drugs 8 2012-04-01 2012-04-01 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...
Royal-Thomas, Tamika; McGee, Daniel; Sinha, Debajyoti; Osmond, Clive; Forrester, Terrence
This article looks at the association of maternal blood pressure with the blood pressure of the offspring from birth to childhood. The Barker hypothesis states that maternal and "in utero" attributes during pregnancy affect a child's cardiovascular health throughout life. We present an analysis of a unique dataset that consists of three distinct developmental processes: maternal cardiovascular health during pregnancy; fetal development; and child's cardiovascular health from birth to 14 years. This study explored whether a mother's blood pressure reading in pregnancy predicts fetal development and determines if this in turn is related to the future cardiovascular health of the child. This article uses data that have been collected prospectively from a Jamaican cohort which involves the following three developmental processes: (1) maternal cardiovascular health during pregnancy which is the blood pressure and anthropometric measurements at seven time-points on the mother during pregnancy; (2) fetal development which consists of ultrasound measurements of the fetus taken at six time-points during pregnancy; and (3) child's cardiovascular health which consists of the child's blood pressure measurements at 24 time-points from birth to 14 years. The inter-relationship of these three processes was examined using linear mixed effects models. Our analyses indicated that attributes later in childhood development, such as child's weight, child's baseline systolic blood pressure (SBP), age and sex, predict the future cardiovascular health of children. The results also indicated that maternal attributes in pregnancy, such as mother's baseline SBP and SBP change, predicted significantly child's SBP over time. PMID:25178900
Postprandial hypotension, defined as a fall in systolic blood pressure (SBP) of 20 mmHg or greater within 2 hours after a meal, is a risk factor for stroke, coronary events and mortality. The clinical suspicion is typically raised by episodes of postprandial syncope or falls, whereas asymptomatic postprandial hypotension is mostly neglected. The magnitude of the postprandial fall in SBP, as detected by 24-hour recording in apparently healthy middle-aged to elderly subjects, was proportional to the severity of the silent cerebrovascular damage. Postprandial hypotension can also be detected by self-measured blood pressure before and within 2 hours after meals using automatic devices. The review highlights the value of home blood pressure monitoring (HBPM) as a screening test for asymptomatic postprandial hypotension in hypertensive patients. Using a HBPM protocol that included duplicated blood pressure measurements before and after three consecutive lunches, we detected unsuspected postprandial hypotension in 27.4% of the 230 hypertensive patients screened. The prevalence of postprandial hypotension was 13.2% in controlled and 42.2% in uncontrolled hypertensive patients (p < 0.001), raising the dilemma of further lowering blood pressure in the setting of postprandial hypotension. The inclusion of preprandial and postprandial measurements in the protocol of HBPM is useful to identify hypertensive patients with postprandial hypotension and may guide adjustments in antihypertensive treatment according to postprandial blood pressure. PMID:26187907
Lancaster, Carolyn; And Others
Text, illustrations, and exercises are utilized in these four learning modules to teach dental hygiene students, nursing students, and the general public how to measure blood pressure. The first module, "Can You Take a Blood Pressure?" by Carolyn Lancaster, defines blood pressure, distinguishes between systolic and diastolic pressure and lists the…
Hayashi, Satoru; Hayase, Toshiyuki; Shirai, Atsushi; Maruyama, Masaru
In this paper, a simulation model based on the partially pressurized collapsible tube model for reproducing noninvasive blood pressure measurement is presented. The model consists of a collapsible tube, which models the pressurized part of the artery, rigid pipes connected to the collapsible tube, which model proximal and distal region far from the pressurized part, and the Windkessel model, which represents the capacitance and the resistance of the distal part of the circulation. The blood flow is simplified to a one-dimensional system. Collapse and expansion of the tube is represented by the change in the cross-sectional area of the tube considering the force balance acting on the tube membrane in the direction normal to the tube axis. They are solved using the Runge-Kutta method. This simple model can easily reproduce the oscillation of inner fluid and corresponding tube collapse typical for the Korotkoff sounds generated by the cuff pressure. The numerical result is compared with the experiment and shows good agreement. PMID:16995754
