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Sample records for blood pressure documentation

  1. Blood pressure documentation in the emergency department.

    PubMed

    Daniel, Ana Carolina Queiroz Godoy; Machado, Juliana Pereira; Veiga, Eugenia Velludo

    2017-01-01

    To analyze the frequency of blood pressure documentation performed by nursing professionals in an emergency department. This is a cross-sectional, observational, descriptive, and analytical study, which included medical records of adult patients admitted to the observation ward of an emergency department, between March and May 2014. Data were obtained through a collection instrument divided into three parts: patient identification, triage data, and blood pressure documentation. For statistical analysis, Pearson's correlation coefficient was used, with a significance level of α<0.05. One hundred fifty-seven records and 430 blood pressure measurements were analyzed with an average of three measurements per patient. Of these measures, 46.5% were abnormal. The mean time from admission to documentation of the first blood pressure measurement was 2.5 minutes, with 42 minutes between subsequent measures. There is no correlation between the systolic blood pressure values and the mean time interval between blood pressure documentations: 0.173 (p=0.031). The present study found no correlation between frequency of blood pressure documentation and blood pressure values. The frequency of blood pressure documentation increased according to the severity of the patient and decreased during the length of stay in the emergency department. Analisar a frequência de registros da pressão arterial realizados por profissionais de enfermagem em uma unidade de emergência. Estudo transversal, observacional, descritivo e analítico, que incluiu registros de pacientes adultos admitidos em leitos de observação de uma unidade de emergência no período de março a maio de 2014. Os dados foram obtidos por meio de um instrumento de coleta de dados dividido em três partes: identificação do paciente, dados de triagem e registro da pressão arterial. Para a análise estatística, foi utilizado o coeficiente de correlação de Pearson, com nível de significância de α<0,05. Foram analisados

  2. Blood pressure

    MedlinePlus Videos and Cool Tools

    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 ...

  3. Low Blood Pressure

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    ... a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the ... reading is 90/60 or lower, you have low blood pressure. Some people have low blood pressure ...

  4. Blood Pressure Test

    MedlinePlus

    ... blood pressure readings at home. Tracking your blood pressure readings It can be helpful in diagnosing or ... options might work best for you. Low blood pressure Low blood pressure that either doesn't cause ...

  5. High blood pressure medicines

    MedlinePlus

    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 ...

  6. High Blood Pressure

    MedlinePlus

    ... 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 ...

  7. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  8. High blood pressure

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000468.htm High blood pressure To use the sharing features on this page, ... body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as two numbers. ...

  9. High Blood Pressure

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure What Is High Blood Pressure? High blood pressure is a common disease in ... the heart, kidneys, brain, and eyes. Types of High Blood Pressure There are two main types of high blood ...

  10. Automatic notifications mediated by anesthesia information management systems reduce the frequency of prolonged gaps in blood pressure documentation.

    PubMed

    Ehrenfeld, Jesse M; Epstein, Richard H; Bader, Stephen; Kheterpal, Sachin; Sandberg, Warren S

    2011-08-01

    Arterial blood pressure (BP) measurement at least every 5 minutes is part of the American Society of Anesthesiologists' monitoring standard, but prolonged BP gaps in electronic anesthesia records have been noted. We undertook multicenter studies to determine the frequency of cases with at least 1 interval ≥10 minutes between successive BP measurements and then to ascertain whether educational feedback via an electronic, near real-time notification system alerting providers to the presence of such gaps would reduce their incidence. We evaluated 212,706 electronic anesthesia records from 3 large academic centers. We determined the fraction of cases with ≥10-minute BP monitoring gaps at baseline and did a root cause analysis to determine common causes for these lapses. We then designed and implemented automated systems at 2 of the hospitals to notify point-of-care providers immediately after such 10-minute gaps occurred and determined the subsequent impact of this feedback on BP gap incidence, compared with baseline. At Hospital A, the notification system reduced the incidence of cases with at least 1 BP gap (1.48%± 0.19% SD vs 0.79% ± 0.36% SD, P < 0.0001). At Hospital B, the gap incidence was not significantly altered when notification was provided after a 10-minute gap had already occurred (2.72% ± 0.60% SD vs 2.45% ± 0.48% SD, P = 0.27), but the incidence was reduced when such notification was provided after 6 minutes without a BP reading (2.72% ± 0.60% SD vs 1.54% ± 0.19% SD, P < 0.0001). At Hospital C, where notification was not implemented, the baseline rate of BP gaps was consistent across the preintervention and follow-up periods (7.03% ± 1.27% SD vs 7.13% ± 0.11% SD, P = 0.74). Although monitors disconnected during position change was the most common identifiable cause of BP gaps, reasons for the missing BP measurements were often not documented. During a week when the electronic charting system was temporarily inoperable, no BP gaps were noted

  11. Automatic Notifications Mediated by Anesthesia Information Management Systems Reduce the Frequency of Prolonged Gaps in Blood Pressure Documentation

    PubMed Central

    Ehrenfeld, Jesse M.; Epstein, Richard H.; Bader, Stephen; Kheterpal, Sachin; Sandberg, Warren S.

    2011-01-01

    Background Arterial blood pressure (BP) measurement at least every five minutes is part of the American Society of Anesthesiologists' (ASA) monitoring standard, but prolonged BP gaps in electronic anesthesia records have been noted. We undertook multicenter studies to determine the frequency of cases with at least one interval ≥ 10 minutes between successive BP measurements and then to ascertain if educational feedback via an electronic, near real-time notification system alerting providers to the presence of such gaps would reduce their incidence. Methods We evaluated 212,706 electronic anesthesia records from three large academic centers. We determined the fraction of cases with ≥ 10 minute BP monitoring gaps at baseline and did a root cause analysis to determine common causes for these lapses. We then designed and implemented automated systems at two of the hospitals to notify point-of-care providers immediately after such 10-minute gaps occurred and determined the subsequent impact of this feedback on BP gap incidence, compared to baseline. Results At Hospital A, the notification system reduced the incidence of cases with at least one BP gap (1.48% ± 0.19% SD vs 0.79% ± 0.36% SD, p<0.0001). At Hospital B, the gap incidence was not significantly altered when notification was provided after a 10-min gap had already occurred (2.72% ± 0.60% SD vs. 2.45% ± 0.48% SD, P=0.27), but the incidence was reduced when such notification was provided after 6 minutes without a BP reading (2.72% ± 0.60% SD vs 1.54% ± 0.19% SD, P<0.0001). At Hospital C, where notification was not implemented, the baseline rate of BP gaps was consistent across the preintervention and follow-up periods (7.03% ± 1.27% SD vs. 7.13% ± 0.11% SD, p=0.74). Although monitors disconnected during position change was the most common identifiable cause of BP gaps, reasons for the missing BPs were often not documented. During a week when the electronic charting system was temporarily inoperable, no

  12. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  13. High Blood Pressure in Pregnancy

    MedlinePlus

    ... The Health Information Center High Blood Pressure in Pregnancy What Is High Blood Pressure? Blood pressure is ... Are the Effects of High Blood Pressure in Pregnancy? Although many pregnant women with high blood pressure ...

  14. Blood pressure measurement

    MedlinePlus

    ... have this problem. High blood pressure is often discovered during a visit to the provider for another ... to develop high blood pressure. If you have diabetes, heart disease, or kidney problems, or if you ...

  15. Low blood pressure

    MedlinePlus

    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 ...

  16. Blood Pressure Quiz

    MedlinePlus

    ... high blood pressure can lead to… stroke. kidney failure. heart attack and heart failure. all of the above. ... high blood pressure can lead to stroke, kidney failure, heart attack and heart failure A is the correct ...

  17. High blood pressure - infants

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007329.htm High blood pressure - infants To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  18. High Blood Pressure Prevention

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure Prevention Steps You Can Take You can take steps to prevent high blood pressure by adopting these healthy lifestyle habits. Follow a ...

  19. Blood Pressure Medicines

    MedlinePlus

    High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, ... and kidney failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight and ...

  20. Hypertension (High Blood Pressure)

    MedlinePlus

    ... Visitor Information RePORT NIH Fact Sheets Home > Hypertension (High Blood Pressure) Small Text Medium Text Large Text Hypertension (High Blood Pressure) YESTERDAY Hypertension is a silent killer because it ...

  1. Understanding Blood Pressure Readings

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Mar 22,2017 What do your ... it’s too high for blood pressure High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  2. Low Blood Pressure

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More Low Blood Pressure - When Blood Pressure Is Too Low Updated:Dec 13,2016 How ... content was last reviewed October 2016 High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  3. High Blood Pressure (Hypertension)

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...

  4. 2012 consensus document of the Italian Society of Hypertension (SIIA): strategies to improve blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy.

    PubMed

    Volpe, Massimo; Rosei, Enrico Agabiti; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Virdis, Agostino; Tocci, Giuliano; Trimarco, Bruno; Filippi, Alessandro; Mancia, Giuseppe

    2013-03-01

    Observational clinical studies have demonstrated that only 30-40% of patients with arterial hypertension achieve the recommended blood pressure goals (below 140/90 mmHg). In contrast, interventional trials consistently showed that it is possible to achieve effective blood pressure targets in about 70% of treated hypertensive patients with different cardiovascular risk profiles, especially through the use of rational, effective and well tolerated combination therapies. In order to bridge the gap between current and desired blood pressure control and to achieve more effective prevention of cardiovascular diseases, the Italian Society of Hypertension (SIIA) has developed an interventional strategy aimed at reaching nearly 70% of treated controlled hypertensive patients by 2015. This ambitious goal can be realistically achieved by a more rational use of modern tools and supports, and also through the use of combination therapy in hypertension in daily clinical practice, especially if this approach can be simplified into a single pill (fixed combination therapy), which is a therapeutic option now also available in Italy. Since about 70-80% of treated hypertensive patients require a combination therapy based on at least two classes of drugs in order to achieve the recommended blood pressure goals, it is of key importance to implement this strategy in routine clinical practice. Amongst the various combination therapies currently available for hypertension treatment and control, the use of those strategies based on drugs that antagonize the renin-angiotensin system, such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) and ACE inhibitors, in combination with diuretics and/or calcium channel blockers, has been shown to significantly reduce the risk of major cardiovascular events and to improve patient compliance to treatment, resulting in a greater antihypertensive efficacy and better tolerability compared with monotherapy. The present document

  5. Low Blood Pressure (Hypotension)

    MedlinePlus

    ... and fatigue. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can lead to dehydration. Blood ... can cause low blood pressure, including: Water pills (diuretics), such as furosemide (Lasix) and hydrochlorothiazide (Maxzide, Microzide, ...

  6. Blood Pressure Control

    NASA Technical Reports Server (NTRS)

    1986-01-01

    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.

  7. Blood Pressure Checker

    NASA Technical Reports Server (NTRS)

    1979-01-01

    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.

  8. [Measuring blood pressure].

    PubMed

    Estrada Reventos, Dolors; Pujol Navarro, Ester

    2008-09-01

    High blood pressure is one of the main factors which lead to cardiovascular cerebral-vascular and kidney diseases; therefore, nursing professionals should have enough basic knowledge to enable them to carry out a precocious diagnosis and correct follow-up procedures. Although students in nursing schools are taught how to correctly measure blood pressure, often this teaching does not meet the recommendations provided by different national and international guidelines. Thus it is important to know how to use the correct methodology to measure blood pressure.

  9. High Blood Pressure

    MedlinePlus

    ... is at rest between beats Health care workers write blood pressure numbers with the systolic number above ... available to discuss recent findings and ongoing research projects about health conditions and social determinants that disproportionately ...

  10. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity and ... blood pressure at home. Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help ...

  11. High Blood Pressure (Hypertension)

    MedlinePlus

    ... can improve your health in other ways. Mastering stress management techniques can lead to other behavior changes — including those that reduce your blood pressure. When looking for ways to manage stress, remember that you have many options. For example: ...

  12. Prevention of High Blood Pressure

    MedlinePlus

    ... 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 ...

  13. Blood pressure monitors for home

    MedlinePlus

    ... type of blood pressure monitor for home use. DIGITAL BLOOD PRESSURE MONITORS A digital device will also have a cuff that wraps ... on its own. The screen will show a digital readout of your systolic and diastolic blood pressure. ...

  14. Automated Blood Pressure Measurement

    NASA Technical Reports Server (NTRS)

    1978-01-01

    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.

  15. Reliability of nocturnal blood pressure dipping.

    PubMed

    Dimsdale, J E; von Känel, R; Profant, J; Nelesen, R; Ancoli-Israel, S; Ziegler, M

    2000-08-01

    Increasing evidence documents the fact that individuals whose blood pressure drops or 'dips' relatively little at night have a higher risk of numerous cardiovascular illnesses. To examine the reliability of various measures of nocturnal blood pressure dipping. This study examined 17 individuals with ambulatory blood pressure monitoring on three 24 h recordings while they pursued a schedule similar to that of in-patients on a clinical research unit. Nocturnal dipping of blood pressure was scored three ways: as the drop in blood pressure between 10 p.m. and 6 a.m. ('clocktime'), as the drop in blood pressure tailored to each individual's reported bedtime ('bedtime'), and as the drop in blood pressure accompanying polysomnographically verified sleep ('sleeptime'). Adequate reliability was obtained for all three measures of dipping. There was, in general, a significant correlation across testing occasions (P<0.05). The correlation coefficient ranged from 0.5 to 0.8, depending on which criterion of dipping was selected and whether the endpoint was systolic blood pressure, diastolic blood pressure, or mean arterial blood pressure. The reliability of systolic blood pressure dipping was somewhat lower than that of diastolic or mean arterial blood pressure dipping. Dipping appears to be a reliable construct. While no one definition of dipping was demonstrably better than another, the most sensible definition of dipping would allow some adjustment for defining 'night' on the basis of each individual's idiosyncratic bed time.

  16. Test Your Blood Pressure IQ

    MedlinePlus

    ... How High Blood Pressure is Diagnosed BP vs. Heart Rate Low Blood Pressure Resistant Hypertension Pulmonary Hypertension High Blood Pressure Myths ... Healthy 6 What are the Symptoms of High Blood Pressure? 7 All About Heart Rate (Pulse) 8 Tachycardia | Fast Heart Rate 9 Warning ...

  17. Living with High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Living With High Blood Pressure If you have high blood pressure, the best thing to do is to talk ... help you track your blood pressure. Pregnancy Planning High blood pressure can cause problems for mother and baby. High ...

  18. What Causes High Blood Pressure?

    MedlinePlus

    ... can cause high blood pressure. Renin-Angiotensin-Aldosterone System The renin-angiotensin-aldosterone system makes angiotensin and ... blood volumes and high blood pressure. Sympathetic Nervous System Activity The sympathetic nervous system has important functions ...

  19. Blood vessels, circulation and blood pressure.

    PubMed

    Hendry, Charles; Farley, Alistair; McLafferty, Ella

    This article, which forms part of the life sciences series, describes the vessels of the body's blood and lymphatic circulatory systems. Blood pressure and its regulatory systems are examined. The causes and management of hypertension are also explored. It is important that nurses and other healthcare professionals understand the various mechanisms involved in the regulation of blood pressure to prevent high blood pressure or ameliorate its damaging consequences.

  20. Blood Pressure Control

    NASA Technical Reports Server (NTRS)

    1992-01-01

    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.

  1. High Blood Pressure Fact Sheet

    MedlinePlus

    ... this? Submit What's this? Submit Button Related CDC Web Sites Heart Disease Stroke High Blood Pressure Salt ... Prevent and Control Chronic Diseases Million Hearts® WISEWOMAN Web Sites with More Information About High Blood Pressure ...

  2. Blood Pressure vs. Heart Rate

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Jan 18,2017 ... content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  3. High Blood Pressure in Pregnancy

    MedlinePlus

    ... 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 ...

  4. High blood pressure and diet

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007483.htm High blood pressure and diet To use the sharing features on ... diet is a proven way to help control high blood pressure . These changes can also help you lose weight ...

  5. High Blood Pressure - Multiple Languages

    MedlinePlus

    ... Well-Being 8 - High Blood Pressure - العربية (Arabic) MP3 Siloam Family Health Center High Blood Pressure - العربية ( ... Being 8 - High Blood Pressure - myanma bhasa (Burmese) MP3 Siloam Family Health Center Chinese, Simplified (Mandarin dialect) ( ...

  6. Controlling your high blood pressure

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000101.htm Controlling your high blood pressure To use the sharing features on this page, ... JavaScript. Hypertension is another term used to describe high blood pressure. High blood pressure can lead to: Stroke Heart ...

  7. What Is High Blood Pressure?

    MedlinePlus

    ... consistently too high. How your blood pressure and circulatory system work In order to survive and function properly, ... and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, ...

  8. Automated office blood pressure.

    PubMed

    Myers, Martin G; Godwin, Marshall

    2012-05-01

    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.

  9. Low Blood Pressure (Hypotension)

    MedlinePlus

    ... if you stand up after lying down. Ordinarily, gravity causes blood to pool in your legs whenever ... eating. It affects mostly older adults. Just as gravity pulls blood to your feet when you stand, ...

  10. Diabetes and blood pressure (image)

    MedlinePlus

    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 ...

  11. Stroke and High Blood Pressure

    MedlinePlus

    ... Disease Venous Thromboembolism Aortic Aneurysm More How High Blood Pressure Can Lead to Stroke Updated:May 3,2017 ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  12. Drinking pattern and blood pressure.

    PubMed

    Seppä, K; Laippala, P; Sillanaukee, P

    1994-03-01

    Large amounts of alcohol are known to increase blood pressure. There is little evidence about the effect of binge drinking of alcohol on blood pressure, although this is the dominant style of alcohol drinking in several countries. The purpose of the present study was to examine the relationship between binge drinking and blood pressure using daily heavy drinkers as a reference group. We examined 260 consecutive nonalcoholic 40- and 45-year-old men participating in a health screening. There were 37 teetotalers, 147 social drinkers, 62 weekend heavy drinkers attending the health screening 2 to 7 days after binge drinking, and 14 men who drank heavily every day. Group division was made using self-reported alcohol consumption and a structured alcohol questionnaire. Blood pressure was measured manually by a mercury manometer. BMDP statistical software was used in the statistical analysis of the material. The diastolic blood pressure of weekend heavy drinkers (mean intake during the weekend, 289 g) did not differ from that found in teetotalers but systolic blood pressure was slightly higher (5 mm Hg, P = .04). In contrast, daily heavy drinkers (mean intake during the weekend [Friday to Saturday], 151 g) had significantly higher systolic (8 mm Hg, P = .04) and diastolic (6 mm Hg, P = .05) blood pressure values than teetotalers. We conclude that different drinking habits seem to have different effects on blood pressure, those of daily heavy drinking being more prominent than those of weekend heavy drinking.

  13. Managing High Blood Pressure Medications

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Managing High Blood Pressure Medications Updated:Jan 3,2017 When your doctor ... health. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  14. High Blood Pressure and Women

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure and Women Updated:Dec 14,2016 Pregnancy and ... Women . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  15. High Blood Pressure Increasing Worldwide

    MedlinePlus

    ... other ways to control blood pressure, including healthy lifestyle choices and maintaining a normal weight, Roth said. Murray said some of the factors responsible for the worldwide increase in high blood pressure are unhealthy diets and obesity. In addition, in developing countries, more people are ...

  16. Serotonin and Blood Pressure Regulation

    PubMed Central

    Morrison, Shaun F.; Davis, Robert Patrick; Barman, Susan M.

    2012-01-01

    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

  17. Beat-to-Beat Blood Pressure Monitor

    NASA Technical Reports Server (NTRS)

    Lee, Yong Jin

    2012-01-01

    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

  18. High blood pressure in women.

    PubMed

    Calhoun, D A; Oparil, S

    1997-01-01

    There is a sexual dimorphism in blood pressure of humans and experimental animals: males tend to have higher blood pressure than females with functional ovaries, while ovariectomy or menopause tends to abolish the sexual dimorphism and cause females to develop a "male" pattern of blood pressure. Hypertensive male laboratory animals tend to have NaCl-sensitive blood pressure, while females are NaCl resistant unless their ovaries are removed, in which case NaCl sensitivity appears. The hormonal basis of NaCl sensitivity of blood pressure and of the sexual dimorphism of hypertension remains to be defined. Synthetic estrogens and progestins, as found in oral contraceptives, tend to elevate blood pressure, while naturally occurring estrogens lower it, or have no effect. Hypertension increases cardiovascular risk in women, as well as men, although the benefits of antihypertensive treatment have been more difficult to demonstrate in women. In the population of the United States, women are more aware of their hypertension, more likely to be treated medically, and more likely to have their blood pressure controlled.

  19. Chaos in blood pressure control.

    PubMed

    Wagner, C D; Nafz, B; Persson, P B

    1996-03-01

    A number of control mechanisms are comprised within blood pressure regulation, ranging from events on the cellular level up to circulating hormones. Despite their vast number, blood pressure fluctuations occur preferably within a certain range (under physiological conditions). A specific class of dynamic systems has been extensively studied over the past several years: nonlinear coupled systems, which often reveal a characteristic form of motion termed "chaos". The system is restricted to a certain range in phase space, but the motion is never periodic. The attractor the system moves on has a non-integer dimension. What all chaotic systems have in common is their sensitive dependence on initial conditions. The question arises as to whether blood pressure regulation can be explained by such models. Many efforts have been made to characterise heart rate variability and EEG dynamics by parameters of chaos theory (e.g., fractal dimensions and Lyapunov exponents). These method were successfully applied to dynamics observed in single organs, but very few studies have dealt with blood pressure dynamics. This mini-review first gives an overview on the history of blood pressure dynamics and the methods suitable to characterise the dynamics by means of tools derived from the field of nonlinear dynamics. Then applications to systemic blood pressure are discussed. After a short survey on heart rate variability, which is indirectly reflected in blood pressure variability, some dynamic aspects of resistance vessels are given. Intriguingly, systemic blood pressure reveals a change in fractal dimensions and Lyapunov exponents, when the major short-term control mechanism--the arterial baroreflex--is disrupted. Indeed it seems that cardiovascular time series can be described by tools from nonlinear dynamics [66]. These methods allow a novel description of some important aspects of biological systems. Both the linear and the nonlinear tools complement each other and can be useful in

  20. High Blood Pressure and Pregnancy

    MedlinePlus

    ... damage. Some women with gestational hypertension eventually develop preeclampsia. Chronic hypertension. Chronic hypertension is high blood pressure ... determine when it began. Chronic hypertension with superimposed preeclampsia. This condition occurs in women with chronic hypertension ...

  1. Medications for High Blood Pressure

    MedlinePlus

    ... Products For Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin ... all their lives. back to top Types of Medications FDA has approved many medications to treat high ...

  2. Indirect Blood Pressure Measuring Device

    NASA Technical Reports Server (NTRS)

    Hum, L.; Cole, C. E.

    1973-01-01

    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.

  3. Indirect Blood Pressure Measuring Device

    NASA Technical Reports Server (NTRS)

    Hum, L.; Cole, C. E.

    1973-01-01

    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.

  4. Blood Pressure and Physical Function

    PubMed Central

    Forbang, Nketi; Ix, Joachim; Criqui, Michael; Rifkin, Dena

    2014-01-01

    Background: Hypertension in older adults is a dynamic process, with significant diurnal fluctuation. Little research has been done on the associations between increased short-term blood pressure variability and blunted night-time dipping in respect to decreased physical function in the elderly. Our aim is to use a cross-sectional analysis to illuminate any associations. Methods: A cross-sectional sub-study (mean age: 72, 67.5% female) was performed on selected participants from the San Diego Population Study (Criqui, et al, 2003). Blood pressure was measured both in the office (3 independent blood pressure readings) and using a 24-hour ambulatory blood pressure monitoring cuff. Blood pressure variability was measured using average real variability (ARV). Physical function was measured using the Short Physical Performance Battery (SPPB) test. Statistical analysis was performed on IBM SPSS Statistics (1911) software. Results: An unadjusted univariate analysis adjusted for age and gender showed associations between 24-hr ARV of SBP (P = .001), 24-hr ARV pulse pressure (P < .001), and percent systolic dipping (P = .011) and SPPB score. After multivariate analysis adjusted for age and gender was performed, the results were substantially attenuated. However, the association of ARV of SBP was not significant with a P-value of .052 and the ARV of pulse pressure remained significant with a P-value of .022. Multivariate hierarchical linear regression models revealed insignificant trends. Conclusions: Increased short-term variability and blunted night-time dipping were associated physical function but were not independent of age and body mass index (BMI). Further research can be done as to the biology of how both age and BMI influence blood pressure patterns. The trends observed in this study may warrant the investigation of abnormal blood pressure patterns in those who are either elderly or have increased BMI.

  5. Nutritional effects on blood pressure.

    PubMed

    Myers, Valerie H; Champagne, Catherine M

    2007-02-01

    There has not been a thorough recent evaluation of the nutritional effects on blood pressure. Apart from outstanding clinical trials like Dietary Approaches to Stop Hypertension, there have been controversial papers on a number of factors influencing blood pressure. This paper is a systematic review of the current literature as it relates to hypertension. Results from many meta-analyses and well controlled clinical trials on the effects of a variety of nutritional factors are presented in this review. Evidence suggests that dietary sodium intake needs reduction. There is a seemingly inverse relationship between protein intake and blood pressure, but data are inconclusive. High monounsaturated fat and fish oil appear to be beneficial. Several studies on dietary fiber indicate that the strongest evidence for blood pressure lowering effects is in hypertensive as opposed to normotensive participants. Vegetarians seem to have lower levels of hypertension and cardiovascular disease risk. Low carbohydrate diets show short-term beneficial effects but are not sustained. High levels of potassium, magnesium, calcium and soy seem to have some benefit, but results remain inconclusive. Weight reduction positively impacts blood pressure. More compelling research defining specific factors is needed to inform the public as to steps needed to reduce blood pressure and improve cardiovascular risk.

  6. Anxiety: A Cause of High Blood Pressure?

    MedlinePlus

    ... Conditions High blood pressure (hypertension) Can anxiety cause high blood pressure? Answers from Sheldon G. Sheps, M.D. Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, ...

  7. High Blood Pressure: Medicines to Help You

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure--Medicines to Help You Share Tweet Linkedin Pin ... Click here for the Color Version (PDF 533KB) High blood pressure is a serious illness. High blood pressure is ...

  8. Wrist Blood Pressure Monitors: Are They Accurate?

    MedlinePlus

    ... be at heart level. Even then, blood pressure measurements taken at the wrist are usually higher and ... a very large arm or find blood pressure measurements painful. In these cases, measuring blood pressure at ...

  9. Night time blood pressure dip

    PubMed Central

    Bloomfield, Dennis; Park, Alex

    2015-01-01

    The advent of ambulatory blood pressure monitoring permitted examination of blood pressures during sleep and recognition of the associated circadian fall in pressure during this period. The fall in pressure, called the “dip”, is defined as the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value. Ten percent to 20% is considered normal. Dips less than 10%, referred to as blunted or absent, have been considered as predicting an adverse cardiovascular event. This view and the broader concept that white coat hypertension itself is a forerunner of essential hypertension is disputable. This editorial questions whether mean arterial pressures over many hours accurately represent the systolic load, whether nighttime dipping varies from measure to measure or is a fixed phenomenon, whether the abrupt morning pressure rise is a risk factor or whether none of these issues are as important as the actual night time systolic blood pressure itself. The paper discusses the difference between medicated and nonmedicated white coat hypertensives in regard to the cardiovascular risk and suggests that further work is necessary to consider whether the quality and duration of sleep are important factors. PMID:26225196

  10. Night time blood pressure dip.

    PubMed

    Bloomfield, Dennis; Park, Alex

    2015-07-26

    The advent of ambulatory blood pressure monitoring permitted examination of blood pressures during sleep and recognition of the associated circadian fall in pressure during this period. The fall in pressure, called the "dip", is defined as the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value. Ten percent to 20% is considered normal. Dips less than 10%, referred to as blunted or absent, have been considered as predicting an adverse cardiovascular event. This view and the broader concept that white coat hypertension itself is a forerunner of essential hypertension is disputable. This editorial questions whether mean arterial pressures over many hours accurately represent the systolic load, whether nighttime dipping varies from measure to measure or is a fixed phenomenon, whether the abrupt morning pressure rise is a risk factor or whether none of these issues are as important as the actual night time systolic blood pressure itself. The paper discusses the difference between medicated and nonmedicated white coat hypertensives in regard to the cardiovascular risk and suggests that further work is necessary to consider whether the quality and duration of sleep are important factors.

  11. Vegetarian diet and blood pressure.

    PubMed

    Beilin, L J; Armstrong, B K; Margetts, B M; Rouse, I L; Vandongen, R

    1987-01-01

    There is now convincing evidence from epidemiological studies and randomized controlled trials that adoption of an ovo-lacto vegetarian diet leads to blood pressure reduction in both normotensive and hypertensive subjects. This effect appears to be independent of both dietary sodium and weight loss but additive to effects of weight reduction. Long-term adherence to a vegetarian diet is associated with less of a rise of blood pressure with age and a decreased prevalence of hypertension. The nutrients responsible for these effects have not been clearly identified and the mechanisms involved are unknown. Resolution of these questions is needed to enable more widespread adoption of dietary changes which may reduce the prevalence of hypertension, reduce antihypertensive drug dependence and by effects on blood pressure and blood lipids ameliorate the natural history of hypertensive cardiovascular disease.

  12. Beat-to-Beat Blood Pressure Monitor

    NASA Technical Reports Server (NTRS)

    Lee, Yong Jin

    2012-01-01

    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.

  13. Implanted Blood-Pressure-Measuring Device

    NASA Technical Reports Server (NTRS)

    Fischell, Robert E.

    1988-01-01

    Arterial pressure compared with ambient bodily-fluid pressure. Implanted apparatus, capable of measuring blood pressure of patient, includes differential-pressure transducer connected to pressure sensor positioned in major artery. Electrical signal is function of differential pressure between blood-pressure sensor and reference-pressure sensor transmitted through skin of patient to recorder or indicator.

  14. Blood pressure regulation: basic concepts.

    PubMed

    Guyton, A C; Hall, J E; Lohmeier, T E; Jackson, T E; Kastner, P R

    1981-06-01

    In this paper we have attempted to explain the difference between proportional pressure control systems and the renal-blood volume-pressure control mechanism, which is an infinite gain pressure control system. Because of this infinite gain of the kidney mechanism, this mechanism has the capability of returning arterial pressure all the way back to the control leve. Furthermore, this mechanism can override the other pressure control mechanisms because of its extreme control capability. On the other hand, the renal-blood volume mechanism for pressure control itself be controlled by many other factors. These other factors are said to change the pressure "set-point" level of the renal system, and then the renal system automatically brings the pressure to the set-point level. It is especially noteworthy, however, that some of the factors that play extreme roles in short-term pressure control-such as heart strength, vascular capacity, and total peripheral resistance-will not alter the long-term arterial pressure level (unless they in some way concurrently alter the set-point of the kidney mechanism).

  15. Blood Pressure Self-Measurement.

    PubMed

    Wagner, Stefan

    2017-01-01

    Blood pressure self-measurement has been used extensively as part of several clinical processes including in the home monitoring setting for mitigating white coat effect and gaining more detailed insights into the blood pressure variability of patients over time. Self-measurement of BP is also being used as part of telemonitoring and telemedicine processes, as well as in the waiting rooms and self-measurement rooms of general practice clinics, specialized hospital department's outpatient clinics, and in other types of care facilitates and institutions.The aim of this review is to provide an overview of where, when, and how blood pressure self-measurement is being used, which official clinical guidelines and procedures are available for its implementation, as well as the opportunities and challenges that are related to its use.

  16. High Blood Pressure (Hypertension) (For Parents)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old High Blood Pressure (Hypertension) KidsHealth > For Parents > High Blood Pressure (Hypertension) A ... posture, and medications. continue Long-Term Effects of High Blood Pressure When someone has high blood pressure, the heart ...

  17. High blood pressure and eye disease

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000999.htm High blood pressure and eye disease To use the sharing features on this page, please enable JavaScript. High blood pressure can damage blood vessels in the retina . The ...

  18. Alcohol: Does It Affect Blood Pressure?

    MedlinePlus

    ... pressure (hypertension) Does drinking alcohol affect your blood pressure? Answers from Sheldon G. Sheps, M.D. Drinking too much alcohol can raise blood pressure to unhealthy levels. Having more than three drinks ...

  19. Automatic blood pressure measuring system (M092)

    NASA Technical Reports Server (NTRS)

    Nolte, R. W.

    1977-01-01

    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.

  20. Automatic blood pressure measuring system (M092)

    NASA Technical Reports Server (NTRS)

    Nolte, R. W.

    1977-01-01

    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.

  1. CHRONOBIOLOGY OF HIGH BLOOD PRESSURE

    PubMed Central

    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.

    2008-01-01

    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

  2. The Environment and Blood Pressure.

    PubMed

    Brook, Robert D

    2017-05-01

    A host of environmental factors can significantly increase arterial blood pressure (BP) including cold temperature, high altitude, loud noises, and ambient air pollutants. Although brief exposures acutely elevate BP, over the long term, chronic exposures may be capable of promoting the development of sustained hypertension. Given their omnipresent nature, environmental factors may play a role in worsening BP control and heightening overall cardiovascular risk at the global public health level. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. High Blood Pressure and Kidney Disease

    MedlinePlus

    ... Kidney disease is diagnosed with urine and blood tests. Health care providers measure blood pressure with a blood pressure ... the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood the kidneys filter ...

  4. Blood pressure control for diabetic retinopathy.

    PubMed

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-31

    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. 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. 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. 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. 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 characteristics, incidence and progression of retinopathy, visual acuity, quality of life

  5. Risk Factors for High Blood Pressure

    MedlinePlus

    ... to achieve target blood pressure goals with treatment. Overweight You are more likely to develop prehypertension or high blood pressure if you’re overweight or obese . The terms “overweight” and “obese” refer ...

  6. Control Blood Pressure, Protect Your Kidneys

    MedlinePlus

    ... Bar Home Current Issue Past Issues Health Lines Control Blood Pressure, Protect Your Kidneys Past Issues / Fall ... Not Alone / Keep Weight Off / Facts About Fat / Control Blood Pressure, Protect Your Kidneys Fall 2008 Issue: ...

  7. Taking your blood pressure at home (image)

    MedlinePlus

    ... sure you are taking your blood pressure correctly. Compare your home machine with the one at your ... sure you are taking your blood pressure correctly. Compare your home machine with the one at your ...

  8. Avoid the Consequences of High Blood Pressure

    MedlinePlus

    ... Aneurysm More Avoid the Consequences of High Blood Pressure Infographic Updated:Oct 31,2016 View a downloadable version of this infographic High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  9. Cuff for Blood-Vessel Pressure Measurements

    NASA Technical Reports Server (NTRS)

    Shimizu, M.

    1982-01-01

    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.

  10. Cuff for Blood-Vessel Pressure Measurements

    NASA Technical Reports Server (NTRS)

    Shimizu, M.

    1982-01-01

    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.

  11. [Ambulatory measurement of blood pressure].

    PubMed

    Mallion, J M; Tremel, F; Siché, J P; Azzouzi, L; Baguet, J P

    1995-12-09

    The advent of new techniques has greatly contributed to the development of ambulatory measurement as a noninvasive method for evaluating blood pressure. The technique implies use of a validated and reliable standardized apparatus. The operator must strictly comply with operating procedures, which must also be explained to the patient. Ambulatory measurement can be meaningful only if the results are compatible with reference values, which have now been established, and if the causes of possible error can be recognized and interpreted. Ambulatory blood pressure measurement has greatly improved our knowledge of physiological and pathological variations over the circadian cycle including day/night variability and the effects of psychosensorial stimulation. Diagnostic indications are clearly identified and include borderline hypertension suspected but not identified after about 3 months, the white coat effect, severe hypertension when modifications in the circadian cycle are suspected, paroxysmal hypertension, suspected pheochromocytoma, and gravid hypertension or an inversion of the circadian cycle possibly preceding an episode of eclampsia. There are also a certain number of particular indications in patients with degenerative or primary conditions affecting their autonomy. The true prognostic value of these recordings was recognized several years ago and has been confirmed by clinical trials. For example, the white blouse effect has no significant implication in terms or predicting less favourable morbidity or mortality. Finally, ambulatory blood pressure measurement has been definitively shown to be a valid method for evaluating the therapeutic effect of an anti-hypertensive drug in a given patient, especially when resting levels are questioned. For therapeutic trials, ambulatory measurements serve as a reference to evaluate the effect of treatment on the circadian cycle. Peak/dip levels can thus be determined in comparison with the residual effect of the drug. A

  12. Cutaneous control of blood pressure.

    PubMed

    Johnson, Randall S; Titze, Jens; Weller, Richard

    2016-01-01

    Textbook theory holds that blood pressure (BP) is regulated by the brain, by blood vessels, or by the kidney. Recent evidence suggests that BP could be regulated in the skin. The skin holds a complex capillary counter current system, which controls body temperature, skin perfusion, and apparently systemic BP. Epidemiological data suggest that sunlight exposure plays a role in controlling BP. Ultraviolet A radiation produces vasodilation and a fall in BP. Keratinocytes and immune cells control blood flow in the extensive countercurrent loop system of the skin by producing nitric oxide, a key regulator of vascular tone. The balance between hypoxia-inducible factor-1α and hypoxia-inducible factor-2α activity in keratinocytes controls skin perfusion, systemic thermoregulation, and systemic BP by nitric oxide-dependent mechanisms. Furthermore, the skin accumulates Na which generates a barrier to promote immunological host defense. Immune cells control skin Na metabolism and the clearance of Na via the lymphatic system. Reduced lymphatic clearance increases BP. Apart from the well-known role of the brain, blood vessels, and the kidney, the skin is important for systemic BP control in humans and in experimental animals.

  13. Blood pressure reprogramming adapter assists signal recording

    NASA Technical Reports Server (NTRS)

    Vick, H. A.

    1967-01-01

    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.

  14. Searching for baseline blood pressure: A comparison of blood pressure at three different care points.

    PubMed

    Ard, John L; Kendale, Samir

    2016-12-01

    A common approach to blood pressure management in the operating room is to keep the intraoperative, pressures within 20% of baseline blood pressure. One question that arises from this recommendation is; what is a patient's true baseline blood pressure? In order to get a more precise definition of baseline blood pressure, a comparison of the first operating room blood pressure was made with the blood pressure taken in a preoperative holding area before surgery, and the blood pressure taken in pre-surgical testing. (before day of surgery). A database of 2087 adult general anesthesia cases was generated, which contained the blood pressure (BP) in the pre-surgical testing clinic, the first BP in preoperative holding on the day of surgery, and the first BP in the operating room. Comparisons were made between the blood pressures taken at each phase of care. All components of BP taken in the OR were statistically significantly higher (p<0.001 for all comparisons) than in either PST or the holding area, while the BP in the latter locations were not significantly different. This blood pressure difference persists whether or not the patient is taking antihypertensive medications. The higher blood pressure measured in the operating rooms precludes using this measurement to determine baseline blood pressure. Blood pressures taken prior to arrival in the operating room are similar to blood pressures taken before the day of surgery. Blood pressure measurements taken prior to entrance in the operating room can be used to determine baseline blood pressure.

  15. Enhancing Documentation of Pressure Ulcer Prevention Interventions: A Quality Improvement Strategy to Reduce Pressure Ulcers.

    PubMed

    Jacobson, Therese M; Thompson, Susan L; Halvorson, Anna M; Zeitler, Kristine

    2016-01-01

    Prevention of hospital-acquired pressure ulcers requires the implementation of evidence-based interventions. A quality improvement project was conducted to provide nurses with data on the frequency with which pressure ulcer prevention interventions were performed as measured by documentation. Documentation reports provided feedback to stakeholders, triggering reminders and reeducation. Intervention reports and modifications to the documentation system were effective both in increasing the documentation of pressure ulcer prevention interventions and in decreasing the number of avoidable hospital-acquired pressure ulcers.

  16. Central blood pressure and chronic kidney disease

    PubMed Central

    Ohno, Yoichi; Kanno, Yoshihiko; Takenaka, Tsuneo

    2016-01-01

    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

  17. Cardiac and Arterial Contribution to Blood Pressure

    DTIC Science & Technology

    2007-11-02

    heart to the blood pressure . We conclude that when the heart hypertrophies, as a result of the hypertension , the changed cardiac behavior, in turn...Plenary Talks Cardiac and Arterial Contribution to Blood Pressure N.Westerhof, Lab. for Physiology, Institute for Cardiovascular Research...Vrije Universiteit of Amsterdam Blood pressure and blood flow result from the interaction of the heart, the pump, and the arterial system, the load

  18. Relation of blood volume and blood pressure in orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.

    1998-01-01

    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.

  19. Relation of blood volume and blood pressure in orthostatic intolerance

    NASA Technical Reports Server (NTRS)

    Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.

    1998-01-01

    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.

  20. Electronic versus paper records: documentation of pressure ulcer data.

    PubMed

    Tubaishat, Ahmad; Tawalbeh, Loai I; AlAzzam, Manar; AlBashtawy, Mohammed; Batiha, Abdul-Monim

    The documentation of patient data on health records is a vital component of the care process. Accurate and complete recording of this data is a necessary practice. The adoption of electronic health records to improve the quality of nursing documentation is on the rise. This study compares the accuracy and completeness of pressure ulcer data documentation between electronic and paper records. A descriptive, comparative design with a retrospective review of patient records. Settings and sample: Two hospitals were chosen purposefully, one using electronic recording of patient data and the other using paper records. In the first phase, all hospitalised patients aged 18 years and over were inspected for pressure ulcers. In the second phase, the files of patients with pressure ulcers were audited. Of the 52 patients with ulcers found in the hospital that used an electronic system, 43 of their records documented the pressure ulcers (83%). Of the 55 patients with pressure ulcers in the hospital using paper records, 39 files had corresponding documentation of the presence of a pressure ulcer (71%). In terms of accuracy and completeness, more comprehensive documentation practice was found on the electronic health records compared with paper records. However, both types of systems have shortcomings in the practice of pressure ulcer data documentation.

  1. Continuous Blood Pressure Monitoring in Daily Life

    NASA Astrophysics Data System (ADS)

    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.

  2. Noninvasive continuous blood pressure monitoring

    NASA Astrophysics Data System (ADS)

    Poghosyan, Armen; Mouradian, Vahram; Hovhannisyan, Levon

    2015-03-01

    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.

  3. Effect of nocturnal blood pressure measurement on sleep and blood pressure during sleep.

    PubMed

    Middeke, M

    1996-01-01

    Nocturnal hypertension is of diagnostic interest and has important prognostic and therapeutic implications. Nighttime blood pressure can easily be measured using ambulatory blood pressure monitoring (ABPM). However, during nocturnal ambulatory blood pressure measurement pump noise, tactile stimuli and pressure produced by cuff inflation may alter the quality of sleep and subsequently influence the physiological fall of night time blood pressure. Eight studies were performed to determine whether non-invasive automated blood pressure monitoring during day and/or night provokes alert reaction, arousal, sleep disturbances and changes in blood pressure and/or heart rate. From these studies it can be concluded: 1) Nighttime blood pressure can be evaluated properly using ABPM. 2) Nocturnal blood pressure is not overestimated by ABPM. 3) ABPM does not induce an alarm reaction and a blood pressure rise when monitored with a silently operating recorder. 4) Sleep is often disturbed by blood pressure measurement without provoking a blood pressure increase. 5) In older patients blood pressure measurement and age-related alterations in sleep quality may influence each other. A patient's protocol has to be carried out and sleep quality should be recorded to provide a proper interpretation of nocturnal blood pressure behavior. ABPM is an important and valuable method to record nocturnal blood pressure for diagnostic and therapeutic purposes.

  4. Pressure natriuresis and the renal control of arterial blood pressure

    PubMed Central

    Ivy, Jessica R; Bailey, Matthew A

    2014-01-01

    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

  5. Pressure natriuresis and the renal control of arterial blood pressure.

    PubMed

    Ivy, Jessica R; Bailey, Matthew A

    2014-09-15

    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.

  6. Measuring Time-Averaged Blood Pressure

    NASA Technical Reports Server (NTRS)

    Rothman, Neil S.

    1988-01-01

    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.

  7. Measuring Time-Averaged Blood Pressure

    NASA Technical Reports Server (NTRS)

    Rothman, Neil S.

    1988-01-01

    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.

  8. Blood pressure control for diabetic retinopathy

    PubMed Central

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-01

    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

  9. Blood pressure behaviour during physical activity.

    PubMed

    Palatini, P

    1988-06-01

    Aerobic exercise is currently being recommended in addition to pharmacological therapy for lowering blood pressure levels in hypertensive patients, i.e. in subjects whose resting blood pressure levels exceed 145/90 mm Hg. On the other hand competitive sports are generally contraindicated in hypertensives, who are thought to be at increased risk of morbidity or mortality from their blood pressure levels. The present knowledge of blood pressure behaviour during isotonic physical activity is almost wholly based on the results obtained by means of the ergometric tests. Several maximal and submaximal exercise protocols have been introduced, but none has proved to be superior for diagnostic purposes. There is general agreement that the systolic blood pressure increase determined by isotonic exercise usually ranges from 50 to 70 mm Hg in both normotensive or hypertensive subjects. Diastolic blood pressure shows only minor changes in the normotensives, while in the hypertensives it tends to substantially increase because of their inability to adequately reduce their peripheral resistance. This mechanism may also explain the delay shown by the hypertensives in reaching pre-exercise blood pressure values during the recovery. On average diastolic blood pressure increases to a greater extent during bicycle ergometry than during treadmill, while no differences in exertional systolic blood pressure have been observed between the 2 tests. The results of several studies indicate that the blood pressure response to isotonic exercise is a marker for detection of hypertension earlier in the course of the disease, while resting blood pressure is still normal. According to some authors it is also of value in predicting future hypertension in individuals with borderline pressure levels. There are no conclusive data on the effect of training on blood pressure response to exercise. The majority of the published studies report small exertional pressure reductions after conditioning, which

  10. Ambulatory blood pressure monitoring in hypertensive adolescents.

    PubMed

    Fixler, D E; Wallace, J M; Thornton, W E; Dimmitt, P

    1990-04-01

    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.

  11. Preeclampsia and High Blood Pressure During Pregnancy

    MedlinePlus

    ... thrombophilia , or lupus • are obese •had in vitro fertilization What are the risks for my baby if ... blood cells. Hypertension: High blood pressure. In Vitro Fertilization: A procedure in which an egg is removed ...

  12. Effects of age on blood pressure (image)

    MedlinePlus

    ... become less elastic with age. The average blood pressure increases from 120/70 to 150/90 and may persist slightly high, even if treated. The blood vessels respond more slowly to a change in body ...

  13. Preeclampsia and High Blood Pressure During Pregnancy

    MedlinePlus

    ... mellitus , thrombophilia , or lupus • are obese •had in vitro fertilization What are the risks for my baby if ... red blood cells. Hypertension: High blood pressure. In Vitro Fertilization: A procedure in which an egg is removed ...

  14. Sustained Blood Pressure Responding during Synthetic Work.

    DTIC Science & Technology

    1982-06-15

    split-half reliabilities of both heart rate and mean * blood pressure were high during task performance. Significant correlations were observed between... blood pressure responses elicited by :1 16 an anagram task showed a high test-retest reliability, even over an interval of 13 months. Examination of the...8217AD-AI5 733 JOHNS HOPKINS UNIV BALTIMORE MO DEPT OF PSYCHIATRY F/6 6/5 SUSTAINED BLOOD PRESSURE RESPONDING DURING SYNTHETIC WORK.(U) JUN A2 R L RAY

  15. Biofeedback With Implanted Blood-Pressure Device

    NASA Technical Reports Server (NTRS)

    Rischell, Robert E.

    1988-01-01

    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.

  16. High blood pressure tests (image)

    MedlinePlus

    ... factors. These lab tests include urinalysis, blood cell count, blood chemistry (potassium, sodium, creatinine, fasting glucose, total cholesterol and HDL cholesterol), and an ECG (electrocardiogram). ...

  17. How to Prevent High Blood Pressure

    MedlinePlus

    ... provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. For most ... pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating. ...

  18. Blood pressure measurement--an overview.

    PubMed

    Dieterle, Thomas

    2012-01-27

    Arterial hypertension continues to represent the leading cause of morbidity and mortality world-wide. Diagnosis and therapy of arterial hypertension require adequate blood pressure measurements. Blood pressure is affected by constitutional and environmental factors as well as the measurement procedure itself, inducing substantial uncertainty with regard to adequate diagnosis and control of arterial hypertension. Therefore, current guidelines recommend that the diagnosis of arterial hypertension should not be solely based on conventional blood pressure measurements in the physician's office or in the hospital, but also on out-of-office ambulatory or home blood pressure measurements using clinically validated semi-automated or automated blood pressure measurement devices. Despite the enormous progress in the field of arterial hypertension, many aspects of blood pressure measurement require further intensive investigation, for example blood pressure measurement in special populations and distinct clinical situations, as well as the applicability and validation of novel measurement approaches and devices. This article provides an overview of current methods and trends in the field of non-invasive blood pressure measurement, an update on current clinical guidelines and an overview of blood pressure measurement in special populations.

  19. Ambulatory blood pressure monitoring in children.

    PubMed

    Sinha, Rajiv; Dionne, Janis

    2011-02-01

    Recently there have been great advances in the use of ambulatory blood pressure monitoring (ABPM) in children. A major boost has been the publication of normative data for blood pressure in children. ABPM has been able to detect significant differences in blood pressure in many disease states including chronic renal failure, polycystic kidney disease and post renal transplantation and has helped in identifying both white coat hypertension and masked hypertension. Current evidence does suggest that sole reliance on clinic blood pressure might not be always appropriate and ABPM has a definite role in pediatric hypertension.

  20. Embedded programmable blood pressure monitoring system

    NASA Astrophysics Data System (ADS)

    Hasan, Md. Mahmud-Ul; Islam, Md. Kafiul; Shawon, Mehedi Azad; Nowrin, Tasnuva Faruk

    2010-02-01

    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.

  1. Nutraceuticals for blood pressure control.

    PubMed

    Sirtori, Cesare R; Arnoldi, Anna; Cicero, Arrigo F G

    2015-01-01

    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.