Verberk, Willem J; Omboni, Stefano; Kollias, Anastasios; Stergiou, George S
Several guidelines recommend opportunistic screening for atrial fibrillation (AF) in subjects aged ≥ 65 years using pulse palpation during routine blood pressure (BP) measurement. However, this method has limited diagnostic accuracy. A specific algorithm for AF detection during automated BP measurement was developed and implemented in a novel oscillometric device (Microlife WatchBP Home-A). In 2013, the UK National Institute for Health and Care Excellence (NICE) recommended this device for AF screening during routine office BP measurement in primary care in subjects ≥ 65 years. A review and meta-analysis of the evidence on the diagnostic accuracy of this algorithm were performed. Six studies (n=2332) investigated the accuracy of AF detection using the Microlife BP monitor and estimated a pooled sensitivity at 0.98 (95% CI 0.95, 1.00) and specificity 0.92 (0.88, 0.96). Analysis of 4 studies (n=1126) showed more readings to improve specificity (from 0.86 to 0.91) and sensitivity (from 0.97 to 0.99). Taking 3 sequential readings with at least 2 detecting AF gave the highest diagnostic accuracy. A single study (n=139) of paroxysmal AF screening with home BP monitoring (3316 days) showed sensitivity 99% and specificity 93%. Another study (n=46) of AF screening with 24h ambulatory BP monitoring showed that AF detected in >15% of all readings has high probability of AF diagnosis requiring confirmation by 24h electrocardiography. AF detection with routine automated BP measurement is a reliable screening tool in the elderly, which requires confirmation by electrocardiography. Paroxysmal AF might also be detected by routine automated home or ambulatory BP monitoring. PMID:26547741
Werneck, André O; Silva, Danilo R P; Souza, Mariana F; Christofaro, Diego G D; Tomeleri, Crisieli M; Fernandes, Rômulo A; Ronque, Enio R V; Coelho-E-Silva, Manuel J; Sardinha, Luís B; Cyrino, Edilson S
The aim of this study was to estimate the prevalence and correlates of blood pressure (BP) according to somatic maturation in Southern Brazilian adolescents. A total of 1321 adolescents participated in the study (732 girls), aged between 10 and 16 years, enrolled in public schools. The assessment of BP was performed using oscillometric equipment. Measurements of body weight, height, waist circumference, and skinfold thickness were performed. Somatic maturation was estimated by the age at peak height velocity. Behavioral and hereditary variables were obtained using a questionnaire. Early-maturing adolescents had the highest prevalence of high BP (28%; 95% confidence interval, 24.6-33.5) compared with other maturational groups (P=.003). In late-maturing adolescents, the variables associated with BP were paternal hypertension (systolic BP: β=4.9; diastolic BP: β=5.3) and early physical activity (systolic BP: β=-4.0; diastolic DBP: β=-3.6). In average-maturing adolescents, waist circumference (systolic BP: β=0.3), body mass index (diastolic BP: β=0.5), and mother's hypertension (diastolic BP: β=1.8) were positively related to BP. In early-maturing adolescents, only waist circumference (systolic BP: β=0.3; diastolic BP: β=0.3) was associated with BP. The authors conclude that the prevalence of high BP is greater in adolescents with early maturity and the outcome appears to be related to biological indicators in this group. On the other hand, in late-maturing adolescents, behavioral and hereditary variables are more related to BP. PMID:26408345
Zoppi, M; Hoigné, R; Keller, M F; Streit, F; Hess, T
A fall in systolic blood pressure without other symptoms of anaphylactic shock has been described following the administration of drugs containing dipyrone. This adverse reaction was first observed in 4 patients by the same team in 1972-1973. Ten further cases with a fall in systolic blood pressure by at least 20 mm Hg occurring within minutes to 6 hours after intravenous administration of dipyrone are presented in this paper. In each of them this adverse reaction was considered to be probable or even definite. During the years 1976-1981 drug exposure was registered for all 15 678 patients of the two medical divisions of Comprehensive Hospital Drug Monitoring Berne. This adverse reaction was found in 7, representing 0.34% of the 2053 patients who received intravenous treatment with a dipyrone preparation. PMID:6658424
Banach, Maciej; Aronow, Wilbert S; Serban, Corina; Sahabkar, Amirhossein; Rysz, Jacek; Voroneanu, Luminita; Covic, Adrian
This paper is an effort to review all the most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2014. Irrespective of advances, the options for improving simultaneous hypercholesterolemia and hypertension management (as well as its complication - chronic kidney disease) remain a problem. Recommending hypolidemic, hypotensive and kidney disease drugs to obtain therapy targets in cardiovascular, diabetic, elderly and kidney disease (=high risk) patients might strengthen risk factor control, improve compliance and the therapy efficacy, and in the consequence reduce the risk of cardiovascular events and mortality rate. That is why the authors have decided to summary and discuss the recent scientific achievements in the field of lipid, blood pressure and kidney. PMID:25819754
Case of diabetes mellitus associated with essential hypertension are mostly type 2 diabetes mellitus(NIDDM) in elderly patients. In the JNC VI and JSH 2004, it is recommended that the therapeutic target blood pressure level should be lower then 130/80 mmHg in hypertension complicated with diabetes mellitus, and this target has recently obtained wide acceptance. On the other hand, the target blood pressure in elderly is recommended below 140/90 mmHg. Accordingly, diabetes mellitus in elderly hypertensives should be treated similarly as in the young and middle-aged. Because ACE inhibitors/ARBs or Ca blockers increase insulin sensitivity, these drugs should be used as the first choice in cases of elderly hypertensive patients complicated with diabetes mellitus. PMID:16408451
Lonjaret, Laurent; Lairez, Olivier; Minville, Vincent; Geeraerts, Thomas
Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation. PMID:25278775
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
McNett, Molly; Koren, Jay
Blood pressure (BP) management is essential in neurocritical care settings to ensure adequate cerebral perfusion and prevent secondary brain injury. Despite consensus on the importance of BP monitoring, significant practice variations persist regarding optimal methods for monitoring and treatment of BP values among patients with neurologic injuries. This article provides a summary of research investigating various approaches for BP management in neurocritical care. Evidence-based recommendations, areas for future research, and current technological advancements for BP management are discussed. PMID:26873756
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.
Savica, Vincenzo; Bellinghieri, Guido; Kopple, Joel D
The incidence and severity of hypertension are affected by nutritional status and intake of many nutrients. Excessive energy intake and obesity are major causes of hypertension. Obesity is associated with increased activity of the renin-angiotensin-aldosterone and sympathetic nervous systems, possibly other mineralcorticoid activity, insulin resistance, salt-sensitive hypertension and excess salt intake, and reduced kidney function. High sodium chloride intake strongly predisposes to hypertension. Increased alcohol consumption may acutely elevate blood pressure. High intakes of potassium, polyunsaturated fatty acids, and protein, along with exercise and possibly vitamin D, may reduce blood pressure. Less-conclusive studies suggest that amino acids, tea, green coffee bean extract, dark chocolate, and foods high in nitrates may reduce blood pressure. Short-term studies indicate that specialized diets may prevent or ameliorate mild hypertension; most notable are the Dietary Approaches to Stop Hypertension (DASH) diet, which is high in fruits, vegetables, and low-fat dairy products, and the DASH low-sodium diet. Long-term compliance to these diets remains a major concern. PMID:20645853
Hatton, D.C.; Edgar, S.; McCarron, D.A. )
Epidemiologists have identified alcohol as a risk factor in hypertension. Attempts to increase blood pressure in rats with chronic alcohol ingestion have met with mixed results. Some investigators have reported increases in blood pressure while others have reported decreases. Most investigators have given alcohol in the drinking water which produced differences in food intake across groups. To control for food intake, Wister rats were simultaneously pair fed a liquid diet with either ethanol as 35% of calories or a control diet using ARF/Israel pair-feeding devices. At 5 weeks of age, animals on ethanol diets had lower systolic blood pressure than control animals (145 (n-19) vs. 121 (n-19) mmHg). There was no difference in weight between ethanol and control animals. The same pattern of results was apparent at 7 weeks (143 (n-13) vs. 119 (n-13) mmHg) and 9 weeks (147 (n-7) vs. 124 (n-7)). The data indicate that ethanol produces hypotension in rats when food intake is controlled.