  2. The DASH diet and blood pressure.

    PubMed

    Craddick, Shirley R; Elmer, Patricia J; Obarzanek, Eva; Vollmer, William M; Svetkey, Laura P; Swain, Martha C

    2003-11-01

    High blood pressure (also called hypertension) is one of the most important and common risk factors for atherosclerotic cardiovascular disease (CVD) and other chronic diseases. National guidelines recommend that all individuals with blood pressure readings of 120/80 mm Hg or higher adopt healthy lifestyle habits, including the Dietary Approaches to Stop Hypertension (DASH) diet, to manage their blood pressure. The DASH diet, which is high in fruits, vegetables, and low-fat dairy products and reduced in fat, has been shown in large, randomized, controlled trials to reduce blood pressure significantly. The DASH diet also has been shown to reduce blood cholesterol and homocysteine levels and to enhance the benefits of antihypertensive drug therapy. The DASH diet should be promoted, along with maintaining healthy weight, reducing sodium intake, increasing regular physical activity, and limiting alcohol intake, for lowering blood pressure and reducing the risk of CVD.

  3. Determinants of blood pressure in Navajo adolescents.

    PubMed

    Coulehan, J L; Topper, M D; Arena, V C; Welty, T K

    1990-01-01

    Hypertension is becoming more common among Navajo people, especially among young men. In a group of 580 Navajo adolescents, we looked for factors associated with variations in blood pressure level. Using our criteria, 11.1% of adolescent males and 1.6% of females had an elevated screening blood pressure. In males, blood pressure was a function of age only, and not significantly related either to obesity (body mass index) or measures of acculturation and personal adjustment. In females, blood pressure was not related to age, but was associated with body mass index. Systolic pressure in females was also associated with poor personal adjustment. Level of acculturation (by our index) had no bearing on blood pressure level in this population.

  4. Perioperative Blood Pressure Control and Management.

    PubMed

    Duke-Novakovski, Tanya; Carr, Anthony

    2015-09-01

    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. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Palpatory Method of Measuring Diastolic Blood Pressure

    PubMed Central

    Sahu, Dinesh; Bhaskaran, M

    2010-01-01

    Background: Most common method for measuring blood pressure is palpatory but only systolic pressure can be measured with this method. In this study we are describing palpatory method of measuring diastolic blood pressure as well. Patients & Methods: We have studied in 200 patients and compared systolic as well as diastolic blood pressures with two methods, auscutatory and palpatory. Systolic and diastolic blood pressure were measured by one of the authors with new palpatory method and noted down. Then an independent observer, who was blinded to the palpatory method's values, measured blood pressure by auscultatory method and noted down. The values were compared in term of range and percentage. Results: The difference were analysed and found that 102 (51%) patients had systolic and diastolic blood pressure measured by palpatory method, within ± 2 mmHg of auscutatory method, 37 (19%) patients had within ± 4 mmHg, 52 (25%) patients had same readings as with auscutatory method, and in 9 (0.5%) patients it could not be measured. Conclusion: The palpatory method would be very useful where frequent blood pressure measurement are being done manually like in wards, in busy OPD, patient on treadmill and also whenever stethoscope is not available. The blood pressure can be measured in noisy environment too. PMID:21547184

  6. Blood pressure and blood lead concentration in bus drivers

    SciTech Connect

    Sharp, D.S.; Osterloh, J.; Becker, C.E.; Bernard, B.; Smith, A.H.; Fisher, J.M.; Syme, S.L.; Holman, B.L.; Johnston, T.

    1988-06-01

    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.

  7. How Is High Blood Pressure Treated?

    MedlinePlus

    ... secondary high blood pressure, he or she will work to treat the other condition or change the medicine suspected of causing your ... when the medications they are taking do not work well for them or another medical condition is leading to uncontrolled blood pressure. Health care ...

  8. The importance of prompt blood pressure control.

    PubMed

    Basile, Jan

    2008-01-01

    Hypertension affects almost one-third of adults in the United States, but blood pressure is adequately controlled in only about 50% to 60% of persons with treated hypertension. Abundant clinical trial evidence has shown that antihypertensive therapy significantly reduces the risk of vascular events, and meta-analyses of observational and clinical trials have shown that greater reductions in blood pressure are associated with greater reductions in risk. Recent trials have also suggested that prompt control of blood pressure is beneficial in high-risk patients with hypertension. A post hoc analysis of a trial comparing an angiotensin II receptor blocker-based program with a calcium channel blocker-based treatment regimen found that the blood pressure response after 1 month (regardless of the drug used) predicted the risk of vascular events and survival. Therapy with > or =2 medications given separately or as a fixed combination is more likely than monotherapy to lower blood pressure to goal in part because drugs from different classes target different mechanisms that regulate blood pressure. Moreover, the likelihood of achieving blood pressure goals is greater if the time to achieve control is shortened, and prompt control of blood pressure is more likely with multiple-drug therapy than with monotherapy.

  9. Dietary sodium intake and arterial blood pressure.

    PubMed

    Dumler, Francis

    2009-01-01

    We sought to summarize major recent studies in the field of dietary sodium intake and arterial blood pressure, and discuss the following trials. INTERSALT: Sodium intake correlates with the rise in blood pressure with age, but not with the prevalence of hypertension. The population study identified a minimal impact of sodium intake on blood pressure (0.9 mm Hg/10 mmol difference in salt intake). DASH: This diet induced significant reductions in blood pressure compared with the control diet. Further decreases were observed with DASH and a 50 mmol/day sodium intake. VANGUARD: Blood pressure was inversely related to urinary potassium, calcium and magnesium but not to sodium excretion. TONE: Cardiovascular events were highest in the usual care group (83%) and lowest in the sodium reduction-plus-weight loss group (56%). META-ANALYSIS: A systematic review of 11 long-term controlled randomized trials reported a small decrease (1.1 mm Hg) in median systolic but not diastolic blood pressure with a reduced dietary sodium intake. In conclusion, (1) sodium restriction in hypertensive patients reduces blood pressure, and (2) the long-term impact of reduced salt intake on blood pressure, mortality, and morbidity remains to be defined.

  10. Blood Pressure. Instructor's Packet. Learning Activity Package.

    ERIC Educational Resources Information Center

    Hime, Kirsten

    This instructor's packet accompanies the learning activity package (LAP) on blood pressure. Contents included in the packet are a time sheet, suggested uses for the LAP, an instruction sheet, final LAP reviews, a final LAP review answer key, a pupil performance checklist, a handout on blood pressure, and student completion cards to issue to…

  11. High Blood Pressure Often Undiagnosed, Untreated

    MedlinePlus

    ... Health, or the U.S. Department of Health and Human Services. More Health News on: Heart Attack High Blood Pressure Stroke Recent Health News Related MedlinePlus Health Topics Heart Attack High Blood Pressure Stroke ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated ...

  12. Determinants of Blood Pressure in Navajo Adolescents.

    ERIC Educational Resources Information Center

    Coulehan, John L.; And Others

    1990-01-01

    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)

  13. Determinants of Blood Pressure in Navajo Adolescents.

    ERIC Educational Resources Information Center

    Coulehan, John L.; And Others

    1990-01-01

    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)

  14. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1972-01-01

    Changes in cerebral blood flow during incremental increases of intracranial pressure produced by infusion of fluid into the cisterna magna were studied in anaesthetized baboons. Cerebral blood flow remained constant at intracranial pressure levels up to approximately 50 mm Hg. At intracranial pressure levels between 50-96 mm Hg a marked increase in cerebral blood flow occurred, associated with the development of systemic hypertension and changes in cerebrovascular resistance. Further increases of intracranial pressure led to a progressive fall in cerebral blood flow. Prior section of the cervical cord prevented both the increase in cerebral blood flow and the systemic hypertension. Alteration of cerebral perfusion pressure by bleeding during the hyperaemia in a further group of animals suggested that autoregulation was at least partially preserved during this phase. After maximum hyperaemia had occurred, however, autoregulation appeared to be lost. The clinical implications of these findings are discussed. PMID:4624687

  15. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Pressure changes within the venous outflow tract from the brain were studied in anaesthetized baboons. Segmental vascular resistance changes were also calculated and the results correlated with the changes in cerebral blood flow, measured by the 133Xenon clearance method. Three different methods were used to raise intracranial pressure: cisterna magna infusion, a supratentorial subdural balloon, and an infratentorial subdural balloon. A close correlation was found between the cortical vein pressure and intracranial pressure with all methods of raising intracranial pressure: the overall correlation coefficient was 0·98. In the majority of animals sagittal sinus pressure showed little change through a wide range of intracranial pressure. In three of the six animals in the cisterna magna infusion group, however, sagittal sinus pressure increased to levels approaching the intracranial pressure during the later stages of intracranial hypertension. Jugular venous pressure showed little change with increasing intracranial pressure. The relationship between cerebral prefusion pressure and cerebral blood flow differed according to the method of increasing intracranial pressure. This was due to differing patterns of change in prevenous vascular resistance as venous resistance increased progressively with increasing pressure in all three groups. The present results confirm, therefore, the validity of the current definition of cerebral perfusion pressure—that is, cerebral perfusion pressure is equal to mean arterial pressure minus mean intracranial pressure—by demonstrating that intracranial pressure does represent the effective cerebral venous outflow pressure. Images PMID:4209160

  16. Effect of measuring ambulatory blood pressure on sleep and on blood pressure during sleep.

    PubMed Central

    Davies, R. J.; Jenkins, N. E.; Stradling, J. R.

    1994-01-01

    OBJECTIVE--To assess whether recording of ambulatory blood pressure at night causes arousal from sleep and a change in the continuous blood pressure recorded simultaneously. DESIGN--Repeated measurement of blood pressure with two ambulatory blood pressure machines (Oxford Medical ABP and A&D TM2420) during continuous measurement of beat to beat blood pressure and continuous electroencephalography. SETTING--Sleep research laboratory. SUBJECTS--Six normal subjects. MAIN OUTCOME MEASURES--The duration of electroencephalographic arousal and the beat to beat changes in blood pressure produced by the measurement of ambulatory blood pressure; the size of any changes that this arousal and change in blood pressure produced in the blood pressure recorded by the ambulatory machine. RESULTS--Both ambulatory blood pressure machines caused arousal from sleep: the mean duration of arousal was 16 seconds (95% range 0-202) with the ABP and 8 seconds (0-73) with the TM2420. Both also caused a rise in beat to beat blood pressure. During non-rapid eye movement sleep, this rise led to the ABP machine overestimating the true systolic blood pressure during sleep by a mean of 10 (SD 14.8) mm Hg and the TM2420 by a mean of 6.3 (8.2) mm Hg. On average, diastolic pressure was not changed, but measurements in individual subjects changed by up to 23 mm Hg. These changes varied in size among subjects and stages of sleep and were seen after measurements that did not cause any electroencephalographic arousal. CONCLUSIONS--Ambulatory blood pressure machines cause appreciable arousal from sleep and therefore alter the blood pressure that they are trying to record. This effect should be taken into account when recordings of blood pressure at night are interpreted in clinical work and epidemiological research. PMID:8167489

  17. Documentation and record-keeping in pressure ulcer management.

    PubMed

    Chamanga, Edwin; Ward, Renee

    2015-05-06

    National and international guidelines recommend the use of clinical assessments and interventions to prevent pressure-related skin damage. This includes the categorisation of pressure ulcers as avoidable or unavoidable, which is challenging in clinical practice, mainly because of poor documentation and record-keeping for care delivered. Documentation and record-keeping are influenced by the individual's employing organisation, maintenance procedures for documentation and record-keeping, and local auditing processes. A transfer sticker to enable patient assessment and promote pressure ulcer documentation was designed and implemented. The transfer sticker captures the date, time and location of a pressure ulcer preventive risk assessment and the plan of care to be implemented. The increased clarity of record of care achieved by using the transfer sticker has enabled the number of avoidable hospital-acquired pressure ulcers resulting from poor documentation on admission or ward transfers to be reduced. The transfer sticker helps staff identify patients at risk and allows interventions to be implemented in a timely manner.

  18. Accurate, reproducible measurement of blood pressure.

    PubMed Central

    Campbell, N R; Chockalingam, A; Fodor, J G; McKay, D W

    1990-01-01

    The diagnosis of mild hypertension and the treatment of hypertension require accurate measurement of blood pressure. Blood pressure readings are altered by various factors that influence the patient, the techniques used and the accuracy of the sphygmomanometer. The variability of readings can be reduced if informed patients prepare in advance by emptying their bladder and bowel, by avoiding over-the-counter vasoactive drugs the day of measurement and by avoiding exposure to cold, caffeine consumption, smoking and physical exertion within half an hour before measurement. The use of standardized techniques to measure blood pressure will help to avoid large systematic errors. Poor technique can account for differences in readings of more than 15 mm Hg and ultimately misdiagnosis. Most of the recommended procedures are simple and, when routinely incorporated into clinical practice, require little additional time. The equipment must be appropriate and in good condition. Physicians should have a suitable selection of cuff sizes readily available; the use of the correct cuff size is essential to minimize systematic errors in blood pressure measurement. Semiannual calibration of aneroid sphygmomanometers and annual inspection of mercury sphygmomanometers and blood pressure cuffs are recommended. We review the methods recommended for measuring blood pressure and discuss the factors known to produce large differences in blood pressure readings. PMID:2192791

  19. Salt, blood pressure, and human health.

    PubMed

    Alderman, M H

    2000-11-01

    The positive relation of sodium intake and blood pressure, first recognized a century ago, has been well established in ecological, epidemiological, and experimental human studies. Equally well established is the association of increasing blood pressure and cardiovascular morbidity and mortality. Indeed, the pharmacological capacity to reduce blood pressure has produced one of the great public health accomplishments of the 20th century. These two facts-the positive relation of blood pressure to strokes and heat attacks and the positive association of sodium intake to blood pressure-underlie the hypothesis that a reduction in sodium intake, by virtue of its hypotensive effect, might prevent strokes and heart attacks. Moreover, even if the effect on blood pressure were in the range of a 1- to 2-mm Hg decline in blood pressure for every 75- to 100-mmol difference in sodium intake, the impact of such a change, applied to the whole population, would be enormous. The problem with this appealing possibility is that a reduction in salt consumption of this magnitude has other-and sometimes adverse-health consequences. The question, therefore, is whether the beneficial hypotensive effects of sodium restriction will outweigh its hazards. Unfortunately, few data link sodium intake to health outcomes, and that which is available is inconsistent. Without knowledge of the sum of the multiple effects of a reduced sodium diet, no single universal prescription for sodium intake can be scientifically justified.

  20. Reproductive hormones and blood pressure during pregnancy.

    PubMed

    Kristiansson, P; Wang, J X

    2001-01-01

    The mechanisms involved in cardiovasular changes during human pregnancy and the complicated aetiology of gestational hypertension are unclear. Reproductive hormones have known effects on the cardiovascular system in the non-pregnant state and in animal systems, but their effects in human pregnancy are uncertain. In this study of pregnant women, the effects of serum concentrations of relaxin, progesterone and oestradiol on arterial blood pressure were studied. Higher serum concentrations of progesterone and relaxin, but not oestradiol, in early pregnancy were related to lower mean systolic blood pressures in the second and third trimesters. No relationship was found between hormonal concentrations and diastolic blood pressures. However, women with a diastolic blood pressure of >90 mmHg in late pregnancy showed statistically significant lower relaxin concentrations in early pregnancy in comparison with women whose diastolic blood pressure was blood pressure (P: < 0.0001) and serum relaxin (P: < 0.01) in early pregnancy, but not progesterone, were independently related to systolic blood pressure in late pregnancy. The results support previous experimental and clinical studies. The effect of relaxin may be explained by a possible vasodilatatory action seen in animal studies and appears to be moderate.

  1. Blood Pressure in Acute Ischemic Stroke

    PubMed Central

    McManus, Michael

    2016-01-01

    Hypertension is present in up to 84% of patients presenting with acute stroke, and a smaller proportion of patients have blood pressures that are below typical values in the context of cerebral ischemia. Outcomes are generally worse in those who present with either low or severely elevated blood pressure. Several studies have provided valuable information about malignant trends in blood pressure during the transition from the acute to the subacute phase of stroke. It is not uncommon for practitioners in clinical practice to identify what appear to be pressure-dependent neurologic deficits. Despite physiologic and clinical data suggesting the importance of blood pressure modulation to support cerebral blood flow to ischemic tissue, randomized controlled trials have not yielded robust evidence for this in acute ischemic stroke. We highlight previous studies involving acute-stroke patients that have defined trends in blood pressure and that have evaluated the safety and efficacy of blood-pressure modulation in acute ischemic stroke. This overview reports the current status of this topic from the perspective of a stroke neurologist and provides a framework for future research. PMID:26833984

  2. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.

    1974-01-01

    Intracranial pressure was raised by expansion of a supratentorial subdural ballon in anaesthetized baboons. Pressures were measured at several sites, both supratentorial and infratentorial, and cerebral blood flow was measured in each cerebral hemisphere separately. Pressures recorded from the right and left lateral ventricles corresponded closely throughout. Highly significant correlations were also obtained between the pressures in the right and left subdural spaces and the mean intraventricular pressure. There was, thus, no evidence of intracompartmental pressure gradients within the supratentorial space. Pressure gradients did, however, develop between the supratentorial and infratentorial compartments in the majority of experiments, although the level of supratentorial pressure at which this occurred, varied. Despite the presence of a large mass lesion over the right cerebral hemisphere, no significant differences developed between levels of cerebral blood flow in the two hemispheres, although flow in the right hemisphere remained consistently slightly lower than that in the left after the ballon was inserted. PMID:4836754

  3. The Birmingham blood pressure school study.

    PubMed Central

    De Giovanni, J. V.; Pentecost, B. L.; Beevers, D. G.; Beevers, M.; Jackson, S. H.; Bannan, L. T.; Osbourne, V. L.; Mathews, K.

    1983-01-01

    Four-hundred and twenty-eight school leavers of 3 ethnic groups (white, black and Asian) were screened for blood pressure, resting pulse rate and general anthropometric characteristics. Asian pupils were both shorter and lighter than the other two groups whilst black males were heavier and taller. There was no significant difference in the mean systolic or diastolic blood pressure between the 3 groups, although the black pupils had a stronger family history of hypertension, particularly on the mother's side. These observations differ in some respects from other ethnic blood pressure studies and establish values for the local population. PMID:6647172

  4. Raised intracranial pressure and cerebral blood flow

    PubMed Central

    Johnston, I. H.; Rowan, J. O.; Harper, A. M.; Jennett, W. B.

    1973-01-01

    Changes in cerebral blood flow with increasing intracranial pressure were studied in anaesthetized baboons during expansion of a subdural balloon in one of two different sites. With an infratentorial balloon, cerebral blood flow bore no clear relation to intracranial pressure, but was linearly related to cerebral perfusion pressure. Apart from an initial change in some animals, cerebrovascular resistance remained constant with increasing intracranial pressure, and autoregulation appeared to be lost from the outset. With a supratentorial balloon, cerebral blood flow remained constant as intracranial pressure was increased to levels around 60 mm Hg, corresponding to a cerebral perfusion pressure range of approximately 100 to 40 mmHg. Cerebrovascular resistance fell progressively, and autoregulation appeared to be effective during this phase. At higher intracranial pressure levels (lower cerebral perfusion pressure levels), autoregulation was lost and cerebral blood flow became directly dependent on cerebral perfusion pressure. The importance of the cause of the increase in intracranial pressure on the response of the cerebral circulation and the relevance of these findings to the clinical situation are discussed. PMID:4196632

  5. Blood pressure and industrial lead exposure.

    PubMed

    Maheswaran, R; Gill, J S; Beevers, D G

    1993-03-15

    The association between environmental lead exposure and raised blood pressure remains controversial. This association was examined in a cross-sectional study in 1981 on 809 male workers who were occupationally exposed to lead in a factory manufacturing car lead accumulator batteries in Birmingham, United Kingdom. Lead exposure was assessed by blood lead levels, blood zinc protoporphyrin levels, and years of industrial exposure to lead. The geometric mean blood lead level was 31.6 micrograms/dl with minimum and maximum values of 0 microgram/dl and 98 micrograms/dl, respectively. Unadjusted systolic blood pressure rose with increasing blood lead levels (analysis of variance, F = 3.3, p < 0.05) from 127 mmHg (95% confidence interval (CI) 123.5-130.5) in men with blood lead levels less than 21 micrograms/dl to 133 mmHg (95% CI 128.7-137.3) in men with levels exceeding 50 micrograms/dl. Following adjustment for the confounding effects of age, body mass index, and alcohol consumption, however, the effect of blood lead on systolic pressure was diminished (analysis of variance, F = 1.3, not significant) to 129 mmHg and 132 mmHg in the respective categories. There was no association between diastolic blood pressure and blood lead. Zinc protoporphyrin levels and years of industrial lead exposure did not raise adjusted systolic or diastolic pressure. In conclusion, subject to the limitations inherent in a cross-sectional survey, the findings are consistent with a weak effect of industrial lead exposure on systolic blood pressure, within the range of exposures observed in this study.

  6. Working meeting on blood pressure measurement: suggestions for measuring blood pressure to use in populations surveys.

    PubMed

    2003-11-01

    As part of the Pan American Hypertension Initiative (PAHI), the Pan American Health Organization and the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States of America conducted a working meeting to discuss blood pressure (BP) measurement methods used in various hypertension prevalence surveys and clinical trials, with the objective of developing a BP measurement protocol for use in hypertension prevalence surveys in the Americas. No such common protocol has existed in the Americas, so it has been difficult to compare hypertension prevention and intervention strategies. This piece describes a proposed standard method for measuring blood pressure for use in population surveys in the Region of the Americas. The piece covers: considerations for developing a common blood pressure measurement protocol, critical issues in measuring blood pressure in national surveys, minimum procedures for blood pressure measurement during surveillance, and quality assessment of blood pressure.

  7. What Is High Blood Pressure Medicine?

    MedlinePlus

    ... make the other lifestyle changes that will help reduce blood pressure, including: reaching and maintaining a healthy weight, lowering sodium (salt) intake, eating a heart-healthy diet, being more regularly physically active, and limiting alcohol ...

  8. Dietary fiber and blood pressure control.

    PubMed

    Aleixandre, A; Miguel, M

    2016-04-01

    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.

  9. Caffeine: How Does It Affect Blood Pressure?

    MedlinePlus

    ... M.D. References Zhang Z, et al. Habitual coffee consumption and risk of hypertension: A systematic review and ... 1212. Steffen M, et al. The effect of coffee consumption on blood pressure and the development of hypertension: ...

  10. Principles and techniques of blood pressure measurement

    PubMed Central

    Ogedegbe, Gbenga; Pickering, Thomas

    2013-01-01

    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

  11. Automatic blood pressure measuring system (M091)

    NASA Technical Reports Server (NTRS)

    1977-01-01

    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.

  12. Alcohol drinking and blood pressure among adolescents.

    PubMed

    Jerez, S J; Coviello, A

    1998-07-01

    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.

  13. Blood pressure and migration in children.

    PubMed

    Beaglehole, R; Eyles, E; Prior, I

    1979-03-01

    The effect of migration on childhood blood pressure levels has been studied by comparing children before and after migration to New Zealand with children who stayed at home on the Pacific atolls of Tokelau. Data were collected in 1971 on 502 children (97% response rate) aged 5--14 years resident in Tokelau and follow-up data were collected in New Zealand and in Tokelau in 1975--1977 (respknse rate 91%). No selection factors were detected before migration. After migration, the younger migrants had significantly higher blood pressures and were heavier, but not taller, than the non-migrants. Weight differences explained some but not all of the blood pressure differences. There were no differences in body size between the 2 groups of older children although the older non migrant girls had higher blood pressure than the migrant girls.

  14. Correlates of Blood Pressure in Elementary Schoolchildren.

    ERIC Educational Resources Information Center

    Melby, Christopher L.; And Others

    1987-01-01

    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)

  15. Automatic blood pressure measuring system (M091)

    NASA Technical Reports Server (NTRS)

    1977-01-01

    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.

  16. Birth weight and childhood blood pressure.

    PubMed

    Edvardsson, Vidar O; Steinthorsdottir, Sandra D; Eliasdottir, Sigridur B; Indridason, Olafur S; Palsson, Runolfur

    2012-12-01

    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.

  17. Weightlifting: Bad for Your Blood Pressure?

    MedlinePlus

    ... Circulation. 2007;116:572. Cornelissen VA, et al. Impact of resistance training on blood pressure and other cardiovascular risk factors: A meta-analysis of randomized, controlled trials. Hypertension. ...

  18. Carotid Stenosis and Ocular Blood Pressure Modelling

    PubMed Central

    Jullian, M.; Kinsner, W.

    1984-01-01

    A model of the human carotid vascular system was developed to study the effects of carotid stenosis on ocular blood pressure and ocular pulse waveform. The model incorporates a non-linear element representing a stenosis. A state variable representation of a reduced model is used in a computer simulation. Results show that carotid stenosis as low as 20% are detectable in the ocular blood pressure waveform.

  19. Salt, blood pressure and cardiovascular disease.

    PubMed

    He, Feng J; MacGregor, Graham A

    2007-07-01

    To review the evidence that relates salt intake to blood pressure and cardiovascular disease. Raised blood pressure throughout the range seen in developed countries is the major cause of cardiovascular disease, responsible for 62% of strokes and 49% of coronary heart disease. There is overwhelming evidence that dietary salt is a major cause of raised blood pressure, and a modest reduction in salt intake lowers blood pressure, which is predicted to reduce cardiovascular disease. Several lines of evidence including ecological, population and prospective cohort studies, as well as follow-up studies of individuals who participated in short-term salt reduction trials, have consistently shown a direct relation between salt intake and cardiovascular risk, and a reduction in population salt intake is associated with a reduction in cardiovascular mortality in the population. The evidence for universal salt reduction is strong, and reducing salt from the current intake of 10-12 g/day to the recommended level of 5-6 g/day will have a major effect on blood pressure and cardiovascular mortality. Additionally, this will result in considerable savings on health expenditure as, not only is raised blood pressure the biggest cause of death, but the second biggest cause of disability worldwide.

  20. Cocoa, blood pressure, and cardiovascular health.

    PubMed

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  1. Menopause and High Blood Pressure: What's the Connection?

    MedlinePlus

    ... blood pressure (hypertension) Is there a connection between menopause and high blood pressure? Answers from Shannon K. ... Tommaso, M.D. Blood pressure generally increases after menopause. Some doctors think this increase suggests that hormonal ...

  2. Sleep Deprivation: A Cause of High Blood Pressure?

    MedlinePlus

    ... High blood pressure (hypertension) Is it true that sleep deprivation can cause high blood pressure? Answers from ... be linked to increased blood pressure. People who sleep five hours or less a night may be ...

  3. Too Many Americans Have High Blood Pressure, Doctors Warn

    MedlinePlus

    ... news/fullstory_163468.html Too Many Americans Have High Blood Pressure, Doctors Warn With February designated National Heart Month, ... physicians warns that too many Americans struggle with high blood pressure. High blood pressure is a major risk factor ...

  4. [Clinical significance of nocturnal blood pressure and blood pressure variability: analysis of 522 cases].

    PubMed

    Palatini, P; Mormino, P; Martina, S; Businaro, R; Penzo, M; Racioppa, A; Guzzardi, G; Anaclerio, M; Pessina, A C

    1990-03-01

    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.

  5. Principles and techniques of blood pressure measurement.

    PubMed

    Pickering, Thomas G

    2002-05-01

    The gold standard for clinical blood pressure measurement continues to be readings taken by a physician using a mercury sphygmomanometer, but this is changing as mercury is gradually being phased out. The oscillometric technique, which primarily detects mean arterial pressure, is increasingly popular for use in electronic devices. Other methods include ultrasound (used mainly to detect systolic pressure) and the finger cuff method of Penaz, which can record beat-to-beat pressure noninvasively from the finger. The preferred location of measurement is the upper arm, but errors may occur because of changes in the position of the arm. Other technical sources of error include inappropriate cuff size and too rapid deflation of the cuff. Clinic readings may be unrepresentative of the patient's true blood pressure because of the white coat effect, which is defined as the difference between the clinic readings and the average daytime blood pressure. Patients with elevated clinic pressure and normal daytime pressure are said to have white coat hypertension. There are three commonly used methods for measuring blood pressure for clinical purposes: clinic readings, self-monitoring by the patient at home, and 24-hour ambulatory readings. Self-monitoring is growing rapidly in popularity and is generally carried out using electronic devices that work on the oscillometric technique. Although standard validation protocols exist, many devices on the market have not been tested for accuracy. Such devices can record blood pressure from the upper arm, wrist, or finger, but the arm is preferred. Twenty-four-hour ambulatory monitoring has been found to be the best predictor of cardiovascular risk in the individual patient and is the only technique that can describe the diurnal rhythm of blood pressure accurately. Ambulatory monitoring is mainly used for diagnosing hypertension, whereas self-monitoring is used for following the response to treatment. Different techniques of blood pressure

  6. Caffeine raises blood pressure at work.

    PubMed

    Lane, J D; Phillips-Bute, B G; Pieper, C F

    1998-01-01

    The study investigated the effects of moderate doses of caffeine on ambulatory blood pressure and heart rate during workday activities. Healthy, nonsmoking, habitual coffee drinkers (N = 21) received daily doses of 100 mg and 500 mg of caffeine on 2 days in a crossover design. Treatment order was random and counterbalanced, and administration was double-blind. Ambulatory monitoring was conducted for 6 to 9 hours during normal workday activities and diary entries were completed at each measurement. Ambulatory data were analyzed for the effects of caffeine dose, controlling for variations in posture, physical activity, and perceived stress. The average workday blood pressure and heart rate were significantly higher when the higher dose of caffeine was consumed. Controlling for other factors, dose-related differences were 4 mm Hg for systolic and 3 mm Hg for diastolic blood pressure, and were 3 bpm for heart rate. Results support earlier evidence that caffeine raises blood pressure at work, and demonstrate that these pressor effects are independent of changes in posture, physical activity, or stress. Daily blood pressure increases associated with caffeine consumption could increase the risk of developing cardiovascular diseases. In addition, caffeine consumption effects might confound ambulatory investigations of the cardiovascular effects of other psychosocial, personality, or health-behavior factors.

  7. Nighttime blood pressure in cluster headache.

    PubMed

    Santos Lasaosa, Sonia; Navarro Calzada, Jorge; Velázquez Benito, Alba; Pérez Lázaro, Cristina

    2011-10-01

    It has been proposed that desaturation of oxygen during an apnea event is the trigger for cluster headache. Obstructive sleep apnea has been associated with a higher than normal cardiovascular morbidity and mortality. Some obstructive sleep apnea syndrome patients lack the sleep-related, nocturnal decrease, or "dip" in blood pressure, which is seen in normal individuals. The aim of this study is to assess whether this non-dipper pattern is present in cluster headache patients. A total of 30 normotensive cluster headache patients underwent an ambulatory blood pressure monitoring. "Non dippers" were defined as patients with a nighttime mean blood pressure fall <10%. Fifteen cluster headache patients (50%) were non-dippers, a frequency higher than expected. The pattern of nocturnal non-dipping is associated with a higher body mass index. Non-dipper patients displayed higher mean nighttime systolic and diastolic blood pressure. No significant difference was observed in the mean 24-hour and daytime blood pressure. The high incidence (50%) of non-dipper pattern in both processes, cluster headache and obstructive sleep apnea syndrome, provides support for the hypothesis of a relationship between theses 2 disorders. © 2011 American Headache Society.

  8. Occupational lead exposure and blood pressure.

    PubMed Central

    Parkinson, D K; Hodgson, M J; Bromet, E J; Dew, M A; Connell, M M

    1987-01-01

    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

  9. Confounders of auscultatory blood pressure measurement.

    PubMed

    Baker, R H; Ende, J

    1995-04-01

    The appropriate use of any test requires the clinician to appreciate that test's limitations. By recognizing the potential confounders of the auscultatory assessment of blood pressure, the clinician minimizes the likelihood of enacting therapeutic decisions based on inaccurate data. When approaching the treatment of a hypertensive patient, several points should be kept in mind. First, the measurement of persistent and severe hypertension in a patient receiving treatment who describes symptoms of orthostatic hypotension with apparently adequate standing blood pressure or who lacks corroborating retinal, echocardiographic, or electrocardiographic signs of hypertension should raise the concern of pseudohypertension or a white-coat response. Similarly, when one finds a normal or near-normal systolic blood pressure in a patient with a clinical picture consistent with severe hypertension, one should make a directed effort to look for an unrecognized auscultatory gap. Second, marked discrepancies in measurements as obtained by different operators or in different settings should raise concern of the white-coat response or methodologic errors by one operator, such as undercuffing, excessive pressure on the head of the stethoscope, rapid deflation of the cuff, or use of different arms. In treating hypertension in even the minimally obese patient, a special point must be made that an adequate size cuff be used for all blood pressure determinations. Third, when blood pressure is determined with the patient in any but the satndardized back-and-arm-supported seated position described above, the clinician should acknowledge the possibility that the position may alter the patient's classification. Fourth, the diagnosis and management of hypertension requires multiple measurements of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Experimental intrarenal reflux and blood pressure.

    PubMed Central

    Moffat, D. B.

    1977-01-01

    The effect on the blood pressure of experimental vesico-ureteric reflux was investigated in adult female Wistar rats. In 6 rats, reflux with isotonic saline produced a transient rise in systemic blood pressure followed by a fall, with return to normal within 2 min (mean BP readings: 121-130-93 mmHg). In 6 rats during water diuresis, reflux with distilled water produced similar changes (114-120-79 mmHg). In 6 rats in which the ureters were divided before reflux, no rise in blood pressure occurred although in 2 of these the pressure showed a marked fall. The pattern of blood pressure changes which occurred as a result of reflux was similar to that produced by a rapid i.v. injection of a corresponding volume of saline and it was concluded that the changes accompanying reflux are due to pyelovenous backflow. This was confirmed by producing reflux with 5% lissamine green which appeared in the peripheral capillaries within 4 s of the reflux in 3 rats. Slow dilatation of the pelvis with saline in 9 rats showed that rupture of the pelvic epithelium occurred at a mean pressure of 99 mmHg. PMID:607990

  11. [Blood pressure goals on the test bench].

    PubMed

    Slany, Jörg

    2011-10-01

    There is little evidence from controlled prospective studies to support the low blood pressure goals stipulated for the treatment of hypertension by present guidelines, especially in high-risk patients with diabetes, renal insufficiency or coronary heart disease. Aim of this review is to scrutinize the potential benefit and risk of low blood pressure on the basis of recent studies and secondary analyses of older studies. In patients with coronary heart disease or equivalent or with diabetes lowering systolic blood pressure to 130 to 135 mmHg reduced primary or secondary cardiovascular endpoints in the majority of studies. Between 120 and 129 mmHg some positive effects could be shown in patients with coronary heart disease but not in patients with diabetes or metabolic syndrome. In patients with diabetic or nondiabetic nephropathy including those with proteinurea no convincing data exist which show a better outcome with systolic blood pressure below 130 versus below 140 mmHg. However, several studies suggest that the risk of stroke may decrease by lowering systolic pressure to 120 mmHg or even lower. Below 120 mmHg an increased risk of cardiac and noncardiac events or death was shown in quite a number of studies. In patients between 70 and 80 years, current evidence suggests lowering systolic blood pressure to 135 to 145 mmHg and in those above 80 years to 145 to 155 mmHg. No evidence was found to justify different diastolic pressure goals for different groups of patients; optimal values fall between 70 and 85 mmHg. Limitations of recent studies are short follow-up, few event rates and small differences in achieved pressure between groups leaving uncertainty about long-term effects. Apart from prevention of stroke there is sparse evidence that lowering systolic blood pressure below 130 mmHg may be beneficial. Current evidence suggests that lowering systolic and diastolic pressure into a range of 130 to 140/70 to 85 may be adequate for all patients with the exception

  12. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring

    PubMed Central

    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

    2015-01-01

    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

  13. Estimation of central systolic blood pressure using an oscillometric blood pressure monitor.

    PubMed

    Cheng, Hao-Min; Wang, Kang-Ling; Chen, Ying-Hwa; Lin, Shing-Jong; Chen, Lung-Ching; Sung, Shih-Hsien; Ding, Philip Yu-An; Yu, Wen-Chung; Chen, Jaw-Wen; Chen, Chen-Huan

    2010-06-01

    Current noninvasive techniques for assessing central aortic pressure require the recording of an arterial pressure wave using a high-fidelity applanation tonometer. We therefore developed and validated a novel method to estimate the central aortic systolic pressure using an oscillometric blood pressure monitor alone. Invasive high-fidelity right brachial and central aortic pressure waves, and left-brachial pulse volume plethysmography from an oscillometric blood pressure monitor, were obtained at baseline and 3 min after administration of sublingual nitroglycerin in 100 patients during cardiac catheterization. In the initial 50 patients (Generation Group), Central systolic blood pressure was predicted by a multi-variate prediction model generated from the comprehensive analysis of the invasive brachial pressure wave, including brachial late-systolic shoulder pressure value and parameters related to wave reflection and arterial compliance. Another prediction model was similarly constructed from the noninvasively calibrated pulse volume plethysmography. Both models were validated in the subsequent 50 patients (Validation Group) with results: r=0.98 (P<0.001) and mean difference=0.5+/-4.5 (95% confidence interval -8.3 to 9.3) mm Hg for the invasive model, and r=0.93 (P<0.001) and mean difference=-0.1+/-7.6 (95% confidence interval -15.0 to 14.8) mm Hg for the noninvasive model. Thus, our results indicate that central aortic systolic blood pressure could be estimated by analysis of the noninvasive brachial pressure wave alone from an oscillometric blood pressure monitor.

  14. WNK signalling pathways in blood pressure regulation.

    PubMed

    Murthy, Meena; Kurz, Thimo; O'Shaughnessy, Kevin M

    2017-04-01

    Hypertension (high blood pressure) is a major public health problem affecting more than a billion people worldwide with complications, including stroke, heart failure and kidney failure. The regulation of blood pressure is multifactorial reflecting genetic susceptibility, in utero environment and external factors such as obesity and salt intake. In keeping with Arthur Guyton's hypothesis, the kidney plays a key role in blood pressure control and data from clinical studies; physiology and genetics have shown that hypertension is driven a failure of the kidney to excrete excess salt at normal levels of blood pressure. There is a number of rare Mendelian blood pressure syndromes, which have shed light on the molecular mechanisms involved in dysregulated ion transport in the distal kidney. One in particular is Familial hyperkalemic hypertension (FHHt), an autosomal dominant monogenic form of hypertension characterised by high blood pressure, hyperkalemia, hyperchloremic metabolic acidosis, and hypercalciuria. The clinical signs of FHHt are treated by low doses of thiazide diuretic, and it mirrors Gitelman syndrome which features the inverse phenotype of hypotension, hypokalemic metabolic alkalosis, and hypocalciuria. Gitelman syndrome is caused by loss of function mutations in the thiazide-sensitive Na/Cl cotransporter (NCC); however, FHHt patients do not have mutations in the SCL12A3 locus encoding NCC. Instead, mutations have been identified in genes that have revealed a key signalling pathway that regulates NCC and several other key transporters and ion channels in the kidney that are critical for BP regulation. This is the WNK kinase signalling pathway that is the subject of this review.

  15. `Sausage string' patterns in blood vessels at high blood pressures

    NASA Astrophysics Data System (ADS)

    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.

  16. Blood Pressure in Infants, Children and Adolescents

    PubMed Central

    Moss, Arthur J.

    1981-01-01

    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

  17. An implantable blood pressure and flow transmitter.

    NASA Technical Reports Server (NTRS)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    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.

  18. Blood pressure measurement using finger cuff.

    PubMed

    Lee, J; Choi, E; Jeong, H; Kim, K; Park, J

    2005-01-01

    Many research groups have studied blood pressure measurement in finger artery because of its convenience. But, low accuracy prohibits many hypertension patients from using this device. So, we suggest measurement algorithm that measure systolic and diastolic blood pressure in finger artery. And we also develop calibration method that decreases the error from difference of finger circumference by subjects. We apply our methods for 90 subjects (age form 20 to 49, 55 male, 35 female) to test feasibility of our method by AAMI SP10 standard. The mean difference of our system is ±4.7mmHg for systolic pressure, ±4.2mmHg for systolic pressure. It proved that the feasibility of our method is clinically acceptable.(under ±5mmHg).

  19. An implantable blood pressure and flow transmitter.

    NASA Technical Reports Server (NTRS)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    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.

  20. [Blood pressure and polycystic ovary syndrome (PCOS)].

    PubMed

    Kiałka, Marta; Milewicz, Tomasz; Klocek, Marek

    2015-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder occurring in women of childbearing age. The literature describes the relationship between PCOS and high blood pressure levels and increased risk of arterial hypertension development, which is an important and strong risk factor for adverse cardiovascular events in the future. Among the main causes of hypertension in PCOS women insulin resistance, hyperandrogenism, greater sympathetic nerve activity and concomitance of obesity are stressed. Because PCOS may contribute to earlier development of hypertension, as well as pre-hypertension, therefore it is advisable to monitor blood pressure systematically, to control known risk factors, and to initiate the treatment of hypertension when the disease occur.

  1. Phaeochromocytoma with nocturnal elevation of blood pressure.

    PubMed Central

    Yamamoto, T.; Jo, T.; Ishibashi, T.

    1978-01-01

    A 47-year-old woman with phaeochromocytoma showed blood pressure changes characterized by the regular appearance of hypertension at night. The urinary excretion of catecholamines and their metabolites showed augmentation roughly parallel with the elevation of the blood pressure. During normotensive periods, the urinary excretion of catecholamines and their metabolites was elevated. The findings suggested that the pressor effect of catecholamine hypersecretion was compromised to a certain degree and that the regular nocturnal appearances of hypertensive paroxysm conceivably resulted from a spontaneous cyclic augmentation of the catecholamine secretion from the tumour. PMID:625458

  2. Coping strategies and diastolic blood pressure.

    PubMed

    Wright, T A; Sweeney, D

    1989-10-01

    An organizational field study involving 95 civil service employees examined the ways these individuals coped with the stressful events of their daily living. Lazarus' cognitive-phenomenological analysis of psychological stress provided the theoretical framework. Subjects indicated on Lazarus' Ways of Coping Checklist those coping thoughts and actions used in the specific encounter described as stressful. As hypothesized, individuals experiencing higher diastolic blood pressure were more likely to cope using strategies characterized by wishful thinking, avoidance, and minimization of threat than were individuals exhibiting lower blood pressure. Implications from both an individual and organizational perspective are discussed.

  3. Blood pressure in head‐injured patients

    PubMed Central

    Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R

    2007-01-01

    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

  4. Dietary phosphorus and blood pressure: international study of macro- and micro-nutrients and blood pressure.

    PubMed

    Elliott, Paul; Kesteloot, Hugo; Appel, Lawrence J; Dyer, Alan R; Ueshima, Hirotsugu; Chan, Queenie; Brown, Ian J; Zhao, Liancheng; Stamler, Jeremiah

    2008-03-01

    Raised blood pressure is a leading cause of morbidity and mortality worldwide; improved nutritional approaches to population-wide prevention are required. Few data are available on dietary phosphorus and blood pressure and none are available on possible combined effects of phosphorus, magnesium, and calcium on blood pressure. The International Study of Macro- and Micro-Nutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40 to 59 from 17 population samples in Japan, China, United Kingdom, and United States. Blood pressure was measured 8 times at 4 visits. Dietary intakes were obtained from four 24-hour recalls plus data on supplement use. Dietary phosphorus was inversely associated with blood pressure in a series of predefined multiple regression models, with the successive addition of potential confounders, both nondietary and dietary. Estimated blood pressure differences per 232 mg/1000 kcal (2 SD) of higher dietary phosphorus were -1.1 to -2.3 mm Hg systolic/-0.6 to -1.5 mm Hg diastolic (n=4680) and -1.6 to -3.5 mm Hg systolic/-0.8 to -1.8 mm Hg diastolic for 2238 "nonintervened" individuals, ie, those without special diet/nutritional supplements or diagnosis/treatment for cardiovascular disease or diabetes. Dietary calcium and magnesium, correlated with phosphorus (partial r=0.71 and r=0.68), were inversely associated with blood pressure. Blood pressures were lower by 1.9 to 4.2 mm Hg systolic/1.2 to 2.4 mm Hg diastolic for people with intakes above versus below country-specific medians for all 3 of the minerals. These results indicate the potential for increased phosphorus/mineral intake to lower blood pressure as part of the recommendations for healthier eating patterns for the prevention and control of prehypertension and hypertension.

  5. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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....

  6. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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....

  7. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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....

  8. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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....

  9. 21 CFR 870.2850 - Extravascular blood pressure transducer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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....

  10. Utility of ambulatory blood pressure monitoring in children and adolescents.

    PubMed

    Graves, John W; Althaf, Mohammed Mahdi

    2006-11-01

    Diagnosis of hypertension is critically dependent on accurate blood pressure measurement. "Accurate" refers to carefully following the guidelines for blood pressure measurement laid out for children and adults to minimize observer and subject errors that commonly occur in clinical blood pressure measurement. Accurate blood pressure measurement is more important in children and adolescents as the misdiagnosis of hypertension may have a life-long adverse impact on insurability and employment. Automated blood pressure measurement offers multiple advantages in achieving high-quality blood pressure determinations by reducing observer errors. The most commonly used form of automated blood pressure measurement is 24-h ambulatory blood pressure measurement (ABPM). Information on ABPM in children has grown exponentially over the last decade. Normative data exists for diagnosis of hypertension in children using ABPM including a novel method for determining normal values with the LMS method. There is further information about the utility of different determinants of 24-h blood pressure such as dipping status, morning surge and blood pressure load. ABPM has been able to detect significant differences in blood pressure in many disease states in children including chronic renal failure, polycystic kidney disease, solitary functioning kidney, and after renal transplantation. Increasingly nonambulatory automated blood pressure determinations have been used in management of hypertension in children. Although nonambulatory automated readings lack information about nocturnal blood pressure or blood pressure during daily activity, studies have suggested that home automated blood pressure measurements are a helpful adjunct to the usual office blood pressure reading.

  11. Blood pressure and serum creatinine in obese female.

    PubMed

    Asrin, M; Nessa, A; Hasan, M I; Das, R K

    2015-01-01

    Obesity is increasing in developed as well as in developing countries. This analytical cross sectional study was carried out to document the relation between blood pressure, serum creatinine and body mass index in female and to assess potential health differences among obese female and normal weight female. This study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2012 to June 2013. Seventy female persons volunteered as subjects. Among them 35 were within normal weight (BMI 18.5-24.9kg/m²) and 35 were obese (BMI≥30kg/m²). Non probability purposive type of sampling technique was used to select the subjects. Measurement of body mass index and blood pressure were done as per procedure. Serum creatinine level was estimated by enzymatic colorimetric method. The results were calculated and analyzed by using SPSS (statistical package for social science, version 17.0), scientific electronic calculator and simultaneously with a computer assisted program like Microsoft excel. Unpaired 't' test was applied to find the significance of difference regarding serum creatinine and blood pressure levels in obese female. The value of p was 1% to indicate highly significant and 5% to indicate simply significant or statistically significant. The mean±SE of systolic blood pressure, diastolic blood pressure and serum creatinine levels were 135.71±1.58mmHg, 88.74±0.95mmHg and 1.03±0.01mg/dl respectively; significant at 1% level for obese group of BMI (p<0.0001). The examinations and biochemical investigations revealed that high BMI is significantly related to increased levels of serum creatinine & blood pressure in obese female which indicate the obese subjects are prone to cardiovascular & metabolic risk.

  12. A wireless blood pressure monitoring system for personal health management.

    PubMed

    Li, Wun-Jin; Luo, Yuan-Long; Chang, Yao-Shun; Lin, Yuan-Hsiang

    2010-01-01

    In this paper, we developed a wireless blood pressure monitoring system which provides a useful tool for users to measure and manage their daily blood pressure values. This system includes an ARM-based blood pressure monitor with a ZigBee wireless transmission module and a PC-based management unit with graphic user interface and database. The wireless blood pressure monitor can measure the blood pressure and heart rate and then store and forward the measuring information to the management unit through the ZigBee wireless transmission. On the management unit, user can easy to see their blood pressure variation in the past using a line chart. Accuracy of blood pressure measurement has been verified by a commercial blood pressure simulator and shown the bias of systolic blood pressure is ≤ 1 mmHg and the bias of diastolic blood pressure is ≤ 1.4 mmHg.

  13. 1 in 7 Obese People Has Normal Blood Pressure, Cholesterol

    MedlinePlus

    ... in 7 Obese People Has Normal Blood Pressure, Cholesterol But that doesn't mean the excess weight ... people studied, 14 percent had normal blood sugar, cholesterol and blood pressure readings, the study found. Doctors ...

  14. Neighborhood Disadvantage and Variations in Blood Pressure

    ERIC Educational Resources Information Center

    Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert

    2015-01-01

    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…

  15. Ethnicity, education, and blood pressure in Cuba.

    PubMed

    Ordunez, Pedro; Munoz, Jose Luis Bernal; Espinosa-Brito, Alfredo; Silva, Luis Carlos; Cooper, Richard S

    2005-07-01

    The causes of variation in hypertension risk by ethnicity and educational level are not well understood. To gain further insight into this issue in a nonindustrialized country, a population-based sample of 1,667 persons aged 15-74 years was recruited in Cienfuegos, Cuba. In this 2001-2002 study, interviewers classified 29% of participants as Black or mulatto and 71% as White. Educational attainment was stratified at the median number of school years. Compared with White women, non-White women had higher blood pressures (3.0/1.7, systolic blood pressure/diastolic blood pressure) and a higher prevalence of hypertension (24%, 95% confidence interval: 20, 28 vs. 15%, 95% confidence interval: 12, 18). Among men, no differences in blood pressure were observed by ethnicity. Men with a lower level of education had a 14% lower risk of hypertension compared with men above the median. However, women with a lower level of education had a 24% increase in risk. The effect of education was equally strong among Whites alone and when occupation was used for stratification. No variation was observed for body mass index or self-reported health behaviors by ethnicity or education. The narrower ethnic gradient in hypertension prevalence than seen in North America and the gender-specific social status effect, in the context of relatively equal living conditions, suggest that the influence of psychosocial stressors may be specific to cultural contexts.

  16. Blood pressure measurement and display system

    NASA Technical Reports Server (NTRS)

    Farkas, A. J.

    1972-01-01

    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.

  17. Neighborhood Disadvantage and Variations in Blood Pressure

    ERIC Educational Resources Information Center

    Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert

    2015-01-01

    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…

  18. Self-measurement of blood pressure

    PubMed Central

    1988-01-01

    Although experience is still limited and more research is needed, the World Hypertension League recommends self-measurement of blood pressure in selected patients as an additional source of information to the practising physician, and as a way of encouraging patients to participate more actively in the therapeutic regimen. PMID:3260828

  19. [Elevated blood pressure as cardiovascular risk factor].