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
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
Petersen, Emilie H; Theilade, Simone; Hansen, Tine W; Lindhardt, Morten K; Rossing, Peter
Discomfort related to cuff inflation may bias 24 h ambulatory blood pressure (BP) measurements, especially during night-time. We accessed the impact of cuff inflations by comparing 24 h BP recorded with a cuff-less tonometric wrist device and an upper-arm oscillometric cuff device. Fifty-three participants with type 2 diabetes were assigned randomly to four 24-h BP recordings with a cuff (TM2430: visit 1 or 2, and 4) and a tonometric device (BPro: visit 1 or 2, 3, and 4). The mean 24 h systolic BP was significantly higher when measured with the cuff versus the tonometric device (141.6±14.6 vs. 128.3±14.6 mmHg, P≤0.01), as was nocturnal BP (6.7±5.3 vs. 10.3±7.6%, P=0.002). In conclusion, nocturnal BP decline was higher when measured with the cuff device, suggesting that cuff inflations did not increase night-time BP. Further evaluation of the tonometric device using the updated European Society of Hypertension International Protocol revision 2010 is recommended before applying it in daily clinical practice. PMID:26154852
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.
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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)
Lehman, Li-wei H.; Saeed, Mohammed; Talmor, Daniel; Mark, Roger; Malhotra, Atul
Objective Minimal clinical research has investigated the significance of different blood pressure monitoring techniques in the ICU and whether systolic vs. mean blood pressures should be targeted in therapeutic protocols and in defining clinical study cohorts. The objectives of this study are to compare real-world invasive arterial blood pressure with noninvasive blood pressure, and to determine if differences between the two techniques have clinical implications. Design We conducted a retrospective study comparing invasive arterial blood pressure and noninvasive blood pressure measurements using a large ICU database. We performed pairwise comparison between concurrent measures of invasive arterial blood pressure and noninvasive blood pressure. We studied the association of systolic and mean invasive arterial blood pressure and noninvasive blood pressure with acute kidney injury, and with ICU mortality. Setting Adult intensive care units at a tertiary care hospital. Patients Adult patients admitted to intensive care units between 2001 and 2007. Interventions None. Measurements and Main Results Pairwise analysis of 27,022 simultaneously measured invasive arterial blood pressure/noninvasive blood pressure pairs indicated that noninvasive blood pressure overestimated systolic invasive arterial blood pressure during hypotension. Analysis of acute kidney injury and ICU mortality involved 1,633 and 4,957 patients, respectively. Our results indicated that hypotensive systolic noninvasive blood pressure readings were associated with a higher acute kidney injury prevalence (p = 0.008) and ICU mortality (p < 0.001) than systolic invasive arterial blood pressure in the same range (≤70 mm Hg). Noninvasive blood pressure and invasive arterial blood pressure mean arterial pressures showed better agreement; acute kidney injury prevalence (p = 0.28) and ICU mortality (p = 0.76) associated with hypotensive mean arterial pressure readings (≤60 mm Hg) were independent of
Banach, Maciej; Serban, Corina; Aronow, Wilbert S; Rysz, Jacek; Dragan, Simona; Lerma, Edgar V; Apetrii, Mugurel; Covic, Adrian
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year. PMID:24573394
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. PMID:18423650
Elias, Merrill F; Dore, Gregory A; Davey, Adam; Robbins, Michael A; Elias, Penelope K
We examined the hypothesis that lowered cognitive performance plays a role in the relation between elevated blood pressure and physical disability in performing basic physical tasks. A community-based sample (N=1025) free from stroke and dementia (mean age: 61.1 years; SD: 13.0 years; 59.8% women) was used. Using path analysis, systolic and diastolic blood pressures (predictor variable) measured over multiple longitudinal examinations were averaged and related to multiple measures of cognition (intermediate variable) and physical ability (PA; outcome variable) measured at wave 6 of the Maine-Syracuse Study. PA was indexed by time required to execute standing, walking, and turning tests. A best-fit path model including blood pressure and multiple demographic and cardiovascular disease covariates was used. Paths from systolic blood pressure to global performance, verbal memory, and abstract reasoning (Similarities test) were significant (P<0.05), as were paths from diastolic blood pressure to global performance, executive functioning, visual spatial organization/memory, verbal memory, working memory, and abstract reasoning. Regardless of the blood pressure predictor, lower cognitive performance (intermediate variable) was related to lower PA (outcome) in the path from blood pressure to PA. The direct path from blood pressure to PA was significant only for systolic blood pressure. Cognitive performance mediates between blood pressure and PA. As compared with systolic blood pressure, more domains of cognitive functioning intervene between diastolic blood pressure and PA. PMID:20404216
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