    PubMed

    Kowalewski, Wiesław; Hebel, Kazimiera

    2013-01-01

    Cardiovascular diseases for decades have been and still are the main and current health problem of the Polish society and there are many reasons for these diseases. Hypertension is one of the major risk factors for developing cardiovascular disease. The factors significantly increasing risk the of cardiovascular disease are in addition to high blood pressure, smoking (also passive), high blood fats (cholesterol and its HDL, LDL fractions as well as triglyceride levels, obesity, lack of exercise, diabetes and hereditary features. Other important factors which play an important role are external factors such as e.g. environmental pollution, lifestyle, stress. Prediction of cardiovascular disease should start from the evaluation of the fetal period because low birth weight may be a risk of coronary heart disease, hypertension, obesity or diabetes in adulthood. The authors of the referred tests showed that the level of blood pressure observed during childhood is closely associated with the level of blood pressure in adults and is also dependent on the body weight. Since the issue of the effects of high pressure on the cardiovascular system is inherent in the issue of the metabolic syndrome, it should be mentioned also that another causative factor may be an irregularity in the removal of urine from the body and the amount of insulin. The control of hypertension is a complex problem, at least in view of the wide range of adverse factors affecting the human body: hypertension is often either a constituent of other lesions. Therefore, it is difficult to treat high blood pressure in the strict sense; more often it is a combination therapy based on pharmacology caused for other reasons.

  20. The Effect of Anthocyanins on Blood Pressure

    PubMed Central

    Zhu, Yongjian; Bo, Yacong; Wang, Xi; Lu, Wenjie; Wang, Xule; Han, Zhanying; Qiu, Chunguang

    2016-01-01

    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

  1. Genetic effects of adiponectin on blood lipids and blood pressure.

    PubMed

    Zhao, Tongfeng; Zhao, Jiangpei

    2011-02-01

    Results from the published studies on the association of adiponectin gene (ADIPOQ) polymorphisms with blood lipids and blood pressure are conflicting. We investigated the association of three ADIPOQ polymorphisms, +45 T > G (rs2241766), +276 G > T (rs1501299) and -11377 C > G (rs266729), with these traits in this meta-analysis. We included 35 studies in this meta-analysis. Dominant models were used for this meta-analysis. We did not detect a significant association of the -11377 C > G polymorphism with blood lipids or blood pressure (P > 0·05). The association of the +45 T > G polymorphism with blood lipids and blood pressure was, similarly, not significant (P > 0·05). The meta-analysis suggested a significant overall association of the +276 G > T polymorphism with lower levels of total cholesterol: weighted mean difference (WMD) = -0·10, 95% confidence interval (CI, -0·17, -0·03), P = 0·005, P(heterogeneity)  = 0·04. This association was marginally significant in East Asians and East Asians with type 2 diabetes: WMD = -0·10, 95% CI (-0·20, 0·00), P = 0·05, P(heterogeneity)  = 0·002, and WMD = -0·09, 95% CI (-0·18, -0·00), P = 0·05, P(heterogeneity)  = 0·80, respectively. After exclusion of a study that was the source of heterogeneity, the association was significant in overall populations and marginally significant in East Asians: WMD= -0·06, 95% CI (-0·11, -0·01), P = 0·01, P(heterogeneity)  = 0·98, and WMD = -0·06, 95% CI (-0·12, 0·00), P = 0·07, P(heterogeneity)  = 0·83, respectively. However, none of these associations were significant after Bonferroni correction (significant threshold: P < 0·003). Our meta-analysis does not suggest any association of the three ADIPOQ polymorphisms with blood lipids and blood pressure. © 2011 Blackwell Publishing Ltd.

  2. Alanine increases blood pressure during hypotension

    NASA Technical Reports Server (NTRS)

    Conlay, L. A.; Maher, T. J.; Wurtman, R. J.

    1990-01-01

    The effect of L-alanine administration on blood pressure (BP) during haemorrhagic shock was investigated using anesthetized rats whose left carotid arteries were cannulated for BP measurement, blood removal, and drug administration. It was found that L-alanine, in doses of 10, 25, 50, 100, and 200 mg/kg, increased the systolic BP of hypotensive rats by 38 to 80 percent (while 100 mg/kg pyruvate increased BP by only 9.4 mmhg, not significantly different from saline). The results suggest that L-alanine might influence cardiovascular function.

  3. Alanine increases blood pressure during hypotension

    NASA Technical Reports Server (NTRS)

    Conlay, L. A.; Maher, T. J.; Wurtman, R. J.

    1990-01-01

    The effect of L-alanine administration on blood pressure (BP) during haemorrhagic shock was investigated using anesthetized rats whose left carotid arteries were cannulated for BP measurement, blood removal, and drug administration. It was found that L-alanine, in doses of 10, 25, 50, 100, and 200 mg/kg, increased the systolic BP of hypotensive rats by 38 to 80 percent (while 100 mg/kg pyruvate increased BP by only 9.4 mmhg, not significantly different from saline). The results suggest that L-alanine might influence cardiovascular function.

  4. [Measurement of blood pressure variability and the clinical value].

    PubMed

    Kékes, Ede; Kiss, István

    2014-10-19

    Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability. They underline that in addition to reduction of blood pressure to target value, it is essential to influence blood pressure fluctuation and decrease blood pressure variability, because blood pressure fluctuation presents a major threat for the hypertensive subjects. Data from national studies are also presented. They welcome that measurement of blood pressure variability has been included in international guidelines.

  5. [Realization of mobile phone based wireless blood pressure monitoring system and its preliminary implementation].

    PubMed

    Wang, Shuo; Gong, Eenhao; Yu, Yang; Liu, Jing

    2011-11-01

    A novel system which could measure blood pressure wirelessly through mobile phone has been proposed and developed. It consisted of a blood pressure signal recorder based on MCU (Micro Control Unit), which could transmit measured data via Bluetooth, and a software embedded on mobile phone, which could calculate the value of blood pressure and the rate of heart beat. The measurement results could easily be stored in text documents or in picture format. Detailed scheme and design of each module in the system was illustrated and experiments were conducted to demonstrate the reliability and stability of the device. A series of new conceptual explorations into blood pressure related issues were conducted with this system, including the variational blood pressure at different time periods in a day, the effect of posture on the measurement results and the impact of movements on blood pressure.

  6. Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism.

    PubMed

    Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C

    2017-07-12

    Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P < 0.01) and average real variability (P < 0.05) of systolic blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P < 0.001). A positive correlation of serum calcium and parathyroid hormone with 24-h-average real variability of systolic BP was observed in the entire primary hyperparathyroidism patients group (P = 0.04, P  = 0.02; respectively). Systolic blood pressure variability is increased in normotensive

  7. Blood pressure control versus atrial fibrillation management in stroke prevention.

    PubMed

    Savoia, Carmine; Sada, Lidia; Volpe, Massimo

    2015-06-01

    Hypertension is one of the major risk factors for atrial fibrillation which in turn is the most prevalent concomitant condition in hypertensive patients. While both these pathological conditions are independent risk factors for stroke, the association of hypertension and atrial fibrillation increases the incidence of disabling strokes. Moreover, documented or silent atrial fibrillation doubles the rate of cardiovascular death. Lowering blood pressure is strongly recommended, particularly for primary stroke prevention. However, a relatively small percentage of hypertensive patients still achieve the recommended blood pressure goals. The management of atrial fibrillation with respect to stroke prevention is changing. New oral anticoagulants represent a major advancement in long-term anticoagulation therapy in non valvular atrial fibrillation. They have several benefits over warfarin, including improved adherence to the anticoagulation therapy. This is an important issue since non-adherence to stroke prevention medications is a risk factor for first and recurrent strokes.

  8. 21 CFR 870.1100 - Blood pressure alarm.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

  9. 21 CFR 870.1100 - Blood pressure alarm.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 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...

  10. 21 CFR 870.1100 - Blood pressure alarm.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 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...

  11. 21 CFR 870.1100 - Blood pressure alarm.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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...

  12. 21 CFR 870.1100 - Blood pressure alarm.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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...

  13. User procedure for self-measurement of blood pressure. First International Consensus Conference on Self Blood Pressure Measurement.

    PubMed

    Mengden, T; Chamontin, B; Phong Chau, N; Luis Palma Gamiz, J; Chanudet, X

    2000-04-01

    To review the medical literature regarding the methodology of self-measurement of blood pressure and to provide some practical recommendations regarding protocol and procedure for measurement, documentation and analysis of data, choice and provision of devices and education of patients and physicians. Technical recommendations regarding measurement of blood pressure do not differ from usual guidelines. Frequency of measurement remains a matter of discussion. At the beginning of the self-measurements of blood pressure and during the titration phase, there should be a 7-day measurement period with two measurement of blood pressure each morning and two measurements in the evening at pre-stipulated times. For long-term observation, a minimum measurement period of 1 week per quarter is required. The minimum number of measurements performed during each period should be a total of 12 readings recorded within seven working days. Depending on individual needs (e.g. poor compliance) or for pharmacologic studies, a higher frequency of readings could be used. Owing to the lack of reliability of patients' diaries, the use of printer-equipped or memory-equipped devices is advocated. All the recorded data, except those obtained on the first day, must be used for analysis. Self-measurement of blood pressure should be performed with validated fully automated devices using a brachial cuff. The preference should be given to apparatus offering the possibility of storing and transmitting measurements. Wrist apparatus should be used with caution due to the risk of measurement errors if it is used inappropriately. A manual device should be considered for patients suffering from irregular cardiac rhythms and patients with large or small arm circumferences, since automated devices have not been validated for use in these situations. Reimbursement of hypertensive patients using validated devices should be considered, so long as they are adequately trained and supervised. In a therapeutic

  14. PZR transducer for monitoring blood pressure

    NASA Astrophysics Data System (ADS)

    Sotelo-Aguilar, Abraham; Martinez-Piñón, Fernando; Álvarez-Chávez, Jose A.

    2009-03-01

    Results on a designed piezo resistive transducer (PZR) are presented in this work. The PZR will be specially manufactured for accurately measuring human blood pressure levels. Such transducer consists of four indifussed piezoresistors within a 10-μm Si membrane. The voltage signal response (VSR) is predicted when pressure is applied to the membrane, using a MEMS design tool that includes Finite Element Analysis (FEA). This transducer has the purpose of serving as a basis for the integration of an implantable Bio-MEMS BP sensor.

  15. Health Instruction Packages: How to Take a Blood Pressure.

    ERIC Educational Resources Information Center

    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…

  16. 21 CFR 870.1130 - Noninvasive blood pressure measurement system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Noninvasive blood pressure measurement system. 870... Noninvasive blood pressure measurement system. (a) Identification. A noninvasive blood pressure measurement... three pressures can be derived through the use of tranducers placed on the surface of the body....

  17. Health Instruction Packages: How to Take a Blood Pressure.

    ERIC Educational Resources Information Center

    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…

  18. Utility of home blood pressure monitoring to evaluate postprandial blood pressure in treated hypertensive patients.

    PubMed

    Alfie, José

    2015-08-01

    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. © The Author(s), 2015.

  19. Dysglycemia induces abnormal circadian blood pressure variability

    PubMed Central

    2011-01-01

    Background Prediabetes (PreDM) in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV). Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S) rats (n = 19) after weaning were fed either an American (AD) or a standard (SD) diet. The AD (high-glycemic-index, high-fat) simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat) mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG), adipokines (leptin and adiponectin), and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-α (TNF-α)] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP) and heart rate (HR) were recorded by telemetry every 5 minutes during both sleep (day) and active (night) periods. Pulse pressure (PP) was calculated (PP = SBP-DBP). Results [mean(SEM)]: The AD fed group displayed significant increase in body weight (after 90 days; p < 0.01). Fasting glucose, adipokine (leptin and adiponectin) concentrations significantly increased (at 90 and 172 days; all p < 0.05), along with a trend for increased concentrations of systemic pro-inflammatory cytokines (MCP-1 and TNF-α) on day 90. The AD fed group, with significantly higher FG, also exhibited significantly elevated circadian (24-hour) overall mean SBP, DBP, PP and HR (all p < 0.05). Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental

  20. High blood pressure in children and adolescents.

    PubMed

    Riley, Margaret; Bluhm, Brian

    2012-04-01

    High blood pressure in children and adolescents is a growing health problem that is often overlooked by physicians. Normal blood pressure values for children and adolescents are based on age, sex, and height, and are available in standardized tables. Prehypertension is defined as a blood pressure in at least the 90th percentile, but less than the 95th percentile, for age, sex, and height, or a measurement of 120/80 mm Hg or greater. Hypertension is defined as blood pressure in the 95th percentile or greater. A secondary etiology of hypertension is much more likely in children than in adults, with renal parenchymal disease and renovascular disease being the most common. Overweight and obesity are strongly correlated with primary hypertension in children. A history and physical examination are needed for all children with newly diagnosed hypertension to help rule out underlying medical disorders. Children with hypertension should also be screened for other risk factors for cardiovascular disease, including diabetes mellitus and hyperlipidemia, and should be evaluated for target organ damage with a retinal examination and echocardiography. Hypertension in children is treated with lifestyle changes, including weight loss for those who are overweight or obese; a healthy, low-sodium diet; regular physical activity; and avoidance of tobacco and alcohol. Children with symptomatic hypertension, secondary hypertension, target organ damage, diabetes, or persistent hypertension despite nonpharmacologic measures should be treated with antihypertensive medications. Thiazide diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are safe, effective, and well tolerated in children.

  1. Lead, blood pressure, and cardiovascular disease in men and women

    SciTech Connect

    Schwartz, J. )

    1991-02-01

    Lead has been shown to be associated with elevated blood pressure in males in the NHANES 2 survey and in numerous other studies. This study confirms the association in males ages 20 to 74 and documents a singificant, although weaker, association in females as well. Prospective cardiovascular disease studies such as the Framingham study indicate that increases in blood pressure should be associated with increased risk of cardiovascular disease. Using electrocardiogram data from NHANES 2, this study confirms the expected association oflead with left ventricular hypertrophy. The logistic risk coefficients from the Framingham study can be combined with the study's association between lead and blood pressure to examine its implication for more serious outcomes. The results suggest that a halving of the population mean blood lead level would reduce myocardial infarctions by approximately 24,000 events per year and incidence of all cardiovascular disease by over 100,000. These numbers suggest a small attributable risk compared ot the vast incidence of cardiovascular disease in the US, but a large attributable risk compared to most environmental toxins. Several biological mechanisms have been identified, with different implications for the use of bone lead as an exposure measure.

  2. Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond

    PubMed Central

    Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob

    2014-01-01

    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

  3. The effect of nutrition on blood pressure.

    PubMed

    Savica, Vincenzo; Bellinghieri, Guido; Kopple, Joel D

    2010-08-21

    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.

  4. Ethanol and blood pressure in rats

    SciTech Connect

    Hatton, D.C.; Edgar, S.; McCarron, D.A. )

    1989-02-09

    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.

  5. Dietary spermidine for lowering high blood pressure

    PubMed Central

    Zimmermann, Andreas; Schroeder, Sabrina; Pendl, Tobias; Harger, Alexandra; Stekovic, Slaven; Schipke, Julia; Magnes, Christoph; Schmidt, Albrecht; Ruckenstuhl, Christoph; Dammbrueck, Christopher; Gross, Angelina S; Herbst, Viktoria; Carmona-Gutierrez, Didac; Pietrocola, Federico; Pieber, Thomas R; Sigrist, Stephan J; Linke, Wolfgang A; Mühlfeld, Christian; Sadoshima, Junichi; Dengjel, Joern; Kiechl, Stefan; Kroemer, Guido; Sedej, Simon; Madeo, Frank

    2017-01-01

    Loss of cardiac macroautophagy/autophagy impairs heart function, and evidence accumulates that an increased autophagic flux may protect against cardiovascular disease. We therefore tested the protective capacity of the natural autophagy inducer spermidine in animal models of aging and hypertension, which both represent major risk factors for the development of cardiovascular disease. Dietary spermidine elicits cardioprotective effects in aged mice through enhancing cardiac autophagy and mitophagy. In salt-sensitive rats, spermidine supplementation also delays the development of hypertensive heart disease, coinciding with reduced arterial blood pressure. The high blood pressure-lowering effect likely results from improved global arginine bioavailability and protection from hypertension-associated renal damage. The polyamine spermidine is naturally present in human diets, though to a varying amount depending on food type and preparation. In humans, high dietary spermidine intake correlates with reduced blood pressure and decreased risk of cardiovascular disease and related death. Altogether, spermidine represents a cardio- and vascular-protective autophagy inducer that can be readily integrated in common diets. PMID:28118075

  6. High-normal blood pressure is associated with visit-to-visit blood pressure variability in the US adults.

    PubMed

    Faramawi, Mohammed F; Delongchamp, Robert; Said, Qayyim; Balamurugan, Appathurai; Hassan, Alaa; Abouelenien, Saly; Ismaeil, Mohamed

    2017-02-01

    High-normal blood pressure and visit-to-visit blood pressure variability are common in clinical settings. They are associated with cardiovascular outcomes. No population based studies have assessed the association between these two phenomena. Our objective was to test the relationship of high-normal blood pressure with visit-to-visit blood pressure variability. A cross-sectional study. We used data from the cross-sectional Third National Health and Nutrition Examination Survey to test the relationship between high-normal blood pressure and visit-to-visit blood pressure variability; we conducted multivariable regression analyses to evaluate the relationship between these two variables. The analysis included 6,071 participants. The participants' mean age was 37.16 years. The means of visit-to-visit systolic and diastolic blood pressure variability were 5.84 mmHg and 5.26 mmHg. High-normal blood pressure was significantly associated with systolic and diastolic blood pressure variability (p values <0.05). High-normal blood pressure is associated with visit-to-visit blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among patients with high-normal blood pressure to reduce the subsequent complications of blood pressure variability.

  7. Ambulatory Blood Pressure Monitoring in Clinical Practice: A Review

    PubMed Central

    Viera, Anthony J.; Shimbo, Daichi

    2016-01-01

    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

  8. Association of Blood Pressure, Blood Glucose, and Temperature With Neurological Outcome After Childhood Stroke.

    PubMed

    Grelli, Kimberly N; Gindville, Melissa C; Walker, C Haley; Jordan, Lori C

    2016-07-01

    To our knowledge, no evidence-based guidelines are available for the best medical management of blood pressure, blood glucose levels, and temperature in pediatric patients after arterial ischemic stroke. To determine the prevalence of abnormal blood pressure, blood glucose levels, and temperature in pediatric patients with acute arterial ischemic stroke and to explore any association between these measures and neurological outcome. We performed a retrospective review of children aged 29 days to 18 years with their first arterial ischemic stroke between January 2009 and December 2013 at a tertiary academic children's hospital. Ninety-eight children with stroke were identified by an International Classification of Diseases, Ninth Revision, code search and medical record review. Blood pressure, blood glucose, and temperature data were collected for 5 days after the stroke. Hypertension was defined as systolic blood pressure at or above the 95th percentile for age, sex, and height for 2 consecutive recordings and 2 consecutive days. Hypotension was defined as systolic and/or diastolic blood pressure below the fifth percentile for age, sex, and height for 2 consecutive recordings. Hyperglycemia was defined as a blood glucose level of 200 mg/dL or greater. Morbidity and mortality at 3 months were documented. Data analyses were performed from July 1, 2014, to December 31, 2015. Abnormal blood pressure, blood glucose levels, and fever in the setting of arterial ischemic stroke. The a priori outcome measure was poor clinical outcome, defined as a Pediatric Stroke Outcome Measure score of 1 or greater, which represents a moderate neurological deficit. The median (interquartile range) age of the 98 children was 6.0 (0.6-14.3) years, and 58 (59.2%) were male. Hypertension was present in 64 (65.3%), hypotension in 67 (68.4%), hyperglycemia in 17 (18.1%), and fever in 37 (37.8%). The strongest association with poor neurological outcome was an infarct size of 4% or greater of

  9. High blood pressure and visual sensitivity

    NASA Astrophysics Data System (ADS)

    Eisner, Alvin; Samples, John R.

    2003-09-01

    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.

  10. Race May Play Role in Obese Teens' Blood Pressure

    MedlinePlus

    ... Race May Play Role in Obese Teens' Blood Pressure Extra pounds appear more problematic for whites and ... teenagers are at increased risk of high blood pressure, but the effects of those extra pounds may ...

  11. Can Whole-Grain Foods Lower Blood Pressure?

    MedlinePlus

    ... more whole-grain foods help lower my blood pressure? Answers from Sheldon G. Sheps, M.D. It might. ... help reduce your chance of developing high blood pressure (hypertension). Whole grains are grains that include the ...

  12. Can Weight Loss Reduce the Need for Blood Pressure Medication?

    MedlinePlus

    ... Can weight loss reduce the need for blood pressure medication? Answers from Sheldon G. Sheps, M.D. If you're ... pounds (2.3 kilograms) can lower your blood pressure. As you slim down, it may be possible ...

  13. Exercise May Help Black Americans Lower Blood Pressure Risk

    MedlinePlus

    ... html Exercise May Help Black Americans Lower Blood Pressure Risk Recommended 150 minutes of moderate activity weekly ... may lower black Americans' risk of high blood pressure, a new study finds. The new research included ...

  14. Snapshot: Blood Pressure in the U.S.

    MedlinePlus

    ... visit this page: About CDC.gov . Home Blood Pressure: Make Control Your Goal Infographic Recommend on Facebook ... Copy the code below to use the Blood Pressure Infographic on your web page or social media ...

  15. A Nutritional Strategy for the Treatment of High Blood Pressure.

    ERIC Educational Resources Information Center

    Podell, Richard N.

    1984-01-01

    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)

  16. High blood pressure - what to ask your doctor

    MedlinePlus

    What to ask your doctor about high blood pressure; Hypertension - what to ask your doctor ... problems? What medicines am I taking to treat high blood pressure? Do they have any side effects? What should ...

  17. High Blood Pressure, Afib and Your Risk of Stroke

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, AFib and Your Risk of Stroke Updated:Aug ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  18. A Nutritional Strategy for the Treatment of High Blood Pressure.

    ERIC Educational Resources Information Center

    Podell, Richard N.

    1984-01-01

    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)

  19. High Blood Pressure, Afib and Your Risk of Stroke

    MedlinePlus

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More High Blood Pressure, Afib and Your Risk of Stroke Updated:Sep ... have a stroke for the first time have high blood pressure . And an irregular atrial heart rhythm — a condition ...

  20. 'Simple 7' Steps Can Help Improve Blood Pressure in Blacks

    MedlinePlus

    ... html 'Simple 7' Steps Can Help Improve Blood Pressure in Blacks Adherence to the American Heart Association ... can reduce black Americans' risk of high blood pressure, researchers say. "We found that even small improvements ...

  1. [An integrated system of blood pressure measurement with bluetooth communication].

    PubMed

    Wang, Wei; Wang, Jing; Sun, Hongyang; Xu, Zuyang; Chai, Xinyu

    2012-07-01

    The development of the integrated blood pressure system with bluetooth communication function is introduced. Experimental results show that the system can complete blood pressure measurement and data transmission wireless effectively, which can be used in m-Health in future.

  2. How High Blood Pressure Can Lead to Stroke

    MedlinePlus

    ... Thromboembolism Aortic Aneurysm More How High Blood Pressure Can Lead to Stroke Updated:May 3,2017 Stroke ... your risk of stroke by understanding those you can control. Popular Articles 1 Understanding Blood Pressure Readings ...

  3. Oscillometric blood pressure measurement: progress and problems.

    PubMed

    van Montfrans, G A

    2001-12-01

    Oscillometric blood pressure measurement has become very popular, but although a number of devices have now passed both the Association for the Advancement of Medical Instrumentation and British Hypertension Society criteria, complacency with the state of the technique is as yet premature. In individual subjects, a substantial number of readings may deviate more than a clinically relevant 5 mmHg in devices that have earned a British Hypertension Society grade A rating. The marketing of pressure-wave-simulating devices is a welcome development as monitors can now be tested for reproducibility; an intra-device standard deviation of less than 2 mmHg has been proposed as the limit. Authors suggest that these simulators are currently better suited to intra- than between-device testing since they are not yet fully confident that the simulated waveforms are indistinguishable from the man-made pressure waves. Simulators should, however, be incorporated into our standard validation protocols in order eventually to obviate the human, fallible, factor in the validation protocols. The currently employed maximal amplitude algorithm has many drawbacks as the parameter identification points for systolic and diastolic pressure depend on many factors, for example pulse pressure, heart rate and arterial stiffness. These errors have now been demonstrated in clinical studies. Modern pattern recognition algorithms are being constructed but have not yet produced convincing results. As repeatedly stated, the development of a more robust and more widely applicable algorithm than the maximal amplitude approach should be allocated a high priority.

  4. Clinical relevance of central blood pressure - a critical review.

    PubMed

    Kostapanos, Michael; McEniery, Carmel M; Wilkinson, Ian B

    2016-11-01

    Vital organs are exposed to the central rather than the brachial blood pressure. To date, central blood pressure can be assessed noninvasively through the use of several devices. In this review, we critically discuss the clinical relevance of central blood pressure assessment. Considerable evidence suggests that central blood pressure is a better predictor of end-organ damage than brachial blood pressure. However, there is still uncertainty concerning the value of central pressure for predicting cardiovascular outcomes, as the existing studies are underpowered to address this issue. A full synthesis of the available data is needed in this regard. Among the different antihypertensive drug classes, beta-blockers appear to lower central blood pressure less than brachial blood pressure. This difference may, at least in part, explain the reduced efficacy of beta-blockers in the prevention of cardiovascular outcomes compared with the other antihypertensive drug classes, which may lower central and brachial blood pressure to a similar extent. Nevertheless, this differential effect might not be relevant to the newer beta-blockers with vasodilating properties, including nebivolol, celliprolol and carvedilol. However, whether a preferential reduction of central blood pressure results in better outcomes should be further assessed by appropriately powered clinical trials. Other emerging challenges include the assessment of the potential predictive value of central blood pressure variability and the development of new antihypertensive medications based on central blood pressure rather than brachial blood pressure.

  5. Sex differences in alpha-adrenergic support of blood pressure.

    PubMed

    Schmitt, Judith A M; Joyner, Michael J; Charkoudian, Nisha; Wallin, B Gunnar; Hart, Emma C

    2010-08-01

    We tested whether the inter-individual variability in alpha-adrenergic support of blood pressure plays a critical role in the sex differences in tonic support of blood pressure by the autonomic nervous system. Blockade of the alpha-adrenergic receptors was achieved via phentolamine and showed a smaller (P < 0.05) decrease in blood pressure in women compared to men, implying that alpha-adrenergic support of blood pressure is less in women than in men.

  6. 21 CFR 870.1140 - Venous blood pressure manometer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a...

  7. 21 CFR 870.1130 - Noninvasive blood pressure measurement system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Noninvasive blood pressure measurement system. (a) Identification. A noninvasive blood pressure...

  8. 21 CFR 870.1120 - Blood pressure cuff.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...

  9. 21 CFR 870.1110 - Blood pressure computer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure computer. 870.1110 Section 870.1110...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1110 Blood pressure computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...

  10. 21 CFR 870.1110 - Blood pressure computer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure computer. 870.1110 Section 870.1110...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1110 Blood pressure computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...

  11. 21 CFR 870.1110 - Blood pressure computer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure computer. 870.1110 Section 870.1110...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1110 Blood pressure computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...

  12. 21 CFR 870.1110 - Blood pressure computer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure computer. 870.1110 Section 870.1110...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1110 Blood pressure computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...

  13. 21 CFR 870.1120 - Blood pressure cuff.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...

  14. 21 CFR 870.1120 - Blood pressure cuff.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...

  15. 21 CFR 870.1120 - Blood pressure cuff.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...

  16. 21 CFR 870.1120 - Blood pressure cuff.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...

  17. Results of Blood Pressure Screening in White College Students.

    ERIC Educational Resources Information Center

    Hahn, William K.; And Others

    1990-01-01

    This report presents blood pressure norms for 18- to 24-year-old White college students, as well as data on the prevalence of high blood pressure for this group. Results were obtained from voluntary blood pressure screening of 1,660 men and 953 women. (IAH)

  18. Results of Blood Pressure Screening in White College Students.

    ERIC Educational Resources Information Center

    Hahn, William K.; And Others

    1990-01-01

    This report presents blood pressure norms for 18- to 24-year-old White college students, as well as data on the prevalence of high blood pressure for this group. Results were obtained from voluntary blood pressure screening of 1,660 men and 953 women. (IAH)

  19. What about African Americans and High Blood Pressure?

    MedlinePlus

    ... whites. • Heredity —A tendency to have high blood pressure runs in families. • Age — In general, the older you get, the greater your chance of developing high blood pressure. • Sex — Men tend to develop high blood pressure ...

  20. 21 CFR 870.1130 - Noninvasive blood pressure measurement system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Noninvasive blood pressure measurement system. (a) Identification. A noninvasive blood pressure...

  1. 21 CFR 870.1130 - Noninvasive blood pressure measurement system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Noninvasive blood pressure measurement system. (a) Identification. A noninvasive blood pressure...

  2. 21 CFR 870.1130 - Noninvasive blood pressure measurement system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Noninvasive blood pressure measurement system. (a) Identification. A noninvasive blood pressure...

  3. Comparison of blood pressure measurements of anesthetized dogs obtained noninvasively with a cylindrical blood pressure cuff and an anatomically modified conical blood pressure cuff.

    PubMed

    Ramos, Sara J; da Cunha, Anderson F; Domingues, Michelle; Shelby, Amanda M; Stout, Rhett W; Acierno, Mark J

    2016-01-01

    To compare blood pressure measured noninvasively with an oscillometric device that involved use of a novel conical cuff and a traditional cylindrical blood pressure cuff. 17 adult hound-type dogs. Dogs were anesthetized, and a 20-gauge, 1.5-inch catheter was inserted in the median sacral artery. The catheter was attached to a pressure transducer via fluid-filled noncompliant tubing, and direct blood pressure was recorded with a multifunction monitor. A specially fabricated conical cuff was placed on the antebrachium. Four sets of direct and indirect blood pressure measurements were simultaneously collected every 2 minutes. Four sets of measurements were then obtained by use of a cylindrical cuff. The cylindrical cuff met American College of Veterinary Internal Medicine consensus guidelines for validation of indirect blood pressure measurements for mean arterial blood pressure (MAP), systolic arterial blood pressure (SAP), and diastolic arterial blood pressure (DAP). The conical cuff met the consensus guidelines for difference of paired measurements, SD, and percentages of measurements within 10 and 20 mm Hg of the value for the reference method, but it failed a correlation analysis. In addition, although bias for the conical cuff was less than that for the cylindrical cuff for SAP, MAP, and DAP measurements, the limits of agreement for the conical cuff were wider than those for the cylindrical cuff for SAP and MAP measurements. On the basis of results of this study, use of a conical cuff for oscillometric blood pressure measurement cannot be recommended.

  4. Modern approaches to blood pressure measurement

    PubMed Central

    Staessen, J.; O'Brien, E.; Thijs, L.; Fagard, R.

    2000-01-01

    BACKGROUND—Blood pressure (BP) is usually measured by conventional sphygmomanometry. Although apparently simple, this procedure is fraught with many potential sources of error. This review focuses on two alternative techniques of BP measurement: ambulatory monitoring and self measurement.
REVIEW—BP values obtained by ambulatory monitoring or self measurement are characterised by high reproducibility, are not subject to digit preference or observer bias, and minimise the transient rise of the blood pressure in response to the surroundings of the clinic or the presence of the observer, the so called white coat effect. For ambulatory monitoring, the upper limits of systolic/diastolic normotension in adults include 130/80 mm Hg for the 24 hour BP and 135/85 and 120/70 mm Hg for the daytime BP and night time BP, respectively. For the the self measured BP these thresholds include 135/85 mm Hg. Automated BP measurement is most useful to identify patients with white coat hypertension. Whether or not white coat hypertension predisposes to sustained hypertension remains debated. However, outcome is better correlated with the ambulatory BP than with the conventional BP. In patients with white coat hypertension, antihypertensive drugs lower the BP in the clinic, but not the ambulatory BP, and also do not improve prognosis. Ambulatory BP monitoring is also better than conventional BP measurement in assessing the effects of treatment. Ambulatory BP monitoring is necessary to diagnose nocturnal hypertension and is especially indicated in patients with borderline hypertension, elderly patients, pregnant women, patients with treatment resistant hypertension, and also in patients with symptoms suggestive of hypotension.
CONCLUSIONS—The newer techniques of BP measurement are now well established in clinical research, for diagnosis in clinical practice, and will increasingly make their appearance in occupational and environmental medicine.


Keywords: ambulatory blood

  5. Cerebral blood flow in normal pressure hydrocephalus

    SciTech Connect

    Mamo, H.L.; Meric, P.C.; Ponsin, J.C.; Rey, A.C.; Luft, A.G.; Seylaz, J.A.

    1987-11-01

    A xenon-133 method was used to measure cerebral blood flow (CBF) before and after cerebrospinal fluid (CSF) removal in patients with normal pressure hydrocephalus (NPH). Preliminary results suggested that shunting should be performed on patients whose CBF increased after CSF removal. There was a significant increase in CBF in patients with NPH, which was confirmed by the favorable outcome of 88% of patients shunted. The majority of patients with senile and presenile dementia showed a decrease or no change in CBF after CSF removal. It is suggested that although changes in CBF and clinical symptoms of NPH may have the same cause, i.e., changes in the cerebral intraparenchymal pressure, there is no simple direct relation between these two events. The mechanism underlying the loss of autoregulation observed in NPH is also discussed.

  6. Principles of Blood Pressure Measurement - Current Techniques, Office vs Ambulatory Blood Pressure Measurement.

    PubMed

    Vischer, Annina S; Burkard, Thilo

    2016-07-15

    Blood pressure measurement has a long history and a crucial role in clinical medicine. Manual measurement using a mercury sphygmomanometer and a stethoscope remains the Gold Standard. However, this technique is technically demanding and commonly leads to faulty values. Automatic devices have helped to improve and simplify the technical aspects, but a standardised procedure of obtaining comparable measurements remains problematic and may therefore limit their validity in clinical practice. This underlines the importance of less error-prone measurement methods such as ambulatory or home blood pressure measurements and automated office blood pressure measurements. These techniques may help to uncover patients with otherwise unrecognised or overestimated arterial hypertension. Additionally these techniques may yield a better prognostic value.

  7. Blood pressure management in mechanical circulatory support

    PubMed Central

    Adatya, Sirtaz

    2015-01-01

    Durable mechanical support has become widely available for end stage heart failure as destination therapy and as bridge to transplantation. The accurate measurement of blood pressure (BP) as well as the recognition and management of hypertension in patients with continuous flow left ventricular assist devices (CF-VADs) is an essential component of optimal clinical care. Strategies for the control of BP in CF-VAD patients are increasingly important as there is an evolving understanding of the connection between hypertension, pump output, and adverse outcomes. As clinical experience grows, optimal BP targets, as well as methods to measure BP in CF-VAD patients have been further defined. PMID:26793332

  8. Clinical aspects of blood pressure autorhythmometry

    NASA Technical Reports Server (NTRS)

    Levine, H.; Halberg, F.

    1974-01-01

    Self-measurements made by a 55-year-old physician with mild to moderate hypertension of ten years' duration are considered. The physician had been in excellent health until age 45 when sustained elevation of blood pressure up to 180/100 mmHg and a slight aortic diastolic murmur were noted. On the basis of the investigation it is suggested that physical and mental performance measures provide an objective basis for assessing the desirability of a given physiological change. Such studies will have to be complemented by a search for long-term effects.

  9. Clinical aspects of blood pressure autorhythmometry

    NASA Technical Reports Server (NTRS)

    Levine, H.; Halberg, F.

    1974-01-01

    Self-measurements made by a 55-year-old physician with mild to moderate hypertension of ten years' duration are considered. The physician had been in excellent health until age 45 when sustained elevation of blood pressure up to 180/100 mmHg and a slight aortic diastolic murmur were noted. On the basis of the investigation it is suggested that physical and mental performance measures provide an objective basis for assessing the desirability of a given physiological change. Such studies will have to be complemented by a search for long-term effects.

  10. Automatic Blood Pressure Measurements During Exercise

    NASA Technical Reports Server (NTRS)

    Weaver, Charles S.

    1985-01-01

    Microprocessor circuits and a computer algorithm for automatically measuring blood pressure during ambulatory monitoring and exercise stress testing have been under development at SRI International. A system that records ECG, Korotkov sound, and arm cuff pressure for off-line calculation of blood pressure has been delivered to NASA, and an LSLE physiological monitoring system that performs the algorithm calculations in real-time is being constructed. The algorithm measures the time between the R-wave peaks and the corresponding Korotkov sound on-set (RK-interval). Since the curve of RK-interval versus cuff pressure during deflation is predictable and slowly varying, windows can be set around the curve to eliminate false Korotkov sound detections that result from noise. The slope of this curve, which will generally decrease during exercise, is the inverse of the systolic slope of the brachial artery pulse. In measurements taken during treadmill stress testing, the changes in slopes of subjects with coronary artery disease were markedly different from the changes in slopes of healthy subjects. Measurements of slope and O2 consumption were also made before and after ten days of bed rest during NASA/Ames Research Center bed rest studies. Typically, the maximum rate of O2 consumption during the post-bed rest test is less than the maximum rate during the pre-bed rest test. The post-bed rest slope changes differ from the pre-bed rest slope changes, and the differences are highly correlated with the drop in the maximum rate of O2 consumption. We speculate that the differences between pre- and post-bed rest slopes are due to a drop in heart contractility.

  11. Automatic Blood Pressure Measurements During Exercise

    NASA Technical Reports Server (NTRS)

    Weaver, Charles S.

    1985-01-01

    Microprocessor circuits and a computer algorithm for automatically measuring blood pressure during ambulatory monitoring and exercise stress testing have been under development at SRI International. A system that records ECG, Korotkov sound, and arm cuff pressure for off-line calculation of blood pressure has been delivered to NASA, and an LSLE physiological monitoring system that performs the algorithm calculations in real-time is being constructed. The algorithm measures the time between the R-wave peaks and the corresponding Korotkov sound on-set (RK-interval). Since the curve of RK-interval versus cuff pressure during deflation is predictable and slowly varying, windows can be set around the curve to eliminate false Korotkov sound detections that result from noise. The slope of this curve, which will generally decrease during exercise, is the inverse of the systolic slope of the brachial artery pulse. In measurements taken during treadmill stress testing, the changes in slopes of subjects with coronary artery disease were markedly different from the changes in slopes of healthy subjects. Measurements of slope and O2 consumption were also made before and after ten days of bed rest during NASA/Ames Research Center bed rest studies. Typically, the maximum rate of O2 consumption during the post-bed rest test is less than the maximum rate during the pre-bed rest test. The post-bed rest slope changes differ from the pre-bed rest slope changes, and the differences are highly correlated with the drop in the maximum rate of O2 consumption. We speculate that the differences between pre- and post-bed rest slopes are due to a drop in heart contractility.

  12. Blood Pressure Regulation: Every Adaptation is an Integration?

    PubMed Central

    Joyner, Michael J.; Limberg, Jacqueline K.

    2013-01-01

    This focused review serves to explore relevant issues in regard to blood pressure regulation and by doing so, provides the initial stimulus paper for the Thematic Review series “Blood Pressure Regulation” to be published in the European Journal of Applied Physiology over the coming months. In this introduction, we highlight how variable normal blood pressure can be and challenge the reader to take another look at some key concepts related to blood pressure regulation. We point out that there is frequently an underappreciated balance between peripheral vasodilation and systemic blood pressure regulation and ask the question: Are changes in blood pressure, in effect, reasonable and integrated adaptations to the physiological challenge at hand? We conclude with the idea that blood pressure regulatory systems are both flexible and redundant; ensuring a wide variety of activities associated with life can be accompanied by a perfusion pressure that can serve multiple masters. PMID:23558925

  13. Using ambulatory blood pressure monitoring to assess blood pressure of firefighters with parental history of hypertension.

    PubMed

    de Mattos, Carlos Eduardo; de Mattos, Marco Antonio; Toledo, Daniele Gusmão; de Siqueira Filho, Aristarco Gonçalves

    2006-12-01

    To evaluate the influence of family history of systemic arterial hypertension (FSAH) on the effect of stress from work in Uniformed Firefighters (BMCs) through Ambulatory Blood Pressure Monitoring (ABPM). A prospective case-control study. Sixty-six healthy BMC underwent ABPM during 12 hours of work at the Communication Center (CC). Thirty-four had hypertensive parents (group 1) and thirty-two had normotensive parents (group 2). Group I differed from group 2 in that it showed higher mean systolic (134.1 +/- 9.9 mmHg X 120.8 +/- 9.9 mmHg p < 0.0001) and diastolic (83.8 +/- 8.3 mmHg X 72.9 +/- 8.6 mmHg p < 0.001) blood pressure, in addition to greater systolic (31.4 +/- 25.6 % X 9.4 +/- 9.4 % p = 0.0001) and diastolic (28.3 +/- 26.6 % X 6.1 +/- 8.9 % p = 0.0001) loads. The prevalence of systemic arterial hypertension (SAH) in group 1 at the workplace was 32.3%. Monitored away from the job, these subjects showed normal blood pressure (functionally hypertensive). Group 2 revealed normal blood pressure (BP) at work. Higher blood pressure in BMC with hypertensive parents is explained independently by the SAH. Subjects who developed SAH during their work at the CC may be considered functionally hypertensive, whereas those with normotensive parents and who underwent psychological stress are free of blood pressure changes.

  14. Calf blood pressure: clinical implications and correlations with arm blood pressure in infants and young children.

    PubMed

    Crapanzano, M S; Strong, W B; Newman, I R; Hixon, R L; Casal, D; Linder, C W

    1996-02-01

    Indirect measurement of lower extremity blood pressure is often used in the clinical setting, although normative data after the newborn period are not readily available. Indirect blood pressure (BP) measurement was obtained in the right arms and right calves of 148 healthy infants and young children 2 weeks to 3 years of age. All measurements were made using an oscillometric device. The infants and children are quiet or asleep and in the supine position. A BP cuff of proper size was chosen. Three measurements were made in both extremities; the average of the second and third measurements was used for all analyses. Age correlated better with calf systolic blood pressure (SBPc) than with arm SBP (SBPa) (r = .52 vs .17). Calf diastolic blood pressure (DBPc) and calf mean blood pressure (MBPc) correlated moderately poorly with age (r = .37 and .39, respectively). There was no order effect. SBPc correlated best with height (r = .53), then age (r = .52), and, finally, weight (r = .51). The correlation between BPc and BPa was moderately low. The correlation of SBPc with SBPa was r = .46; that of DBPc with DBPa was r = .37; and that of MBPc with MBPa was r = .41. From birth to 6 months, SBPc was slightly lower than SBPa (1 to 3 mm Hg). SBPc increased linearly relative to SBPa and began to exceed SBPa at 6 months of age. The pattern of DBP and MBP was similar. Wide variability of blood pressure parameters was noted between the infants and children at all ages. Reference data are presented for BPc and the difference between BPc and BPa in healthy infants and children from 2 weeks to 3 years of age. BPc is not equivalent to BPa and should not be arbitrarily substituted. Because of the wide variability among healthy infants and children, SBPc measurements should be interpreted with caution when evaluating for coarctation of the aorta.

  15. 21 CFR 870.1140 - Venous blood pressure manometer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Venous blood pressure manometer. 870.1140 Section... pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous catheter to indicate manometrically the central or peripheral venous pressure. (b) Classification. Class...

  16. 21 CFR 870.1140 - Venous blood pressure manometer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Venous blood pressure manometer. 870.1140 Section... pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous catheter to indicate manometrically the central or peripheral venous pressure. (b) Classification. Class...

  17. 21 CFR 870.1140 - Venous blood pressure manometer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Venous blood pressure manometer. 870.1140 Section... pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous catheter to indicate manometrically the central or peripheral venous pressure. (b) Classification. Class...

  18. 21 CFR 870.1140 - Venous blood pressure manometer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Venous blood pressure manometer. 870.1140 Section... pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a venous catheter to indicate manometrically the central or peripheral venous pressure. (b) Classification. Class...

  19. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors.

    PubMed

    Cornelissen, Véronique A; Fagard, Robert H

    2005-10-01

    Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure-regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of > or =4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg (P<0.001) and 3.3/3.5 mm Hg (P<0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; P<0.001 for all). Systemic vascular resistance decreased by 7.1% (P<0.05), plasma norepinephrine by 29% (P<0.001), and plasma renin activity by 20% (P<0.05). Body weight decreased by 1.2 kg (P<0.001), waist circumference by 2.8 cm (P<0.001), percent body fat by 1.4% (P<0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (P<0.01); HDL cholesterol increased by 0.032 mmol/L(-1) (P<0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.

  20. E-health blood pressure control program.

    PubMed

    Ahern, David K; Stinson, Lynda J; Uebelacker, Lisa A; Wroblewski, Joseph P; McMurray, Jerome H; Eaton, Charles B

    2012-01-01

    Both technological and human factors design requirements for integration of home blood pressure monitoring (HBPM) into a patient centered medical home (PCMH) model primary care practice are described. Patients with uncontrolled hypertension were given home blood pressure (BP) monitors, and after a three-month run-in period introduced to either a high-tech only (HBPM connectivity to personal health record and tailored Web portal access) or a high-tech/"high-touch" (high-tech solution plus patient navigator [PN]) solution. Features of the Web portal included: BP graphing function, traffic-light feedback system of BP goal attainment, economic incentives for self-monitoring, and dual patient-facing and care-team-facing dashboard functions. The e-health BP control system with PN support was well received by patients, providers, and the healthcare team. Current e-health technology and limited technological literacy of many patients suggest that a PN or some other personnel resource may be required for the adoption of patient-facing technology in primary care.

  1. [High blood pressure and physical exercise].

    PubMed

    Sosner, P; Gremeaux, V; Bosquet, L; Herpin, D

    2014-06-01

    High blood pressure is a frequent pathology with many cardiovascular complications. As highlighted in guidelines, the therapeutic management of hypertension relies on non-pharmacological measures, which are diet and regular physical activity, but both patients and physicians are reluctant to physical activity prescription. To acquire the conviction that physical activity is beneficial, necessary and possible, we can take into account some fundamental and clinical studies, as well as the feedback of our clinical practice. Physical inactivity is a major risk factor for cardiovascular morbidity and mortality, and hypertension contributes to increase this risk. Conversely, regular practice of physical activity decreases very significantly the risk by up to 60%. The acute blood pressure changes during exercise and post-exercise hypotension differs according to the dynamic component (endurance or aerobic and/or strength exercises), but the repetition of the sessions leads to the chronic hypotensive benefit of physical activity. Moreover, physical activity prescription must take into account the assessment of global cardiovascular risk, the control of the hypertension, and the opportunities and desires of the patient in order to promote good adherence and beneficial lifestyle change. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Previous blood pressure measurement and associated factors in student adolescents

    PubMed Central

    Magalhães, Marina Gabriella Pereira de Andrada; Farah, Breno Quintella; de Barros, Mauro Virgilio Gomes; Ritti-Dias, Raphael Mendes

    2015-01-01

    Objective To identify prevalence of previous blood pressure measurement and analyze some associated factors in adolescents. Methods This cross-sectional study included 6,077 adolescents aged 14 to 19 years. Demographic characteristics included (sex, age, period of study, region of residence, work, skin color, and economic) status, history of blood pressure measurement within last 12 months, local of blood pressure measurement, and reading obtained. To assess associations between previous blood pressure measurement with demographic characteristics and high blood pressure we used descriptive statistics and logistic regression analysis. Results Out of the adolescents, 56.8% reported no blood pressure measurement within the last 12 months. The health centers and the physician’s office were most mentioned places for blood pressure measurement (28.3% and 36.9%, respectively). Boys (odds ratio of 1.64 95%CI: 1.46-1.84) aged 14 to 16 years (odds ratio of 1.12; 95%CI: 1.01-1.25), whose economic status was unfavorable (odds ratio of 1.48; 95%CI: 1.32-1.67) were significantly associated with no blood pressure measurement. Working was a protective factor for was not blood pressure measurement (odds ratio of 0.84; 95%CI: 0.73-0.97). Conclusion Most of adolescents did not have their blood pressure measured within the last 12 months. Boys aged 14 to 16 years and those with unfavorable economic status had higher chance of not having their blood pressure measured. PMID:26466061

  3. Relationship between height and blood pressure in Japanese schoolchildren.

    PubMed

    Fujita, Yuki; Kouda, Katsuyasu; Nakamura, Harunobu; Nishio, Nobuhiro; Takeuchi, Hiroichi; Iki, Masayuki

    2010-10-01

    Blood pressure examinations for health education use have been conducted at several schools in Japan. It has been reported that blood pressure is closely associated with bodyweight and height in US children. The aim of the present paper was to evaluate the association between height and blood pressure in Japanese schoolchildren. In Iwata city in Japan, blood pressure screening was conducted by the school administration. A total of 98.9% (10,152/10,270 children) of all fifth (10-year-olds) and ninth graders (14-year-olds) residing in the Old Iwata area from 2002 to 2007 were analyzed. In 10-year-old and 14-year-old boys, regression analysis indicated that a positive correlation between weight and blood pressure was the strongest among the three body size indices (height, weight, and body mass index), but the association between height and blood pressure was also significant. For girls from both the 10 and 14 year age groups, the correlation of weight and blood pressure was stronger than those for the other body size indices, but there were also significant associations between height and blood pressure, except for height and diastolic blood pressure in the 14-year-olds. There is a significant positive relationship between height and blood pressure. Further study is necessary to provide a blood pressure reference based on height in the Japanese program to prevent children from developing lifestyle-related risk factors. © 2010 The Authors. Pediatrics International © 2010 Japan Pediatric Society.

  4. [Development of an automatic pneumatic tourniquet system that determines pressures in synchrony with systolic blood pressure].

    PubMed

    Liu, Hongyun; Li, Kaiyuan; Zhang, Zhengbo; Guo, Junyan; Wang, Weidong

    2012-11-01

    The correlation coefficients between arterial occlusion pressure and systolic blood pressure, diastolic blood pressure, limb circumference, body mass etc were obtained through healthy volunteer experiments, in which tourniquet were applied on upper/lower extremities. The prediction equations were derived from the data of experiments by multiple regression analysis. Based on the microprocessor C8051F340, a new pneumatic tourniquet system that can determine tourniquet pressure in synchrony with systolic blood pressure was developed and verified the function and stability of designed system. Results showed that the pneumatic tourniquet which automatically adjusts occlusion pressure in accordance with systolic blood pressure could stop the flow of blood to get a bloodless field.

  5. Birthweight and blood pressure among children in Harare, Zimbabwe

    PubMed Central

    Woelk, G.; Emanuel, I.; Weiss, N.; Psaty, B.

    1998-01-01

    AIM—To determine whether poor uterine growth may be associated with increased blood pressure and subsequent hypertension in adulthood.
METHODS—A retrospective cohort study of 756 schoolchildren (mean age 6.5 years) was carried out in six low income areas in Harare city, Zimbabwe. Indices of intrauterine growth and blood pressure were assessed.
RESULTS—Adjusted for current weight, the children's systolic blood pressure was inversely related to their birthweight; for each decreasing kg of birthweight, systolic blood pressure rose by 1.73 mm Hg (95% CI; 0.181 to 3.28). After adjustment for current weight, systolic blood pressure was also inversely associated with occipito-frontal circumference, but not with birth length or gestational age. Diastolic blood pressure was not associated with any of the intrauterine indices.
CONCLUSION—Fetal size may be inversely related to systolic blood pressure in childhood in an African population.

 PMID:9828738

  6. Birthweight and blood pressure among children in Harare, Zimbabwe.

    PubMed

    Woelk, G; Emanuel, I; Weiss, N S; Psaty, B M

    1998-09-01

    To determine whether poor uterine growth may be associated with increased blood pressure and subsequent hypertension in adulthood. A retrospective cohort study of 756 schoolchildren (mean age 6.5 years) was carried out in six low income areas in Harare city, Zimbabwe. Indices of intrauterine growth and blood pressure were assessed. Adjusted for current weight, the children's systolic blood pressure was inversely related to their birthweight; for each decreasing kg of birthweight, systolic blood pressure rose by 1.73 mm Hg (95% CI; 0.181 to 3.28). After adjustment for current weight, systolic blood pressure was also inversely associated with occipito-frontal circumference, but not with birth length or gestational age. Diastolic blood pressure was not associated with any of the intrauterine indices. Fetal size may be inversely related to systolic blood pressure in childhood in an African population.

  7. Accuracy in Blood Pressure Monitoring: The Effect of Noninvasive Blood Pressure Cuff Inflation on Intra-arterial Blood Pressure Values

    PubMed Central

    Sheshadri, Veena; Tiwari, Akhilesh Kumar; Nagappa, Mahesh; Venkatraghavan, Lashmi

    2017-01-01

    Context: Both invasive and noninvasive blood pressure (invasive arterial blood pressure [IABP] and noninvasive BP [NIBP]) monitors are used perioperatively; however, they often produce different values. The reason for this discrepancy is not clear, and it is possible that the act of cuff inflation itself might affect the IABP values, especially with the recurrent cycling of NIBP cuff. Aim: The aim of this study was to determine the effect of ipsilateral NIBP cuff inflation on the contralateral IABP values. Settings and Designs: Prospective, observational study. Materials and Methods: One hundred consecutive patients were studied. The NIBP device was set to cycle every 5 min for a total of 6 times. During each cuff inflation cycle, changes in IABP values from the arterial line in the contralateral arm were recorded. A total of 582 measurements were included for data analysis. Statistical Analysis: Chi-square, paired t-test, analysis of variance. Results: Mean (± standard deviation) changes in systolic BP (SBP), diastolic BP, and mean BP with cuff inflation were 6.7 ± 5.9, 2.6 ± 4.0, and 4.0 ± 3.9 mmHg, respectively. We observed an increase of 0–10 mmHg in SBP in majority (73.4%) of cuff inflations. The changes in IABP did not differ between the patients with or without hypertension or with the baseline SBP. Conclusions: This study showed that there is a transient reactive rise in IABP values with NIBP cuff inflation. This is important information in the perioperative and intensive care settings, where both these measurement techniques are routinely used. The exact mechanism for this effect is not known but may be attributed to the pain and discomfort from cuff inflation. PMID:28298779

  8. Accuracy in Blood Pressure Monitoring: The Effect of Noninvasive Blood Pressure Cuff Inflation on Intra-arterial Blood Pressure Values.

    PubMed

    Sheshadri, Veena; Tiwari, Akhilesh Kumar; Nagappa, Mahesh; Venkatraghavan, Lashmi

    2017-01-01

    Both invasive and noninvasive blood pressure (invasive arterial blood pressure [IABP] and noninvasive BP [NIBP]) monitors are used perioperatively; however, they often produce different values. The reason for this discrepancy is not clear, and it is possible that the act of cuff inflation itself might affect the IABP values, especially with the recurrent cycling of NIBP cuff. The aim of this study was to determine the effect of ipsilateral NIBP cuff inflation on the contralateral IABP values. Prospective, observational study. One hundred consecutive patients were studied. The NIBP device was set to cycle every 5 min for a total of 6 times. During each cuff inflation cycle, changes in IABP values from the arterial line in the contralateral arm were recorded. A total of 582 measurements were included for data analysis. Chi-square, paired t-test, analysis of variance. Mean (± standard deviation) changes in systolic BP (SBP), diastolic BP, and mean BP with cuff inflation were 6.7 ± 5.9, 2.6 ± 4.0, and 4.0 ± 3.9 mmHg, respectively. We observed an increase of 0-10 mmHg in SBP in majority (73.4%) of cuff inflations. The changes in IABP did not differ between the patients with or without hypertension or with the baseline SBP. This study showed that there is a transient reactive rise in IABP values with NIBP cuff inflation. This is important information in the perioperative and intensive care settings, where both these measurement techniques are routinely used. The exact mechanism for this effect is not known but may be attributed to the pain and discomfort from cuff inflation.

  9. [Riva-Rocci and blood pressure].

    PubMed

    van Gijn, Jan; Gijselhart, Joost P

    2013-01-01

    Scipione Riva-Rocci (1863-1937) was educated in Turin as a physician and later as a doctor of internal medicine. In 1896 and 1897 he published a series of four articles (in Italian) on a new method for measuring blood pressure. Previous non-invasive methods were all based on compression of the radial pulse, in keeping with centuries of medical tradition, but they were cumbersome and unreliable. Riva-Rocci's innovation consisted in compressing the brachial artery instead, at the level of the upper arm. For this purpose he devised an inflatable rubber tube, which was rigid on the outside. Disappearance of the radial pulse on palpation indicated the systolic arterial pressure, as Riva-Rocci confirmed by calibration experiments in animals and with human cadavers. His instrument was introduced world-wide after a chance visit by the American neurosurgeon Harvey Cushing (1869-1939). The Russian surgeon Nikolai Korotkoff (1874-1920) was the first to apply auscultation of the artery below the cuff (in 1905), a method that allowed determination of diastolic arterial pressure. Riva-Rocci was Chief of Medicine at the municipal hospital in Varese from 1900 to 1928, where he developed a special interest in paediatrics.

  10. [Uncontrolled factors of blood pressure in essential hypertension: from "patient's high blood pressure" to "hypertensive patient"].

    PubMed

    Xiong, Xing-Jiang; Wang, Jie

    2014-04-01

    Hypertension is a significant medical and public health issue which puts an enormous burden on health care resources and the community. It is a chronic medical condition in which the systemic arterial blood pressure (BP) is elevated. Serious complications including cardiovascular and cerebrovascular diseases would be preventable if the rise in BP with age could be prevented or diminished. The majority of hypertensive patients require long-term treatment. Oral antihypertensive drugs, lifestyle modification including exercise and dietary modification are milestones for hypertension therapy. However, the control rate of hypertension hasn't reached the expected requirements currently. "Three lows" status quo, just low awareness, low treatment, and low control, are still the major problems confronting modern medicine. Recently, uncontrolled factors of blood pressure are widely concerned, which include insomnia, constipation, mood disorders, exogenous, etc. What's more, the control strategies of hypertension should not only pay close attention to "patient's high blood pressure", but also to "hypertensive patient". Therefore, the treatment of uncontrolled factors of blood pressure plays an important role in hypertensive therapy, which could be further research priorities.

  11. Hypertensive episodes and circadian fluctuations of blood pressure in patients with phaeochromocytoma: studies by long-term blood pressure monitoring based on a volume-oscillometric method.

    PubMed

    Imai, Y; Abe, K; Miura, Y; Nihei, M; Sasaki, S; Minami, N; Munakata, M; Taira, N; Sekino, H; Yamakoshi, K

    1988-01-01

    A new portable device for the indirect measurement of arterial blood pressure was successfully applied to detect paroxysmal hypertension and circadian fluctuation of blood pressure in patients with phaeochromocytoma. The device utilizes the volume-oscillometric technique, it is equipped with a microprocessor and allows long-term automatic monitoring of indirect blood pressure in the human finger. Compared with conventional fully automated portable devices of the arm-cuff type, our current equipment is lighter, less noisy, and causes less discomfort. With this device repeated measurements can be made without causing stress or discomfort, and without disturbing sleep. The arterial pressure measurement obtained using this device was reliable and reproducible. In some patients certain symptoms, possibly due to phaeochromocytoma, had been observed for several years before the study, although hypertension had not been identified. While these patients had consistently high circulating catecholamine levels, nocturnal falls in blood pressure were clearly documented. This suggests that plasma catecholamines released from the phaeochromocytoma, though excessive, may be of less physiological importance than other regulatory mechanisms concerned with circadian fluctuation of blood pressure, e.g. the sympathetic nervous system and/or hypothalamo-pituitary-adrenal system. This new device has proved to be a reliable means of monitoring long-term blood pressure and is useful in the diagnosis of paroxysmal hypertension in patients with phaeochromocytoma.

  12. Association between ambient temperature and blood pressure and blood pressure regulators: 1831 hypertensive patients followed up for three years.

    PubMed

    Chen, Qing; Wang, Jinwei; Tian, Jun; Tang, Xun; Yu, Canqing; Marshall, Roger J; Chen, Dafang; Cao, Weihua; Zhan, Siyan; Lv, Jun; Lee, Liming; Hu, Yonghua

    2013-01-01

    Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05) respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range) was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.

  13. European Society of Hypertension practice guidelines for home blood pressure monitoring.

    PubMed

    Parati, G; Stergiou, G S; Asmar, R; Bilo, G; de Leeuw, P; Imai, Y; Kario, K; Lurbe, E; Manolis, A; Mengden, T; O'Brien, E; Ohkubo, T; Padfield, P; Palatini, P; Pickering, T G; Redon, J; Revera, M; Ruilope, L M; Shennan, A; Staessen, J A; Tisler, A; Waeber, B; Zanchetti, A; Mancia, G

    2010-12-01

    Self-monitoring of blood pressure by patients at home (home blood pressure monitoring (HBPM)) is being increasingly used in many countries and is well accepted by hypertensive patients. Current hypertension guidelines have endorsed the use of HBPM in clinical practice as a useful adjunct to conventional office measurements. Recently, a detailed consensus document on HBPM was published by the European Society of Hypertension Working Group on Blood Pressure Monitoring. However, in daily practice, briefer documents summarizing the essential recommendations are needed. It is also accepted that the successful implementation of clinical guidelines in routine patient care is dependent on their acceptance by involvement of practising physicians. The present document, which provides concise and updated guidelines on the use of HBPM for practising physicians, was therefore prepared by including the comments and feedback of general practitioners.

  14. Cocoa, Blood Pressure, and Vascular Function

    PubMed Central

    Ludovici, Valeria; Barthelmes, Jens; Nägele, Matthias P.; Enseleit, Frank; Ferri, Claudio; Flammer, Andreas J.; Ruschitzka, Frank; Sudano, Isabella

    2017-01-01

    Cardiovascular disease (CVD) represents the most common cause of death worldwide. The consumption of natural polyphenol-rich foods, and cocoa in particular, has been related to a reduced risk of CVD, including coronary heart disease and stroke. Intervention studies strongly suggest that cocoa exerts a beneficial impact on cardiovascular health, through the reduction of blood pressure (BP), improvement of vascular function, modulation of lipid and glucose metabolism, and reduction of platelet aggregation. These potentially beneficial effects have been shown in healthy subjects as well as in patients with risk factors (arterial hypertension, diabetes, and smoking) or established CVD (coronary heart disease or heart failure). Several potential mechanisms are supposed to be responsible for the positive effect of cocoa; among them activation of nitric oxide (NO) synthase, increased bioavailability of NO as well as antioxidant, and anti-inflammatory properties. It is the aim of this review to summarize the findings of cocoa and chocolate on BP and vascular function. PMID:28824916

  15. Management of blood pressure in acute stroke.

    PubMed

    Goodfellow, John A; Dawson, Jesse; Quinn, Terence J

    2013-08-01

    The importance of elevated or low arterial blood pressure (BP) early after stroke, and the need for pharmacological intervention to control BP, remains controversial. Debate surrounds if, when and how to intervene. This debate is informed by conflicting results from observational data and underpowered clinical trials and substantive outcome data are lacking. Accordingly, management decisions have largely been left up to the individual treating physician and guidelines are based on 'good practice' and theory rather than level 1, grade A evidence. Substantial progress has been made in recent years, particularly in the field of hemorrhagic stroke, where recently presented and soon to completed large-scale trials may finally give us a firm evidence base. For ischemic stroke, many important studies have informed our understanding of the basic pathophysiology, epidemiology, treatment and outcomes of BP management in acute stroke and, although not yet constituting a solid 'evidence base', are helping us from the 'cognitive quick-sand' of small studies and personal experiences.

  16. Sodium intake and blood pressure in children.

    PubMed

    Hanevold, Coral D

    2013-10-01

    Elevation of blood pressure (BP) and the risk for progression to hypertension (HTN) is of increasing concern in children and adolescents. Indeed, it is increasingly recognized that target organ injury may begin with even low levels of BP elevation. Sodium intake has long been recognized as a modifiable risk factor for HTN. While it seems clear that sodium impacts BP in children, its effects may be enhanced by other factors including obesity and increasing age. Evidence from animal and human studies indicates that sodium may have adverse consequences on the cardiovascular system independent of HTN. Thus, moderation of sodium intake over a lifetime may reduce risk for cardiovascular morbidity in adulthood. An appetite for salt is acquired, and intake beyond our need is almost universal. Considering that eating habits in childhood have been shown to track into adulthood, modest sodium intake should be advocated as part of a healthy lifestyle.

  17. Familial aggregation and childhood blood pressure.

    PubMed

    Wang, Xiaoling; Xu, Xiaojing; Su, Shaoyong; Snieder, Harold

    2015-01-01

    There is growing concern about elevated blood pressure (BP) in children. The evidence for familial aggregation of childhood BP is substantial. Twin studies have shown that a large part of the familial aggregation of childhood BP is due to genes. The first part of this review provides the latest progress in gene finding for childhood BP, focusing on the combined effects of multiple loci identified from the genome-wide association studies on adult BP. We further review the evidence on the contribution of the genetic components of other family risk factors to the familial aggregation of childhood BP including obesity, birth weight, sleep quality, sodium intake, parental smoking, and socioeconomic status. At the end, we emphasize the promise of using genomic-relatedness-matrix restricted maximum likelihood (GREML) analysis, a method that uses genome-wide data from unrelated individuals, in answering a number of unsolved questions in the familial aggregation of childhood BP.

  18. Familial Aggregation and Childhood Blood Pressure

    PubMed Central

    Xu, Xiaojing; Su, Shaoyong; Snieder, Harold

    2015-01-01

    There is growing concern about elevated blood pressure (BP) in children. The evidence for familial aggregation of childhood BP is substantial. Twin studies have shown that a large part of the familial aggregation of childhood BP is due to genes. The first part of this review provides the latest progress in gene finding for childhood BP, focusing on the combined effects of multiple loci identified from the genome-wide association studies on adult BP. We further review the evidence on the contribution of the genetic components of other family risk factors to the familial aggregation of childhood BP including obesity, birth weight, sleep quality, sodium intake, parental smoking, and socioeconomic status. At the end, we emphasize the promise of using genomic-relatedness-matrix restricted maximum likelihood (GREML) analysis, a method that uses genome-wide data from unrelated individuals, in answering a number of unsolved questions in the familial aggregation of childhood BP. PMID:25432901

  19. [Hypertensive urgency or high blood pressure variability?

    PubMed

    Rodionov, A V

    2017-01-01

    Hypertensive urgency (HU) is a common reason particularly for elderly patients to seek medical advice. Severe asymptomatic hypertension and situational high blood pressure (BP) in patients with its high variability is frequently taken as HU. The use of short-acting antihypertensive drugs is not only indicated in these situations, but it may also increase the risk of cardiovascular events (CVE). Over the past decade, increased BP variability is an independent predictor for a higher risk of CVE. Among the major groups of antihypertensive drugs, there are calcium antagonists, mainly amlodipine, which has the greatest potential to reduce BP variability. Thus, calcium antagonists can be considered as first-line drugs for patients with high BP variability.

  20. The epidemiology of blood pressure and its worldwide management.

    PubMed

    Rahimi, Kazem; Emdin, Connor A; MacMahon, Stephen

    2015-03-13

    Despite the vast amount of evidence on the benefits of blood pressure lowering accumulated to date, elevated blood pressure is still the leading risk factor for disease and disability worldwide. The purpose of this review is to summarize the epidemiological evidence underpinning the association between blood pressure and a range of conditions. This review focuses on the association between systolic and diastolic blood pressures and the risk of cardiovascular and renal disease. Evidence for and against the existence of a J-shaped curve association between blood pressure and cardiovascular risk, and differences in the predictive power of systolic, diastolic, and pulse pressure, are described. In addition, global and regional trends in blood pressure levels and management of hypertension are reviewed. © 2015 American Heart Association, Inc.

  1. Peripheral blood pressure by Dinamap and central blood pressure by applanation tonometry in outpatient general practice.

    PubMed

    Santiago, Luiz Miguel; Simões, Ana Rita; Ricardo Miranda, Paula; Matias, Catarina; Rosendo, Inês; Constantino, Liliana; Santos, Tiago; Neto, Maria da Glória; Francisco, Maria dos Prazeres

    2013-06-01

    Central blood pressure (CBP) is the pressure exerted by the blood column at any given moment on the aortic and carotid artery walls, which is a close proxy for the blood pressure inside the brain and the heart, and is thus a better marker of cardiovascular morbidity and mortality than peripheral blood pressure (PBP). To assess how the augmentation index (AI), peripheral pulse pressure (pPP), central pulse pressure (cPP) and subendocardial viability ratio (SEVR) vary in hypertensive patients according to level of control of CBP and PBP. We performed an observational, cross-sectional study in a convenience sample from a general practice in Central Portugal over a period of four days in May 2010. Measurements were taken after a four-minute resting period. The following values were considered to reflect controlled pressures: PBP <140/90 mmHg, CBP <130/80 mmHg, pPP <55 mmHg and cPP <45 mmHg. The sample included 92 patients, 38 male (41.3%), mean age 62.3±11.1 years, with no significant difference in gender distribution. PBP was controlled in 55 (59.8%), and CBP in 53 (57.6%). Both PBP and CBP were controlled in 50 patients (54.3%) and neither was controlled in 34 (37.9%). pPP and cPP were significantly lower in those with controlled PBP (p<0.001) and CBP (p<0.001). AI was non-significantly lower in those with controlled PBP (78±9 vs. 80.7) and those with controlled CBP (78±9 vs.81±7) (p=0.02). SEVR was within the desirable range in 92 patients (92.2%). 78.4% of individuals were taking drugs acting on the renin angiotensin aldosterone system (RAAS). In a convenience sample of 92 patients, PBP and CBP were controlled in 59.8% and 57.6%, respectively. Those with controlled PBP had significantly better peripheral systolic and diastolic blood pressure, CBP, pPP and cPP; the same was true of those with controlled CBP, who also had a significantly better AI. The percentage of the cardiac cycle in diastole had a desirable value for 92,2% of the subjects. Copyright © 2011

  2. Blood pressure management in children on dialysis.

    PubMed

    Paglialonga, F; Consolo, S; Edefonti, A; Montini, G

    2017-06-09

    Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM). Reduction of interdialytic weight gain (IDWG) is critical, as higher IDWG is associated with a worse left ventricular mass index and poorer BP control: it can be obtained by means of salt restriction, reduced fluid intake, and optimized sodium removal in dialysis. Optimization of peritoneal dialysis and intensified hemodialysis or hemodiafiltration have been shown to improve both fluid and sodium management, leading to better BP levels. Studies comparing different antihypertensive agents in children are lacking. The pharmacokinetic properties of each drug should be considered. At present, BP control remains suboptimal in many patients and efforts are needed to improve the long-term outcomes of children on dialysis.

  3. Current status of aggressive blood pressure control

    PubMed Central

    Chrysant, Steven G

    2011-01-01

    The concept of treatment of hypertension has gone through wide swings over the years. From ignoring blood pressure (BP) treatment initially, to aggressive BP control recently. As newer and more effective drugs were developed, it was possible to lower BP to very low levels. However, recent studies have shown that aggressive BP control might not be in the best interest of the patient. Low levels of diastolic BP (DBP) have been associated with increased cardiovascular events, a situation known as the J-curve effect. This has been seen mostly with low DBP, since the coronary arteries are perfused during the diastolic phase of the cardiac cycle. Due to an autoregulatory mechanism, the heart is protected against wide fluctuations of BP. However, the presence of coronary heart disease, hypertension, especially with left ventricular hypertrophy, shift the curve to higher BP levels and makes the heart more liable to DBP fluctuations. The J-Curve effect has been reported by most investigators, but not by others. Recently, a J-Curve effect has been observed with systolic BP (SBP), as well. In contrast to the heart, the brain is very infrequently subjected to J-curve effect, and in contrast to the heart, the brain’s blood flow autoregulation depends mostly on the SBP. A Medline search of the English literature on this subject was conducted between 1992 and 2010 and 11 pertinent articles were selected. These articles with collateral literature will be discussed in this concise review. PMID:21499494

  4. Current status of aggressive blood pressure control.

    PubMed

    Chrysant, Steven G

    2011-03-26

    The concept of treatment of hypertension has gone through wide swings over the years. From ignoring blood pressure (BP) treatment initially, to aggressive BP control recently. As newer and more effective drugs were developed, it was possible to lower BP to very low levels. However, recent studies have shown that aggressive BP control might not be in the best interest of the patient. Low levels of diastolic BP (DBP) have been associated with increased cardiovascular events, a situation known as the J-curve effect. This has been seen mostly with low DBP, since the coronary arteries are perfused during the diastolic phase of the cardiac cycle. Due to an autoregulatory mechanism, the heart is protected against wide fluctuations of BP. However, the presence of coronary heart disease, hypertension, especially with left ventricular hypertrophy, shift the curve to higher BP levels and makes the heart more liable to DBP fluctuations. The J-Curve effect has been reported by most investigators, but not by others. Recently, a J-Curve effect has been observed with systolic BP (SBP), as well. In contrast to the heart, the brain is very infrequently subjected to J-curve effect, and in contrast to the heart, the brain's blood flow autoregulation depends mostly on the SBP. A Medline search of the English literature on this subject was conducted between 1992 and 2010 and 11 pertinent articles were selected. These articles with collateral literature will be discussed in this concise review.

  5. The Effect of Strenuous Exercise on Blood Pressure.

    ERIC Educational Resources Information Center

    Cvancara, Victor

    1992-01-01

    Presents a laboratory experiment designed to help students understand the concept of diastolic blood pressure, the pressure during which the left ventricle of the heart is not contracting. Examines the effect of strenuous exercise on blood pressure. Includes materials needed, procedures, results, and discussion of the results. (MDH)

  6. Blood lead concentrate and blood pressure after CCl/sub 4/ treatment

    SciTech Connect

    Loyke, H.F.

    1985-05-01

    Since Pb has been found to influence blood pressure in rats (Diaz-Rivera and Horn 1945), the pressure and Pb levels were measured in renal hypertensive, spontaneous hypertensive rats (SHR), normotensive, and CCl/sub 4/ treated and untreated rats to determine whether blood Pb levels are altered in an attempt to characterize the vasodepressor substance and relate those levels to blood pressure.

  7. Reproducibility of ambulatory blood pressure load.

    PubMed

    Zachariah, P K; Sheps, S G; Bailey, K R; Wiltgen, C M; Moore, A G

    1990-12-01

    Twenty-two hypertensive patients were monitored during two separate drug-free occasions with a Del Mar Avionics ambulatory device. Blood pressure loads (percentage of systolic and diastolic readings more than 140 and 90 mmHg, respectively) and mean BP were measured both to determine their reproducibility and to examine how they correlate with each other. The systolic and diastolic mean awake BPs for day 1 and day 2 were 140/93 mmHg and 140/91 mmHg, respectively, and BP loads were 45%/55% and 43%/54%. Moreover, mean BP loads correlated highly (r = 0.93) with mean BP values taken on the same day. Both ambulatory mean SBP and BP load were highly reproducible (r = 0.87 and 0.80, respectively, during the awake hours), and mean DBP and load were fairly reproducible (r = 0.59 and 0.39, respectively, during the awake hours). Clinically, however, both were consistent from day 1 to day 2. Mean and individual standard deviations also were reproducible for both systolic and diastolic pressures and loads.

  8. Oscillometric blood pressure standards for children.

    PubMed

    Park, M K; Menard, S W; Schoolfield, J

    2005-01-01

    We previously reported blood pressure (BP) readings obtained by the Dinamap (DIN) (Model 8100) were 10 mmHg higher than those obtained by auscultatory methods and thus were not interchangeable. DIN BP data on 7208 schoolchildren ages 5 to 17 were analyzed to generate normative DIN BP standards and to examine the rational for presenting BP standards according to age and height percentiles. Three BP measurements were taken in the sitting position using a BP cuff width 40% to 50% of the circumference of the arm. Boys' systolic pressures (SP) were significantly (p < 0.05) greater (up to 11 mmHg) than those of the girls in subjects age 13 to 17 years. SP levels were most closely correlated with weight (r = 0.595), followed by height (r = 0.560) and age (r = 0.518). When BP levels were adjusted for age and weight, the correlation coefficient of DIN SP with height was negligible (r = 0.026 for boys; r = 0.085 for girls), whereas when adjusted for age and height, the correlation of SP with weight remained high (r = 0.303 for boys; r = 0.216 for girls), indicating that height is not an important independent predictor of BP levels. In conclusion, Dinamap-specific BP standards presented in this report are the only standards that have been generated according to the current BP guidelines recommended by national committees. We found no rational for presenting BP standards according to age and height percentiles.

  9. Circadian rhythm of blood pressure reflects the severity of cardiac impairment in familial amyloid polyneuropathy.

    PubMed

    Algalarrondo, Vincent; Eliahou, Ludivine; Thierry, Isabelle; Bouzeman, Abdeslam; Dasoveanu, Madalina; Sebag, Claude; Moubarak, Ghassan; Le Guludec, Dominique; Samuel, Didier; Adams, David; Dinanian, Sylvie; Slama, Michel S

    2012-05-01

    Cardiac amyloidosis due to familial amyloid polyneuropathy (FAP) includes restrictive cardiomyopathy, thickened cardiac walls, conduction disorders and cardiac denervation. Impaired blood pressure variability has been documented in FAP related to the Val30Met mutation. To document blood pressure variability in FAP patients with various mutation types and its relationship to the severity of cardiac involvement. Blood pressure variability was analysed in 49 consecutive FAP patients and was compared with a matched control population. Cardiac evaluation included echocardiography, right heart catheterization, electrophysiological study, Holter electrocardiogram and metaiodobenzylguanidine (MIBG) scintigraphy. A non-dipping pattern was found in 80% of FAP patients and in 35% of control patients (P<0.0001); this was due to a significantly lower diurnal blood pressure in FAP patients (FAP group, 113 ± 21 mmHg; control group, 124 ± 8 mmHg; P<0.0001), whereas nocturnal blood pressures were similar. Among FAP patients, a non-dipping pattern was significantly associated with haemodynamic involvement, cardiac thickening or conduction disorders. These associations did not depend on the average blood pressure levels. Impaired blood pressure variability was more frequent and more pronounced in patients with multiple criteria for severe cardiac amyloidosis. Low blood pressure variability is common in cardiac amyloidosis due to FAP. A non-dipping pattern was more frequently observed in FAP patients with haemodynamic impairment, cardiac thickening or conduction disorders. It is suggested that impairment of circadian rhythm of blood pressure reflects the severity of cardiac amyloidosis due to FAP. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. Effects of Ya-hom on blood pressure in rats.

    PubMed

    Suvitayavat, W; Tunglert, S; Thirawarapan, S S; Bunyapraphatsara, N

    2005-03-21

    The effects of Ya-hom, a traditional Thai herbal formulation, on blood pressure were evaluated to verify its use for fainting treatment. Ya-hom has several recipes, which are composed of different medicinal plants in varying ratio. We have selected the most popular commercial preparation to determine the effect on the blood pressure in rats. The water extract of Ya-hom at doses of 0.2, 0.4, 0.6 and 0.8 g/kg initially transiently decreased pressure and over time, increased blood pressure. The duration of the Ya-hom effect on decreasing and increasing blood pressure was dose dependent. The time to maximal effect of Ya-hom on increasing blood pressure was also dose dependent. Phentolamine attenuated the blood pressure decreasing effect but did not affect the blood pressure increasing effect of Ya-hom. Ya-hom was previously shown to increase aortic ring contraction, which was partially inhibited by phentolamine, and increased atrial contraction. It is possible that phentolamine inhibits the effect of Ya-hom on vascular smooth muscle contraction resulting in a prominent positive inotropic effect. This may be the same reason that phentolamine does not influence the effect of Ya-hom on increasing blood pressure. The dominant effect of Ya-hom on increasing blood pressure supports the use of Ya-hom for the treatment of fainting.

  11. Artificial arterial blood pressure artifact models and an evaluation of a robust blood pressure and heart rate estimator

    PubMed Central

    Li, Qiao; Mark, Roger G; Clifford, Gari D

    2009-01-01

    Background Within the intensive care unit (ICU), arterial blood pressure (ABP) is typically recorded at different (and sometimes uneven) sampling frequencies, and from different sensors, and is often corrupted by different artifacts and noise which are often non-Gaussian, nonlinear and nonstationary. Extracting robust parameters from such signals, and providing confidences in the estimates is therefore difficult and requires an adaptive filtering approach which accounts for artifact types. Methods Using a large ICU database, and over 6000 hours of simultaneously acquired electrocardiogram (ECG) and ABP waveforms sampled at 125 Hz from a 437 patient subset, we documented six general types of ABP artifact. We describe a new ABP signal quality index (SQI), based upon the combination of two previously reported signal quality measures weighted together. One index measures morphological normality, and the other degradation due to noise. After extracting a 6084-hour subset of clean data using our SQI, we evaluated a new robust tracking algorithm for estimating blood pressure and heart rate (HR) based upon a Kalman Filter (KF) with an update sequence modified by the KF innovation sequence and the value of the SQI. In order to do this, we have created six novel models of different categories of artifacts that we have identified in our ABP waveform data. These artifact models were then injected into clean ABP waveforms in a controlled manner. Clinical blood pressure (systolic, mean and diastolic) estimates were then made from the ABP waveforms for both clean and corrupted data. The mean absolute error for systolic, mean and diastolic blood pressure was then calculated for different levels of artifact pollution to provide estimates of expected errors given a single value of the SQI. Results Our artifact models demonstrate that artifact types have differing effects on systolic, diastolic and mean ABP estimates. We show that, for most artifact types, diastolic ABP estimates are

  12. Home blood pressure monitoring: a survey of potential users.

    PubMed

    Kelly, P L; Harrison, D W

    1994-01-01

    Fifty respondents were surveyed using a recently developed questionnaire designed to evaluate the educational needs of the users of self-monitoring blood pressure apparatus. The categories evaluated included each subject's background and family health history, general knowledge about blood pressure, lifestyle factors affecting blood pressure, and factors affecting the measurement of blood pressure, as well as questions about owning a home monitor and recalibration and maintenance factors. The results indicate considerable disparity between the subjects' levels of knowledge about lifestyle factors affecting blood pressure and the subjects' knowledge of factors essential to accurate self-monitoring of blood pressure. The implications of and need for the design of educational training protocols are discussed.

  13. A novel SCFA receptor, the microbiota, and blood pressure regulation

    PubMed Central

    Pluznick, Jennifer

    2014-01-01

    The maintenance of blood pressure homeostasis is a complex process which is carefully regulated by a variety of inputs. We recently identified two sensory receptors (Olfactory receptor 78 and G protein couple receptor 41) as novel regulators of blood pressure. Both Olfr78 and Gpr41 are receptors for short chain fatty acids (SCFAs), and we showed that propionate (a SCFA) modifies blood pressure in a manner which is differentially modulated by the absence of either Olfr78 or Gpr41. In addition, propionate modifies renin release in an Olfr78-dependent manner. Our study also demonstrated that antibiotic treatment modulates blood pressure in Olfr78 null mice, indicating that SCFAs produced by the gut microbiota likely influence blood pressure regulation. In this addendum, we summarize the findings of our recent study and provide a perspective on the implications of the interactions between the gut microbiota and blood pressure control. PMID:24429443

  14. [Usefulness for detection of inappropriate blood pressure variability using 'wearable blood pressure sensor'].

    PubMed

    Iijima, Katsuya

    2015-11-01

    In the clinical settings, it has frequently seen that the elderly have rapid blood pressure (BP) elevation and decline, leading to such as orthostatic disorders and post-urination syncope. Excessive blood pressure variability (BPV) according to aging leads to aggravation of hypertensive target organ damage due to both disturbed baroreflex function and arterial stiffening. We developed continuous BP monitoring sensor using newly developing device 'wearable BP sensor', as our advantageous approach of without a cuff-stress. The new mobile device could reflect continuous beat-to-beat systolic BP, heart rate(HR), these very close changes and double product(sBPX HR) as a major indicator of cardiac lead, in consistent with cuff-based BP value. Our new challenge using this device might approach to the potential to achieve the quality-up of treatment strategy with consideration for very short-term BPV.

  15. Blood Pressure: Is It Affected by Cold Weather?

    MedlinePlus

    ... your narrowed veins and arteries. In addition to cold weather, blood pressure may also be affected by a sudden change in weather patterns, such as a weather front or a storm. Your body — and blood vessels — ...

  16. Announcement: National High Blood Pressure Education Month - May 2016.

    PubMed

    2016-05-27

    May is National High Blood Pressure Education Month. High blood pressure (hypertension) is a major contributor to heart disease and stroke, two leading causes of death in the United States.* High blood pressure affects one third of U.S. adults, or approximately 75 million persons, yet approximately 11 million of these persons are not aware they have hypertension, and approximately 18 million are not being treated (unpublished data) (1,2).

  17. Timing of blood pressure measurement related to caffeine consumption.

    PubMed

    Mort, Jane R; Kruse, Heather R

    2008-01-01

    To determine whether patients should wait 30 minutes after caffeine consumption to have their blood pressure measured. Literature was obtained by searching MEDLINE (1980-September 2007), International Pharmaceutical Abstracts (1980-September 2007), and the Cochrane Database of Systematic Reviews (1994-September 2007). Search terms included caffeine and blood pressure. Literature was also obtained from citations in relevant articles. Articles that examined caffeine's acute effect on blood pressure were reviewed, with additional focus on caffeine tolerance and hypertensive status. Caffeine appears to affect blood pressure through adenosine receptor inhibition and an increased release of select neurotransmitters. Caffeine levels peak 30-120 minutes after oral intake and caffeine's half-life is 3-6 hours. The effect of caffeine on blood pressure has been examined for decades, with variable results depending on factors such as population examined (eg, hypertensive status, physical stressors, age) and study design (eg, acute effects, chronic ingestion, retrospective epidemiologic review). Caffeine tolerance diminishes the acute effect of caffeine on blood pressure, and hypertensive individuals are more susceptible to blood pressure changes. Reviews of caffeine's acute effect on blood pressure indicate changes of 3-15 mm Hg systolic and 4-13 mm Hg diastolic. Typically, blood pressure changes occur within 30 minutes, peak in 1-2 hours, and may persist for more than 4 hours. Having a patient abstain from caffeine for 30 minutes prior to blood pressure monitoring is not adequate to avoid caffeine's potential effects. An alternative approach to blood pressure monitoring would be to ask the patient about recent caffeine consumption and interpret the blood pressure reading based on this information. In addition, healthcare practitioners should provide education regarding caffeine's effects.

  18. Indirect blood pressure measurement: a need to reassess.

    PubMed

    Anderson, F D; Cunningham, S G; Maloney, J P

    1993-07-01

    Indirect blood pressure measurement is the assessment tool used most frequently in epidemiological studies and hypertension management in the population at large. To review indirect blood pressure measurement within the context of nursing practice. Nurses are not following recommended American Heart Association measurement guidelines. A national program of certification in indirect blood pressure measurement, similar to that of basic and advanced cardiac life support, is needed. An initial approach to evaluating present practice is also suggested.

  19. [Blood pressure variability: clinical interest or simple curiosity?].

    PubMed

    Ciaroni, Stefano

    2007-03-14

    Blood pressure variability is a physiological phenomenon influenced by many internal and external factors. This variability could be also influenced by pathological conditions such as arterial hypertension. Two forms must be mainly distinguished: the blood pressure variability at long and short-term. The latter could only be studied by continuous recordings. In this article will be analysed the interest of measuring blood pressure variability, its cardiovascular prognosis and the therapeutic tools when it is increased.

  20. In-Clinic Blood Pressure Prediction of Normal Ambulatory Blood Pressure Monitoring in Pediatric Hypertension Referrals.

    PubMed

    Johnson, Philip K; Ferguson, Michael A; Zachariah, Justin P

    2016-07-01

    Since younger patients have low pretest probability of hypertension and are susceptible to reactive and masked hypertension, ambulatory blood pressure monitoring (ABPM) can be useful. To better target use in referred patients, we sought to define in-clinic systolic blood pressure (SBP) measures that predicted normal ABPM and target end organ damage. Data were collected on consecutive patients referred for high BP undergoing an ambulatory BP monitor from 2010 to 2013 (n = 248, 33.9% female, mean age 15.5 ± 3.6 years). Candidate in-clinic predictors were systolic maximum, minimum, or average BPs obtained by auscultative, oscillometric, or both. Multivariable logistic regression models were used to determine the prediction of normal ABPM by in-clinic BP predictors. Separate models considered predicting left ventricular hypertrophy (LVH) by in-clinic SBP vs. ABPM-defined hypertension. Identified predictor utility was tested with receiver operator characteristic curves. Maximum (OR 0.97 [95% CI 0.94-0.99]; P = .047), minimum (0.96 [0.94-0.99]; P = .002), and average (0.97 [0.95-1.00]; P = .04) in-clinic auscultative SBP predicted normal ABPM. Each had a c-statistic of 0.58. LVH was associated with in-clinic auscultative minimum SBP treated continuously (1.05, [1.01-1.10], P = .01) or dichotomized at the 90th percentile (8.23, [1.48-45.80], P = .02), as well as ABPM-defined hypertension (3.31, [1.23-8.91], P = .02). Both predictors had poor sensitivity and specificity. In youth, normal auscultative in-clinic systolic blood pressure indices weakly predicted normal ambulatory blood pressure and target end organ damage. © 2016 Wiley Periodicals, Inc.

  1. Blood Pressure and Global Risk Assessment in a Swedish Population

    PubMed Central

    Eckner, Jenny; Larsson, Charlotte A.; Råstam, Lennart; Lindblad, Ulf

    2012-01-01

    This study investigated the association between SCORE and the 2007 ESH-ESC blood pressure categories and explored achievements of blood pressure goals considering global risk. In 2001–2005, a random sample of inhabitants aged 30–74 years in southwestern Sweden was invited to a survey of cardiovascular risk factors. The study enrolled 2816 participants (participation rate 76%). Blood pressure was categorized according to the 2007 ESH-ESC guidelines. Global risk of 10-year CVD death was estimated using the Swedish SCORE chart also accounting for additional risk from diabetes (SCORE-DM). SCORE-DM increased in both sexes from optimal blood pressure to manifest hypertension but did not differ between the normal blood pressure categories. However, SCORE-DM became significantly higher among those with temporarily high blood pressure (men 3.3 SD (1.7), women 1.1 (1.8)) and hypertension (3.6 (2.0), 2.0 (2.0)), compared to optimal blood pressure (1.6 (2.9), 0.6 (1.9)). In the presence of both hypertension and diabetes, high-risk subjects dominated (men 76%, women 61%), and correspondingly a major proportion of patients with known hypertension were at high risk at a blood pressure ≥160/100 mm Hg. These findings have strong implications on blood pressure evaluation in clinical practice and support the use of SCORE to evaluate global risk. PMID:22991653

  2. Does Schumann resonance affect our blood pressure?

    PubMed Central

    Mitsutake, G.; Otsuka, K.; Hayakawa, M.; Sekiguchi, M.; Cornélissen, G.; Halberg, F.

    2008-01-01

    Objectives To investigate whether Schumann resonance (SR) affects blood pressure (BP), heart rate (HR), and depression and, if so, whether the putative BP reactivity to SR (BPR-SR) is associated with health-related lifestyle (HLS), disease-related illnesses (DRI), and depression. Methods A sample of 56 adults in Urausu, Hokkaido, Japan, wore an ambulatory BP monitor, except for the time in the shower, for seven consecutive days. They completed the Geriatric Depression Scale-Short Form and a health survey questionnaire on HLS and DRI. Group mean differences and within-individual differences in systolic (S) and diastolic (D) BP, mean arterial pressure (MAP), double product (DP), and HR were, respectively, compared between normal and enhanced SR days, using Student’s t-test. Correlations between BPR-SR and other characteristics (i.e. age, gender, HLS, DRI, subjective health, and depression) were analyzed, using Pearson’s product moment correlation. Results and discussion Group mean SBP, DBP, MAP, and DP for enhanced SR days were lower than those for normal days (P = 0.005-0.036). DRI was negatively associated with BPR-SR in SBP, DBP, MAP, and DP (P = 0.003-0.024), suggesting a better health status for those who showed lower BP on enhanced SR days. HLS was negatively associated with BPR-SR in DBP and MAP (P = 0.016-0.029). Males showed higher BPR-SR in DBP and MAP than females (P = 0.0044-0.016). Neither subjective health nor depression was significantly associated with BPR-SR. Future studies based on larger sample sizes are planned to see whether possible health effects can be generalized. PMID:16275477

  3. Noninvasive automatic blood pressure monitoring does not attenuate nighttime hypotension. Evidence from 24 h intraarterial blood pressure monitoring.

    PubMed

    Villani, A; Parati, G; Groppelli, A; Omboni, S; Di Rienzo, M; Mancia, G

    1992-10-01

    Automatic ambulatory blood pressure monitoring makes use of repeated cuff inflations throughout the day and night. This may interfere with the cardiovascular effects of sleep and thus alter the 24 h blood pressure profile. The possibility that intermittent automatic blood pressure measurements prevent nocturnal hypotension was examined in 17 mild or moderate essential hypertensive patients in whom blood pressure was recorded intraarterially for 48 h by the Oxford technique. During the first or the second 24 h period, blood pressure was also monitored noninvasively by the SpaceLabs (Redmond, WA) 5300 (n = 10) and by the Sandoz Pressure System SPS 1558 (Lavanchy Electronique, Prilly, Switzerland) (n = 7) devices, automatic measurements being performed at 15 min intervals during the day and at 30 min intervals during the night. Separate computer analysis of 24 h intraarterial tracings obtained in absence and in concomitance of contralateral automatic blood pressure monitoring showed that the occurrence of automatic measurements had not interfered with the day-night intraarterial blood pressure and heart rate profiles. Thus the frequent cuff inflations that characterize automatic blood pressure monitoring do not attenuate nighttime hypotension and bradycardia. This finding supports use of the noninvasive approach in assessing blood pressure profiles.

  4. Predicting Increased Blood Pressure Using Machine Learning

    PubMed Central

    Golino, Hudson Fernandes; Amaral, Liliany Souza de Brito; Duarte, Stenio Fernando Pimentel; Soares, Telma de Jesus; dos Reis, Luciana Araujo

    2014-01-01

    The present study investigates the prediction of increased blood pressure by body mass index (BMI), waist (WC) and hip circumference (HC), and waist hip ratio (WHR) using a machine learning technique named classification tree. Data were collected from 400 college students (56.3% women) from 16 to 63 years old. Fifteen trees were calculated in the training group for each sex, using different numbers and combinations of predictors. The result shows that for women BMI, WC, and WHR are the combination that produces the best prediction, since it has the lowest deviance (87.42), misclassification (.19), and the higher pseudo R 2 (.43). This model presented a sensitivity of 80.86% and specificity of 81.22% in the training set and, respectively, 45.65% and 65.15% in the test sample. For men BMI, WC, HC, and WHC showed the best prediction with the lowest deviance (57.25), misclassification (.16), and the higher pseudo R 2 (.46). This model had a sensitivity of 72% and specificity of 86.25% in the training set and, respectively, 58.38% and 69.70% in the test set. Finally, the result from the classification tree analysis was compared with traditional logistic regression, indicating that the former outperformed the latter in terms of predictive power. PMID:24669313

  5. Observer error in blood pressure measurement.

    PubMed Central

    Neufeld, P D; Johnson, D L

    1986-01-01

    This paper describes an experiment undertaken to determine observer error in measuring blood pressure by the auscultatory method. A microcomputer was used to display a simulated mercury manometer and play back tape-recorded Korotkoff sounds synchronized with the fall of the mercury column. Each observer's readings were entered into the computer, which displayed a histogram of all readings taken up to that point and thus showed the variation among observers. The procedure, which could easily be adapted for use in teaching, was used to test 311 observers drawn from physicians, nurses, medical students, nursing students and others at nine health care institutions in Ottawa. The results showed a strong bias for even-digit readings and standard deviations of roughly 5 to 6 mm Hg. The standard deviation for the systolic readings was somewhat smaller for the physicians as a group than for the nurses (3.5 v. 5.9 mm Hg). However, the standard deviations for the diastolic readings were roughly equal for these two groups (approximately 5.5 mm Hg). Images Fig. 1 PMID:3756693

  6. Does nicotinic acid (niacin) lower blood pressure?

    PubMed Central

    Bays, H E; Rader, D J

    2009-01-01

    Nicotinic acid (niacin) is a well-established treatment for dyslipidaemia – an important cardiovascular disease (CVD) risk factor. However, niacin may also reduce blood pressure (BP), which is another important CVD risk factor. This review examines the limited publicly available data on niacin’s BP effects. Acute administration of immediate-release niacin may lower BP because of niacin’s acute vasodilatory effects. Although not always supported by clinical trial data, the package insert of a prescription, extended-release niacin describes niacin-induced acute hypotension. From a chronic standpoint, larger studies, such as the Coronary Drug Project, suggest that niacin may lower BP when administered over a longer period of time. Post hoc analyses of some of the more recent niacin clinical trials also support a more chronic, dose-dependent, BP-lowering effect of niacin. Because laropiprant [a prostaglandin D2 (PGD2) type 1 (DP1) receptor antagonist] does not attenuate niacin’s BP-lowering effects, it is unlikely that any chronic lowering of BP by niacin is due to dilation of dermal vessels through activation of the DP1 receptor by PGD2. Further research is warranted to evaluate the extent and mechanisms of niacin’s effects on BP. PMID:19054161

  7. Neurohumoral blood pressure regulation in lead exposure

    SciTech Connect

    Boscolo, P.; Carmignani, M.

    1988-06-01

    Previous human studies demonstrated that lead exposure may modify the metabolism of catecholamines and of hormones controlled by the hypothalamo-pituitary axis and may affect the kallikrein-kinin system. This paper reports unpublished data on the plasma renin activity of lead-exposed workers; these results are in agreement with those of previous human and experimental studies suggesting that the synthesis or release of renin is increased after short and moderate exposure to inorganic lead and reduced whenever the exposure is prolonged. Previous experimental investigations demonstrated that lead may act on the cardiovascular system, with effects on the renin-angiotensin system, on the reactivity to stimulation of peripheral catecholaminergic receptors, on sympathetic and vagal tone, and on reactivity to the stimulation of baroreceptors. This paper reports the results of a study on male Sprague-Dawley rats that received 0, 15, 30, and 60 ..mu..g/mL of lead in drinking water for 18 months. Blood pressure was increased in the rats receiving 30 and 60 ppm of lead; cardiac inotropism was augmented only in those receiving the higher dose of the metal, and heart rate was not modified. Cardiovascular responses to agonists indicated that lead exposure affects the renin-angiotensin system and induces sympathetic hyperactivity be acting on central and peripheral sympathetic junctions increasing the responsiveness to stimulation of ..cap alpha../sub 2/-adrenoreceptors and by increasing the reactivity to stimulation of cardiac and vascular ..beta..-adrenergic and dopaminergic receptors.

  8. The importance of sleep blood pressure.

    PubMed

    Morgan, Trefor Owen

    2010-06-01

    Blood pressure (BP) varies throughout the day owing to interactions between the sympathetic nervous and the renin-angiotensin systems. When awake BP is controlled by sympathetic nervous system activity but during sleep the renin-angiotensin system becomes more important. The lower BP during sleep is a more powerful predictor of outcome than the awake BP. Certain individuals do not have the fall in BP with sleep and this worsens the outcome. Inadequate handling of sodium by the kidney is an important factor preventing this BP fall. The different drug classes have varying effects on BP during 24 h. Drugs that act independently of the two controlling systems have a similar effect at day and night. Drugs that act on the sympathetic nervous system have a greater effect during the day and little effect during sleep unless the sympathetic system is still active. Drugs that act via the renin-angiotensin system have a greater effect during sleep. Controlling BP during sleep may improve outcome.

  9. Effects of thiazolidinediones on blood pressure.

    PubMed

    Giles, Thomas D; Sander, Gary E

    2007-08-01

    Peroxisome-proliferator-activated receptor-gamma (PPAR-gamma) agonists (known as thiazolidinediones; TDZs) activate nuclear receptors that regulate gene expression; they were developed as insulin-sensitizing drugs to treat type 2 diabetes mellitus. Although the prototypic TZD troglitazone was withdrawn from the market due to hepatic toxicity, rosiglitazone and pioglitazone are mainstays in managing type 2 diabetes mellitus. TZDs exert their hypoglycemic effect by reducing insulin resistance, hence improving insulin sensitivity. However, TZDs also exhibit a broad range of cardiovascular actions, with the clinical consequence of reduction in blood pressure (BP), observed in animal models and human diabetic subjects. The magnitude of reduction appears to be about 4 to 5 mm Hg in systolic and 2 to 4 mm Hg in diastolic BP--sufficient to significantly reduce subsequent cardiovascular event rates. But these BP-reducing properties, which are not present with metformin or sulfonylureas, are particularly important when viewed in conjunction with hypoglycemic effects. A significant proportion of patients with type 2 diabetes mellitus and BP mildly above target range might be successfully treated for both processes with a single drug.

  10. Resting blood pressure values of adult athletes.

    PubMed

    Varga-Pintér, Barbara; Horváth, Patrícia; Kneffel, Zsuzsanna; Major, Zsuzsanna; Osváth, Péter; Pavlik, Gábor

    2011-01-01

    Regular physical activity has a favorable effect upon the prevention and treatment of hypertension. Various movements in sports, however, affect blood pressure (BP) differently. In the present study, the resting BP data of a large number (3,697) of young men and women (age: 19-40 years) who participated in sports medical examinations were compared according to their sport. Athletes were arranged into definite subgroups based on their different sport activities, i.e. if their movement pattern characteristics were similar and no significant intergroup differences were seen in BP values. BP values were lower in the dynamic type athletes (speed, endurance sports and ball games) than in the static type. Out of the endurance athletes, BP values were not lower in cycle racers, kayakers/canoeists and rowers. In water athletes, BP values were higher than in corresponding dry-land athletes. There was a quite large significant difference between the BP values of athletes involved in static muscular activity (power athletes) and dynamic-type strength athletes (combat competitors). Although cycling, kayaking/canoeing and competitive water sports increase BP, as leisure time activities they more than likely do not elevate BP. Copyright © 2011 S. Karger AG, Basel.

  11. Blood pressure measurement under standardized indoor condition may mask seasonal blood pressure variation in men with mildly elevated blood pressure.

    PubMed

    Hattori, Tomomi; Munakata, Masanori

    2015-01-01

    Blood pressure (BP) is generally higher in cold than in warm seasons. This seasonal BP change is largely attributable to outdoor temperature changes. However, if such a typical seasonal change is observed in BP measured under a standardized indoor condition remains unclear. Resting supine BPs and heart rate (HR) were measured under a standardized room temperature during summer and the next winter in 104 untreated men (38.1 ± 4.4 years). Subjects were classified as having normotension (NT group: n = 79) or mildly elevated BP (ME group: n = 25) according to the summer measurements. Seasonal variation was defined as the difference from winter to summer measurements. We also examined body composition, endocrine parameters, and renal function. Age did not differ in the two groups (37.6 ± 4.2 versus 39.1 ± 4.9 years). The mean seasonal change in systolic BP was 2.7 ± 1.1 mmHg for the NT group and -4.6 ± 1.9 mmHg for the ME group (p = 0.001). Laboratory and outdoor temperatures did not differ between the two groups in either season. HR, noradrenaline, and estimated glomerular filtration rate were significantly higher during winter in the NT group but not in ME group. Typical seasonal change in BP may be masked in mildly elevated BP measured under a standardized indoor condition. The mechanisms are multifactorial. Our data suggest that out-of-office BP measurements are necessary for correctly understanding seasonal BP change especially in individuals with mildly elevated BP.

  12. Dietary potassium and blood pressure in a population.

    PubMed

    Khaw, K T; Barrett-Connor, E

    1984-06-01

    A population based study of 685 men and women aged 20 to 79 yr in a predominantly Caucasian community in Southern California found dietary potassium intake estimated from 24-h recall dietary history to be significantly and negatively correlated with age-adjusted systolic pressure in both men and women and with age-adjusted diastolic blood pressure in men. These correlations remained after exclusion of persons taking antihypertension medication or those with categorical hypertension (blood pressure greater than 160/95), and also persisted after adjusting for other dietary variables including alcohol and calcium intake. In women, correlations with blood pressure increased after excluding those taking sex hormones, suggesting that hormonal status may be an important determinant of blood pressure in women and may obscure other relationships. These findings support the etiological relationship of dietary potassium with blood pressure in populations.

  13. Asymmetric features of short-term blood pressure variability.

    PubMed

    Guzik, Przemyslaw; Piskorski, Jaroslaw; Krauze, Tomasz; Narkiewicz, Krzysztof; Wykretowicz, Andrzej; Wysocki, Henryk

    2010-11-01

    Prolongations of cardiac cycles have a significantly larger contribution to short-term heart rate variability than shortenings--this is called heart rate asymmetry. Our aim is to establish the existence of blood pressure asymmetry phenomenon, which has not been done so far. We used 30-min resting continuous recordings of finger pressure waveforms from 227 healthy young volunteers (19-31 years old; 97 female), and performed Poincaré plot analysis of systolic blood pressure (SBP) to quantify the effect. Median contribution of SBP increases (C(i)) to short-term blood pressure variability was 52.8% (inter-quartile range: 50.9-55.1%) and median number of SBP increases (N(i)) was 48.8% (inter-quartile range: 47.2-50.1%). The C(i)>50% was found in 82% (P<0.0001; binomial test) and N(i)<50% in 75% (P<0.0001) of the subjects. Although SBP increases are significantly less abundant than reductions, their contribution to short-term blood pressure variability is significantly larger, which means that short-term blood pressure variability is asymmetric. SBP increases and reductions have unequal contribution to short-term blood pressure variability at supine rest in young healthy people. As this asymmetric behavior of blood pressure variability is present in most of the healthy studied people at rest, it can be concluded that blood pressure asymmetry is a physiological phenomenon.

  14. Hypertension in chronic kidney disease: role of ambulatory blood pressure monitoring

    PubMed Central

    VanDeVoorde, Rene G.; Mitsnefes, Mark M.

    2015-01-01

    Children with chronic kidney disease have a markedly increased risk of cardiovascular morbidity and children with end stage renal disease have an estimated 30 times greater risk of cardiovascular mortality than the general pediatric population. In adults, the link between hypertension and cardiovascular disease is well-documented but that association has not been so readily apparent in children with chronic kidney disease. This may be in part because the early changes in blood pressure that occur in these patients do not necessarily manifest with changes in casual blood pressure measurements. Ambulatory blood pressure monitoring, with its ability to gather multiple readings both during the normal activities of the day and the night, is felt to be a more veritable measure of blood pressure. Its use in children has been hampered by limited data on normative values and difficulties in blood pressure classification, while its use in adults is ever expanding. However, with an increasing number of studies in children with chronic kidney disease, ambulatory blood pressure has revealed a greater prevalence of abnormal findings in this population and has been shown to better predict cardiovascular risk than current standards. Two large multi-center studies in Europe and North America have revealed even greater utility of ambulatory blood pressure measures in this population. It is hoped that continued use of ambulatory monitoring in children will help overcome some of its perceived limitations while also validating its use in those at high risk of cardiovascular morbidity. PMID:27346928

  15. Confidence limits for interpretation of home blood pressure recordings.

    PubMed

    Krakoff, Lawrence R

    2009-08-01

    Accurate and precise estimation of arterial blood pressure is needed for the management of hypertension. Multiple measurements can be obtained from recorded home blood pressures devices. Averages and other statistics can be calculated. Confidence intervals provide an assessment of the precision with which average pressures are measured. This study evaluated confidence intervals for systolic pressure, diastolic pressure, and pulse pressure from recorded home blood pressure measurements. Fifty-three patients with high normal blood pressure, suspected white coat hypertension, or refractory hypertension were assessed by recorded home blood pressure. They were instructed to take four measurements each day for 1 week using a device that stores each measurement. Measurements were downloaded from the device to a computer, stored as data files, and analyzed by software. Average pressures and confidence intervals for each participant were rapidly calculated by standard statistical methods. The average width of the 95% confidence intervals for systolic pressure, diastolic pressure, and pulse pressure were 8, 5, and 6 mmHg, respectively with large inter-individual differences. Significant positive correlations were found between the width of the confidence intervals and the average systolic (P<0.05) or pulse pressure (P<0.01). However, the correlation for diastolic pressure was not significant. Confidence intervals can be easily calculated for recorded home blood pressures with device storage and may provide a useful approach when cut-off points for classification as normal pressure, high normal pressure, or definite hypertension are to be excluded. This information, combined with knowledge of other risk factors, may help guide decisions for improved management.

  16. Contribution of parental blood pressures to association between low birth weight and adult high blood pressure: cross sectional study

    PubMed Central

    Walker, Brian R; McConnachie, Alex; Noon, Joseph P; Webb, David J; Watt, Graham C M

    1998-01-01

    Objective: To examine the possibility that low birth weight is a feature of the inherited predisposition to high blood pressure. Design: Cross sectional study. Setting: Primary care medical centre in Edinburgh. Subjects: One offspring of 452 families (231 men and 221 women aged 16-26 years) in whom blood pressure, weight, and height were measured in 1986 and whose parents had blood pressure measured in 1979. Birth weights were obtained from case records (270 offspring) or by questionnaires sent to the mothers (182 offspring). Main outcome measures: Birth weight and adult systolic blood pressure in offspring in relation to parental blood pressure. Results: If parental blood pressures were not considered, a 1 kg decrease in birth weight was associated with a 2.24 mm Hg increase in systolic blood pressure of offspring (P=0.06) after correction for current weight and sex. However, parental blood pressures correlated positively with blood pressure of offspring, and higher maternal blood pressure was associated with lower birth weight (−3.03 g/mm Hg, P<0.01). After correction for parental blood pressures, a 1 kg decrease in birth weight was associated with only a 1.71 mm Hg increase in the systolic blood pressure of the offspring (P=0.15). Conclusions: Low birth weight is a feature of the inherited predisposition to hypertension, perhaps because it is associated with higher maternal blood pressure during pregnancy. Parental blood pressure may be an important confounding factor in the relation between low birth weight and subsequent hypertension. Key messages Hypertension has both inherited and environmental causes The relation between low birth weight and hypertension in later life may result from the mother’s nutritional environment during pregnancy This study found that mothers who have higher blood pressure in later life deliver babies with lower birth weight, who also develop higher blood pressure Hereditary factors therefore explain part of the

  17. Automatic blood pressure monitors. Evaluation of three models in volunteers.

    PubMed

    Imbelloni, Luiz Eduardo; Beato, Lúcia; Tolentino, Ana Paula; de Souza, Dulcimar Donizete; Cordeiro, José Antônio

    2004-02-01

    Since 1903, blood pressure has been noninvasively monitored (NIBP), either with manual sphygmomanometer or automated noninvasive devices. One NIBP measurement problem is the considerable variance in blood pressure data, both within and between available techniques. The oscillometric method for NIBP monitoring evaluates blood pressure during cuff deflation. Difficulties in blood pressure measurement by oscillometry may arise from: inadequate cuff size, inadequate cuff application, undetected fails in cuff, hoses, or connectors, arm movement, shock and vascular compression proximal to the cuff. This study aimed at evaluating the reliability of three noninvasive blood pressure monitoring devices during five measurements. Blood pressure of 60 healthy female volunteers aged 20 to 40 years was evaluated from 7 am to 11 am, in the sitting position during a normal workday. Five measures were taken with each device at 2-minute intervals. Three automatic blood pressure monitors were studied. No patient was obese, hypertensive or suffering from cardiac disease and cardiac arrhythmia. Indirect measurements were made according to manufacturers' instructions. There were no differences in demographics among the three studied groups. Mean intrapersonal variation from one measurement to the other was up to 6.7 mmHg for systolic blood pressure (SBP), 4.9 mmHg for mean blood pressure (MBP) and 3.3 mmHg for diastolic blood pressure (DBP) with 95% confidence interval. The highest difference between measures in the same volunteer was 49 mmHg for SBP, 46 mmHg for MBP and 28 mmHg for DBP. This study has shown significant variations in SBP, MBP and DBP and that SBP is the most reliable parameter to check blood pressure changes in volunteers.

  18. Circadian rhythm and blood pressure control: physiological and pathophysiological factors.

    PubMed

    Coca, A

    1994-07-01

    To review current knowledge on blood pressure variability. Blood pressure variability has a time-course ranging from a few seconds or minutes (short-term variability) to 24 h (long-term variability) or 1 year (seasonal variations). The variability is influenced by physiological factors such as physical and mental activity (posture, exercise, talking) or behavioral and environmental factors (salt, caffeine, alcohol), and by pathological conditions. In patients with essential hypertension, the day-night pattern of blood pressure change is generally similar to that of normotensives, with a significant nocturnal blood pressure fall (dippers), except that the entire profile is shifted upwards. Nevertheless, in some essential hypertensives the nocturnal fall in blood pressure is absent or reversed (non-dippers), in spite of a decrease in the nocturnal heart rate. In several forms of secondary hypertension (pheochromocytoma, renal failure) and other clinical conditions (sleep apnea syndrome, diabetes mellitus, cardiac transplantation) the nocturnal fall in blood pressure is also absent or reversed. Blood pressure variability and the blunted nocturnal fall in blood pressure may be clinically relevant. Several studies have demonstrated that subjects whose 24-h variability was higher than the group average were more likely to have target-organ damage. Moreover, hypertensive women with a blunted nocturnal fall in blood pressure (non-dippers) are more likely to suffer morbid cardiovascular events than dippers. On theoretical grounds, therefore, antihypertensive treatment that reduces blood pressure variability and preserves the nocturnal fall in blood pressure will help to protect target organs in hypertension. So far, this has not been demonstrated in clinical trials.

  19. The Effect of Job Strain on Nighttime Blood Pressure Dipping among Men and Women with High Blood Pressure

    PubMed Central

    Fan, Lin-bo; Blumenthal, James A.; Hinderliter, Alan L.; Sherwood, Andrew

    2013-01-01

    Objectives Blunted nighttime blood pressure dipping is an established cardiovascular risk factor. This study examined the effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure. Methods The sample consisted of 122 blue collar and white collar workers (men=72, women=50). Job psychological demands, job control and social support were measured by the Job Content Questionnaire. Job strain was assessed by the ratio of job demands/job control. Nighttime blood pressure dipping was evaluated from 24-hour ambulatory blood pressure monitoring performed on three workdays. Results Men with high job strain had a 5.4 mm Hg higher sleep systolic blood pressure (P=0.03) and 3.5 mm Hg higher sleep pulse pressure (P=0.02) compared to men with low job strain. Men with high job strain had a smaller fall in systolic blood pressure and pulse pressure from awake to sleep than those with low job strain (P<0.05). Hierarchical analyses showed that job strain was an independent determinant of systolic blood pressure dipping (P=0.03) among men after adjusting for ethnicity, body mass index, anxiety and depression symptoms, current smoking status, and alcohol consumption. Further exploratory analyses indicated that job control was the salient component of job strain associated with blood pressure dipping (p=.03). Conclusions High job strain is associated with a blunting of the normal diurnal variation in blood pressure and pulse pressure, which may contribute to the relationship between job strain and cardiovascular disease. PMID:22460541

  20. The effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure.

    PubMed

    Fan, Lin-Bo; Blumenthal, James A; Hinderliter, Alan L; Sherwood, Andrew

    2013-01-01

    Blunted nighttime blood pressure dipping is an established cardiovascular risk factor. This study examined the effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure. The sample consisted of 122 blue- and white collar workers (men=72, women=50). The Job Content Questionnaire was used to measure job psychological demands, job control, and social support. The ratio of job demands to job control was used to assess job strain. Nighttime blood pressure dipping was evaluated from 24-hour ambulatory blood pressure monitoring performed on three workdays. Men with high job strain had a 5.4 mm Hg higher sleep systolic blood pressure (P=0.03) and 3.5 mm Hg higher sleep pulse pressure (P=0.02) compared to men with low job strain. Men with high job strain had a smaller fall in systolic blood pressure and pulse pressure from awake to sleep state than those with low job strain (P<0.05). Hierarchical analyses showed that job strain was an independent determinant of systolic blood pressure dipping (P=0.03) among men after adjusting for ethnicity, body mass index, anxiety and depression symptoms, current smoking status, and alcohol consumption. Further exploratory analyses indicated that job control was the salient component of job strain associated with blood pressure dipping (P=0.03). High job strain is associated with a blunting of the normal diurnal variation in blood pressure and pulse pressure, which may contribute to the relationship between job strain and cardiovascular disease.

  1. Cardiovascular Risk in Hypertension in Relation to Achieved Blood Pressure Using Automated Office Blood Pressure Measurement.

    PubMed

    Myers, Martin G; Kaczorowski, Janusz; Dolovich, Lisa; Tu, Karen; Paterson, J Michael

    2016-10-01

    The SPRINT (Systolic Blood Pressure Intervention Trial) reported that some older, higher risk patients might benefit from a target systolic blood pressure (BP) of <120 versus <140 mm Hg. However, it is not yet known how the BP target and measurement methods used in SPRINT relate to cardiovascular outcomes in real-world practice. SPRINT used the automated office BP technique, which requires the patient to be resting quietly and alone, with multiple readings being recorded automatically using an electronic oscillometric sphygmomanometer. We studied the relationship between achieved automated office BP at baseline and cardiovascular events in 6183 community-dwelling residents of Ontario aged ≥66 years who were receiving antihypertensive therapy and followed for a mean of 4.6 years. Adjusted hazard ratios (95% confidence intervals) were computed for 10 mm Hg increments in achieved automated office BP at baseline using Cox proportional hazards regression and the BP category with the lowest event rate as the reference category. Based on 904 fatal and nonfatal cardiovascular events, the nadir of cardiovascular events was at the systolic pressure category of 110 to 119 mm Hg, which was lower than the next highest category of 120 to 129 mm Hg (hazard ratio 1.30 [1.01, 1.66]). The hazard ratio for diastolic pressure was relatively unchanged above 60 mm Hg. Pulse pressure exhibited an increase in hazard ratio (1.33 [1.02, 1.72]) at ≥80 mm Hg. These results using automated office BP measurement in a usual treatment setting extend the finding in SPRINT of an optimum target systolic BP of <120 mm Hg to routine clinical practice. © 2016 American Heart Association, Inc.

  2. Let's Talk about High Blood Pressure and Stroke

    MedlinePlus

    ... minutes to write your questions for the next time you see your healthcare provider: What should my blood pressure be? How often should my blood pressure be checked? ©2015, American Heart Association Multi-language Fact Sheet Topics Heart-related Conditions What is ...

  3. Role of ambulatory blood pressure monitoring in resistant hypertension.

    PubMed

    Grassi, Guido; Bombelli, Michele; Seravalle, Gino; Brambilla, Gianmaria; Dell'oro, Raffaella; Mancia, Giuseppe

    2013-06-01

    Ambulatory blood pressure monitoring has gained growing popularity in the diagnosis and treatment of essential hypertension for several reasons, such as the lack of the so-called white-coat effect, the greater reproducibility as compared with clinic blood pressure, the ability to provide information on blood pressure phenomena of prognostic value and the closer relationship with the risk of cardiovascular morbidity and mortality. All the above-mentioned main features of ambulatory blood pressure monitoring are also true for resistant hypertension. In addition, however, in resistant hypertension, blood pressure monitoring allows one to precisely define the diagnosis of this clinical condition, by excluding the presence of white-coat hypertension, which is responsible for a consistent number of "false" resistant hypertensive cases. The approach also allows one to define the patterns of blood pressure variability in this clinical condition, as well as its relationships with target organ damage. Finally, it allows one to assess the effects of therapeutic interventions, such as renal nerves ablation, aimed at improving blood pressure control in this hypertensive state. The present paper will critically review the main features of ambulatory blood pressure monitoring in resistant hypertension, with particular emphasis on the diagnosis and treatment of this high-risk hypertensive state.

  4. High Blood Pressure in Pregnancy - Multiple Languages: MedlinePlus

    MedlinePlus

    ... الدم أثناء الحمل - العربية Bilingual PDF Health Information Translations Bosnian (Bosanski) High Blood Pressure in Pregnancy Visok ... u trudnoći - Bosanski (Bosnian) Bilingual PDF Health Information Translations Chinese - Simplified (简体中文) High Blood Pressure in Pregnancy ...

  5. [Long time regulation of arterial blood pressure: facts and hypothesis].

    PubMed

    Tsyrlin, V A

    2013-01-01

    The date about long time increase of blood pressure in conditions of excessive salt intake, constriction of renal artery in animals with initial low baroreceptor reflex is presented. Arterial hypertension in this case is accompanied by increase activity of sympathetic nervous system. The supposition that arterial baroreceptor reflex place a role in long time regulation of arterial blood pressure is expressed.

  6. The Republic of Georgia High Blood Pressure Control Program.

    PubMed

    Barbakadze, Vakhtang Y; Koblianidze, Levan G; Kipshidze, Nodar N; Grim, Clarence E; Grim, Carlene M; Tavill, Frederick

    2006-01-01

    52% of adults have uncontrolled hypertension in the Republic of Georgia. We incorporated a blood pressure control program into an existing primary healthcare system in an attempt to improve the rate of blood pressure control. We conducted standardized trainings of rural primary care providers--doctors and nurses--in accurate measurement of blood pressure according to the Shared Care Method of Training and Certification. Our attention was focused especially on patient management based on Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) guidelines. Antihypertensive treatment was implemented by a stepped-care approach; hydrochlorothiazide and atenolol were given to patients at follow-up visits at no cost. The treatment goal was < 140/ 90 mm Hg based on the office blood pressure. A total of 251 patients with uncontrolled hypertension were enrolled in the program; 32% had stage I hypertension, 41% had stage II hypertension, and 27% had stage III, as defined by JNC VI. During the first 30 months of followup, blood pressure decreased gradually from 170/95 to 140/ 82 mm Hg. The rate of high blood pressure control increased progressively up to 59%. We conclude that hypertension control can be improved in all groups of patients, even in a healthcare system with limited resources. We emphasize that Georgia or any other healthcare system should not wait for universal health care to improve high blood pressure control. It can be incorporated into whatever system exists today.

  7. Normalization effect of sports training on blood pressure in hypertensives.

    PubMed

    Chen, Yi-Liang; Liu, Yuh-Feng; Huang, Chih-Yang; Lee, Shin-Da; Chan, Yi-Sheng; Chen, Chiu-Chou; Harris, Brennan; Kuo, Chia-Hua

    2010-02-01

    Exercise is recommended as a lifestyle intervention in preventing hypertension based on epidemiological findings. However, previous intervention studies have presented mixed results. This discrepancy could be associated with shortcomings related to sample sizes or the inclusion of normotensive participants. The aim of this prospective cohort study (N = 463) was to compare the chronic effect of increasing sports training time on resting blood pressure for normotensives and hypertensives. We assessed systolic blood pressure, diastolic blood pressure, body mass index (BMI), and homeostasis model assessment for insulin resistance (HOMA-IR) for 69 untreated hypertensive patients (age 20.6 +/- 0.1 years, systolic blood pressure >140 mmHg) and 394 normotensive controls (age 20.6 +/- 0.1 years) before training and at follow-up visits at 12 months. All participants enrolled in various sports training lessons for 8 hours a week. The baseline BMI and HOMA-IR in the hypertensive group were significantly higher than those in the control group. For the normotensive control group, no significant changes in systolic and diastolic blood pressure were observed after training. However, for the hypertensives, systolic and diastolic blood pressure were significantly reduced after training by approximately 15 mmHg and approximately 4 mmHg, respectively, and HOMA-IR was reduced by approximately 25%. In conclusion, the effect of sports training to lower blood pressure was confined to the group of hypertensives, which may account for the overall minimal reduction in blood pressure observed in previous intervention studies.

  8. 21 CFR 870.1110 - Blood pressure computer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal from...

  9. Heart and Artery Damage and High Blood Pressure

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More How High Blood Pressure Can Lead to a Heart Attack Updated:Dec ... sheet This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  10. Americans with High Blood Pressure Still Eating Too Much Salt

    MedlinePlus

    ... medlineplus.gov/news/fullstory_163977.html Americans With High Blood Pressure Still Eating Too Much Salt Average sodium intake ... March 8, 2017 (HealthDay News) -- For Americans with high blood pressure, cutting back on salt is an important way ...

  11. CDC Vital Signs: High Blood Pressure and Cholesterol

    MedlinePlus

    ... 1.36 MB] Read the MMWR Science Clips High Blood Pressure and Cholesterol Out of Control Recommend on Facebook ... by County http://apps.nccd.cdc.gov/GISCVH2/ High Blood Pressure and High Cholesterol Among US Adults SOURCES: National ...

  12. Taking blood pressure: too important to trust to humans?

    PubMed

    Vidt, Donald G; Lang, Richard S; Seballos, Raul J; Misra-Hebert, Anita; Campbell, John; Bena, James F

    2010-10-01

    The measurement of blood pressure in the physician's office is subject to a number of observer errors and also to the "white-coat effect." Automatic devices that measure blood pressure without a human observer in the room can eliminate many of these problems. We argue for greater use of these devices in the physician's office.

  13. Social Support, Assimilation and Biological Effective Blood Pressure Levels.

    ERIC Educational Resources Information Center

    Walsh, Anthony; Walsh, Patricia Ann

    1987-01-01

    The twin processes of migration and assimilation are highly stressful. This stress can be manifested in elevated blood pressure. According to this study, immigrants receiving high levels of social support had significantly lower blood pressure levels than those receiving less social support. (VM)

  14. Specific Genetic Influences on Nighttime Blood Pressure

    PubMed Central

    Xu, Xiaojing; Su, Shaoyong; Treiber, Frank A.; Vlietinck, Robert; Fagard, Robert; Derom, Catherine; Gielen, Marij; Loos, Ruth J.F.; Snieder, Harold

    2015-01-01

    OBJECTIVES Nighttime blood pressure (BP) has been shown to be superior to daytime BP in predicting hypertension related target organ damage and cardiac mortality. In our Georgia Cardiovascular Twin Study, we showed that apart from the genes that also influence daytime BP, specific genetic determinants explained 44% and 67% of the nighttime systolic BP (SBP) and diastolic BP (DBP) heritabilities, respectively. Here, we determined whether these results could be confirmed in a much larger twin cohort of young adults with 24-hour ambulatory BP measurements. METHODS Ambulatory BP was available in 703 white twins (308 pairs and 87 singletons, aged 18–34 years, 50% males) from the Prenatal Programming Twin Study. A bivariate quantitative genetic twin model was used to analyze daytime and nighttime BP. We conducted a meta-analysis to compare and integrate results from the 2 twin cohorts. RESULTS Model fitting showed no sex differences for any of the measures. Heritabilities were 0.60 and 0.51 for SBP and 0.54 and 0.46 for DBP at daytime and nighttime. The specific heritability due to novel genetic effects emerging during the nighttime was 0.21 for SBP and 0.26 for DBP, which comprised 41% and 57% of the total nighttime heritability for SBP and DBP, respectively. Meta-analysis confirmed absence of cohort differences with very similar combined results. CONCLUSIONS In addition to genes that influence both daytime and nighttime BP, a large part of the heritability is explained by genes that specifically influence BP at night. PMID:25205800

  15. Neurohumoral blood pressure regulation in lead exposure.

    PubMed Central

    Boscolo, P; Carmignani, M

    1988-01-01

    Previous human studies demonstrated that lead exposure may modify the metabolism of catecholamines and of hormones controlled by the hypothalamo-pituitary axis and may affect the kallikrein-kinin system. This paper reports unpublished data on the plasma renin activity of lead-exposed workers; these results are in agreement with those of previous human and experimental studies suggesting that the synthesis or release of renin is increased after short and moderate exposure to inorganic lead and reduced whenever the exposure is prolonged. Previous experimental investigations demonstrated that lead may act on the cardiovascular system, with effects on the renin-angiotensin system, on the reactivity to stimulation of peripheral catecholaminergic receptors, on sympathetic and vagal tone, and on reactivity to the stimulation of baroreceptors. This paper reports the results of a study on male Sprague-Dawley rats that received 0, 15, 30, and 60 micrograms/mL of lead in drinking water for 18 months. Blood pressure was increased in the rats receiving 30 and 60 ppm of lead; cardiac inotropism was augmented only in those receiving the higher dose of the metal, and heart rate was not modified. Cardiovascular responses to agonists indicated that lead exposure affects the renin-angiotensin system and induces sympathetic hyperactivity by acting on central and peripheral sympathetic junctions increasing the responsiveness to stimulation of alpha 2-adrenoreceptors and by increasing the reactivity to stimulation of cardiac and vascular beta-adrenergic and dopaminergic receptors. The cAMP-dependent availability of Ca2+ for contractile mechanisms of the cardiovascular muscle cells was affected by lead. PMID:3060351

  16. Beyond salt: lifestyle modifications and blood pressure.

    PubMed

    Frisoli, Tiberio M; Schmieder, Roland E; Grodzicki, Tomasz; Messerli, Franz H

    2011-12-01

    Lifestyle changes have been shown to effect significant blood pressure (BP) reductions. Although there are several proposed neurohormonal links between weight loss and BP, body mass index itself appears to be the most powerful mediator of the weight-BP relationship. There appears to be a mostly linear relationship between weight and BP; as weight is regained, the BP benefit is mostly lost. Physical activity, but more so physical fitness (the physiological benefit obtained from physical activity), has a dose-dependent BP benefit but reaches a plateau at which there is no further benefit. However, even just a modest physical activity can have a meaningful BP effect. A diet rich in fruits and vegetables with low-fat dairy products and low in saturated and total fat (DASH) is independently effective in reducing BP. Of the dietary mineral nutrients, the strongest data exist for increased potassium intake, which reduces BP and stroke risk. Vitamin D is associated with BP benefit, but no causal relationship has been established. Flavonoids such as those found in cocoa and berries may have a modest BP benefit. Neither caffeine nor nicotine has any significant, lasting BP effect. Biofeedback therapies such as those obtained with device-guided breathing have a modest and safe BP benefit; more research is needed before such therapies move beyond those having an adjunctive treatment role. There is a strong, linear relationship between alcohol intake and BP; however, the alcohol effects on BP and coronary heart disease are divergent. The greatest BP benefit seems to be obtained with one drink per day for women and with two per day for men. This benefit is lost or attenuated if the drinking occurs in a binge form or without food. Overall, the greatest and most sustained BP benefit is obtained when multiple lifestyle interventions are incorporated simultaneously.

  17. Finger blood pressure during leg resistance exercise.

    PubMed

    Gomides, R S; Dias, R M R; Souza, D R; Costa, L A R; Ortega, K C; Mion, D; Tinucci, T; de Moraes Forjaz, C L

    2010-08-01

    Blood pressure (BP) assessment during resistance exercise can be useful to avoid high BP, reducing cardiovascular risk, especially in hypertensive individuals. However, non-invasive accurate technique for this purpose is not available. The aim of this study was to compare finger photoplethysmographic (FPP) and intra-arterial BP values and responses during resistance exercise. Eight non-medicated hypertensive subjects (5 males, 30-60 years) were evaluated during pre-exercise resting period and during three sets of the knee extension exercise performed at 80% of 1RM until fatigue. BP was measured simultaneously by FPP and intra-arterial methods. Data are mean+/-SD. Systolic BP was significantly higher with FPP than with intra-arterial: at pre-exercise (157+/-13 vs. 152+/-10 mmHg; p<0.01) and the mean (202+/-29 vs. 198+/-26 mmHg; p<0.01), and the maximal (240+/-26 vs. 234+/-16 mmHg; p<0.05) values achieved during exercise. The increase in systolic BP during resistance exercise was similar between FPP and intra-arterial (+73+/-29 vs. +71+/-18 mmHg; p=0.59). Diastolic BP values and increases were lower with FPP. In conclusion, FPP provides similar values of BP increment during resistance exercise than intra-arterial method. However, it overestimates by 2.6+/-6.1% the maximal systolic BP achieved during this mode of exercise and underestimates by 8.8+/-5.8% the maximal diastolic BP.

  18. Breathing-control lowers blood pressure.

    PubMed

    Grossman, E; Grossman, A; Schein, M H; Zimlichman, R; Gavish, B

    2001-04-01

    We hypothesise that routinely applied short sessions of slow and regular breathing can lower blood pressure (BP). Using a new technology BIM (Breathe with Interactive Music), hypertensive patients were guided towards slow and regular breathing. The present study evaluates the efficacy of the BIM in lowering BP. We studied 33 patients (23M/10F), aged 25-75 years, with uncontrolled BP. Patients were randomised into either active treatment with the BIM (n = 18) or a control treatment with a Walkman (n = 15). Treatment at home included either musically-guided breathing exercises with the BIM or listening to quiet music played by a Walkman for 10 min daily for 8 weeks. BP and heart rate were measured both at the clinic and at home with an Omron IC BP monitor. Clinic BP levels were measured at baseline, and after 4 and 8 weeks of treatment. Home BP measurements were taken daily, morning and evening, throughout the study. The two groups were matched by initial BP, age, gender, body mass index and medication status. The BP change at the clinic was -7.5/-4.0 mm Hg in the active treatment group, vs -2.9/-1.5 mm Hg in the control group (P = 0.001 for systolic BP). Analysis of home-measured data showed an average BP change of -5.0/-2.7 mm Hg in the active treatment group and -1.2/+0.9 mm Hg in the control group. Ten out of 18 (56%) were defined as responders in the active treatment group but only two out of 14 (14%) in the control group (P = 0.02). Thus, breathing exercise guided by the BIM device for 10 min daily is an effective non-pharmacological modality to reduce BP.

  19. [Blood pressure measurement and screening of hypertension in children].

    PubMed

    Chiolero, Arnaud; Burnier, Michel; Paradis, Gilles; Paccaud, Fred; Bovet, Pascal

    2008-09-10

    Children with elevated blood pressure are at risk of being hypertensive in adulthood and of developing complications such as ventricular hypertrophy. Obesity is a cause of hypertension. Because the prevalence of obesity is increasing, some authors argue that the systematic screening for hypertension in children and adolescents is justified for early prevention and treatment. Sex, age and height all influence children's blood pressure. When elevated blood pressure is identified, complementary investigations and treatment might be necessary. However, due to the difficulties of obtaining a valid estimate of blood pressure, to the moderate tracking of blood pressure from childhood to adulthood, and the rarity of hypertension cases in childhood, the usefulness of systematic screening of hypertension during childhood is still controversial.

  20. Blood pressure in Tokelauan children in two contrasting environments.

    PubMed

    Beaglehole, R; Eyles, E; Salmond, C; Prior, I

    1978-10-01

    To assess the influence of the environment on blood pressure levels in children, the patterns of blood pressure in Tokelauan children resident in the isolated atolls of Tokelau and in New Zealand are compared. Blood pressure was measured twice by one observer using a random zero sphygmomanometer on 571 (96% response) Tokelauan children resident on the atolls and on 856 (95% response) Tokelauan children resident in New Zealand. After adjusting for cuff size and controlling for age, weight and height, the systolic blood pressure of New Zealand resident children was found to be significantly higher in boys of all ages and in girls under the age of eight. The difference does not appear to be due to selective migration; the association of the heavier weight of the New Zealand resident children with part of this blood pressure difference may be important from a preventive viewpoint.

  1. A Ubiquitous Blood Pressure Sensor Worn at the Ear

    NASA Astrophysics Data System (ADS)

    Koizumi, Hiroshi; Shimada, Junichi; Uenishi, Yuji; Tochikubo, Osamu

    2009-12-01

    Blood pressure (BP) measurement and BP control are important for the prevention of lifestyle diseases, especially hypertension, which can lead to more serious conditions, such as cardiac infarction and cerebral apoplexy. The purpose of our study is to develop a ubiquitous blood pressure sensor that is more comfortable and less disruptive of users' daily activities than conventional blood pressure sensors. Our developed sensor is worn at an ear orifice and measures blood pressure at the tragus. This paper describes the concept, configuration, and the optical and electronic details of the developed ear-worn blood pressure sensor and presents preliminary evaluation results. The developed sensor causes almost no discomfort and produces signals whose quality is high enough for detecting BP at an ear, making it suitable for ubiquitous usage.

  2. Raised intracranial pressure and cerebral blood flow. 5. Effects of episodic intracranial pressure waves in primates.

    PubMed Central

    Johnston, I H; Rowan, J O; Park, D M; Rennie, M J

    1975-01-01

    The effects of episodic waves of intracranial pressure on cerebral blood flow were studied in primates. Six pressure waves each of 20 minutes' duration and ranging from 50 to 100 mmHg in magnitude were induced in baboons, at intervals of 30 minutes, in an attempt to simulate clinical plateau waves. With pressure waves up to 75 mmHg, cerebral blood flow remained at control levels despite falling cerebral perfusion pressures. Between the initial pressure waves a marked hyperaemia developed, with cerebral blood flow increasing by as much as 100%, and this appeared to be a means whereby adequate flow was maintained during pressure waves. Later pressure waves, up to 100 mmHg, eventually reduced blood flow below control levels, although moderately high flows were maintained during periods of very low perfusion pressure. Brain metabolism was affected by eht episodic pressure waves, although no consistent change was seen. Images PMID:812960

  3. Body mass index modulates blood pressure heritability: the Family Blood Pressure Program.

    PubMed

    Simino, Jeannette; Shi, Gang; Weder, Alan; Boerwinkle, Eric; Hunt, Steven C; Rao, Dabeeru C

    2014-04-01

    Candidate gene and twin studies suggest that interactions between body mass index (BMI) and genes contribute to the variability of blood pressure (BP). To determine whether there is evidence for gene-BMI interactions, we investigated the modulation of BP heritability by BMI using 4,153 blacks, 1,538 Asians, 4,013 whites, and 2,199 Hispanic Americans from the Family Blood Pressure Program. To capture the BP heritability dependence on BMI, we employed a generalized variance components model incorporating linear and Gaussian interactions between BMI and the genetic component. Within each race and network subgroup, we used the Akaike information criterion and likelihood ratio test to select the appropriate interaction function for each BP trait (systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)) and determine interaction significance, respectively. BP heritabilities were significantly modified by BMI in the GenNet and SAPPHIRe Networks, which contained the youngest and least-obese participants, respectively. GenNet Whites had unimodal SBP, MAP, and PP heritabilities that peaked between BMI values of 33 and 37kg/m(2). The SBP and MAP heritabilities in GenNet Hispanic Americans, as well as the PP heritability in GenNet blacks, were increasing functions of BMI. The DBP and SBP heritabilities in the SAPPHIRe Chinese and Japanese, respectively, were decreasing functions of BMI. BP heritability differed by BMI in the youngest and least-obese networks, although the shape of this dependence differed by race. Use of nonlinear gene-BMI interactions may enhance BP gene discovery efforts in individuals of European ancestry.

  4. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring: The GUSTO Birth Cohort Study.

    PubMed

    Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Lek, Ngee; Meaney, Michael; Gluckman, Peter D; Godfrey, Keith M; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

    2015-11-01

    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 = 0.35), and 0.05 (-0

  5. [Relationship between occupational stress and blood glucose, blood lipid, blood pressure of video display terminal operators].

    PubMed

    Zhang, Xing; Song, Hui; Chen, Nan; Liu, He-rong; Zhu, Ling-qin; Zhang, Zhen-xiang; Wang, Ling

    2007-03-01

    To explore the relationship between occupational stress and blood glucose, Blood lipid and blood pressure. 108 video display terminals(VDT) operators who had the working experience were recruited to the study. The occupational stress indicator (OSI), the lever of blood glucose, cholesterol, triglyceride, lipoprotein of high density and lipoprotein of low density in serum were measured by using GOD-PAP, CHOD-PAP, GPO-PAP and PVS. The subjects were classified into three groups according to the score of occupational stress. The contents of blood glucose of low, middle and high level of stress groups were (3.39 +/- 1.24), (3.59 +/- 1.26), (2.54 +/- 0.94) mmol/L respectively (F = 7.324, P < 0.01), and with the increase of level of stress, the content of blood glucose decreased significantly (r = -0.376, P < 0.01). The level of blood glucose of VDT operators is affected by occupational stress, among video display terminals and it can be used as the index for estimating occupational stress.

  6. Diagnostic use of ambulary blood pressure monitoring in medical practice.

    PubMed

    McCall, W C; McCall, V R

    1981-07-01

    This paper covers the use of a long-term, ambulatory, indirect blood pressure monitoring device in a series of sequentially selected, consenting patients exhibiting an office blood pressure of 140/90 mmGh or greater. Of the 62 patients reported, 32 percent were found to have randomly elevated pressures neither requiring treatment or labeling as hypertensive. The Pressurometer III (Del Mar Avionics) offers a major improvement in the diagnosis of hypertension.

  7. A Discussion on the Regulation of Blood Flow and Pressure.

    PubMed

    Wolff, Christopher B; Collier, David J; Shah, Mussadiq; Saxena, Manish; Brier, Timothy J; Kapil, Vikas; Green, David; Lobo, Melvin

    2016-01-01

    This paper discusses two kinds of regulation essential to the circulatory system: namely the regulation of blood flow and that of (systemic) arterial blood pressure. It is pointed out that blood flow requirements sub-serve the nutritional needs of the tissues, adequately catered for by keeping blood flow sufficient for the individual oxygen needs. Individual tissue oxygen requirements vary between tissue types, while highly specific for a given individual tissue. Hence, blood flows are distributed between multiple tissues, each with a specific optimum relationship between the rate of oxygen delivery (DO2) and oxygen consumption (VO2). Previous work has illustrated that the individual tissue blood flows are adjusted proportionately, where there are variations in metabolic rate and where arterial oxygen content (CaO2) varies. While arterial blood pressure is essential for the provision of a sufficient pressure gradient to drive blood flow, it is applicable throughout the arterial system at any one time. Furthermore, It is regulated independently of the input resistance to individual tissues (local arterioles), since they are regulated locally, that being the means by which the highly specific adequate local requirement for DO2 is ensured. Since total blood flow is the summation of all the individually regulated tissue blood flows cardiac inflow (venous return) amounts to total tissue blood flow and as the heart puts out what it receives cardiac output is therefore determined at the tissues. Hence, regulation of arterial blood pressure is independent of the distributed independent regulation of individual tissues. It is proposed here that mechanical features of arterial blood pressure regulation will depend rather on the balance between blood volume and venous wall tension, determinants of venous pressure. The potential for this explanation is treated in some detail.

  8. Exercise: A Drug-Free Approach to Lowering High Blood Pressure

    MedlinePlus

    ... pressure — the top number in a blood pressure reading — by an average of 4 to 9 millimeters ... is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor's ...

  9. Direct measurement of capillary blood pressure in the human lip

    NASA Technical Reports Server (NTRS)

    Parazynski, S. E.; Tucker, B. J.; Aratow, M.; Crenshaw, A.; Hargens, A. R.

    1993-01-01

    In this study, we developed and tested a new procedure for measuring microcirculatory blood pressures above heart level in humans. Capillary and postcapillary venule blood pressures were measured directly in 13 human subjects by use of the servonulling micropressure technique adapted for micropuncture of lip capillaries. Pressure waveforms were recorded in 40 separate capillary vessels and 14 separate postcapillary venules over periods ranging from 5 to 64 s. Localization and determination of capillary and postcapillary vessels were ascertained anatomically before pressure measurements. Capillary pressure was 33.2 +/- 1.5 (SE) mm Hg in lips of subjects seated upright. Repeated micropunctures of the same vessel gave an average coefficient of variation of 0.072. Postcapillary venule pressure was 18.9 +/- 1.6 mm Hg. This procedure produces a direct and reproducible means of measuring microvascular blood pressures in a vascular bed above heart level in humans.

  10. Direct measurement of capillary blood pressure in the human lip

    NASA Technical Reports Server (NTRS)

    Parazynski, S. E.; Tucker, B. J.; Aratow, M.; Crenshaw, A.; Hargens, A. R.

    1993-01-01

    In this study, we developed and tested a new procedure for measuring microcirculatory blood pressures above heart level in humans. Capillary and postcapillary venule blood pressures were measured directly in 13 human subjects by use of the servonulling micropressure technique adapted for micropuncture of lip capillaries. Pressure waveforms were recorded in 40 separate capillary vessels and 14 separate postcapillary venules over periods ranging from 5 to 64 s. Localization and determination of capillary and postcapillary vessels were ascertained anatomically before pressure measurements. Capillary pressure was 33.2 +/- 1.5 (SE) mm Hg in lips of subjects seated upright. Repeated micropunctures of the same vessel gave an average coefficient of variation of 0.072. Postcapillary venule pressure was 18.9 +/- 1.6 mm Hg. This procedure produces a direct and reproducible means of measuring microvascular blood pressures in a vascular bed above heart level in humans.

  11. A longitudinal evaluation of blood pressure in children.

    PubMed Central

    Levine, R S; Hennekens, C H; Klein, B; Ferrer, P L; Gourley, J; Cassady, J; Gelband, H; Jesse, M J

    1979-01-01

    Blood pressure levels obtained on two occasions, one year apart, were evaluated among 212 children. An overall correlation of .65 was obtained for systolic pressure and .43 for diastolic pressure. The results suggest that adult levels of correlation are not reached in childhood and that screening programs must consider the relative lability of children's measurements in establishing referral criteria. PMID:507251

  12. Nighttime blood pressure, systolic blood pressure variability, and left ventricular mass index in children with hypertension.

    PubMed

    Sharma, Ajay P; Mohammed, Javed; Thomas, Benson; Lansdell, Nathan; Norozi, Kambiz; Filler, Guido

    2013-08-01

    Nighttime blood pressure (BP) and systolic BP variability on ambulatory blood pressure monitoring (ABPM) have been strongly associated with target-organ damage in hypertensive adults. The clinical relevance of these variables in children with hypertension remains under-studied. The study group included children aged 5-18 years old referred to the outpatient nephrology clinic for an elevated casual BP who underwent an ABPM and echocardiography (ECHO) study and did not have secondary hypertension. The interpretation of ABPM parameters and left ventricular mass index (LVMI) was based on normative references. Seventy-two children fulfilled the inclusion criteria. The association of various potential predictors including age, BMI z-score, casual BP z-score and ABPM parameters (BP z-score, BP load, nocturnal dipping and BP variability- within-subject standard deviation (SD) of BP) with LVMI was analyzed. On adjusted regression analysis, nighttime systolic BP load [standardized regression coefficient (β) 0.23; p < 0.05] and daytime systolic BP variability (β 0.37; p < 0.05) had significant association with LVMI. In children with primary hypertension, nighttime systolic BP load and daytime systolic BP variability had a stronger association with LVMI than casual BP and other ABPM parameters. Future longitudinal studies are needed to establish the causality among these variables.

  13. Clinical significance of home blood pressure measurements for the prevention and management of high blood pressure.

    PubMed

    Imai, Yutaka; Hosaka, Miki; Elnagar, Noha; Satoh, Michihiro

    2014-01-01

    1. Ambulatory blood pressure (ABP) monitoring (M) provides BP information at many points on any particular day during unrestricted routine daily activities, whereas home blood pressure (HBP) monitoring provides a lot of BP information obtained under fixed times and conditions over a long period of time, thus mean values of HBP provide high reproducibility, and thus an overall superiority compared with ABP.  2. HBP is at least equally or better able than ABP to predict hypertensive target organ damage and prognosis of cardiovascular disease.  3. HBPM allows for ongoing disease monitoring by patients, improves adherence to antihypertensive treatment, and can provide health-care providers with timely clinical data and direct and immediate feedback regarding diagnosis and treatment of hypertension.  4. HBPM provides BP information in relation to time; that is, BP in the morning, in the evening and at night during sleep, and it is an essential tool for the diagnosis of white-coat and masked hypertension.  5. HBPM yields minimal alerting affects and no or minimal placebo effect, and can therefore distinguish small, but significant, serial changes in BP. It is thus the most practical method for monitoring BP in the day-to-day management of hypertension. 6. The superiority of HBPM over ABPM and clinic BPM is apparent from almost all practical and clinical research perspectives. © 2013 Wiley Publishing Asia Pty Ltd.

  14. Automatic noninvasive measurement of systolic blood pressure using photoplethysmography

    PubMed Central

    Nitzan, Meir; Patron, Amikam; Glik, Zehava; Weiss, Abraham T

    2009-01-01

    Background Automatic measurement of arterial blood pressure is important, but the available commercial automatic blood pressure meters, mostly based on oscillometry, are of low accuracy. Methods In this study, we present a cuff-based technique for automatic measurement of systolic blood pressure, based on photoplethysmographic signals measured simultaneously in fingers of both hands. After inflating the pressure cuff to a level above systolic blood pressure in a relatively slow rate, it is slowly deflated. The cuff pressure for which the photoplethysmographic signal reappeared during the deflation of the pressure-cuff was taken as the systolic blood pressure. The algorithm for the detection of the photoplethysmographic signal involves: (1) determination of the time-segments in which the photoplethysmographic signal distal to the cuff is expected to appear, utilizing the photoplethysmographic signal in the free hand, and (2) discrimination between random fluctuations and photoplethysmographic pattern. The detected pulses in the time-segments were identified as photoplethysmographic pulses if they met two criteria, based on the pulse waveform and on the correlation between the signal in each segment and the signal in the two neighboring segments. Results Comparison of the photoplethysmographic-based automatic technique to sphygmomanometry, the reference standard, shows that the standard deviation of their differences was 3.7 mmHg. For subjects with systolic blood pressure above 130 mmHg the standard deviation was even lower, 2.9 mmHg. These values are much lower than the 8 mmHg value imposed by AAMI standard for automatic blood pressure meters. Conclusion The photoplethysmographic-based technique for automatic measurement of systolic blood pressure, and the algorithm which was presented in this study, seems to be accurate. PMID:19857254

  15. [The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document].

    PubMed

    Leal-Noval, S R; Muñoz, M; Asuero, M; Contreras, E; García-Erce, J A; Llau, J V; Moral, V; Páramo, J A; Quintana, M; Basora, M; Bautista-Paloma, F J; Bisbe, E; Bóveda, J L; Castillo-Muñoz, A; Colomina, M J; Fernández, C; Fernández-Mondéjar, E; Ferrándiz, C; García de Lorenzo, A; Gomar, C; Gómez-Luque, A; Izuel, M; Jiménez-Yuste, V; López-Briz, E; López-Fernández, M L; Martín-Conde, J A; Montoro-Ronsano, B; Paniagua, C; Romero-Garrido, J A; Ruiz, J C; Salinas-Argente, R; Sánchez, C; Torrabadella, P; Arellano, V; Candela, A; Fernández, J A; Fernández-Hinojosa, E; Puppo, A

    2013-05-01

    Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: "Does this particular AABT reduce the transfusion rate or not?" All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  16. [The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document].

    PubMed

    Leal-Noval, S R; Muñoz, M; Asuero, M; Contreras, E; García-Erce, J A; Llau, J V; Moral, V; Páramo, J A; Quintana, M; Basora, M; Bautista-Paloma, F J; Bisbe, E; Bóveda, J L; Castillo-Muñoz, A; Colomina, M J; Fernández, C; Fernández-Mondéjar, E; Ferrándiz, C; García de Lorenzo, A; Gomar, C; Gómez-Luque, A; Izuel, M; Jiménez-Yuste, V; López-Briz, E; López-Fernández, M L; Martín-Conde, J A; Montoro-Ronsano, B; Paniagua, C; Romero-Garrido, J A; Ruiz, J C; Salinas-Argente, R; Sánchez, C; Torrabadella, P; Arellano, V; Candela, A; Fernández, J A; Fernández-Hinojosa, E; Puppo, A

    2013-05-01

    Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: « Does this particular AABT reduce the transfusion rate or not?» All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

  17. ‘Sausage-string’ deformations of blood vessels at high blood pressures

    NASA Astrophysics Data System (ADS)

    Alstrøm, P.; Mikkelsen, R.; Gustafsson, F.; Holstein-Rathlou, N.-H.

    1999-12-01

    A new instability is proposed to explain the ‘sausage-string’ patterns of alternating constrictions and dilatations formed in blood vessels at high blood pressure conditions. Our theory provides predictions for the conditions under which the cylindrical geometry of a blood vessel becomes unstable. The theory is related to experimental observations in rats, where high blood pressure is induced by intravenous infusion of angiotensin II.

  18. Geographical and socioeconomic distribution of high blood pressure and borderline high blood pressure in a Swedish rural county.

    PubMed

    Haglund, B J

    1985-01-01

    This report on "high" blood pressure (HBP) and "borderline high" blood pressure (BHBP) is based on a cross-sectional study in a rural Swedish county. The study was initiated in the Spring of 1977, selecting 7986 individuals aged 25-75 years, in 5-year intervals, in the 16 municipalities of Skaraborg County. A combination of health examination and a survey using polling of the population by interview was used. The blood pressure values that are presented are based on a casual measurement taken after a 5-minute rest period. The limits of HBP and BHBP correspond to the Swedish standard limits. Only a few researchers in Sweden have focused on the correlation between socioeconomic factors and hypertension. Moreover, few examinations have been made internationally concerning the correlation between socioeconomic factors and borderline hypertension. There was a significant variation in mean values of high blood pressure when comparing socioeconomic groups and comparing occupations. These differences associated with educational level were more pronounced for women than for men. Workers, especially men and persons with less formal education, had the highest mean blood pressure. Significant differences between socioeconomic groups existed even after adjustment for age, sex, weight index, smoking and treatment of hypertension. The socioeconomic differences constitute the most plausible explanation of differences seen between municipalities. "Borderline high" blood pressure was more prevalent than "high" blood pressure. Socioeconomic differences were greater within the borderline high blood pressure group than in the high blood pressure group. i.e., the differences between workers and civil servants were somewhat greater in the borderline high blood pressure group. Since there are socioeconomic differences, it might be possible to concentrate preventive activities in local communities on risk groups.

  19. Blood pressure in early autosomal dominant polycystic kidney disease.

    PubMed

    Schrier, Robert W; Abebe, Kaleab Z; Perrone, Ronald D; Torres, Vicente E; Braun, William E; Steinman, Theodore I; Winklhofer, Franz T; Brosnahan, Godela; Czarnecki, Peter G; Hogan, Marie C; Miskulin, Dana C; Rahbari-Oskoui, Frederic F; Grantham, Jared J; Harris, Peter C; Flessner, Michael F; Bae, Kyongtae T; Moore, Charity G; Chapman, Arlene B

    2014-12-11

    Hypertension is common in autosomal dominant polycystic kidney disease (ADPKD) and is associated with increased total kidney volume, activation of the renin-angiotensin-aldosterone system, and progression of kidney disease. In this double-blind, placebo-controlled trial, we randomly assigned 558 hypertensive participants with ADPKD (15 to 49 years of age, with an estimated glomerular filtration rate [GFR] >60 ml per minute per 1.73 m(2) of body-surface area) to either a standard blood-pressure target (120/70 to 130/80 mm Hg) or a low blood-pressure target (95/60 to 110/75 mm Hg) and to either an angiotensin-converting-enzyme inhibitor (lisinopril) plus an angiotensin-receptor blocker (telmisartan) or lisinopril plus placebo. The primary outcome was the annual percentage change in the total kidney volume. The annual percentage increase in total kidney volume was significantly lower in the low-blood-pressure group than in the standard-blood-pressure group (5.6% vs. 6.6%, P=0.006), without significant differences between the lisinopril-telmisartan group and the lisinopril-placebo group. The rate of change in estimated GFR was similar in the two medication groups, with a negative slope difference in the short term in the low-blood-pressure group as compared with the standard-blood-pressure group (P<0.001) and a marginally positive slope difference in the long term (P=0.05). The left-ventricular-mass index decreased more in the low-blood-pressure group than in the standard-blood-pressure group (-1.17 vs. -0.57 g per square meter per year, P<0.001); urinary albumin excretion was reduced by 3.77% with the low-pressure target and increased by 2.43% with the standard target (P<0.001). Dizziness and light-headedness were more common in the low-blood-pressure group than in the standard-blood-pressure group (80.7% vs. 69.4%, P=0.002). In early ADPKD, the combination of lisinopril and telmisartan did not significantly alter the rate of increase in total kidney volume. As

  20. Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Schrier, Robert W.; Abebe, Kaleab Z.; Perrone, Ronald D.; Torres, Vicente E.; Braun, William E.; Steinman, Theodore I.; Winklhofer, Franz T.; Brosnahan, Godela; Czarnecki, Peter G.; Hogan, Marie C.; Miskulin, Dana C.; Rahbari-Oskoui, Frederic F.; Grantham, Jared J.; Harris, Peter C.; Flessner, Michael F.; Bae, Kyongtae T.; Moore, Charity G.; Chapman, Arlene B.

    2015-01-01

    BACKGROUND Hypertension is common in autosomal dominant polycystic kidney disease (ADPKD) and is associated with increased total kidney volume, activation of the renin–angiotensin–aldosterone system, and progression of kidney disease. METHODS In this double-blind, placebo-controlled trial, we randomly assigned 558 hypertensive participants with ADPKD (15 to 49 years of age, with an estimated glomerular filtration rate [GFR] >60 ml per minute per 1.73 m2 of body-surface area) to either a standard blood-pressure target (120/70 to 130/80 mm Hg) or a low blood-pressure target (95/60 to 110/75 mm Hg) and to either an angiotensin-converting–enzyme inhibitor (lisinopril) plus an angiotensin-receptor blocker (telmisartan) or lisinopril plus placebo. The primary outcome was the annual percentage change in the total kidney volume. RESULTS The annual percentage increase in total kidney volume was significantly lower in the low-blood-pressure group than in the standard-blood-pressure group (5.6% vs. 6.6%, P = 0.006), without significant differences between the lisinopril–telmisartan group and the lisinopril–placebo group. The rate of change in estimated GFR was similar in the two medication groups, with a negative slope difference in the short term in the low-blood-pressure group as compared with the standard-blood-pressure group (P<0.001) and a marginally positive slope difference in the long term (P = 0.05). The left-ventricular-mass index decreased more in the low-blood-pressure group than in the standard-blood-pressure group (−1.17 vs. −0.57 g per square meter per year, P<0.001); urinary albumin excretion was reduced by 3.77% with the low-pressure target and increased by 2.43% with the standard target (P<0.001). Dizziness and light-headedness were more common in the low-blood-pressure group than in the standard-blood-pressure group (80.7% vs. 69.4%, P = 0.002). CONCLUSIONS In early ADPKD, the combination of lisinopril and telmisartan did not significantly

  1. Threshold and Target for Blood Pressure Lowering in the Elderly.

    PubMed

    Grassi, Guido; Quarti-Trevano, Fosca; Casati, Anna; Dell'Oro, Raffaella

    2016-12-01

    Detection of elevated blood pressure values in elderly patients represents a common clinical condition associated with an increased cardiovascular risk. This has been shown to be the case in both systodiastolic and isolated systolic hypertension as well. However, despite the evidence of the benefits of the blood pressure lowering intervention in terms of reduction of cardiovascular morbidity and mortality, at least two issues related to antihypertensive drug treatment in aged individuals are still undefined: (1) the blood pressure threshold at which antihypertensive drug should be initiated and (2) the blood pressure goals of the therapeutic intervention. The present paper will critically review the evidence available so far on these two issues as well as the position of current guidelines and consensus statements. Emphasis will be given to the analysis of the new data of the Systolic Blood Pressure Interventional Trial (SPRINT), which have recently demonstrated the benefits, even in individuals aged more than 75 years, of a tight blood pressure reduction to systolic blood pressure to 120 mmHg or less. The potential limitations of the trial will be also critically addressed and the expectations of ongoing clinical studies investigating the issue in elderly patients properly emphasized. Although of interest, the results of the SPRINT trial encompass a number of limitations which limit their applicability to the general elderly hypertensive population. A prudent approach will be to adopt in clinical practice the less intensive and more conservative targets recommended by current guidelines.

  2. John Henryism and blood pressure among Nigerian civil servants

    PubMed Central

    Markovic, N.; Bunker, C. H.; Ukoli, F. A.; Kuller, L. H.

    1998-01-01

    STUDY OBJECTIVE: Among urban Nigerian civil servants, higher socioeconomic status is related to increased blood pressure. In the United States, the relation between increased blood pressure and low socioeconomic status or low level of education has been found to be potentiated by high effort active coping (John Henryism) among African- Americans. Thus, the potentiating effect of high effort active coping as measured by the John Henryism Active Coping Scale, on socioeconomic status, as measured by job grade, was considered in relation to blood pressure in a Nigerian civil servant population. DESIGN: The influence of John Henryism on the association between educational level or socioeconomic status and increased blood pressure was examined during a comprehensive blood pressure survey. John Henryism refers to a strong behavioural predisposition to actively cope with psychosocial environmental stressors. SETTING: Benin City, Nigeria. PARTICIPANTS: Nigerian civil servant sample of 658 adults, aged 20 to 65 years. MAIN RESULTS: Among those with high John Henryism scores of upper socioeconomic status, whether measured by education level or job grade, there was a trend toward higher systolic and diastolic blood pressures, adjusted for age and body mass index, in men and women, though not statistically significant. CONCLUSIONS: This trend is consistent with recent findings of increased blood pressure among women and African- Americans with high John Henryism and high status jobs.   PMID:9616424

  3. Factors influencing validation of ambulatory blood pressure measuring devices.

    PubMed

    O'Brien, E; Atkins, N; Staessen, J

    1995-11-01

    With the introduction of 24 h ambulatory blood pressure monitoring into clinical practice a vast market for ambulatory blood pressure monitoring devices has been created. To satisfy this market manufacturers are producing an array of ambulatory blood pressure monitoring devices. There is no obligation on manufacturers to have such devices validated independently, even though two national protocols, one from the British Hypertension Society (BHS) and the other from the Association for the Advancement of Medical Instrumentation (AAMI), call for independent validation and state the means of doing so. However, many factors can influence the validation procedure. They include compliance to the protocol being employed; the accuracy of the standard; establishing precisely the model being validated; the influences of blood pressure level, age and exercise on device accuracy; the provisions necessary for special populations, such as pregnant women, the elderly and children; the influence of oscillometric versus Korotkoff sound detection and electrocardiographic gating on comparative measurements; the assessment of performance as distinct from accuracy; and the relevance of general factors, such as the algorithm being employed and computer compatibility. Forty-three ambulatory blood pressure monitoring devices have been marketed for ambulatory blood pressure measurement and of those only 18 have been validated according to either the BHS or the AAMI protocol. The influence of the factors listed above on the validation studies of those devices will be considered and the relevance of validation procedures to the clinical use of ambulatory blood pressure monitoring devices will be discussed.

  4. [Breast feeding and systemic blood pressure in infants].

    PubMed

    Hernández-González, Martha A; Díaz-De-León, Luz V; Guízar-Mendoza, Juan M; Amador-Licona, Norma; Cipriano-González, Marisol; Díaz-Pérez, Raúl; Murillo-Ortiz, Blanca O; De-la-Roca-Chiapas, José María; Solorio-Meza, Sergio Eduardo

    2012-01-01

    Blood pressure levels in childhood influence these levels in adulthood, and breastfeeding has been considered such as a cardioprotective. We evaluated the association between blood pressure levels and feeding type in a group of infants. We conducted a comparative cross-sectional study in term infants with appropriate weight at birth, to compare blood pressure levels in those children with exclusively breastfeeding, mixed-feeding and formula feeding. The comparison of groups was performed using ANOVA and multiple regression analysis was used to identify variables associated with mean arterial blood pressure levels. A p value < 0.05 was considered significant. We included 20 men and 24 women per group. Infant Formula Feeding had higher current weight and weight gain compared with the other two groups (p < 0.05). Systolic, diastolic and mean blood pressure levels, as well as respiratory and heart rate were higher in the groups of exclusively formula feeding and mixed-feeding than in those with exclusively breastfeeding (p < 0.05). Multiple regression analysis identified that variables associated with mean blood pressure levels were current body mass index, weight gain and formula feeding. Infants in breastfeeding show lower blood pressure, BMI and weight gain.

  5. Grandparental education, parental education and adolescent blood pressure.

    PubMed

    Kwok, Man Ki; Schooling, C Mary; Leung, Gabriel M; Subramanian, Subu V

    2016-09-01

    Maternal and paternal education could affect childhood blood pressure differently. Grandparental education might also play a role. Disentangling their contribution to childhood blood pressure may shed light on the persistence of disparities and potential windows of intervention. Using 5604 participants from a Chinese birth cohort born in 1997 and followed-up until ~13years (68% of follow-up), we examined the associations of parental education and grandparental education with age-, sex, and height-specific blood pressure z-scores or prehypertension status. Parental education was inversely associated with adolescent systolic (-0.11 z-score, equivalent to -1.17mmHg, 95% confidence interval (CI) -0.19 to -0.04 for grade ≥12 compared with grade ≤9) and diastolic blood pressure (-0.07 z-score, equivalent to -0.79mmHg, 95% CI -0.11 to -0.04). The magnitude of association was similar for maternal or paternal education. Grandparental education was not associated with adolescent blood pressure. No association with prehypertension was found. In an economically developed non-Western setting, both maternal and paternal, but not grandparental, education was associated with adolescent blood pressure. Blood pressure may be responsive to contemporary family socioeconomic conditions that may be scrutinized for suitable interventions. Copyright © 2016. Published by Elsevier Inc.

  6. Organ-specificity of placebo effects on blood pressure.

    PubMed

    Meissner, Karin; Ziep, Dagmar

    2011-10-28

    There is increasing evidence that verbal suggestions accompanying placebo interventions can alter autonomic functions. The underlying mechanisms of these changes are not well understood. However, previous studies point at the specificity of such effects. The aim of the experiment was to lower blood pressure by a placebo intervention and to investigate the specificity of autonomic changes. Forty-five healthy participants received a single administration of an active drug (a homeopathic remedy), an identically-looking placebo drug, or no drug. Active drugs and placebo drugs were administered in a double-blind design and were accompanied by verbal suggestions of a blood-pressure lowering effect. Systolic and diastolic blood pressure, the electrocardiogram, electrodermal activity, and the electrogastrogram were recorded during 30min before and after the intervention, and changes in situational anxiety were assessed. Results indicated a decrease of systolic blood pressure in the placebo group, as compared to the control group. Diastolic blood pressure levels, heart rate, respiratory sinus arrhythmia, skin conductance, gastric slow-wave frequency and situational anxiety did not change differentially between groups. In conclusion, the reduction in systolic blood pressure following the placebo intervention could not be attributed to stress relief or anxiety reduction. Rather, results suggest that the placebo intervention specifically reduced systolic blood pressure. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Blood pressure change with age in salt-sensitive teenagers.

    PubMed

    Ye, Tao; Liu, Zhi-quan; Mu, Jian-jun; Fu, Xi-han; Yang, Jun; Gao, Bao-lin; Zhang, Xiao-hong

    2004-12-01

    To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing. Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years. After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7 +/- 12.1 mmHg vs. 2.8 +/- 5.2 mmHg, P < 0.01; 12.2% +/- 12.0% vs. 2.5% +/- 4.4%, P < 0.001, respectively). There was a similar trend for diastolic blood pressure (8.4 +/- 6.4 mmHg vs. 3.7 +/- 6.4 mmHg, P = 0.052; 13.2% +/- 10.6% vs. 6.8% +/- 10.1%, P = 0.053, respectively). Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.

  8. Effect of Calcitriol Supplementation on Blood Pressure in Older Adults.

    PubMed

    Bricio-Barrios, Jaime Alberto; Palacios-Fonseca, Alín Jael; Del Toro-Equihua, Mario; Sanchez-Ramirez, Carmen Alicia

    2016-01-01

    Recent studies suggest that vitamin D plays an important role in the control of blood pressure. Unfortunately, because older adults are more likely to have low 25-hydroxyvitamin-D [25(OH)D] levels, this study investigated whether calcitriol supplementation reduces blood pressure in older adults with hypertension. The design was a double-blind placebo-controlled randomized clinical trial with 36 randomly assigned subjects (71.7 ± 10 years). Blood pressure and serum levels of 25(OH)D before and after calcitriol intervention (1,000 IU daily for 6 weeks; n = 22) or placebo (n = 23) for 6 weeks were analyzed. At the end of the study, the calcitriol group presented a significant decrease of systolic blood pressure [20.25 mmHg (p = 0.001)] and diastolic blood pressure [7 mmHg (p = 0.01)], compared with the placebo group. In conclusion, 1,000 IU/day of calcitriol for 6 weeks efficiently reduced systolic and diastolic blood pressure levels in this population of older adults presenting with high blood pressure (Clinical Trial Approbation NCT02047799).

  9. A prediction model of blood pressure for telemedicine.

    PubMed

    Kwong, Enid Wai-Yung; Wu, Hao; Pang, Grantham Kwok-Hung

    2016-08-04

    This paper presents a new study based on a machine learning technique, specifically an artificial neural network, for predicting systolic blood pressure through the correlation of variables (age, BMI, exercise level, alcohol consumption level, smoking status, stress level, and salt intake level). The study was carried out using a database containing a variety of variables/factors. Each database of raw data was split into two parts: one part for training the neural network and the remaining part for testing the performance of the network. Two neural network algorithms, back-propagation and radial basis function, were used to construct and validate the prediction system. According to the experiment, the accuracy of our predictions of systolic blood pressure values exceeded 90%. Our experimental results show that artificial neural networks are suitable for modeling and predicting systolic blood pressure. This new method of predicting systolic blood pressure helps to give an early warning to adults, who may not get regular blood pressure measurements that their blood pressure might be at an unhealthy level. Also, because an isolated measurement of blood pressure is not always very accurate due to daily fluctuations, our predictor can provide the predicted value as another figure for medical staff to refer to. © The Author(s) 2016.

  10. Aerobic exercise reduces blood pressure in resistant hypertension.

    PubMed

    Dimeo, Fernando; Pagonas, Nikolaos; Seibert, Felix; Arndt, Robert; Zidek, Walter; Westhoff, Timm H

    2012-09-01

    Regular physical exercise is broadly recommended by current European and American hypertension guidelines. It remains elusive, however, whether exercise leads to a reduction of blood pressure in resistant hypertension as well. The present randomized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension. Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents. Fifty subjects with resistant hypertension were randomly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program (target lactate, 2.0±0.5 mmol/L). Blood pressure was assessed by 24-hour monitoring. Arterial compliance and cardiac index were measured by pulse wave analysis. The training program was well tolerated by all of the patients. Exercise significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg, respectively (P=0.03 each). Regular exercise reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves. Arterial compliance and cardiac index remained unchanged. Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment. It should be included in the therapeutic approach to resistant hypertension.

  11. Nutritional status and blood pressure in adolescent students.

    PubMed

    Cossio-Bolaños, Marco; Cossio-Bolaños, Wilbert; Menacho, Adriana Araya; Gómez Campos, Rossana; Silva, Yuri Muniz da; Abella, Carlos Pablos; de Arruda, Miguel

    2014-08-01

    Obesity is the main risk factor for arterial hypertension andis associatedwitha higher morbidity, both in the short and long term. To compare anthropometric and blood pressure indicators in terms of the nutritional status, to verify the relationship between nutritional status and blood pressure, and to establish the prevalence of hypertension in terms of the nutritional status in both male and female adolescents. Cross-sectional, descriptive study on 499 adolescent students aged 11-15 years old. Weight, height, body mass index (BMI), fat percentage, and blood pressure were measured and assessed. The BMI was used to classify participants (normal weight, overweight, obese), and the prevalence of hypertension was determined using values above the 95th percentile. As per the BMI classification, 81% of girls and 76.5% ofboys had normal weight, 15.7% of girls and 15.5% of boys were overweight, and 3.3% of girls and 8% of boys were obese. As per the blood pressure classification, hypertension was observed in 6.4% of boys and in 9% of girls. A relationship was found between nutritional status and blood pressure (boys: c2= 53.48; girls: c2= 85.21). Overweight and obese adolescents had more body fat and a higher blood pressure than normal weight adolescents. Also, a relationship was determined betweennutritional status and blood pressure in both male and female students. The higher the BMI, the higher the prevalence of hypertension.

  12. Coffee, caffeine and blood pressure: a critical review.

    PubMed

    Nurminen, M L; Niittynen, L; Korpela, R; Vapaatalo, H

    1999-11-01

    We review the published data relating to intake of coffee and caffeine on blood pressure in man. We also refer to studies on the possible mechanisms of actions of these effects of caffeine. The MEDLINE and Current Contents databases were searched from 1966 to April 1999 using the text words 'coffee or caffeine' and 'blood pressure or hypertension'. Controlled clinical and epidemiologic studies on the blood pressure effects of coffee or caffeine are reviewed. We also refer to studies on the possible mechanisms of action of these effects of caffeine. Acute intake of coffee and caffeine increases blood pressure. Caffeine is probably the main active component in coffee. The pressor response is strongest in hypertensive subjects. Some studies with repeated administration of caffeine showed a persistent pressor effect, whereas in others chronic caffeine ingestion did not increase blood pressure. Epidemiologic studies have produced contradictory findings regarding the association between blood pressure and coffee consumption. During regular use tolerance to the cardiovascular responses develops in some people, and therefore no systematic elevation of blood pressure in long-term and in population studies can be shown. We conclude that regular coffee may be harmful to some hypertension-prone subjects. The hemodynamic effects of chronic coffee and caffeine consumption have not been sufficiently studied. The possible mechanisms of the cardiovascular effects of caffeine include the blocking of adenosine receptors and the inhibition of phosphodiesterases.

  13. Dark chocolate and blood pressure: a novel study from Jordan.

    PubMed

    Al-Safi, Saafan A; Ayoub, Nehad M; Al-Doghim, Imad; Aboul-Enein, Faisal H

    2011-11-01

    The goal of this study was to assess the effect of dark chocolate intake on cardiovascular parameters like blood pressure and heart rate values in a normotensive population. This is a randomized cross-sectional study involving a total of 14,310 adults that were selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in the outpatient settings. Participants reported their weekly intake of dark chocolate that has been further classified into mild (1-2 bars/week), moderate (3-4 bars/week), and high intake ( > 4 bars/week). For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured three times with (10-15) minute intervals in the sitting position and the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP values. All measured blood pressure values were significantly decreased for participants who reported higher dark chocolate consumption. Our results showed that heart rate values were not affected by variable intake of dark chocolate. In addition, increasing dark chocolate intake was associated with a significant decrease of blood pressure values in participants irrespective of the family history of hypertension or the age of the individual. However, heart rate values were unaffected. Higher intake of dark chocolate can be associated with lower values of blood pressure, while its effect on heart rate values was not consistent.

  14. Tobacco exposure, weight status, and elevated blood pressure in adolescents.

    PubMed

    Huntington-Moskos, Luz; Turner-Henson, Anne; Rice, Marti

    2014-08-01

    The pathogenesis of hypertension begins in youth. An estimated 4% of US adolescents have diagnosed hypertension and 17% have elevated blood pressures, predisposing them to hypertension and cardiovascular disease (CVD) later in life. There is limited research on the clustering of CVD risk factors such as tobacco exposure and weight status that may be associated with high blood pressure in adolescents. The aim of this exploratory study was to determine the relationships between total smoke exposure (TSE; cigarette smoking and secondhand smoke), waist circumference, and blood pressure in a sample of rural adolescents, ages 15-18. A convenience sample of 148 adolescents ages 15-18 was recruited from two rural high schools (88 female and 60 male, all Caucasian). Adolescents were assessed for tobacco exposure (self-report, salivary cotinine), weight status (body mass index, waist circumference), and blood pressure. Self-report measures of tobacco exposure included the Uptake Continuum and Peer and Family Smoking measure. Age, gender, waist circumference and salivary cotinine contributed to 35% of the variance in systolic blood pressure and 18% in diastolic blood pressure. One-fourth (25%) of adolescent males and 11% of adolescent females had elevated systolic blood pressures. Approximately one-fifth of the sample (22%) had elevated salivary cotinine levels indicative of tobacco use and secondhand smoke exposure. TSE and waist circumference were predictors of elevated blood pressure in adolescents. Public health measures need to address clusters of risk factors including blood pressure, tobacco exposure, and weight status among adolescents in order to reduce CVD.

  15. Prevalence of pre-high blood pressure and high blood pressure among non-overweight children and adolescents using international blood pressure references in developed regions in China.

    PubMed

    Tian, Changwei; Xu, Shuang; Wang, Hua; Wang, Wenming; Shen, Hui

    2017-09-01

    There is a lack of data on the prevalence of pre-high blood pressure (PreHBP) and high blood pressure (HBP), based on recent international blood pressure references, in non-overweight children and adolescents. To describe the prevalence of PreHBP and HBP in non-overweight children and adolescents in developed regions of China. In total, 588 097 non-overweight children and adolescents aged 6-17 years from the National Surveys on Chinese Students' Constitution and Health in 2015 were included. The prevalence of PreHBP was 13.41% and subjects in urban areas had a higher prevalence of PreHBP (14.14%) than those in rural areas (12.92%). Subjects in regions with a high (13.56%) or moderate (13.61%) socioeconomic status showed a higher prevalence of PreHBP than those in regions with a relatively low socioeconomic status (12.76%). A similar pattern was found for the prevalence of HBP, and the prevalence of HBP was 18.25% for all participants, 20.55% for subjects in urban areas, 16.71% in rural areas, 18.76% in high socioeconomic areas, 18.62% in moderate socioeconomic areas and 16.70% in relatively low socioeconomic areas. A large proportion of non-overweight children and adolescents had elevated blood pressure and there were urban-rural and socioeconomic disparities in the prevalence of elevated blood pressure.

  16. Effects of psychological distress on blood pressure in adolescents.

    PubMed

    Weinrich, S; Weinrich, M; Hardin, S; Gleaton, J; Pesut, D J; Garrison, C

    2000-10-01

    This cross-sectional survey measured relationships among blood pressure and measures of psychologic distress, family structure, and economic status in a sample of adolescents exposed to Hurricane Hugo. Spielberger's Anger Scale and Derogatis' Brief Symptom Inventory were used. Data analysis revealed 5% of the 1079 adolescents were hypertensive. Multiple regression analyses revealed the following predictors of higher diastolic blood pressure: African-American race, recipient of subsidized lunch, exposure to Hurricane Hugo, and higher anger-in scores in males. The effects of a catastrophic event such as a hurricane on blood pressure and the effects of introjected anger have implications for both health care consumers and providers.

  17. Goat meat does not cause increased blood pressure.

    PubMed

    Sunagawa, Katsunori; Kishi, Tetsuya; Nagai, Ayako; Matsumura, Yuka; Nagamine, Itsuki; Uechi, Shuntoku

    2014-01-01

    While there are persistent rumors that the consumption of goat meat dishes increases blood pressure, there is no scientific evidence to support this. Two experiments were conducted to clarify whether or not blood pressure increases in conjunction with the consumption of goat meat dishes. In experiment 1, 24 Dahl/Iwai rats (15 weeks old, body weight 309.3±11.1 g) were evenly separated into 4 groups. The control group (CP) was fed a diet containing 20% chicken and 0.3% salt on a dry matter basis. The goat meat group (GM) was fed a diet containing 20% goat meat and 0.3% salt. The goat meat/salt group (GS) was fed a diet containing 20% goat meant and 3% to 4% salt. The Okinawan mugwort (Artemisia Princeps Pampan)/salt group (GY) was fed a diet containing 20% goat meat, 3% to 4% salt and 5% of freeze-dried mugwort powder. The experiment 1 ran for a period of 14 weeks during which time the blood pressure of the animals was recorded. The GS, and GY groups consumed significantly more water (p<0.01) than the CP and GM groups despite the fact that their diet consumption levels were similar. The body weight of animals in the CP, GM, and GS groups was similar while the animals in the GY group were significantly smaller (p<0.01). The blood pressure in the GM group was virtually the same as the CP group throughout the course of the experiment. In contrast, while the blood pressure of the animals in the GS and GY group from 15 to 19 weeks old was the same as the CP group, their blood pressures were significantly higher (p<0.01) after 20 weeks of age. The GY group tended to have lower blood pressure than the GS group. In experiment 2, in order to clarify whether or not the increase in blood pressure in the GS group and the GY group in experiment 1 was caused by an excessive intake of salt, the effects on blood pressure of a reduction of salt in diet were investigated. When amount of salt in the diet of the GS and GY group was reduced from 4% to 0.3%, the animal's blood pressure

  18. Goat Meat Does Not Cause Increased Blood Pressure

    PubMed Central

    Sunagawa, Katsunori; Kishi, Tetsuya; Nagai, Ayako; Matsumura, Yuka; Nagamine, Itsuki; Uechi, Shuntoku

    2014-01-01

    While there are persistent rumors that the consumption of goat meat dishes increases blood pressure, there is no scientific evidence to support this. Two experiments were conducted to clarify whether or not blood pressure increases in conjunction with the consumption of goat meat dishes. In experiment 1, 24 Dahl/Iwai rats (15 weeks old, body weight 309.3±11.1 g) were evenly separated into 4 groups. The control group (CP) was fed a diet containing 20% chicken and 0.3% salt on a dry matter basis. The goat meat group (GM) was fed a diet containing 20% goat meat and 0.3% salt. The goat meat/salt group (GS) was fed a diet containing 20% goat meant and 3% to 4% salt. The Okinawan mugwort (Artemisia Princeps Pampan)/salt group (GY) was fed a diet containing 20% goat meat, 3% to 4% salt and 5% of freeze-dried mugwort powder. The experiment 1 ran for a period of 14 weeks during which time the blood pressure of the animals was recorded. The GS, and GY groups consumed significantly more water (p<0.01) than the CP and GM groups despite the fact that their diet consumption levels were similar. The body weight of animals in the CP, GM, and GS groups was similar while the animals in the GY group were significantly smaller (p<0.01). The blood pressure in the GM group was virtually the same as the CP group throughout the course of the experiment. In contrast, while the blood pressure of the animals in the GS and GY group from 15 to 19 weeks old was the same as the CP group, their blood pressures were significantly higher (p<0.01) after 20 weeks of age. The GY group tended to have lower blood pressure than the GS group. In experiment 2, in order to clarify whether or not the increase in blood pressure in the GS group and the GY group in experiment 1 was caused by an excessive intake of salt, the effects on blood pressure of a reduction of salt in diet were investigated. When amount of salt in the diet of the GS and GY group was reduced from 4% to 0.3%, the animal’s blood pressure

  19. High Blood Pressure (Hypertension) (For Parents)

    MedlinePlus

    ... pumps blood into the arteries and through the circulatory system, and the other is from the arteries as ... For Parents MORE ON THIS TOPIC Heart and Circulatory System Your Child's Weight A Primer on Preemies Kidney ...

  20. Negative experiences and predonation blood pressure at the subsequent donation in blood donors.

    PubMed

    Hoogerwerf, M D; Veldhuizen, I J T; van den Hurk, K; de Kort, W L A M; Sluiter, J K; Frings-Dresen, M H W

    2016-02-01

    Negative donation experiences, like being deferred or experiencing an adverse reaction, might upset blood donors, resulting in anticipatory stress responses such as elevated blood pressure at the subsequent visit. We therefore explored associations between blood donors' negative donation experiences and their blood pressure at the subsequent visit. Blood pressure of donors with no history of negative experiences in three consecutive donations was compared to the blood pressure of donors with a negative experience during the second of the three donations. Blood pressure (systolic and diastolic) measured prior to the third donation was compared between the two groups, using linear regression analyses. Two types of negative experiences (adverse reactions and deferral) were analysed, stratifying for donation type and sex, and adjusting for age and predonation blood pressure at baseline. In total, 248 118 (50% female) donors were included in the analyses. Eleven per cent (26 380 donors, 61% female) had experienced a negative experience. Fainting and dizziness were associated with significant (P < 0·05) increases in systolic blood pressure: in men, 3·0 mmHg (fainting) and 2·0 mmHg (dizziness); in women, 2·0 mmHg (fainting) and 1·4 mmHg (dizziness). Deferral was associated with significant (P < 0·05) increases in both systolic (men: 0·7 mmHg, women: 0·3 mmHg) and diastolic (men: 0·2 mmHg, women: 0·3 mmHg) blood pressure. Whole blood donations with negative experiences were associated with a statistically significant higher predonation blood pressure at the subsequent visit. This indicates that negative experiences might cause an anticipatory stress reaction in a subsequent donation. © 2015 International Society of Blood Transfusion.

  1. Relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men

    SciTech Connect

    Pocock, S.J.; Shaper, A.G.; Ashby, D.; Delves, H.T.; Clayton, B.E.

    1988-06-01

    The relationship between blood lead concentration and blood pressure is examined in a survey of 7371 men aged 40 to 59 from 24 British towns. After allowance for relevant confounding variables, including town of residence and alcohol consumption, there exists a very weak but statistically significant positive association between blood lead and both systolic and diastolic blood pressure. After 6 years of follow-up, 316 of these men had major ischemic heart disease, and 66 had a stroke. After allowance for the confounding effects of cigarette smoking and town of residence there is no evidence that blood lead is a risk factor for these cardiovascular events. However, as the blood lead-blood pressure association is so weak, it is unlikely that any consequent association between lead and cardiovascular disease could be demonstrated from prospective epidemiological studies. An overview of data from this and other large epidemiological surveys provides reasonable consistent evidence on lead and blood pressure. While NHANES II data on 2254 US men indicate a slightly stronger association between blood lead and systolic blood pressure, data from two Welsh studies on over 2000 men did not show a statistically significant association. Nevertheless, such statistical association cannot be taken as establishing a causal effect of low-level lead exposure on blood pressure.

  2. The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension.

    PubMed

    Beckett, Linda; Godwin, Marshall

    2005-06-28

    Increasing evidence suggests that ABPM more closely predicts target organ damage than does clinic measurement. Future guidelines may suggest ABPM as routine in the diagnosis and monitoring of hypertension. This would create difficulties as this test is expensive and often difficult to obtain. The purpose of this study is to determine the degree to which the BpTRU automatic blood pressure monitor predicts results on 24 hour ambulatory blood pressure monitoring (ABPM). A quantitative analysis comparing blood pressure measured by the BpTRU device with the mean daytime blood pressure on 24 hour ABPM. The study was conducted by the Centre for Studies in Primary Care, Queen's University, Kingston, Ontario, Canada on adult primary care patients who are enrolled in two randomized controlled trials on hypertension. The main outcomes were the mean of the blood pressures measured at the three most recent office visits, the initial measurement on the BpTRU-100, the mean of the five measurements on the BpTRU monitor, and the daytime average on 24 hour ABPM. The group mean of the three charted clinic measured blood pressures (150.8 (SD10.26) / 82.9 (SD 8.44)) was not statistically different from the group mean of the initial reading on BpTRU (150.0 (SD21.33) / 83.3 (SD12.00)). The group mean of the average of five BpTRU readings (140.0 (SD17.71) / 79.8 (SD 10.46)) was not statistically different from the 24 hour daytime mean on ABPM (141.5 (SD 13.25) / 79.7 (SD 7.79)). Within patients, BpTRU average correlated significantly better with daytime ambulatory pressure than did clinic averages (BpTRU r = 0.571, clinic r = 0.145). Based on assessment of sensitivity and specificity at different cut-points, it is suggested that the initial treatment target using the BpTRU be set at <135/85 mmHG, but achievement of target should be confirmed using 24 hour ABPM. The BpTRU average better predicts ABPM than does the average of the blood pressures recorded on the patient chart from the three

  3. Benefit of Blood Pressure Control in Diabetic Patients.

    PubMed

    Kintscher, Ulrich

    2015-07-01

    The coexistence of arterial hypertension and diabetes represents a devastating partnership for cardiovascular health. Thus, blood pressure and blood glucose control are essential therapeutic goals to reduce cardiovascular risk and other diabetes-related endpoints in these patients. The major benefit of blood pressure lowering in diabetes comes from a marked reduction of cardiovascular and renal endpoints. New target blood pressure values to achieve maximum cardiovascular and renal protection will be discussed. In addition to the reduction of macrovascular endpoints, blood pressure lowering therapy in diabetic patients has also been discussed to improve microvascular diseases during diabetes, in particular microalbuminuria or diabetic retinopathy. However, current clinical trial evidence is less robust than for macrovascular disease. Clinical studies showed controversial results, and will be discussed. Finally, new data from the ADVANCE-ON study about the long-term, sustained benefit of blood pressure lowering in hypertensive, diabetic patients has been recently published, and will be evaluated in the context of previous evidence. In summary, the present article will discuss selected new topics in the field of hypertension and diabetes focusing on the benefits achieved by blood pressure lowering in these patients.

  4. [Current clinical aspects of ambulatory blood pressure monitoring].

    PubMed

    Sauza-Sosa, Julio César; Cuéllar-Álvarez, José; Villegas-Herrera, Karla Montserrat; Sierra-Galán, Lilia Mercedes

    2016-01-01

    Systemic arterial hypertension is the prevalentest disease worldwide that significantly increases cardiovascular risk. An early diagnosis together to achieve goals decreases the risk of complications significatly. Recently have been updated the diagnostic criteria for hypertension and the introduction of ambulatory blood pressure monitoring. The introduction into clinical practice of ambulatory blood pressure monitoring was to assist the diagnosis of «white coat hypertension» and «masked hypertension». Today has also shown that ambulatory blood pressure monitoring is better than the traditional method of recording blood pressure in the office, to the diagnosis and to adequate control and adjustment of drug treatment. Also there have been introduced important new concepts such as isloted nocturnal hypertension, morning blood pressure elevation altered and altered patterns of nocturnal dip in blood pressure; which have been associated with increased cardiovascular risk. Several studies have shown significant prognostic value in some stocks. There are still other concepts on which further study is needed to properly establish their introduction to clinical practice as hypertensive load variability, pulse pressure and arterial stiffness. In addition to setting values according to further clinical studies in populations such as elderly and children.

  5. Postaerobic Exercise Blood Pressure Reduction in Very Old Persons With Hypertension.

    PubMed

    Oliveira, Joana; Mesquita-Bastos, José; Argel de Melo, Cristina; Ribeiro, Fernando

    2016-01-01

    A single bout of aerobic exercise acutely decreases blood pressure, even in older adults with hypertension. Nonetheless, blood pressure responses to aerobic exercise in very old adults with hypertension have not yet been documented. Therefore, this study aimed to assess the effect of a single session of aerobic exercise on postexercise blood pressure in very old adults with hypertension. Eighteen older adults with essential hypertension were randomized into exercise (N = 9, age: 83.4 ± 3.2 years old) or control (N = 9, age: 82.7 ± 2.5 years old) groups. The exercise group performed a session of aerobic exercise constituting 2 periods of 10 minutes of walking at an intensity of 40% to 60% of the heart rate reserve. The control group rested for the same period of time. Anthropometric variables and medication status were evaluated at baseline. Heart rate and systolic and diastolic blood pressures were measured at baseline, after exercise, and at 20 and 40 minutes postexercise. Systolic blood pressure showed a significant interaction for group × time (F3,24 = 6.698; P = .002; ηp(2) = 0.153). In the exercise group, the systolic blood pressure at 20 (127.3 ± 20.9 mm Hg) and 40 minutes (123.7 ± 21.0 mm Hg) postexercise was significantly lower in comparison with baseline (135.6 ± 20.6 mm Hg). Diastolic blood pressure did not change. Heart rate was significantly higher after the exercise session. In the control group, no significant differences were observed. A single session of aerobic exercise acutely reduces blood pressure in very old adults with hypertension and may be considered an important nonpharmacological strategy to control hypertension in this age group.

  6. Should we tell them when their blood pressure is up?

    PubMed Central

    Linden, W; Herbert, C P; Jenkins, A; Raffle, V

    1989-01-01

    We carried out two studies to determine the effects of feedback on subsequent blood pressure and heart rate readings in subjects without significant cardiovascular abnormalities. In both studies the subjects were randomly assigned to be told that their blood pressure was normal or was high or to receive no feedback at all; 3 minutes later another reading was taken and correct feedback provided. Study 1 was done in 114 patients who attended a family practice teaching unit for an office visit; subjects taking cardioactive medication or with chronically elevated blood pressure (diastolic pressure more than 95 mm Hg) or known low pressure (diastolic pressure less than 60 mm Hg) were excluded. Half of the subjects received feedback from a nurse and the other half from a physician. We found no effect of type of feedback or type of practitioner on subsequent readings. No adaptation of diastolic blood pressure or heart rate took place, whereas a similar rest period in the laboratory consistently triggers cardiovascular adaptation. Given the field nature of the study it was not clear whether the intervention was not powerful or whether the practitioner-patient interactions diffused the effects of an otherwise powerful intervention. Therefore, a second study with the same design was carried out in a controlled laboratory setting with 61 university students who believed they were in the adaptation phase of an experimental stress protocol. The subjects did not interact with the experimenter, who provided only the initial feedback, via intercom. The findings replicated those of study 1: type of feedback had no significant effect on subsequent blood pressure levels, and all types of feedback prevented cardiovascular adaptation. We recommend that patients be allowed to rest alone for at least 10 minutes before blood pressure is measured. Our findings suggest that practitioners need not be concerned about telling normotensive or borderline hypertensive patients that their blood

  7. Clinical evaluation of a self blood pressure monitor according to the First International Consensus Conference on Self Blood Pressure Measurement.

    PubMed

    Ploin, Dominique; Baguet, Jean-Philippe; Pierre, Hélène; De Gaudemaris, Régis; Mallion, Jean-Michel

    2002-12-01

    The Calor TensioSense Bras automatic blood pressure monitor has obtained European Union certification, but the clinical validity of this new oscillometric device when handled by lay subjects has yet to be evaluated. The design employed prospective and blinded blood pressure measurements and a validation procedure according to the criteria set out by the First International Consensus Conference on Self Blood Pressure Measurement (1999). Thirty-three subjects were recruited, 11 in each of three strata of systolic blood pressure (<130, 130-160 and >160 mmHg). Blood pressure was measured sequentially seven times, alternating observer and lay measurements. Two certified observers used two mercury columns and a double stethoscope; the subjects used the automatic device. All blood pressure readings and recordings were blinded. Adequate cuff sizes were used, and the subjects' position was standardized. Discrepancy analysis between manual and automatic measurements was carried out using VAPA software. Dispersion of the discrepancies between manual and automatic measurements showed no specific trend. Out of the 99 systolic blood pressure measurements, 53, 76 and 89 discrepancies were less than 5, 10 and 15 mmHg, respectively. Of the 99 diastolic blood pressure measurements, 62, 86 and 97 discrepancies were less than 5, 10 and 15 mmHg, respectively. The mean inter-observer discrepancy was 1 mmHg for both systolic and diastolic blood pressure comparisons. This evaluation showed that this device complies with the international validation protocol requirements. Thus, the device can, providing adequate instruction is given in the clinic, be recommended for self-measurement by patients at home, as well as for clinical or epidemiological research. Copyright 2002 Lippincott Williams & Wilkins

  8. The Microbiome and Blood Pressure: Can Microbes Regulate Our Blood Pressure?

    PubMed

    Al Khodor, Souhaila; Reichert, Bernd; Shatat, Ibrahim F

    2017-01-01

    The surfaces of the human body are heavily populated by a highly diverse microbial ecosystem termed the microbiota. The largest and richest among these highly heterogeneous populations of microbes is the gut microbiota. The collection of microbes and their genes, called the microbiome, has been studied intensely through the past few years using novel metagenomics, metatranscriptomics, and metabolomics approaches. This has enhanced our understanding of how the microbiome affects our metabolic, immunologic, neurologic, and endocrine homeostasis. Hypertension is a leading cause of cardiovascular disease worldwide; it contributes to stroke, heart disease, kidney failure, premature death, and disability. Recently, studies in humans and animals have shown that alterations in microbiota and its metabolites are associated with hypertension and atherosclerosis. In this review, we compile the recent findings and hypotheses describing the interplay between the microbiome and blood pressure, and we highlight some prospects by which utilization of microbiome-related techniques may be incorporated to better understand the pathophysiology and treatment of hypertension.

  9. Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

    PubMed Central

    Kang, In Sook; Shin, Jinho; Ihm, Sang-Hyun; Kim, Ju Han; Park, Sungha; Kim, Kwang-Il; Kim, Woo-Shik; Kim, Soon Gil; Shin, Gil Ja

    2016-01-01

    Background and Objectives Blood pressure variability (BPV) was recently shown to be a risk factor of stroke. White coat hypertension (WCH) used to be regarded as innocuous, but one long-term follow-up study reported that WCH increased stroke rate compared to normotension (NT). In this study, we aimed to evaluate the relationship between WCH and BPV. Subjects and Methods We analyzed 1398 subjects from the Korean Ambulatory Blood Pressure Registry, who were divided into NT (n=364), masked hypertension (n=122), white coat hypertension (n=254), and sustained hypertension (n=658) groups. Results Baseline characteristics were similar among groups. The average real variability (ARV), a highly sensitive BPV parameter, was highest in the WCH group, followed by the sustained hypertension, masked hypertension, and NT groups. The results persisted after being adjusted for covariates. The WCH vs. sustained hypertension results (adjusted mean±standard error) were as follows: 24-h systolic ARV, 22.9±0.8 vs. 19.4±0.6; 24-h diastolic ARV, 16.8±0.6 vs. 14.3±0.5; daytime systolic ARV, 21.8±0.8 vs. 16.8±0.6; and daytime diastolic ARV, 16.2±0.6 vs. 13.4±0.5 (p<0.001 for all comparisons). Conclusion From the registry data, we found that subjects with WCH or masked hypertension had higher BPV than NT. However, long-term follow-up data assessing the clinical influences of WCH on stroke are needed. PMID:27275173

  10. Blood pressure percentile charts to identify high or low blood pressure in children.

    PubMed

    Banker, Ashish; Bell, Cynthia; Gupta-Malhotra, Monesha; Samuels, Joshua

    2016-07-19

    The goal was to develop familiar blood pressure (BP) charts representing BP percentile curves similar to CDC growth charts to improve screening of both high and low BP in children. Since height accounts for substantially more BP variability than age and is a more direct measure of body size and maturation in children, height-specific BP percentile curves were drawn separately for males and females. We used the 2004 Fourth Report data source and equations to calculate the BP threshold value for each gender and 5 cm height group. By slightly underestimating a child's BP percentile for high BP and slightly overestimating a child's BP percentile for low BP, these charts guarantee 100 % sensitivity in detecting abnormal BP. Sensitivity and specificity of the chart cut-offs were confirmed in a sample of 1254 healthy children from a school-based blood pressure screening program. The 1st, 5th, 25th, 50th, 75th, 90th, 95th, and 99th BP percentile curves are depicted in the chart for each corresponding gender and height from 85 to 190 cm, mimicking the ubiquitous CDC "growth charts". Shaded areas of the chart differentiate abnormal BP status categories: hypotension, normal BP, prehypertension, Stage 1 hypertension, and Stage 2 hypertension. Sensitivity was confirmed to be 100 % with specificity above 94 %. These simplified BP charts improve upon currently available BP screening reference with the following features: (a) tracking BP longitudinally in an individual child, (b) full physiological range of BP percentiles represented in percentile curve format for rapid identification both high and low BP, (c) easy to use with absolute height alone avoiding the additional step of determining height percentile, (d) incorporation of adult threshold for pre-hypertension to assist in accurate transition from adolescence into adulthood, (e) high sensitivity and specificity to ensure all children at risk are identified with very few false positives.

  11. [Selection and maintenance of the blood pressure monitor for self-blood pressure monitoring (SBPM)].

    PubMed

    Wiliński, Jerzy; Kusiak, Aleksander; Wiliński, Bogdan; Smolik, Przemysław; Klima, Łukasz; Chmielewska, Jowita; Czarnecka, Danuta

    2013-01-01

    The choice of an attested blood pressure (BP) monitor with an adequate arm cuff size and its proper maintenance are crucial for obtaining reliable results in Self-Blood Pressure Monitoring (SBPM) practice. The aim of the study was to assess the factors determining the BP monitor selection, its purchase place and technical use aspects. Two hun. dred consecutive patients with arte. rial hypertension regularly performing SBPM (100 individuals from a munici. pal primary health care centre and 100 from a specialized hypertension office at a university cardiology clinic, aged 57.7 +/-12.4 years, 54.0% female) have undergone an inquiry study based on the European Society of Hyperten. sion (ESH) guidelines for home BP monitoring. Almost half of the re. spondents are utilizing BP monitors that are not routinely recommended for SBPM: wrist devices - 22.0%, aneroid appliances -15.0%, mercury monitors - 7.0% and finger monitors - 1.0%. Only 45.0% of the study participants have checked if the cuff size is ap. propriate, whereas arm circumference in 26.0% of the patients exceeded 34 cm and in 3.5% of the individuals was below 24 cm. As few as 2.5% of SBPM practitioners perform regular techni. cal checkups of their BP monitors. Patients of a specialized hypertension office have significantly more often chosen their BP apparatus according to the doctor's recommendation than primary health care patients (27.0% vs 12.0%, p=0.007, respectively). Sphygmomanometer type and appropriate arm cuff size selections for SBPM is random. The aspects of BP monitor attest and its proper maintenance are neglected. Physicians recommend an adequate BP apparatus choice too rarely.

  12. Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease

    PubMed Central

    Magnussen, Costan G.; Smith, Kylie J.

    2016-01-01

    A high blood pressure level in adults is considered the single most important modifiable risk factor for global disease burden, especially those of cardiovascular (CV) origin such as stroke and ischemic heart disease. Because blood pressure levels have been shown to persist from childhood to adulthood, elevations in pediatric levels have been hypothesized to lead to increased CV burden in adulthood and, as such, might provide a window in the life course where primordial and primary prevention could be focused. In the absence of substantive data directly linking childhood blood pressure levels to overt adult CV disease, this review outlines the available literature that examines the association between pediatric blood pressure and adult preclinical markers of CV disease. PMID:27168729

  13. Theory and practice of manual blood pressure measurement.

    PubMed

    Cork, Alison

    This article outlines the process of taking a manual blood pressure measurement. The author suggests that it is a skill that nursing students should be using in clinical practice rather than relying on automated monitors.

  14. Yoga Called Good Medicine for High Blood Pressure

    MedlinePlus

    ... fullstory_162446.html Yoga Called Good Medicine for High Blood Pressure People who added this practice to a healthy ... in people who are at risk for developing hypertension, a new study finds. "Patients with pre-hypertension [ ...

  15. Unusual blood pressure response during standing therapy in tetraplegic man.

    PubMed

    Ogata, Hisayoshi; Ogata, Toru; Hoshikawa, Shinya; Uematsu, Azusa; Ogawa, Tetsuya; Saitou, Sakiko; Kitamura, Taku; Nakazawa, Kimitaka

    2010-02-01

    We report a case of an individual with cervical spinal cord injury who showed a unique blood pressure response during passive standing and passive walking-like leg movement, i.e., hypertension with standing and hypotension with leg movement.

  16. Blood Pressure Fluctuations Tied to Dementia Risk in Study

    MedlinePlus

    ... for dementia or Alzheimer's disease, new research from Japan suggests. People whose systolic blood pressure (the top ... School of Medical Sciences, Kyushu University, Fukuoka City, Japan; Costantino Iadecola, M.D., professor, neurology, director, Feil ...

  17. Racial differences in hypertension: implications for high blood pressure management.

    PubMed

    Lackland, Daniel T

    2014-08-01

    The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African Americans with greater risks than Caucasians. Blood pressure levels have consistently been higher for African Americans with an earlier onset of hypertension. Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure. The reasons for the racial disparities in elevated blood pressure and hypertension-related outcomes risk remain unclear. However, the implications of the disparities of hypertension for prevention and clinical management are substantial, identifying African American men and women with excel hypertension risk and warranting interventions focused on these differences. In addition, focused research to identify the factors attributed to these disparities in risk burden is an essential need to address the evidence gaps.

  18. High Blood Pressure and Sex: Overcome the Challenges

    MedlinePlus

    ... achieve and maintain erections — often referred to as erectile dysfunction. The problem is fairly common. High blood pressure ... have similar effects. Even a single episode of erectile dysfunction can cause anxiety. Fears that it will happen ...

  19. Religiosity and its relation to blood pressure among selected Kuwaitis.

    PubMed

    Al-Kandari, Yagoub Yousif

    2003-07-01

    This study examines the relationship between blood pressure and the religious practices of Kuwaitis as members of a Muslim society. Religious variables were measured via a sociocultural questionnaire. Blood pressure measurements were taken with a sphygmomanometer. Non-opportunistic samples were taken from 223 Kuwaitis. The difference in religious commitment between Muslim Sunnis and Muslim Shiites was examined using a t-test. Matrix correlation was used to examine the relationship between religious commitment and some other variables. Multiple regression was conducted to determine the effect of religiosity on blood pressure, as well as statistically controlling for other variables such as body mass index, socioeconomic status, smoking, gender and age. It was found that both systolic and diastolic blood pressure were affected by religious commitment and religious activities

  20. Blood Pressure: Does It Have a Daily Pattern?

    MedlinePlus

    ... night. With Sheldon G. Sheps, M.D. References Kaplan NM. Ambulatory blood pressure monitoring and white coat ... www.uptodate.com/home. Accessed Feb. 12, 2015. Kaplan NM, et al. Kaplan's Clinical Hypertension. 10th ed. ...

  1. Even Small Rise in Blood Pressure Can Harm Black Patients

    MedlinePlus

    ... html Even Small Rise in Blood Pressure Can Harm Black Patients Study shows higher early death and ... These findings provide further evidence of the potential harms in terms of increased risk of heart attacks, ...

  2. Automated analysis of blood pressure measurements (Korotkov sound)

    NASA Technical Reports Server (NTRS)

    Golden, D. P.; Hoffler, G. W.; Wolthuis, R. A.

    1972-01-01

    Automatic system for noninvasive measurements of arterial blood pressure is described. System uses Korotkov sound processor logic ratios to identify Korotkov sounds. Schematic diagram of system is provided to show components and method of operation.

  3. Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease.

    PubMed

    Magnussen, Costan G; Smith, Kylie J

    2016-01-01

    A high blood pressure level in adults is considered the single most important modifiable risk factor for global disease burden, especially those of cardiovascular (CV) origin such as stroke and ischemic heart disease. Because blood pressure levels have been shown to persist from childhood to adulthood, elevations in pediatric levels have been hypothesized to lead to increased CV burden in adulthood and, as such, might provide a window in the life course where primordial and primary prevention could be focused. In the absence of substantive data directly linking childhood blood pressure levels to overt adult CV disease, this review outlines the available literature that examines the association between pediatric blood pressure and adult preclinical markers of CV disease.

  4. [Decreasing systolic blood pressure with isometric muscle training: a CAT].

    PubMed

    Espinoza Salinas, Alexis; Sánchez, Pablo Aguilera; Zafra Santos, Edson; Cofre Bolados, Cristian; Prado Núñez, Hugo; Pavez Von Martens, Gustavo

    2014-09-11

    Hypertension is a major risk factor for cardiovascular diseases such as coronary heart disease or heart failure. One of the interventions for the management of this disorder is isometric muscle training on upper and lower limbs. To prove the validity and applicability of results regarding the effectiveness of isometric training in hypertensive subjects. We also attempt to answer the following question: what is the effectiveness of isometric muscle training on the decrease of systolic blood pressure in hypertensive patients? Critical appraisal of the systematic review and meta-analysis "Isometric exercise training for blood pressure management". Isometric training reduces systolic blood pressure in normotensive and medicated hypertensive subjects, with a standardized mean difference of 6.77 mm Hg (95% confidence interval: 7.93-5.62). It is reasonable to recommend isometric muscle training with the aim of lowering systolic blood pressure, considering the impact of the results of the articles analyzed and the applicability of this type of training.

  5. Effects of electrical stimulation of acupuncture points on blood pressure.

    PubMed

    Zhang, John; Ng, Derek; Sau, Amy

    2009-03-01

    Arterial hypertension is considered a major contributor to coronary arterial disease. The purpose of the study was to investigate the effects of Hans electrical stimulation of acupuncture points on blood pressure. Subjects with normal and elevated blood pressure were recruited and randomly assigned into control and experimental groups. Only the experimental subjects received active Hans electrical stimulation on 2 acupuncture points for 30 minutes each session, twice a week for 5 weeks. Twenty-seven subjects (17 male) were recruited and completed the study. The average age of the subjects was 25 +/- 5 years. The youngest subject was 20 years old and the oldest was 36 years old. After using the Hans electrical stimulation on acupuncture points for 5 weeks, the systolic blood pressure decreased significantly in the experimental group with active treatment. The mean systolic blood pressure was 117.8 +/- 4.2 mm Hg before the treatment and was reduced to 110.8 +/- 5.5 mm Hg (P < .05) in the third week and to 110.1 +/- 5.8 mm Hg in the fifth week (P < .05). The mean diastolic blood pressure was 78.1 +/- 5.0 mm Hg before treatment and was reduced to 77.4 +/- 4.3 mm Hg (P > .05) in the third week and to 74.8 +/- 4.3 mm Hg (P > .05) in the fifth week, but both did not reach statistically significant levels. The systolic and diastolic blood pressures in the control group did not show statistically significant changes. The mean systolic blood pressure was 115.6 +/- 13.3 mm Hg before the treatment and was reduced to 113.0 +/- 12.6 mm Hg (P > 0.05) in the third week and to 112.2 +/- 10.3 mm Hg in the fifth week (P > .05). The mean diastolic blood pressure was 76.4 +/- 7.9 mm Hg before treatment and was reduced to 76.5 +/- 6.9 mm Hg (P > .05) in the third week and to 73.9 +/- 5.4 mm Hg (P > .05) in the fifth week. It was concluded that Hans electrical stimulation of acupuncture points reduced systolic blood pressure but not the diastolic blood pressure in the current subject

  6. Blood pressure and risk of prostate cancer: Cohort Norway (CONOR).

    PubMed

    Martin, Richard M; Vatten, Lars; Gunnell, David; Romundstad, Pål

    2010-03-01

    Some studies suggest that raised blood pressure may increase prostate cancer risk. We investigated associations of blood pressure with prostate cancer within the CONOR collaborative cohorts of Norway. Between 1994 and 2003, 82,098 men from ten population-based cohorts in Norway completed standardised questionnaires and physical examinations, including resting blood pressure. The unique 11-digit identification number of Norwegian citizens allowed linkage with the Cancer Registry of Norway. A total of 78,768 (96%) men who were cancer-free at baseline and average age of 50.3 years (standard deviation, SD: 15.2) were followed up for a mean of 9.15 years. 11.4% of these men used antihypertensive drugs at baseline. During follow-up (1994-2006), 1,974 incident prostate cancers were diagnosed. We found a 4% (95% confidence interval, CI = 0-9%) increased risk of prostate cancer per one SD (18.3 mmHg) increase in systolic blood pressure and similar findings for diastolic blood pressure (hazard ratio, HR: 1.05 per SD; 95% CI = 1.01-1.10). The association was stronger for advanced (HR: 1.16 per SD increase in systolic blood pressure; 95% CI = 1.05-1.27) compared with localised (1.01; 0.95-1.08) prostate cancer (p for heterogeneity in hazard ratios = 0.02). Raised blood pressure was associated with an increased risk of prostate cancer, particularly advanced cancers at diagnosis. Understanding the mechanisms underlying these findings may provide biological insights into prostate carcinogenesis. Even if the association was causal, our data suggest that raised blood pressure would account for only 3% of prostate cancers, so the public health impact of this association may be limited.

  7. Adiposity and Blood Pressure in 110 000 Mexican Adults.

    PubMed

    Gnatiuc, Louisa; Alegre-Díaz, Jesus; Halsey, Jim; Herrington, William G; López-Cervantes, Malaquías; Lewington, Sarah; Collins, Rory; Tapia-Conyer, Roberto; Peto, Richard; Emberson, Jonathan R; Kuri-Morales, Pablo

    2017-04-01

    Previous studies have reached differing conclusions about the importance of general versus central markers of adiposity to blood pressure, leading to suggestions that population-specific adiposity thresholds may be needed. We examined the relevance of adiposity to blood pressure among 111 911 men and women who, when recruited into the Mexico City Prospective Study, were aged 35 to 89 years, had no chronic disease, and were not taking antihypertensives. Linear regression was used to estimate the effects on systolic and diastolic blood pressure of 2 markers of general adiposity (body mass index and height-adjusted weight) and 4 markers of central adiposity (waist circumference, hip circumference, waist:hip ratio, and waist:height ratio), adjusted for relevant confounders. Mean (SD) adiposity levels were: body mass index (28.7±4.5 kg/m(2)), height-adjusted weight (70.2±11.2 kg), waist circumference (93.3±10.6 cm), hip circumference (104.0±9.0 cm), waist:hip ratio (0.90±0.06), and waist:height ratio (0.60±0.07). Associations with blood pressure were linear with no threshold levels below which lower general or central adiposity was not associated with lower blood pressure. On average, each 1 SD higher measured adiposity marker was associated with a 3 mm Hg higher systolic blood pressure and 2 mm Hg higher diastolic blood pressure (SEs <0.1 mm Hg), but for the waist:hip ratio, associations were only approximately half as strong. General adiposity associations were independent of central adiposity, but central adiposity associations were substantially reduced by adjustment for general adiposity. Findings were similar for men and women. In Mexican adults, often overweight or obese, markers of general adiposity were stronger independent predictors of blood pressure than measured markers of central adiposity, with no threshold effects. © 2017 The Authors.

  8. Adiposity and Blood Pressure in 110 000 Mexican Adults

    PubMed Central

    Gnatiuc, Louisa; Halsey, Jim; Herrington, William G.; López-Cervantes, Malaquías; Lewington, Sarah; Collins, Rory; Tapia-Conyer, Roberto; Peto, Richard; Kuri-Morales, Pablo

    2017-01-01

    Previous studies have reached differing conclusions about the importance of general versus central markers of adiposity to blood pressure, leading to suggestions that population-specific adiposity thresholds may be needed. We examined the relevance of adiposity to blood pressure among 111 911 men and women who, when recruited into the Mexico City Prospective Study, were aged 35 to 89 years, had no chronic disease, and were not taking antihypertensives. Linear regression was used to estimate the effects on systolic and diastolic blood pressure of 2 markers of general adiposity (body mass index and height-adjusted weight) and 4 markers of central adiposity (waist circumference, hip circumference, waist:hip ratio, and waist:height ratio), adjusted for relevant confounders. Mean (SD) adiposity levels were: body mass index (28.7±4.5 kg/m2), height-adjusted weight (70.2±11.2 kg), waist circumference (93.3±10.6 cm), hip circumference (104.0±9.0 cm), waist:hip ratio (0.90±0.06), and waist:height ratio (0.60±0.07). Associations with blood pressure were linear with no threshold levels below which lower general or central adiposity was not associated with lower blood pressure. On average, each 1 SD higher measured adiposity marker was associated with a 3 mm Hg higher systolic blood pressure and 2 mm Hg higher diastolic blood pressure (SEs <0.1 mm Hg), but for the waist:hip ratio, associations were only approximately half as strong. General adiposity associations were independent of central adiposity, but central adiposity associations were substantially reduced by adjustment for general adiposity. Findings were similar for men and women. In Mexican adults, often overweight or obese, markers of general adiposity were stronger independent predictors of blood pressure than measured markers of central adiposity, with no threshold effects. PMID:28223471

  9. Adaptive PI Regulation of Blood Pressure of Hypertension patients.

    PubMed

    Zhu, K Y; Zheng, H; Lavanya, J

    2005-01-01

    This paper presents an adaptive PI control of mean blood pressure using vasoactive drugs like SNP. A new algorithm updating variations in time delay and sensitivity of the system is proposed and its effectiveness is discussed. For demonstration, simulations under clinical conditions are carried out and the results show that the adaptive control system can effectively handle the changes in patient's dynamics and provide satisfactory performance in regulation of blood pressure of hypertension patients.

  10. Nitric oxide production and blood pressure reduction during haemodialysis.

    PubMed

    Chang, Chiz-Tzung; Chien, Ming-Hui; Yang, Kai-Liang; Yu, Chien-Chih; Hsu, Jing-Fang; Wang, I-Kuan; Lim, Paik-Seong; Huang, Chiu-Ching

    2014-09-01

    A decrease of systolic blood pressure in excess of 20 mmHg during haemodialysis treatment (IDD) is common for haemodialysis patients. Intradialytic hypotension (IDH) is symptomatic IDD by definition. Overproduction of nitric oxide (NO) is a possible cause of IDD. Dialysate nitrate and nitrite amount can be used as an indicator of intradialysis NO production. Our aim was to find the predictor of NO production in IDD patients. Partial dialysate samples were collected during the whole haemodialysis session and total dialysate nitrate and nitrite amount was measured to assess the association of intradialysis NO production with blood pressure change. There were 31 IDD patients and 71 patients who did not develop IDD (NIDD) included in the study. Among the IDD patients, 13 were IDH patients with a mean systolic blood pressure lower than that of the other 18 symptomless IDD patients (96.6 ± 3.4 mmHg vs 125.0 ± 3.8 mmHg, P<0.001). The median value of NO production was higher in the IDD than in the NIDD patients (447.7 μg vs 238.8 μg, P<0.001). The NO production correlated linearly with blood pressure reduction (R=0.487, P<0.001). The multivariate analysis showed that NO production was positively associated with predialysis systolic blood pressure. Nitric oxide production during haemodialysis was higher in IDD than in NIDD patients. IDH often occurred when systolic blood pressure was reduced to below 100 mmHg. The amount of NO produced during haemodialysis, which may be associated with predialysis systolic blood pressure, can be used to predict intradialysis blood pressure decrease. © 2014 Asian Pacific Society of Nephrology.

  11. Socioeconomic Status Modifies the Seasonal Effect on Blood Pressure

    PubMed Central

    Cois, Annibale; Ehrlich, Rodney

    2015-01-01

    Abstract Seasonal variations in blood pressure have been consistently reported. However, uncertainty remains about the size of the seasonal effect in different regions, and about factors that explain the differences observed across and within populations. Using data from a national panel study, we investigated seasonal variations in blood pressure in the South African adult population, and whether these variations differed across socioeconomic strata. We estimated age-specific seasonal effects on blood pressure using a multilevel structural equation model, with repeated measurements nested within subjects. Effect modification by socioeconomic status was assessed by repeating the analyses in the subpopulations defined by levels of education, household income per capita, and type of housing. In men and women, season had a statistically significant effect on blood pressure, with higher levels in winter and lower levels in summer. For systolic blood pressure, the magnitude of the seasonal effect was 4.25/4.21 mmHg (women/men) and was higher in the older age groups. For diastolic blood pressure, the effect size was 4.00/4.01 mmHg, with no evident age trend. Seasonal effects were higher among subjects in the lowest socioeconomic classes than in the highest, with differences between 2.4 and 7.7 mmHg, depending on gender, whether systolic or diastolic blood pressure, and socioeconomic status indicator. In the South African adult population, blood pressure shows seasonal variation modified by age and socioeconomic status. These variations have epidemiological, clinical, and public health implications, including the prospect of population level intervention to reduce elevated risk of cold weather cardiovascular morbidity. PMID:26334893

  12. Ambulatory versus conventional methods for monitoring blood pressure during pregnancy.

    PubMed

    Bergel, E; Carroli, G; Althabe, F

    2002-01-01

    Hypertensive disorders are among the most common medical complications of pregnancy and a leading cause of maternal and perinatal morbidity and mortality world-wide. Blood pressure measurement plays a central role in the screening and management of hypertension during pregnancy. In recent years the validity of conventional (clinic) blood pressure measurement has been questioned and efforts have been made to improve the technique with ambulatory automated devices that provide a large number of measurements over a period of time, usually a 24-hour period. To assess whether the use of ambulatory blood pressure monitoring during pregnancy improves subsequent maternal and feto-neonatal outcomes, women-newborn quality of life or use of health service resources, compared with conventional (clinic) blood pressure measurements. These effects will be assessed for the following subgroups: (1) Women at low or average risk of hypertensive disorders of pregnancy (unselected). (2) Women defined as high risk of hypertensive disorders of pregnancy. (3) Women with hypertension without other signs of pre-eclampsia. (4) Women with established pre-eclampsia. The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register, MEDLINE, LILACS and EMBASE were searched. Date of last search: July 2001. All randomised trials comparing ambulatory blood pressure monitoring versus conventional (clinic) blood pressure monitoring in pregnancy. Quasi-random designs will be excluded. Two reviewers evaluated all potentially relevant articles, examined each study for possible inclusion and assessed the methodological quality using the Cochrane guidelines. No trials included. There is no randomised controlled trial evidence to support the use of ambulatory blood pressure monitoring during pregnancy. Randomized trials with adequate design and sample sizes are needed to evaluate the possible advantages and risks of ambulatory blood pressure monitoring during pregnancy

  13. Cost-effectiveness of Intensive Blood Pressure Management.

    PubMed

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil; Schuler, Alejandro; Owens, Douglas K; Goldhaber-Fiebert, Jeremy D

    2016-11-01

    Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events. To evaluate the incremental cost-effectiveness of intensive blood pressure management compared with standard management. This cost-effectiveness analysis conducted from September 2015 to August 2016 used a Markov cohort model to estimate cost-effectiveness of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age- and cause-specific mortality, calibrated to rates reported in SPRINT. We also used population-based observational data to model development of heart failure, myocardial infarction, stroke, and subsequent mortality. Costs were based on published sources, Medicare data, and the National Inpatient Sample. Treatment of hypertension to a systolic blood pressure goal of 120 mm Hg (intensive management) or 140 mm Hg (standard management). Lifetime costs and quality-adjusted life-years (QALYs), discounted at 3% annually. Standard management yielded 9.6 QALYs and accrued $155 261 in lifetime costs, while intensive management yielded 10.5 QALYs and accrued $176 584 in costs. Intensive blood pressure management cost $23 777 per QALY gained. In a sensitivity analysis, serious adverse events would need to occur at 3 times the rate observed in SPRINT and be 3 times more common in the intensive management arm to prefer standard management. Intensive blood pressure management is cost-effective at typical thresholds for value in health care and remains so even with substantially higher adverse event rates.

  14. Early life stress and blood pressure levels in late adulthood.

    PubMed

    Alastalo, H; Räikkönen, K; Pesonen, A-K; Osmond, C; Barker, D J P; Heinonen, K; Kajantie, E; Eriksson, J G

    2013-02-01

    Severe stress experienced in early life may have long-term consequences on adult physiological functions. We studied the long-term effects of separation on blood pressure levels in non-obese subjects who were separated temporarily in childhood from their parents during World War II (WWII). The original clinical study cohort consists of people born during 1934-1944 in Helsinki, Finland. This substudy includes 1361 non-obese subjects (body mass index <30 kg m(-2)). Of these, 192 (14.1%) had been evacuated abroad during WWII. The remaining subjects served as controls. Blood pressure levels and use of blood pressure medication were studied. The separated subjects had significantly higher systolic blood pressure values than the non-separated (148.6+21.5 vs 142.2+19.6 mm Hg, P<0.0001) in adult life. Those subjects separated in early childhood had markedly higher systolic and diastolic blood pressure values in adult life compared with the non-separated (154.6 vs 142.5 mm Hg; 95% confidence interval (CI) 2.6-14.7; P<0.005 and 90.8 vs 87.7 mm Hg; 95% CI 1.0-7.3; P<0.02, respectively). Systolic blood pressure was also higher in the group separated for a duration of <1 year (151.7 vs 142.2 mm Hg; 95% CI 0.0-12.4; P<0.05) compared with the non-separated. Besides being separated, age at separation and duration of separation also influenced blood pressure levels in adult life. This could be due to early hormonal and metabolic programming, during plastic periods in early life, influencing blood pressure levels in adult life.

  15. APOL1 and blood pressure changes in young adults.

    PubMed

    Nadkarni, Girish N; Coca, Steven G

    2017-10-01

    APOL1 risk variants have been shown to be associated with kidney disease and hypertension. In this study, Chen and colleagues assess the association of these risk variants with longitudinal blood pressure in young adults. We review the current literature on association of these alleles with blood pressure and propose future directions to resolve the existing controversies. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  16. Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults.

    PubMed

    Faramawi, Mohammed F; Delongchamp, Robert; Lin, Yu-Sheng; Liu, Youcheng; Abouelenien, Saly; Fischbach, Lori; Jadhav, Supriya

    2015-04-01

    The association between environmental lead exposure and blood pressure variability, an important risk factor for cardiovascular disease, is unexplored and unknown. The objective of the study was to test the hypothesis that lead exposure is associated with blood pressure variability. American participants 17 years of age or older from National Health and Nutrition Examination Survey III were included in the analysis. Participants' blood lead concentrations expressed as micrograms per deciliter were determined. The standard deviations of visit-to-visit systolic and diastolic blood pressure were calculated to determine blood pressure variability. Multivariable regression analyses adjusted for age, gender, race, smoking and socioeconomic status were employed. The participants' mean age and mean blood lead concentration were 42.72 years and 3.44 mcg/dl, respectively. Systolic blood pressure variability was significantly associated with environmental lead exposure after adjusting for the effect of the confounders. The unadjusted and adjusted means of visit-to-visit systolic blood pressure variability and the β coefficient of lead exposure were 3.44, 3.33 mcg/dl, β coefficient = 0.07, P < 0.01. This study documents a positive linear relationship between environmental lead exposure and systolic blood pressure variability. Screening adults with fluctuating blood pressure for lead exposure could be warranted.

  17. Short Term Effects of Cocoa Consumption on Blood Pressure

    PubMed Central

    Alleyne, T; Alleyne, A; Arrindell, D; Balleram, N; Cozier, D; Haywood, R; Humphrey, C; Pran, L; Rampersad, K; Reyes, D; Bahall, S; Holder, R; Ignacio, D

    2014-01-01

    Hypertension, defined as diastolic pressure ≥ 90 mmHg and systolic pressure ≥ 140 mmHg, is a major cause of morbidity and mortality among black populations globally. Several studies have shown that prolonged consumption of cocoa or cocoa containing products leads to decreased blood pressure (BP) in hypertensives. In this study, we investigated the flavonoid content of the top selling cocoa/cocoa based products in Trinidad and Tobago and attempted to determine if consumption of cocoa had any immediate impact on blood pressure levels. The flavonoid content of three 100% cocoa powder products and four cocoa-based formulas was measured using a modified Folin-Ciocalteu procedure. The brand with the highest flavonoid content, 372 gallic acid equivalents, was selected to evaluate the short-term impact of cocoa consumption on blood pressure. Thirty-six participants comprising nineteen hypertensives and seventeen persons with normal blood pressure had their blood pressure recorded on three separate days using ambulatory blood pressure monitors; the blood pressure was recorded every half hour for eight hours. On the first day, the participants received no intervention but on the second and third days, they received either the intervention (5 g cocoa in 125 ml water) or a placebo, in any order. Statistical analysis conducted using t-test statistic and a 95% confidence interval revealed that whether participants regularly took antihypertensive medication or not, a single intervention of cocoa induced decreases in both the diastolic and systolic BPs that were significant (p = 0.0001). Mean decreases of between 8 mmHg and 18 mmHg were observed. PMID:25429467

  18. Disproportional decrease in office blood pressure compared with 24-hour ambulatory blood pressure with antihypertensive treatment: dependency on pretreatment blood pressure levels.

    PubMed

    Schmieder, Roland E; Schmidt, Stephanie T; Riemer, Thomas; Dechend, Ralf; Hagedorn, Ina; Senges, Jochen; Messerli, Franz H; Zeymer, Uwe

    2014-11-01

    The long-term relationship between 24-hour ambulatory blood pressure (ABP) and office BP in patients on therapy is not well documented. From a registry we included all patients in whom antihypertensive therapy needed to be uptitrated. Drug treatment included the direct renin inhibitor aliskiren or an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or drugs not blocking the renin-angiotensin system, alone or on top of an existing drug regimen. In all patients, office BP and 24-hour ABP were obtained at baseline and after 1 year with validated devices. In the study population of 2722 patients, there was a good correlation between the change in office BP and 24-hour ABP (systolic: r=0.39; P<0.001; diastolic: r=0.34; P<0.001). However, the numeric decrease in office BP did not correspond to the decrease in ABP in a 1:1 fashion, for example, a decrease of 10, 20, and 30 mm Hg corresponded to a decrease of ≈7.2, 10.5, and 13.9 mm Hg in systolic ABP, respectively. The disproportionally greater decrease in systolic office BP compared with ABP was dependent on the level of the pretreatment BP, which was consistently higher for office BP than ABP. The white coat effect (difference between office BP and ABP) was on average 10/5 mm Hg lower 1 year after intensifying treatment and the magnitude of that was also dependent on pretreatment BP. There was a disproportionally greater decrease in systolic office BP than in ABP, which for both office BP and ABP seemed to depend on the pretreatment BP level. © 2014 American Heart Association, Inc.

  19. Failure of the community-based Vita-Stat automated blood pressure device to accurately measure blood pressure.

    PubMed

    Whitcomb, B L; Prochazka, A; LoVerde, M; Byyny, R L

    1995-05-01

    To evaluate the Vita-Stat automated blood pressure computer (a patient-operated blood pressure measuring device available in the community) to determine its value as an instrument to monitor blood pressure in the ambulatory patient. Comparative study using the Vita-Stat vs a gold standard, the mercury sphygmomanometer. Three local grocery stores. Sixty-three passersby who agreed to answer questions and to sit for several measurements of blood pressure. Simultaneous measurement of blood pressure with each subject wearing a Vita-Stat cuff on the left arm and a mercury sphygmomanometer cuff on the right arm. Two pressures were measured sequentially in the same manner. The reproducibility, accuracy, sensitivity, and specificity of the Vita-Stat computer compared with the gold standard. In sequential measurements, the Vita-Stat readings of both systolic and diastolic blood pressure correlated less well with each other than did the mercury readings (intramachine differences). The Vita-Stat readings also correlated poorly with the mercury readings of systolic and diastolic blood pressure (intermachine differences). The variability in readings recorded by the Vita-Stat were striking, with differences of up to 60 mm Hg from the mercury readings. More than half (63.2%) of the subjects had Vita-Stat readings that were more than 5 mm Hg different from the mercury readings. Vita-Stat systolic readings were usually lower than mercury readings and also varied by as much as 60 mm Hg below in one patient to 58 mm Hg above the mercury reading in another. The sensitivity of the Vita-Stat in correctly diagnosing hypertension was 0.26; the negative predictive value was 0.45. Our data suggest that the Vita-Stat is not only inconsistent but inaccurate in measuring blood pressure in the ambulatory patient and is, therefore, not appropriate to use as a monitoring device.

  20. Techniques for estimating blood pressure variation using video images.

    PubMed

    Sugita, Norihiro; Obara, Kazuma; Yoshizawa, Makoto; Abe, Makoto; Tanaka, Akira; Homma, Noriyasu

    2015-01-01

    It is important to know about a sudden blood pressure change that occurs in everyday life and may pose a danger to human health. However, monitoring the blood pressure variation in daily life is difficult because a bulky and expensive sensor is needed to measure the blood pressure continuously. In this study, a new non-contact method is proposed to estimate the blood pressure variation using video images. In this method, the pulse propagation time difference or instantaneous phase difference is calculated between two pulse waves obtained from different parts of a subject's body captured by a video camera. The forehead, left cheek, and right hand are selected as regions to obtain pulse waves. Both the pulse propagation time difference and instantaneous phase difference were calculated from the video images of 20 healthy subjects performing the Valsalva maneuver. These indices are considered to have a negative correlation with the blood pressure variation because they approximate the pulse transit time obtained from a photoplethysmograph. However, the experimental results showed that the correlation coefficients between the blood pressure and the proposed indices were approximately 0.6 for the pulse wave obtained from the right hand. This result is considered to be due to the difference in the transmission depth into the skin between the green and infrared light used as light sources for the video image and conventional photoplethysmogram, respectively. In addition, the difference in the innervation of the face and hand may be related to the results.

  1. Neural and hormonal control of blood pressure in conscious monkeys.

    PubMed

    Cornish, K G; Barazanji, M W; Iaffaldano, R

    1990-01-01

    The contribution of the autonomic nervous system, angiotensin II (ANG II), and arginine vasopressin (AVP) to the control of blood pressure (BP) was examined in 12 chronically instrumented tethered monkeys. The vasopressin antagonist, [d(CH2)5AVP] (Manning Compound, MC), the ANG II antagonist, saralasin (SAR), and the ganglionic blocking drug, hexamethonium (Hx), were injected in a random sequence into the left atrium (LA) while BP and heart rate (HR) were monitored. When given as the first antagonist, MC caused a slight decrease in BP; SAR did not significantly decrease BP regardless of the sequence of administration, whereas Hx caused a consistent decrease in blood pressure of 35-50 mmHg. Seven (4 intact and 3 with renal denervation) additional animals were involved in hemorrhage experiments. Blood pressure was reduced to 50-60 mmHg by hemorrhage and then allowed to return spontaneously. Ten to 15 min after the end of the hemorrhage, MC was given. When blood pressure had stabilized, SAR was given. Blood pressure returned to 80-90 mmHg after the hemorrhage. MC did not affect the blood pressure recovery; however, saralasin reduced it to the post-hemorrhage levels. We would conclude that the sympathetic nervous system is the primary controlling mechanism for BP in the conscious primate, with AVP making a minor contribution. The release of renin would appear to be primarily under the control of the sympathetic nervous system.

  2. Potential benefits of exercise on blood pressure and vascular function.

    PubMed

    Pal, Sebely; Radavelli-Bagatini, Simone; Ho, Suleen

    2013-01-01

    Physical activity seems to enhance cardiovascular fitness during the course of the lifecycle, improve blood pressure, and is associated with decreased prevalence of hypertension and coronary heart disease. It may also delay or prevent age-related increases in arterial stiffness. It is unclear if specific exercise types (aerobic, resistance, or combination) have a better effect on blood pressure and vascular function. This review was written based on previous original articles, systematic reviews, and meta-analyses indexed on PubMed from years 1975 to 2012 to identify studies on different types of exercise and the associations or effects on blood pressure and vascular function. In summary, aerobic exercise (30 to 40 minutes of training at 60% to 85% of predicted maximal heart rate, most days of the week) appears to significantly improve blood pressure and reduce augmentation index. Resistance training (three to four sets of eight to 12 repetitions at 10 repetition maximum, 3 days a week) appears to significantly improve blood pressure, whereas combination exercise training (15 minutes of aerobic and 15 minutes of resistance, 5 days a week) is beneficial to vascular function, but at a lower scale. Aerobic exercise seems to better benefit blood pressure and vascular function. Copyright © 2013 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  3. Antihypertensive treatments obscure familial contributions to blood pressure variation.

    PubMed

    Cui, Jisheng S; Hopper, John L; Harrap, Stephen B

    2003-02-01

    The linkage and association between inherent blood pressure and underlying genotype is potentially confounded by antihypertensive treatment. We estimated blood pressure variance components (genetic, shared environmental, individual-specific) in 767 adult volunteer families by using a variety of approaches to adjusting blood pressure of the 244 subjects (8.2%) receiving antihypertensive medications. The additive genetic component of variance for systolic pressure was 73.9 mm Hg(2) (SE, 8.8) when measured pressures (adjusted for age by gender within each generation) were used but fell to 61.4 mm Hg(2) (SE, 8.0) when treated subjects were excluded. When the relevant 95th percentile values were substituted for treated systolic pressures, the additive genetic component was 81.9 mm Hg(2) (SE, 9.5), but individual adjustments in systolic pressure ranged from -53.5 mm Hg to +64.5 mm Hg (mean, +17.2 mm Hg). Instead, when 10 mm Hg was added to treated systolic pressure, the additive genetic component rose to 86.6 mm Hg(2) (SE, 10.1). Similar changes were seen in the shared environment component of variance for systolic pressure and for the combined genetic and shared environmental (ie, familial) components of diastolic pressure. There was little change in the individual-specific variance component across any of the methods. Therefore, treated subjects contribute important information to the familial components of blood pressure variance. This information is lost if treated subjects are excluded and obscured by treatment effects if unadjusted measured pressures are used. Adding back an appropriate increment of pressure restores familial components, more closely reflects the pretreatment values, and should increase the power of genomic linkage and linkage disequilibrium analyses.

  4. Impact of calibration on estimates of central blood pressures.

    PubMed

    Soender, T K; Van Bortel, L M; Møller, J E; Lambrechtsen, J; Hangaard, J; Egstrup, K

    2012-12-01

    Using the Sphygmocor device it is recommended that the radial pressure wave is calibrated for brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP). However it has been suggested that brachial-to-radial pressure amplification causes underestimation of central blood pressures (BPs) using this calibration. In the present study we examined if different calibrations had an impact on estimates of central BPs and on the clinical interpretation of our results. On the basis of ambulatory BP measurements, patients were categorized into patients with controlled, uncontrolled or resistant hypertension. We first calibrated the radial pressure wave as recommended and afterwards recalibrated the same pressure wave using brachial DBP and calculated mean arterial pressure. Recalibration of the pressure wave generated significantly higher estimates of central SBP (P=0.0003 and P<0.0001 at baseline and P=0.0001 and P=0.0002 after 6 months). Using recommended calibration we found a significant change in central SBP in both treatment groups (P=0.05 and P=0.01), however, after recalibrating significance was lost in patients with resistant hypertension (P=0.15). We conclude that calibration with DBP and mean arterial pressure produces higher estimates of central BPs than recommended calibration. The present study also shows that this difference between the two calibration methods can produce more than a systematic error and has an impact on interpretation of clinical results.

  5. Novel pressure-gradient driven component for blood extraction

    NASA Astrophysics Data System (ADS)

    Fujioka, K.; Khumpuang, S.; Horede, M.; Sugiyama, S.

    2006-01-01

    Portable blood analysis devices are usually appreciable for applications in blood diagnostic system. We have designed and fabricated a low-cost and simple deal blood extraction device for a biomedical analysis. The device mainly composes of blood extraction tool and a functional bio-chemical analyzing element. In this work, we report the fabrication and pressure-gradient testing results of the blood extraction tool which consists of painless microneedle array and pressure-gradient tank. Microneedle array was fabricated by X-ray lithography using PCT (Plane-pattern to Cross-section Transfer) technique. The idea of our extraction device was simple but capability which is just to hold a sufficient pressure gradient between the tank and blood vessel. The device can draw the volume of blood up to 237 μl. The device was made of low-cost and disposable materials since it is expected to be used for single blood analysis system. In this work, we introduce design, fabrication and mechanism of the pressure gradient driven component including the extraction test results. The fabrication method of microneedle used in our system is also described.

  6. Anger Expression and Blood Pressure in Adolescents

    ERIC Educational Resources Information Center

    Starner, Tamie M.; Peters, Rosalind M.

    2004-01-01

    The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation…

  7. Anger Expression and Blood Pressure in Adolescents

    ERIC Educational Resources Information Center

    Starner, Tamie M.; Peters, Rosalind M.

    2004-01-01

    The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation…

  8. Quiz: Does Your Blood Pressure Pass the Test? | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Special Section: Healthy Blood Pressure Quiz: Does Your Blood Pressure Pass the Test? Past Issues / Winter 2010 Table of Contents Blood pressure changes throughout the day. It is highest while ...

  9. Blood Pressure Numbers: What They Mean | NIH MedlinePlus the Magazine

    MedlinePlus

    ... please turn Javascript on. Special Section: Healthy Blood Pressure Blood Pressure Numbers: What They Mean Past Issues / Winter 2010 ... time, you're at risk. Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of ...

  10. Treatment: Types of Blood Pressure Medications | NIH MedlinePlus the Magazine

    MedlinePlus

    ... page please turn Javascript on. Feature: High Blood Pressure Treatment: Types of Blood Pressure Medications Past Issues / Fall 2011 Table of Contents Treatment: Types of Blood Pressure Medications Here’s a rundown on the main types ...

  11. Leisure-Time Exercise Could Lower Your Risk of High Blood Pressure

    MedlinePlus

    ... Leisure-time exercise could lower your risk of high blood pressure American Heart Association Rapid Access Journal Report September ... copyright American Heart Association Download (1.4 MB) High Blood Pressure A high blood pressure reading. copyright American Heart ...

  12. Documentation.

    ERIC Educational Resources Information Center

    Burt, Lorna; Lewandowski, Carol

    This workbook, designed for workplace literacy courses, contains materials for a course on documentation. The six sessions of the course cover the following topics: (1) general principles of procedure writing; (2) principles of clear communication (clarity, audience, visuals) and identification of systems types, accounts, and customer requests;…

  13. Fluid balance, renal function, and blood pressure.

    PubMed

    Guyton, A C; Young, D B; DeClue, J W; Trippodo, N; Hall, J E

    1975-10-01

    After many detours in the search for the basic mechanism of hypertension, evidence now seems to corroborate the earliest concept that developed in the 1800's, namely, that hypertension almost always results from a tendency of the kidneys to retain water and salt. Animal studies show that the amount of excess body water and salt required to cause hypertension is exceedingly small, and that the hypertensive effect of the excess water and salt may not develop for days or weeks. When vascular constriciton occurs simultaneously, as occurs in the presence of large quantities of angiotensin, the blood volume may be less than normal, but even in these circumstances the fluid volume is relatively increased and is responsible for the hypertension because the vascular constrictont has decreased the capacity of the circulation to a greater extent than the decrease in blood volume.

  14. The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

    PubMed

    Li, Dan

    2016-08-01

    To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete

  15. Relationship Between Preoperative Evaluation Blood Pressure and Preinduction Blood Pressure: A Cohort Study in Patients Undergoing General Anesthesia.

    PubMed

    van Klei, Wilton A; van Waes, Judith A R; Pasma, Wietze; Kappen, Teus H; van Wolfswinkel, Leo; Peelen, Linda M; Kalkman, Cor J

    2017-02-01

    For outcomes research where changes in intraoperative blood pressure are a possible causative factor, it is important to determine an appropriate source for a reference value. We studied to what extent preinduction blood pressure values in the operating room differ from those obtained during preoperative evaluation outside the operating room. Cohort study including 4408 patients aged 60 years or older undergoing noncardiac surgery. The outcome was the difference between the preinduction mean blood pressure (MBP) and the MBP obtained during preoperative evaluation. A difference of ≥10 mm Hg was considered clinically relevant. A paired samples t test was used to estimate the difference. Linear regression was used to obtain estimates adjusted for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure. Complete data were available for 3660 (83%) patients. There were 2228 (61%) patients with a difference of ≥10 mm Hg between the preinduction and preoperative MBP. The overall mean difference between both MBPs was 11 mm Hg (95% confidence interval, 10-11) with important variability among individuals. Patients with higher preoperative MBP values had smaller differences. After adjusting for patient characteristics, comorbidity, medications, type of surgery, and preoperative blood pressure, the difference decreased an estimated 5.0 mm Hg (95% confidence interval, 4.7-5.4) for every increase of 10 mm Hg in preoperative MBP. Patient characteristics, comorbidity, type of surgery, or medication were not strongly associated with the difference. The average preinduction blood pressure was higher than the preoperative blood pressure. This difference between the measurements can be explained by stress-induced effects and regression to the mean. To define an optimal reference value for research purposes or to arrive at a clinical perioperative blood pressure target, one should consider that there is important variability both within

  16. Prepubertal stature and blood pressure in early old age

    PubMed Central

    Montgomery, S.; Berney, L.; Blane, D.

    2000-01-01

    AIMS—To test the hypothesis that childhood growth rate is a marker for formation of control mechanisms that influence blood pressure in early old age.
METHODS—Data are from a sample of 149 (74 male) members of Sir John Boyd Orr's survey of British families conducted between 1937 and 1939. Measured heights were collected between ages 5 and 8 years, and in early old age between 1997 and 1998. Multiple linear regression investigated the relations of blood pressure with age and sex standardised childhood height with adjustment for potential confounding factors, including adult height. Inclusion of both childhood and adult heights in the same model was used to estimate growth, as measures of childhood height are relative to adult height.
RESULTS—Mean blood pressures in early old age for those in the shortest childhood height fifth were 167.8 and 76.3 mm Hg for systolic blood pressure and pulse pressure, respectively. For the tallest fifth they were 150.8 and 63.7 mm Hg, respectively. After adjustment for potential confounding factors including adult height, the mean increase for the shortest childhood height fifth compared with the tallest was 28.5 mm Hg for systolic pressure (p = 0.015) and 22.8 mm Hg (p = 0.010) for pulse pressure. The relations of blood pressure with adult height were not statistically significant in the adjusted models.
CONCLUSION—Prepubertal growth rate is associated with the formation of mechanisms associated with the control of blood pressure in later life.

 PMID:10799423

  17. AGT and RH blood group polymorphisms affect blood pressure and lipids in Afro-Caribbeans.

    PubMed

    Robinson, M T; Wilson, T W; Nicholson, G A; Grell, G A C; Etienne, C; Grim, C M; Wilson, D; Grim, C E

    2004-05-01

    Population blood pressure variation is most likely due to multiple genes. This is likely the reason why monogenic testing with the angiotensinogen (AGT) gene polymorphisms on chromosome 1 (1q42-43), especially M235T, has met with negative results, especially in those of African descent. The RH blood group system, also on chromosome 1 (1 p36.2-34), has likewise been associated with blood pressure variation in African-Americans and with the rise in blood pressure with age in whites. Using a random sample of the population, we investigated the combined effects of single and combined variation of the AGTN M235T and RH genotypes on blood pressure, lipids, and lipoprotein concentrations in Afro-Caribbeans aged 18-60 years from the island nation of Dominica. In monogenic analysis, AGT M235T was not associated with blood pressure. However, it was associated with HDL (MM 42+/-23, MT 44+/-12, TT 52+/-14 (P=0.002)). RH genotype was significantly associated with systolic blood pressure (P=0.006) and Apo-A (P=0.003). These effects remained after adjustment for age, gender, weight, and BMI. In the polygenetic analysis, AGT M235T and RH were significantly associated with systolic blood pressure (P=0.037; interaction effects, P=0.068). The association of the AGT M235T with blood pressure across RH blood group haplotypes was then tested. Of the five RH haplotypes available for analysis, the AGT M235T was significantly associated with blood pressure within the "D" haplotype (P=0.01). The RH blood group and gender were significantly associated with systolic blood pressure and Apo-A levels (P=0.005 and 0.012, respectively). All interactions were independent of age and weight. In conclusion, we demonstrate a significant association of AGT M235T with blood pressure and cholesterol metabolism in an Afro-Caribbean population in the "genetic context" of the RH blood group system. Further investigation of these interactions may help understand the effects of genetic factors on

  18. Ambulatory Blood Pressure Monitoring in Frequently Relapsing Nephrotic Syndrome.

    PubMed

    Sarkar, Subhankar; Sinha, Aditi; Lakshmy, Ramakrishnan; Agarwala, Anuja; Saxena, Anita; Hari, Pankaj; Bagga, Arvind

    2017-01-01

    To screen patients with frequently relapsing nephrotic syndrome (FRNS) for the presence of ambulatory hypertension and left ventricular hypertrophy. Following ethical and parental approvals, consecutive patients with FRNS of ≥2 y duration were enrolled. Those with estimated glomerular filtration rate <60 ml/min/1.73 m(2) and known familial hypercholesterolemia or diabetes mellitus were excluded. Clinic blood pressure was measured by oscillometry and 24-h ambulatory blood pressure was recorded by Spacelab 90207; echocardiography was done for left ventricular mass. Ambulatory hypertension was defined as the presence of clinic blood pressure >95th centile for age, sex and height, and systolic blood pressure load exceeding 25 %. Of 99 patients, 73 were boys; their median (IQR) age was 120 (84-156) mo. Clinic blood pressure was >95th percentile in 63 (63.6 %) patients. Ambulatory hypertension was present in 33 (33.3 %), including 14 patients with severe hypertension; 16 (16.1 %) had masked hypertension and 30 (30.3 %) had white coat hypertension. Non-dipping was seen in 72 and 55 patients had high nocturnal systolic blood pressure load. Of 21 patients with increased left ventricular mass index, 9 (42.9 %) had ambulatory hypertension, 3 (14.3 %) had masked hypertension and 6 (28.6 %) patients had white coat hypertension. Compared to those with normal blood pressure, patients with ambulatory hypertension were younger at onset of nephrotic syndrome (odds ratio, OR 0.94; 95 % CI 0.91-0.98; P = 0.002), longer duration of frequently relapsing disease (OR 1.05; 95 % CI 1.00-1.10; P = 0.034) and higher body mass index (BMI) (OR 1.61; 95 % CI 1.07-4.40; P = 0.020). BMI was positively correlated with 24-h systolic blood pressure load (r = 0.23; P = 0.002) and with the left ventricular mass index (r = 0. 57; P = 0.001). Many patients with FRNS showed high prevalence of clinic, ambulatory and white coat hypertension, emphasizing the need to

  19. The relationship of electronically monitored physical activity to blood pressure, heart rate, and the circadian blood pressure profile.

    PubMed

    Mansoor, G A; White, W B; McCabe, E J; Giacco, S

    2000-03-01

    We studied how closely changes in electronically monitored physical activity are reflected in changes in blood pressure and heart rate in a group of untreated hypertensive subjects. Thirty-nine hypertensive patients (office blood pressure > 140/ 90 mm Hg) of mean age 57 +/- 10 years (mean +/-SD) wore an ambulatory blood pressure monitor and a wrist actigraph simultaneously. Both average and peak activity for 5 min before each valid blood pressure reading were determined, as was average activity for awake and sleep periods, determined by patient kept diaries. For the overall group, awake and 24-h activities were inversely correlated to age (n = 39, r = -0.42; P = 0.01 and n = 39, r = -0.38; P = 0.01, respectively). No correlation was found between group awake activity and group-average blood pressure or heart rate. For individual patients, there was marked variation in the degree of correlation between awake activity measures (both peak and average) and blood pressure and heart rate. The strongest positive correlation was between activity levels and the heart rate-pressure product. Nondipper profile hypertensives had higher sleep activity than dipper hypertensives (44 +/- 28 units/min v 25 +/- 20 units/min, df = 37, t = 2.12; P = 0.04), but awake activity levels were similar. The higher sleep activity remained after adjustment for age. These findings indicate that the relationship between actigraphic activity and hemodynamic parameters is highly variable and that the rate-pressure product is the strongest correlate of short-term activity. Furthermore, hypertensives with the nondipper profile have higher sleep activity than dipper hypertensives. These findings stress the need for further study into the role of day-to-day activity in determining ambulatory blood pressure and heart rate variability.

  20. Blood pressures obtained by indirect measurement in conscious dogs.

    PubMed

    Coulter, D B; Keith, J C

    1984-06-01

    Heart rate and arterial systolic, mean, and diastolic blood pressures were measured indirectly in apparently healthy dogs in clinical situations (examination rooms, cages, or runs) and in 3 groups of abnormal dogs. An electronic automatic sphygmomanometer measured and analyzed arterial pulses (oscillometric method). Apparently healthy dogs had a mean +/- SD heart rate of 134 +/- 32 beats/min and systolic, mean, and diastolic pressures of 144 +/- 27, 110 +/- 21, and 91 +/- 20 mm of Hg, respectively. The mean systolic pressure was significantly higher in hospitalized dogs than in nonhospitalized dogs. When compared with relaxed dogs, playful dogs had a higher mean heart rate. Apprehensive dogs had a higher mean diastolic pressure than did relaxed dogs. The mean heart rate and blood pressures of panting dogs were not significantly different from the mean values from relaxed dogs. Heavier (greater than 18 kg) and older (greater than 2 years) dogs had lower mean heart rates and higher pressures, compared with lighter (less than or equal to 18 kg) and younger (less than or equal to 2 years) dogs. Infection with Dirofilaria immitis had no effect on heart rate and blood pressures when compared with apparently healthy dogs. Dogs with renal failure had a significantly higher mean diastolic pressure and dogs with mitral regurgitation had a significantly lower mean diastolic pressure, compared with apparently healthy dogs.

  1. Screening blood pressure measurement in children: are we saving lives?

    PubMed

    Brady, Tammy M; Redwine, Karen M; Flynn, Joseph T

    2014-06-01

    Blood Pressure screening in children and adolescents is currently recommended by several prominent medical organizations, including the American Heart Association, the National High Blood Pressure Education Program, the National Heart, Lung, and Blood Institute, the European Society of Hypertension, and the American Academy of Pediatrics. This practice was recently subject to intense scientific review by the U.S. Preventive Services Task Force. The conclusion of the Task Force was that "current evidence is insufficient to assess the balance of benefits and harms of screening for primary hypertension in asymptomatic children and adolescents." This commentary provides an alternate interpretation of current evidence for blood pressure screening in children and adolescents and highlights its importance as a part of routine medical care.

  2. Home blood pressure measurement in elderly patients with cognitive impairment: comparison of agreement between relative-measured blood pressure and automated blood pressure measurement.

    PubMed

    Plichart, Matthieu; Seux, Marie-Laure; Caillard, Laure; Chaussade, Edouard; Vidal, Jean-Sébastien; Boully, Clémence; Hanon, Olivier

    2013-08-01

    Home blood pressure measurement (HBPM) is recommended by guidelines for hypertension management. However, this method might be difficult to use in elderly individuals with cognitive disorders. Our aim was to assess the agreement and the feasibility of HBPM by a relative as compared with 24-h ambulatory blood pressure monitoring (ABPM) in elderly patients with dementia. Sixty outpatients with dementia aged 75 years and older with office hypertension (≥140/90 mmHg) were subjected successively to HBPM by a trained relative and 24-h ABPM. The order of the two methods was randomized. Current guidelines' thresholds for the diagnosis of hypertension were used. The mean (SD) age of the patients was 80.8 (6.1) years (55% women) and the mean (SD) mini-mental state examination score was 20.1 (6.9). The feasibility of relative-HBPM was very high, with a 97% success rate (defined by ≥12/18 measurements reported). The blood pressure measurements were highly correlated between the two methods (r=0.75 and 0.64 for systolic blood pressure and diastolic blood pressure, respectively; P<0.001 for both). The agreement between the methods for the diagnosis of sustained hypertension and white-coat hypertension was excellent (overall agreement, 92%; κ coefficient, 0.81; 95% CI, 0.61-0.93). Similar results were found for daytime-ABPM. In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM.

  3. Repeat variation of electrocardiogram, blood pressure, and blood cholesterol within one hour and six months1

    PubMed Central

    Simonson, Ernst; Keys, Ancel

    1970-01-01

    The intraindividual repeat variation of the conventional 12-lead electrocardiogram, of blood pressure, and of blood cholesterol was determined in 27 middle-aged healthy men with an interval of one hour and six months. In 7 of 17 analysed electrocardiographic items the variation within six months was significantly greater than that within one hour; in 10 items, the variation was not significantly different. Blood pressure varied as much within one hour as within six months, while the intraindividual variation of serum cholesterol was significantly greater for the six-month period. The intraindividual variation, expressed as the coefficient of variation, was greater for the electrocardiogram than for either blood pressure or cholesterol. There were large differences between various electrocardiographic items in the repeat variation. There was high intraclass correlation of most items analysed, but no significant covariation between electrocardiographic item vs. blood pressure or cholesterol. PMID:5470047

  4. Quantitative and qualitative retinal microvascular characteristics and blood pressure.

    PubMed

    Cheung, Carol Y; Tay, Wan T; Mitchell, Paul; Wang, Jie J; Hsu, Wynne; Lee, Mong L; Lau, Qiangfeng P; Zhu, Ai L; Klein, Ronald; Saw, Seang M; Wong, Tien Y

    2011-07-01

    The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs. Retinal photographs from the Singapore Malay Eye Study, a population-based cross-sectional study of 3280 (78.7% response) persons aged 40-80 years, were analyzed. Quantitative changes in the retinal vasculature (branching angle, vascular tortuosity, fractal dimension, and vascular caliber) were measured using a semi-automated computer-based program. Qualitative signs, including focal arteriolar narrowing (FAN), arteriovenous nicking (AVN), opacification of the arteriolar wall (OAW), and retinopathy (e.g., microaneurysms, retinal hemorrhages), were assessed from photographs by trained technicians. After excluding persons with diabetes and ungradable photographs, 1913 persons provided data for this analysis. In multivariable linear regression models controlling for age, sex, BMI, use of antihypertensive medication, and other factors, retinal arteriolar branching asymmetry ratio, arteriolar tortuosity, venular tortuosity, fractal dimension, arteriolar caliber, venular caliber, FAN, AVN, and retinopathy were independently associated with mean arterial blood pressure. In contrast, arteriolar/venular branching angle, venular branching asymmetry ratio and OAW were not related to blood pressure. Retinal arteriolar caliber (sβ = -0.277) and FAN (sβ = 0.170) had the strongest associations with mean arterial blood pressure, and higher blood pressure levels were associated with increasing number of both quantitative and qualitative retinal vascular signs (P trend <0.001). Elevated blood pressure is associated with a spectrum of quantitative and qualitative retinal vascular signs, with the number of signs increasing with higher blood pressure levels.

  5. High blood pressure in acute ischemic stroke and underlying disorders.

    PubMed

    Toyoda, Kazunori; Okada, Yasushi; Jinnouchi, Juro; Gotoh, Seiji; Yokoyama, Yoko; Fujimoto, Shigeru; Ibayashi, Setsuro

    2006-01-01

    The Acute Candesartan Cilexetil Therapy in Stroke Survivors (ACCESS) study indicated that early treatment with an angiotensin type 1 receptor blocker in acute stroke patients who had relatively high blood pressure improved cardiovascular morbidity and mortality in the chronic stage. To better interpret the findings of this study, we determined whether stroke patients with high acute blood pressure had specific underlying conditions. We divided 712 consecutive patients who were hospitalized within 48 h after the onset of brain infarction into two groups: 77 patients with high acute blood pressure that met the criteria of the ACCESS study and the 635 remaining patients. Underlying risk factors and comorbidities, stroke characteristics, as well as mortality, vascular events, and disability at 3 weeks were compared between the two groups. Patients with high acute blood pressure more frequently had diabetes mellitus (p < 0.01), intracranial arterial stenosis (p < 0.02), higher levels of hemoglobin A1c (p < 0.005), higher creatinine levels (p < 0.005), and tended to more frequently have ischemic heart disease (p < 0.09) and infarcts <1.5 cm in diameter (p < 0.09) than the other patients. On multivariate analysis, high levels of hemoglobin A1c, high creatinine levels, and intracranial arterial stenosis were independently predictive of high acute blood pressure. At 3 weeks after the stroke onset, patients with high acute blood pressure were more dependent in their daily living activities (p < 0.02) and more frequently developed vascular events or death (p < 0.005) than the other patients. Poorly controlled diabetes mellitus and advanced renal damage appeared to correlate with acute hypertension after stroke. Since intracranial arterial stenosis also seemed to contribute to high acute blood pressure, one should be careful not to induce cerebral hypoperfusion by the early use of antihypertensives. Copyright (c) 2006 S. Karger AG, Basel.

  6. Blood pressure associates with standing balance in elderly outpatients.

    PubMed

    Pasma, Jantsje H; Bijlsma, Astrid Y; Klip, Janneke M; Stijntjes, Marjon; Blauw, Gerard Jan; Muller, Majon; Meskers, Carel G M; Maier, Andrea B

    2014-01-01

    Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment. In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex. Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements. Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.

  7. Blood Pressure Associates with Standing Balance in Elderly Outpatients

    PubMed Central

    Pasma, Jantsje H.; Bijlsma, Astrid Y.; Klip, Janneke M.; Stijntjes, Marjon; Blauw, Gerard Jan; Muller, Majon; Meskers, Carel G. M.; Maier, Andrea B.

    2014-01-01

    Objectives Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment. Materials and Methods In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197) and continuously (subsample, n = 58) before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1) the ability to maintain standing balance; 2) self-reported impaired standing balance; and 3) history of falls, adjusted for age and sex. Results Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements. Conclusion Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care. PMID:25222275

  8. Ambient air pollution exposure and blood pressure changes during pregnancy

    PubMed Central

    Lee, Pei-Chen; Talbott, Evelyn O.; Roberts, James M.; Catov, Janet M.; Bilonick, Richard A.; Stone, Roslyn A.; Sharma, Ravi K.; Ritz, Beate

    2013-01-01

    Background Maternal exposure to ambient air pollution has been associated with adverse birth outcomes such as preterm delivery. However, only one study to date has linked air pollution to blood pressure changes during pregnancy, a period of dramatic cardiovascular function changes. Objectives We examined whether maternal exposures to criteria air pollutants, including particles of less than 10 µm (PM10) or 2.5 µm diameter (PM2.5), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3), in each trimester of pregnancy are associated with magnitude of rise of blood pressure between the first 20 weeks of gestation and late pregnancy in a prospectively followed cohort of 1684 pregnant women in Allegheny County, PA. Methods Air pollution measures for maternal ZIP code areas were derived using Kriging interpolation. Using logistic regression analysis, we evaluated the associations between air pollution exposures and blood pressure changes between the first 20 weeks of gestation and late pregnancy. Results First trimester PM10 and ozone exposures were associated with blood pressure changes between the first 20 weeks of gestation and late pregnancy, most strongly in non-smokers. Per interquartile increases in first trimester PM10 and O3 concentrations were associated with mean increases in systolic blood pressure of 1.88 mmHg (95% CI = 0.84 to 2.93) and 1.84 (95% CI = 1.05 to 4.63), respectively, and in diastolic blood pressure of 0.63 mmHg (95% CI= −0.50 to 1.76) and 1.13 (95% CI= −0.46 to 2.71) in non-smokers. Conclusions Our novel finding suggests that first trimester PM10 and O3 air pollution exposures increase blood pressure in the later stages of pregnancy. These changes may play a role in mediating the relationships between air pollution and adverse birth outcomes. PMID:22835955

  9. Blood-Pressure Measuring System Gives Accurate Graphic Output

    NASA Technical Reports Server (NTRS)

    1965-01-01

    The problem: To develop an instrument that will provide an external (indirect) measurement of arterial blood pressure in the form of an easily interpreted graphic trace that can be correlated with standard clinical blood-pressure measurements. From sphygmograms produced by conventional sphygmographs, it is very difficult to differentiate the systolic and diastolic blood-pressure pulses and to correlate these indices with the standard clinical values. It is nearly impossible to determine these indices when the subject is under physical or emotional stress. The solution: An electronic blood-pressure system, basically similar to conventional ausculatory sphygmomanometers, employing a standard occluding cuff, a gas-pressure source, and a gas-pressure regulator and valve. An electrical output transducer senses cuff pressure, and a microphone positioned on the brachial artery under the occluding cuff monitors the Korotkoff sounds from this artery. The output signals present the conventional systolic and diastolic indices in a clear, graphical display. The complete system also includes an electronic timer and cycle-control circuit.

  10. Pathophysiology of blood pressure in the elderly.

    PubMed

    Swales, J D

    1979-05-01

    Several of the factors responsible for circulatory control are modified in the elderly. Loss of elasticity of the aortic wall produces a widened pulse pressure and a high incidence of systolic hypertension. Attempts to normalize this may be associated with disabling diastolic hypotension. Arterial baroreceptor sensitivity and responsiveness of the renin-angiotensin system is reduced. Further, the renal capacity to conserve sodium and water is impaired. All these increase the risks associated with antihypertensive treatment, but do not contra-indicate such treatment.

  11. Visually evoked blood flow responses and interaction with dynamic cerebral autoregulation: correction for blood pressure variation.

    PubMed

    Gommer, Erik D; Bogaarts, Guy; Martens, Esther G H J; Mess, Werner H; Reulen, Jos P H

    2014-05-01

    Visually evoked flow responses recorded using transcranial Doppler ultrasonography are often quantified using a dynamic model of neurovascular coupling. The evoked flow response is seen as the model's response to a visual step input stimulus. However, the continuously active process of dynamic cerebral autoregulation (dCA) compensating cerebral blood flow for blood pressure fluctuations may induce changes of cerebral blood flow velocity (CBFV) as well. The effect of blood pressure variability on the flow response is evaluated by separately modeling the dCA-induced effects of beat-to-beat measured blood pressure related CBFV changes. Parameters of 71 subjects are estimated using an existing, well-known second order dynamic neurovascular coupling model proposed by Rosengarten et al., and a new model extending the existing model with a CBFV contributing component as the output of a dCA model driven by blood pressure as input. Both models were evaluated for mean and systolic CBFV responses. The model-to-data fit errors of mean and systolic blood pressure for the new model were significantly lower compared to the existing model: mean: 0.8%±0.6 vs. 2.4%±2.8, p<0.001; systolic: 1.5%±1.2 vs. 2.2%±2.6, p<0.001. The confidence bounds of all estimated neurovascular coupling model parameters were significantly (p<0.005) narrowed for the new model. In conclusion, blood pressure correction of visual evoked flow responses by including cerebral autoregulation in model fitting of averaged responses results in significantly lower fit errors and by that in more reliable model parameter estimation. Blood pressure correction is more effective when mean instead of systolic CBFV responses are used. Measurement and quantification of neurovascular coupling should include beat-to-beat blood pressure measurement.

  12. Renoprotection, renin inhibition, and blood pressure control: the impact of aliskiren on integrated blood pressure control.

    PubMed

    Rashid, Haroon-Ur

    2010-01-01

    Hypertension (HTN) is an important factor in progressive loss of renal function. The kidney can be both a contributor to and a target of HTN. The functional integrity of the kidney is vital for the maintenance of cardiovascular homeostasis. Chronic activation of the renin system causes HTN and, ultimately, end-organ damage. Direct renin inhibitors (DRIs) inhibit plasma renin activity (PRA), thereby preventing the conversion of angiotensinogen to angiotensin I; consequently, the levels of both Ang I and Ang II are reduced. There is no compensatory increase in PRA activity with DRIs as seen with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). There are reasons to speculate that renin inhibition might prove to be a superior strategy for blocking the renin-angiotensin-aldosterone system compared with ACEIs or ARBs. Evidence for the efficacy of aliskiren (a DRI) is considered to be relatively strong, based on published, short-term, double-blind, randomized, controlled trials showing that aliskiren is as effective as other antihypertensive agents in reducing blood pressure (BP), with no rebound effects on BP after treatment withdrawal. When combined with diuretics, fully additive BP reduction is seen. When given with an ACEI or ARB, aliskiren produces significant additional BP reduction indicative of complimentary pharmacology and more complete renin-angiotensin system blockade.

  13. Blood pressure morning surge, exercise blood pressure response and autonomic nervous system.

    PubMed

    Tanindi, Asli; Ugurlu, Murat; Tore, Hasan Fehmi

    2015-08-01

    We investigated blood pressure (BP) response to exercise with respect to BP morning surge (MS), and the association between MS, exercise treadmill test (ETT) and heart rate variability (HRV) indices. Eighty-four healthy subjects without hypertension were enrolled. Ambulatory BP monitoring and 24-hour Holter recordings were obtained for sleep-trough MS and HRV indices: low-frequency (LF) component, high-frequency (HF) component and LF/HF ratio. ETT was performed, and BPs were obtained at rest, end of each stage, and recovery. Third-minute heart rate recovery (HRR) and BP recovery ratio (BPRR) were calculated. When analysed in quartiles of MS, systolic BP at low workloads was higher in the highest than in the lowest quartile, although maximum BPs at maximum exercise were not significantly different. BPRR was highest in the highest quartile in contrast to HRR, which was lowest in the highest quartile. LF/HF was highest during both at daytime and night-time in the highest quartile. BPRR and LF/HF were positively, and HRR was inversely associated with MS. Subjects with a high MS have higher BP at low workloads, at which most daily activities are performed, and impairment in some indices, which indirectly reflect the autonomic nervous system.

  14. Medical students and measuring blood pressure: Results from the American Medical Association Blood Pressure Check Challenge.

    PubMed

    Rakotz, Michael K; Townsend, Raymond R; Yang, Jianing; Alpert, Bruce S; Heneghan, Kathleen A; Wynia, Matthew; Wozniak, Gregory D

    2017-06-01

    Blood pressure (BP) measurement is the most common procedure performed in clinical practice. Accurate BP measurement is critical if patient care is to be delivered with the highest quality, as stressed in published guidelines. Physician training in BP measurement is often limited to a brief demonstration during medical school without retraining in residency, fellowship, or clinical practice to maintain skills. One hundred fifty-nine students from medical schools in 37 states attending the American Medical Association's House of Delegates Meeting in June 2015 were assessed on an 11-element skillset on BP measurement. Only one student demonstrated proficiency on all 11 skills. The mean number of elements performed properly was 4.1. The findings suggest that changes in medical school curriculum emphasizing BP measurement are needed for medical students to become, and remain, proficient in BP measurement. Measuring BP correctly should be taught and reinforced throughout medical school, residency, and the entire career of clinicians. © 2017 American Medical Association. Journal of Clinical Hypertension published by Wiley Periodicals, Inc.

  15. The Microbiome and Blood Pressure: Can Microbes Regulate Our Blood Pressure?

    PubMed Central

    Al Khodor, Souhaila; Reichert, Bernd; Shatat, Ibrahim F.

    2017-01-01

    The surfaces of the human body are heavily populated by a highly diverse microbial ecosystem termed the microbiota. The largest and richest among these highly heterogeneous populations of microbes is the gut microbiota. The collection of microbes and their genes, called the microbiome, has been studied intensely through the past few years using novel metagenomics, metatranscriptomics, and metabolomics approaches. This has enhanced our understanding of how the microbiome affects our metabolic, immunologic, neurologic, and endocrine homeostasis. Hypertension is a leading cause of cardiovascular disease worldwide; it contributes to stroke, heart disease, kidney failure, premature death, and disability. Recently, studies in humans and animals have shown that alterations in microbiota and its metabolites are associated with hypertension and atherosclerosis. In this review, we compile the recent findings and hypotheses describing the interplay between the microbiome and blood pressure, and we highlight some prospects by which utilization of microbiome-related techniques may be incorporated to better understand the pathophysiology and treatment of hypertension. PMID:28674682

  16. Feasibility of blood pressure telemonitoring in patients with poor blood pressure control.

    PubMed

    McCant, Felicia; McKoy, Gwendolyn; Grubber, Janet; Olsen, Maren K; Oddone, Eugene; Powers, Benjamin; Bosworth, Hayden B

    2009-01-01

    We examined the feasibility of using home blood pressure (BP) telemonitoring devices for managing patients with poor BP control. We enrolled 591 subjects with a diagnosis of hypertension. Patients were randomized to usual care (n = 147) or to the intervention arm (n = 441). Those in the intervention arm were issued with a home BP telemonitoring device. The device transmitted BP readings automatically via the home telephone line. Technical alerts were generated if patients did not transmit their BP readings according to the protocol. During the first six months, 693 technical alerts were generated by 267 patients. About half of these patients (112) generated more than two technical alerts. Resolution of the alerts showed that 61% were caused by patient non-adherence. Patients who generated >2 technical alerts were younger (61 vs. 64 years; P = 0.001) and were more likely to be non-Caucasian (64% vs. 47%, P = 0.002) than those generating 2 or fewer alerts. Despite the potential for improving health care using home BP telemonitoring, certain patients will require more support to use the equipment successfully.

  17. Pressure Gradient Estimation Based on Ultrasonic Blood Flow Measurement

    NASA Astrophysics Data System (ADS)

    Nitta, Naotaka; Homma, Kazuhiro; Shiina, Tsuyoshi

    2006-05-01

    Mechanical load to the blood vessel wall, such as shear stress and pressure, which occurs in blood flow dynamics, contribute greatly to plaque rupture in arteriosclerosis and to biochemical activation of endothelial cells. Therefore, noninvasive estimations of these mechanical loads are able to provide useful information for the prevention of vascular diseases. Although the pressure is the dominant component of mechanical load, for practical purposes, the pressure gradient is also often important. So far, we have investigated the estimation of the kinematic viscosity coefficient using a combination of the Navier-Stokes equations and ultrasonic velocity measurement. In this paper, a method for pressure gradient estimation using the estimated kinematic viscosity coefficient is proposed. The validity of the proposed method was investigated on the basis of the analysis with the data obtained by computer simulation and a flow phantom experiment. These results revealed that the proposed method can provide a valid estimation of the pressure gradient.

  18. Does chocolate reduce blood pressure? A meta-analysis

    PubMed Central

    2010-01-01

    Background Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. Methods We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP) for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive). Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P < 0.05. Results Fifteen trial arms of 13 assessed studies met the inclusion criteria. Pooled meta-analysis of all trials revealed a significant blood pressure-reducing effect of cocoa-chocolate compared with control (mean BP change ± SE: SBP: -3.2 ± 1.9 mmHg, P = 0.001; DBP: -2.0 ± 1.3 mmHg, P = 0.003). However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 ± 3.0 mmHg; P = 0.0009; DBP: -2.7 ± 2.2 mm Hg, P = 0.01), while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 ± 2.3 mmHg, P = 0.17; DBP: -1.3 ± 1.6 mmHg, P = 0.12). Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30 mg to 1000 mg in

  19. Does chocolate reduce blood pressure? A meta-analysis.

    PubMed

    Ried, Karin; Sullivan, Thomas; Fakler, Peter; Frank, Oliver R; Stocks, Nigel P

    2010-06-28

    Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP) for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive). Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P < 0.05. Fifteen trial arms of 13 assessed studies met the inclusion criteria. Pooled meta-analysis of all trials revealed a significant blood pressure-reducing effect of cocoa-chocolate compared with control (mean BP change +/- SE: SBP: -3.2 +/- 1.9 mmHg, P = 0.001; DBP: -2.0 +/- 1.3 mmHg, P = 0.003). However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 +/- 3.0 mmHg; P = 0.0009; DBP: -2.7 +/- 2.2 mm Hg, P = 0.01), while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 +/- 2.3 mmHg, P = 0.17; DBP: -1.3 +/- 1.6 mmHg, P = 0.12). Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30 mg to 1000 mg in the active treatment

  20. Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: The CoCo trial

    PubMed Central

    2010-01-01

    Background Insufficient blood pressure control is a frequent problem despite the existence of effective treatment. Insufficient adherence to self-monitoring as well as to therapy is a common reason. Blood pressure self-measurement at home (Home Blood Pressure Measurement, HBPM) has positive effects on treatment adherence and is helpful in achieving the target blood pressure. Only a few studies have investigated whether adherence to HBPM can be improved through simple measures resulting also in better blood pressure control. Objective Improvement of self-monitoring and improved blood pressure control by using a new colour-coded blood pressure diary. Outcome Primary outcome: Change in systolic and/or diastolic blood pressure 6 months after using the new colour-coded blood pressure diary. Secondary outcome: Adherence to blood pressure self-measurement (number of measurements/entries). Methods/Design Randomised controlled study. Population: 138 adult patients in primary care with uncontrolled hypertension despite therapy. The control group uses a conventional blood pressure diary; the intervention group uses the new colour-coded blood pressure diary (green, yellow, red according a traffic light system). Expected results/conclusion The visual separation and entries in three colour-coded areas reflecting risk (green: blood pressure in the target range ≤ 140/≤ 90 mmHg, yellow: blood pressure >140/>90 mmHg, red: blood pressure in danger zone > 180 mmHg/>110 mmHg) lead to better self-monitoring compared with the conventional (non-colour-coded) blood pressure booklet. The colour-coded, visualised information supports improved perception (awareness and interpretation) of blood pressure and triggers correct behaviour, in the means of improved adherence to the recommended treatment as well as better communication between patients and doctors resulting in improved blood pressure control. Trial registration ClinicalTrials.gov ID NCT01013467 PMID:20398258

  1. Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge.

    PubMed

    Robillard, Rébecca; Lanfranchi, Paola A; Prince, François; Filipini, Daniel; Carrier, Julie

    2011-03-01

    To determine how aging affects the impact of sleep deprivation on blood pressure at rest and under orthostatic challenge. Subjects underwent a night of sleep and 24.5 h of sleep deprivation in a crossover counterbalanced design. Sleep laboratory. Sixteen healthy normotensive men and women: 8 young adults (mean 24 years [SD 3.1], range 20-28 years) and 8 elderly adults (mean 64.1 years [SD 3.4], range 60-69 years). Sleep deprivation. Brachial cuff arterial blood pressure and heart rate were measured in semi-recumbent and upright positions. These measurements were compared across homeostatic sleep pressure conditions and age groups. Sleep deprivation induced a significant increase in systolic and diastolic blood pressure in elderly but not young adults. Moreover, sleep deprivation attenuated the systolic blood pressure orthostatic response in both age groups. Our results suggest that sleep deprivation alters the regulatory mechanisms of blood pressure and might increase the risk of hypertension in healthy normotensive elderly.

  2. Fluid-filled blood pressure measurement systems.

    PubMed

    Li, J K; van Brummelen, A G; Noordergraaf, A

    1976-05-01

    The performance of catheter-manometer systems for the measurement of pulsatile pressure has been evaluated by both experimental techniques and theoretical considerations. The former approach has shown, on occasion, multiple maxima in the amplitude response. The latter has been approached in a variety of ways, ranging from extreme lumping to application of transmission line theory while employing different configurations in the system's representation. Multiple maxima have also been seen, The present paper identifies the sources of the differences found and compares the relative merits of various theoretical approaches. It introduces the compliance of the system as a figure of merit and provides a simple first-order approximation formula for evaluation of the quality of a system. Damping and impedance matching to improve the system's frequency response were studied. It was found that they were not needed in a very stiff or a very compliant system, nor should one worry about the representation of such a system.

  3. High blood pressure and syncope: orthostatic hypotension as a link.

    PubMed

    Rafanelli, Martina; Ungar, Andrea

    2016-06-22

    The prevalence of hypertension increases with the age. Diagnostic criteria are the same as for the young, but in older adults isolated systolic hypertension is more frequent, due to loss of vascular compliance. Blood pressure should be measured on both sides in the seated position, moreover in the supine and upright position to detect orthostatic hypotension. Ambulatory blood pressure monitoring is useful to detect white coat hypertension and masked hypertension, to tailor the treatment and search for diurnal and nocturnal blood pressure pattern abnormalities. Given that frailty can affect the relationship between blood pressure and mortality, the clinician should properly evaluate and monitor physical performance and cognitive status, throughout specific tools, as the Fried Frailty Phenotype, aiming at a systolic blood pressure target between 130 and 150 mmHg. Before starting hypotensive drugs, a careful risk and benefits' evaluation should be performed given the high risk of hypertension and hypotension consequences and the frequent coexistence of orthostatic hypotension, which predisposes to syncope and falls.

  4. A website for blood pressure measuring devices: dableducational.com.

    PubMed

    O'Brien, Eoin

    2003-08-01

    Consumers are faced with an ever-increasing array of blood pressure measuring devices, whether for use in clinical areas or for use by individuals anxious to measure their own blood pressure. Validation protocols that allow for independent evaluation of blood pressure measuring devices are available, and some of the devices on the market have been evaluated according to these protocols. The results of such evaluations have been published periodically in medical journals. However, such surveys are not readily available to the public and to health care authorities with responsibility for purchasing blood pressure measuring equipment for use in clinical medicine, and because of the necessarily lengthy publication process they are no longer up-to-date at the time of publication. Moreover, the results of published validation studies are often flawed because of protocol violations and the conclusions may not be valid. These considerations have been the stimulus for the establishment of an independent non-profit website, which will provide quarterly updates on the accuracy and performance of blood pressure measuring devices on the market as well as an expert assessment of the validation procedures on which recommendations are based. The ethos of the website is primarily educational and it is hoped that it will serve as a forum for the provision of much-needed information that will ultimately improve the management of hypertension. The website is due to be launched shortly and this paper outlines the general principles that have governed its establishment and the facilities that it will provide.

  5. Placental programming of blood pressure in Indian children

    PubMed Central

    Winder, Nicola R; Krishnaveni, Ghattu V; Hill, Jacqueline C; Karat, Chitra LS; Fall, Caroline HD; Veena, Sargoor R; Barker, David JP

    2011-01-01

    Aim To determine whether the size and shape of the placental surface predict blood pressure in childhood. Methods We studied blood pressure in 471 nine-year-old Indian children whose placental length, breadth and weight were measured in a prospective birth cohort study. Results In the daughters of short mothers (blood pressure (SBP) rose as placental breadth increased (β = 0.69 mmHg/cm, p = 0.05) and as the ratio of placental surface area to birthweight increased (p = 0.0003). In the daughters of tall mothers, SBP rose as the difference between placental length and breadth increased (β = 1.40 mmHg/cm, p = 0.007), that is as the surface became more oval. Among boys, associations with placental size were only statistically significant after adjusting for current BMI and height. After adjustment, SBP rose as placental breadth, area and weight decreased (for breadth β = −0.68 mmHg/cm, p < 0.05 for all three measurements). Conclusions The size and shape of the placental surface predict childhood blood pressure. Blood pressure may be programmed by variation in the normal processes of placentation: these include implantation, expansion of the chorionic surface in mid-gestation and compensatory expansion of the chorionic surface in late gestation. PMID:21166711

  6. Chagas disease, a risk factor for high blood pressure.

    PubMed

    Vicco, Miguel Hernán; Rodeles, Luz; Yódice, Agustina; Marcipar, Iván

    2014-12-01

    Chagas disease is a parasite infection caused by the protozoan Trypanosoma cruzi. Its most common complications is chronic Chagas heart disease but impairments of the systemic vasculature also has been observed. Although the different mechanisms that regulate blood pressure are disrupted, to our knowledge data on the association of hypertension and chronic Chagas disease are scarce. In this regard we evaluate whether Chagas disease constitutes a high blood pressure risk factor. We recruited 200 individuals, half of them with positive serology for T. cruzi. They were subjected to a complete clinical examination. The mean age of sampled individuals was 46.7 ± 12.3, and the mean of systolic and diastolic blood pressure were 124 ± 12 mmHg and 82 ± 10 mmHg, respectively. There were no between-group differences regarding age, sex distribution or body mass index. Chagas disease contributed significantly to high blood pressure (OR = 4, 95% CI 1.8323-7.0864, p = 0.0002). Our results reveal an important association between Chagas disease and high blood pressure, which should be contemplated by physicians in order to promote preventive cardiovascular actions in patients with Chagas disease.

  7. [Relationship of the blood pressure's level and skinfold thickness].

    PubMed

    Sönmez, Hulki Meltem; Karabaş, Münire Kuru; Soysal, Neslihan

    2007-03-01

    Hypertension is an important problem of the public health. Insufficient education of the people along with insufficient physical examination also plays a role in the poor success of the diagnosis and treatment of the hypertension. We investigated whether the skinfold thickness has an importance in the prediction of blood pressure or not. In Aydin City area 110 women and 100 men selected by randomized sampling method were included into our study. Body mass index, blood pressure and skinfold thickness were measured according to the international guidelines. There was a moderate correlation between the skinfold and body mass index (r= 0.494, p=0.000) and there was a mild correlation between the body mass index and systolic and diastolic blood pressures (r=0.225, p=0.000 and r=0.300, p=0.000, respectively). There was no correlation between the skinfold thickness and systolic and diastolic blood pressures (r=0.058, p=0.400 and r=0.090, p=0.194, respectively). It is concluded that body mass index, not skinfold thickness, can be used for the prediction of the blood pressure. Some other factors independent from the body mass index might be the determinants of the skinfold thickness.

  8. Efficacy of flavonoids in the management of high blood pressure.

    PubMed

    Clark, Jaime L; Zahradka, Peter; Taylor, Carla G

    2015-12-01

    Plant compounds such as flavonoids have been reported to exert beneficial effects in cardiovascular disease, including hypertension. Information on the effects of isolated individual flavonoids for management of high blood pressure, however, is more limited. This review is focused on the flavonoids, as isolated outside of the food matrix, from the 5 main subgroups consumed in the Western diet (flavones, flavonols, flavanones, flavan-3-ols, and anthocyanins), along with their effects on hypertension, including the potential mechanisms for regulating blood pressure. Flavonoids from all 5 subgroups have been shown to attenuate a rise in or to reduce blood pressure during several pathological conditions (hypertension, metabolic syndrome, and diabetes mellitus). Flavones, flavonols, flavanones, and flavanols were able to modulate blood pressure by restoring endothelial function, either directly, by affecting nitric oxide levels, or indirectly, through other pathways. Quercetin had the most consistent blood pressure-lowering effect in animal and human studies, irrespective of dose, duration, or disease status. However, further research on the safety and efficacy of the flavonoids is required before any of them can be used by humans, presumably in supplement form, at the doses required for therapeutic benefit.

  9. Effects of Citrus sinensis juice on blood pressure.

    PubMed

    Asgary, Sedigheh; Keshvari, Mahtab

    2013-01-01

    Citrus sinensis juice (CSJ) is a rich source of dietary flavonoids which reduce the risk of adverse cardiovascular events. This study aimed to examine the effects of four-week intake of natural and commercial orange (Citrus sinensis) juice on blood pressure in healthy volunteers. In this single-blind randomized crossover study, 22 healthy subjects (age: 18-59 years old) were included and randomly divided into two groups of 11. Group A consumed commercial CSJ during the first four-week period. After a two-week washout period, they consumed natural CSJ for another four weeks. The procedure was reversed in group B. The participants were asked to drink 500 ml/day of either natural or commercial CSJ twice a day with breakfast and dinner. The effects of orange juice on blood pressure were evaluated. After drinking commercial CSJ, diastolic and systolic blood pressure were significantly decreased (5.13%; P = 0.03 and -5.91%; P = 0.003, respectively). However, consumption of natural CSJ did not have significant effects on either diastolic or systolic blood pressure. Commercial CSJ significantly decreased blood pressure. Higher flavonoid, pectin, and essential oils content of concentrated products compared to natural juice might have been responsible for this finding. Nevertheless, further studies to focus on dose-response effects are recommended.

  10. Different training programs decrease blood pressure during submaximal exercise.

    PubMed

    Niño, Oscar; Balagué, Natalia; Aragonés, Daniel; Alamo, Juan; Oviedo, Guillermo; Javierre, Casimiro; Guillamo, Elisabet; Delicado, Maria C; Viscor, Gines; Ventura, Josep L

    2017-09-13

    Our purpose was to study the effects of aerobic, resistance, and mixed (aerobic and resistance) training programs on blood pressure, both at rest and during submaximal exercise in healthy people. We randomized 39 physically active, healthy participants into aerobic, resistance, and mixed (aerobic and resistance) exercise groups, and a control group. The exercise groups trained for 60 min three times/week for 6 weeks, and a submaximal cycle ergometer test was performed before and after training, and 3 weeks after detraining. Continuous blood pressure was determined before and during the test. At the submaximal test, both systolic and diastolic blood pressures decreased significantly (p < 0.05) after detraining in the exercise groups. However, between pre-training and detraining, we found significant reductions at rest only in the mixed exercise group (p < 0.05). Although all exercise had similar effects on blood pressure during submaximal exercise, the mixed aerobic and resistance exercise may be optimal for blood pressure reduction, by the addition of diverse physiological pathways.

  11. Noninvasive blood pressure measurement scheme based on optical fiber sensor

    NASA Astrophysics Data System (ADS)

    Liu, Xianxuan; Yuan, Xueguang; Zhang, Yangan

    2016-10-01

    Optical fiber sensing has many advantages, such as volume small, light quality, low loss, strong in anti-jamming. Since the invention of the optical fiber sensing technology in 1977, optical fiber sensing technology has been applied in the military, national defense, aerospace, industrial, medical and other fields in recent years, and made a great contribution to parameter measurement in the environment under the limited condition .With the rapid development of computer, network system, the intelligent optical fiber sensing technology, the sensor technology, the combination of computer and communication technology , the detection, diagnosis and analysis can be automatically and efficiently completed. In this work, we proposed a noninvasive blood pressure detection and analysis scheme which uses optical fiber sensor. Optical fiber sensing system mainly includes the light source, optical fiber, optical detector, optical modulator, the signal processing module and so on. wavelength optical signals were led into the optical fiber sensor and the signals reflected by the human body surface were detected. By comparing actual testing data with the data got by traditional way to measure the blood pressure we can establish models for predicting the blood pressure and achieve noninvasive blood pressure measurement by using spectrum analysis technology. Blood pressure measurement method based on optical fiber sensing system is faster and more convenient than traditional way, and it can get accurate analysis results in a shorter period of time than before, so it can efficiently reduce the time cost and manpower cost.

  12. Creatine kinase activity is associated with blood pressure.

    PubMed

    Brewster, Lizzy M; Mairuhu, Gideon; Bindraban, Navin R; Koopmans, Richard P; Clark, Joseph F; van Montfrans, Gert A

    2006-11-07

    We previously hypothesized that high activity of creatine kinase, the central regulatory enzyme of energy metabolism, facilitates the development of high blood pressure. Creatine kinase rapidly provides adenosine triphosphate to highly energy-demanding processes, including cardiovascular contraction, and antagonizes nitric oxide-mediated functions. Relatively high activity of the enzyme, particularly in resistance arteries, is thought to enhance pressor responses and increase blood pressure. Tissue creatine kinase activity is reported to be high in black people, a population subgroup with greater hypertension risk; the proposed effects of high creatine kinase activity, however, are not "race dependent." We therefore assessed whether creatine kinase is associated with blood pressure in a multiethnic population. We analyzed a stratified random sample of the population of Amsterdam, The Netherlands, consisting of 1444 citizens (503 white European, 292 South Asian, 580 black, and 69 of other ethnicity) aged 34 to 60 years. We used linear regression analysis to investigate the association between blood pressure and normal serum creatine kinase after rest, as a substitute measure of tissue activity. Creatine kinase was independently associated with blood pressure, with an increase in systolic and diastolic pressure, respectively, of 8.0 (95% CI, 3.3 to 12.7) and 4.7 (95% CI, 1.9 to 7.5) mm Hg per log creatine kinase increase after adjustment for age, sex, body mass index, and ethnicity. Creatine kinase is associated with blood pressure. Further studies are needed to explore the nature of this association, including how variation in cardiovascular creatine kinase activity may affect pressor responses.

  13. Noninvasive continuous arterial blood pressure monitoring with Nexfin®.

    PubMed

    Martina, Jerson R; Westerhof, Berend E; van Goudoever, Jeroen; de Beaumont, Edouard M F H; Truijen, Jasper; Kim, Yu-Sok; Immink, Rogier V; Jöbsis, Dorothea A; Hollmann, Markus W; Lahpor, Jaap R; de Mol, Bas A J M; van Lieshout, Johannes J

    2012-05-01

    If invasive measurement of arterial blood pressure is not warranted, finger cuff technology can provide continuous and noninvasive monitoring. Finger and radial artery pressures differ; Nexfin® (BMEYE, Amsterdam, The Netherlands) measures finger arterial pressure and uses physiologic reconstruction methodologies to obtain values comparable to invasive pressures. Intra-arterial pressure (IAP) and noninvasive Nexfin arterial pressure (NAP) were measured in cardiothoracic surgery patients, because invasive pressures are available. NAP-IAP differences were analyzed during 30 min. Tracking was quantified by within-subject precision (SD of individual NAP-IAP differences) and correlation coefficients. The ranges of pressure change were quantified by within-subject variability (SD of individual averages of NAP and IAP). Accuracy and precision were expressed as group average ± SD of the differences and considered acceptable when smaller than 5 ± 8 mmHg, the Association for the Advancement of Medical Instrumentation criteria. NAP and IAP were obtained in 50 (34-83 yr, 40 men) patients. For systolic, diastolic, mean arterial, and pulse pressure, median (25-75 percentiles) correlation coefficients were 0.96 (0.91-0.98), 0.93 (0.87-0.96), 0.96 (0.90-0.97), and 0.94 (0.85-0.98), respectively. Within-subject precisions were 4 ± 2, 3 ± 1, 3 ± 2, and 3 ± 2 mmHg, and within-subject variations 13 ± 6, 6 ± 3, 9 ± 4, and 7 ± 4 mmHg, indicating precision over a wide range of pressures. Group average ± SD of the NAP-IAP differences were -1 ± 7, 3 ± 6, 2 ± 6, and -3 ± 4 mmHg, meeting criteria. Differences were not related to mean arterial pressure or heart rate. Arterial blood pressure can be measured noninvasively and continuously using physiologic pressure reconstruction. Changes in pressure can be followed and values are comparable to invasive monitoring.

  14. Cuffless differential blood pressure estimation using smart phones.

    PubMed

    Chandrasekaran, Vikram; Dantu, Ram; Jonnada, Srikanth; Thiyagaraja, Shanti; Subbu, Kalyan Pathapati

    2013-04-01

    Smart phones today have become increasingly popular with the general public for their diverse functionalities such as navigation, social networking, and multimedia facilities. These phones are equipped with high-end processors, high-resolution cameras, and built-in sensors such as accelerometer, orientation-sensor, and light-sensor. According to comScore survey, 26.2% of U.S. adults use smart phones in their daily lives. Motivated by this statistic and the diverse capability of smart phones, we focus on utilizing them for biomedical applications. We present a new application of the smart phone with its built-in camera and microphone replacing the traditional stethoscope and cuff-based measurement technique, to quantify vital signs such as heart rate and blood pressure. We propose two differential blood pressure estimating techniques using the heartbeat and pulse data. The first method uses two smart phones whereas the second method replaces one of the phones with a customized external microphone. We estimate the systolic and diastolic pressure in the two techniques by computing the pulse pressure and the stroke volume from the data recorded. By comparing the estimated blood pressure values with those measured using a commercial blood pressure meter, we obtained encouraging results of 95-100% accuracy.

  15. Prolonged photostress macular recovery after reduced blood pressure.

    PubMed

    Myhre, K; Brinchmann-Hansen, O

    1991-06-01

    In order to investigate an association between systemic blood pressure and restitution of normal visual function in dim illumination after photostress, macular recovery time and blood pressure were measured in two groups: 1) 90 young and healthy military pilots and applicants for military pilot training; and 2) 10 hypertensive patients before and after 12 weeks of antihypertensive treatment. Young normotensive subjects (20/20 vision) with low diastolic blood pressure performed less well (longer macular recovery time) than those with higher pressure (r = -0.42, p less than or equal to 0.05). Among the hypertensive patients three were given doxazosin, three, prazosin, and four, placebo. The treatment period produced significant fall in blood pressures, a small reduction in intraocular pressure (p less than or equal to 0.03) and a lengthening of initial monocular recovery period (p = 0.04) in addition to reduced monocular (p = 0.015) and binocular (p = 0.022) macular recovery in the remaining part of the 2-min test period. This observation may be important for antihypertensive treated patients whose occupation requires fast visual adjustment to changing stimuli in dim light.

  16. Association between blood lead levels and blood pressures in a non-smoking healthy Korean population.

    PubMed

    Lee, Kyu Rae; Ko, Ki Dong; Hwang, In Cheol; Suh, Heuy Sun; Kim, Kyoung Kon

    2017-09-01

    The Korea National Health and Nutrition Examination Survey (KNHANES) has been performed every 3 years in Korea to help prevent cardiovascular mortality in the general population. Previous studies showed an association between blood lead levels and cardiovascular mortality. In order to assess the relationship between blood lead concentration and blood pressure in the healthy general population, we investigated whether blood lead levels were related to blood pressure in a non-smoking healthy population without any known medical diseases in the 2013 KNHANES. 896 (mean age 40.55±13.83 years; body mass index 23.06±3.33 kg/m(2)) subjects who had no known diseases were included among 8018 subjects. Exclusion criteria were: hypertension, diabetes, hyperlipidaemia, cerebrovascular events, renal insufficiency, liver cirrhosis, thyroid dysfunction, any cardiovascular or renal disease, and any malignancy. Blood pressures were measured three times by sphygmomanometers, 5 min apart. Blood pressures were then expressed as the average between the second and third values. Height, weight, waist circumferences and blood pressure, as well as total cholesterol, high density lipoprotein cholesterol, triglycerides, low density lipoprotein cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), white blood cell count and blood lead levels were measured. In addition, dietary components were analysed by 24 hour recall. The association between log blood lead levels and systolic/diastolic pressure was stronger after it was controlled for age, sex, education, body mass index (BMI), waist circumference and fasting plasma glucose (FPG) (p=0.048, 0.002). Furthermore, the association between log blood lead levels and systolic pressure (p=0.048) and diastolic pressure (p=0.002) was more evident when controlled for age, sex, education, BMI, waist circumference, FPG, AST and ALT. Blood lead levels are significant determinants of systolic and diastolic blood pressure

  17. Ethnic Differences in Physical Fitness, Blood Pressure and Blood Chemistry in Women (AGES 20-63)

    NASA Technical Reports Server (NTRS)

    Ayers, G. W.; Wier, L. T.; Jackson, A. S.; Stuteville, J. E.; Keptra, Sean (Technical Monitor)

    1999-01-01

    This study examined the role of ethnicity on the aerobic fitness, blood pressure, and selected blood chemistry values of women. One hundred twenty-four females (mean age 41.37 +/- 9.0) were medically Examined at the NASA/Johnson Space Center occupational health clinic. Ethnic groups consisted of 23 Black (B), 18 Hispanic (H) and 83 Non-minority (NM). Each woman had a maximum Bruce treadmill stress test (RER greater than or = 1.1) and a negative ECG. Indirect calorimetry, skinfolds, self-report physical activity (NASA activity scale), seated blood pressure, and blood chemistry panel determined VO2max, percent fat, level of physical activity, blood pressure and blood chemistry values. ANOVA revealed that the groups did not differ (p greater than 0.05) in age, VO2 max, weight, percent fat, level of physical activity, total cholesterol, or HDL-C. However, significant differences (p greater than 0.05) were noted in BMI, diastolic blood pressure, and blood chemistries. BMI was 3.17 higher in H than in NM; resting diastolic pressures were 5.69 and 8.05 mmHg. lower in NM and H than in B; triglycerides were 48.07 and 37.21 mg/dl higher in H than in B and NM; hemoglobin was .814 gm/dl higher in NM than B; fasting blood sugar was 15.41 mg/dl higher in H than NM; The results of this study showed that ethnic groups differed in blood pressure and blood chemistry values but not aerobic fitness or physical activity. There was an ethnic difference in BMI but not percent fat.

  18. Ethnic Differences in Physical Fitness, Blood Pressure and Blood Chemistry in Women (AGES 20-63)

    NASA Technical Reports Server (NTRS)

    Ayers, G. W.; Wier, L. T.; Jackson, A. S.; Stuteville, J. E.; Keptra, Sean (Technical Monitor)

    1999-01-01

    This study examined the role of ethnicity on the aerobic fitness, blood pressure, and selected blood chemistry values of women. One hundred twenty-four females (mean age 41.37 +/- 9.0) were medically Examined at the NASA/Johnson Space Center occupational health clinic. Ethnic groups consisted of 23 Black (B), 18 Hispanic (H) and 83 Non-minority (NM). Each woman had a maximum Bruce treadmill stress test (RER greater than or = 1.1) and a negative ECG. Indirect calorimetry, skinfolds, self-report physical activity (NASA activity scale), seated blood pressure, and blood chemistry panel determined VO2max, percent fat, level of physical activity, blood pressure and blood chemistry values. ANOVA revealed that the groups did not differ (p greater than 0.05) in age, VO2 max, weight, percent fat, level of physical activity, total cholesterol, or HDL-C. However, significant differences (p greater than 0.05) were noted in BMI, diastolic blood pressure, and blood chemistries. BMI was 3.17 higher in H than in NM; resting diastolic pressures were 5.69 and 8.05 mmHg. lower in NM and H than in B; triglycerides were 48.07 and 37.21 mg/dl higher in H than in B and NM; hemoglobin was .814 gm/dl higher in NM than B; fasting blood sugar was 15.41 mg/dl higher in H than NM; The results of this study showed that ethnic groups differed in blood pressure and blood chemistry values but not aerobic fitness or physical activity. There was an ethnic difference in BMI but not percent fat.

  19. Risk, prevention and treatment of pressure ulcers--nursing staff knowledge and documentation.

    PubMed

    Gunningberg, L; Lindholm, C; Carlsson, M; Sjödén, P O

    2001-01-01

    The aims were to investigate (i) registered nurses' and nursing assistants' knowledge of risk, prevention and treatment of pressure ulcer before implementing a system for risk assessment and pressure ulcer classification for patients with hip fracture (ii) interventions documented in the patient's records by registered nurses, and (iii) to what extent reported and documented interventions accord with the Swedish quality guidelines. Nursing staff (n=85) completed a questionnaire, and patient's records (n=55) were audited retrospectively. The majority of the nursing staff reported that they performed risk assessment when caring for a patient with hip fracture. These risk assessments were, however, not comprehensive. The most frequently reported preventive interventions were repositioning, use of lotion, mattresses/overlays and cushions for the heels. These interventions were to some extent documented in the patient's records. Nutritional support, reduction of shear and friction, hygiene and skin moisture, and patient's education were reported to a small extent and not documented at all. The Swedish quality guidelines regarding prevention and treatment of pressure ulcers were not fully implemented in clinical practice. It was concluded that nursing staff's knowledge and documentation of risk, prevention and treatment of pressure ulcers for patients with hip fractures could be improved.

  20. Multiplex blood PCR in combination with blood cultures for improvement of microbiological documentation of infection in febrile neutropenia.

    PubMed

    Lamoth, F; Jaton, K; Prod'hom, G; Senn, L; Bille, J; Calandra, T; Marchetti, O

    2010-10-01

    The frequent lack of microbiological documentation of infection by blood cultures (BC) has a major impact on clinical management of febrile neutropenic patients, especially in cases of unexplained persistent fever. We assessed the diagnostic utility of the LightCycler SeptiFast test (SF), a multiplex blood PCR, in febrile neutropenia. Blood for BC and SF was drawn at the onset of fever and every 3 days of persistent fever. SF results were compared with those of BC, clinical documentation of infection, and standard clinical, radiological, and microbiological criteria for invasive fungal infections (IFI). A total of 141 febrile neutropenic episodes in 86 hematological patients were studied: 44 (31%) microbiologically and 49 (35%) clinically documented infections and 48 (34%) unexplained fevers. At the onset of fever, BC detected 44 microorganisms in 35/141 (25%) episodes. Together, BC and SF identified 78 microorganisms in 61/141 (43%) episodes (P = 0.002 versus BC or SF alone): 12 were detected by BC and SF, 32 by BC only, and 34 by SF only. In 19/52 (37%) episodes of persistent fever, SF detected 28 new microorganisms (7 Gram-positive bacterial species, 15 Gram-negative bacterial species, and 6 fungal species [89% with a clinically documented site of infection]) whereas BC detected only 4 pathogens (8%) (P = 0.001). While BC did not detect fungi, SF identified 5 Candida spp. and 1 Aspergillus sp. in 5/7 probable or possible cases of IFI. Using SeptiFast PCR combined with blood cultures improves microbiological documentation in febrile neutropenia, especially when fever persists and invasive fungal infection is suspected. Technical adjustments may enhance the efficiency of this new molecular tool in this specific setting.