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Hernández Véliz D, Valdés González Y, Armas Rojas NB, De la Noval García R, Ringrose J, Padwal R. Validation of combiomed hipermax-BF model A7101 automatic oscillometric upper-arm sphygmomanometer in general population: AAMI/ESH/ISO universal standard (ISO 81060-2:2018/Amd 1:2020). J Hum Hypertens 2024:10.1038/s41371-024-00948-9. [PMID: 39182003 DOI: 10.1038/s41371-024-00948-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 08/11/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024]
Abstract
This study evaluates the accuracy of the Hipermax-BF model A7101 (Combiomed, Havana, Cuba) automatic oscillometric upper-arm sphygmomanometer for office and home use in general population as part of the HEARTS in the Americas initiative. The research was developed according to the Universal Standard AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020. The subjects were recruited according to the requirements of age, gender, blood pressure values and upper-arm circumference. The same upper-arm sequential blood pressure measurement method was used. For measurements with the device under test, the 2-piece cuff from 22-44 cm limb circumference range was used. 92 subjects were recruited and 85 were analyzed. Mean age was 44.8 ± 14.7 years, mean upper-arm circumference was 32.3 ± 6.2, and 56.5% were female. For Validation Criterion 1, the mean value ± standard deviation of the differences in readings between the device under test and the reference device was 1.2 ± 4.9/0.8 ± 4.9 mmHg (systolic/diastolic). For both pressures, in criterion 1 the standard requires a mean value of the differences ≤ ± 5 mmHg and a standard deviation ≤ ± 8 mmHg. For Validation Criterion 2, the standard deviation of the mean blood pressure differences per subject was 4.2/4.2 mmHg (systolic/diastolic). According to Table 1 of criterion 2, for the mean values of 1.2/0.8 mmHg (systolic/diastolic), the maximum allowable standard deviation had to be < 6.84 for systolic and < 6.89 for diastolic pressure. The Combiomed Hipermax-BF A7101 automatic sphygmomanometer meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018/Amd 1:2020) in the general population.
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Affiliation(s)
- Damaris Hernández Véliz
- Institute of Cardiology and Cardiovascular Surgery, 17th street 702 between A and Paseo Avenue, Havana, 10400, Cuba
| | | | - Nurys Bárbara Armas Rojas
- Institute of Cardiology and Cardiovascular Surgery, 17th street 702 between A and Paseo Avenue, Havana, 10400, Cuba
| | - Reinaldo De la Noval García
- Institute of Cardiology and Cardiovascular Surgery, 17th street 702 between A and Paseo Avenue, Havana, 10400, Cuba
| | | | - Raj Padwal
- University of Alberta, Edmonton, AB, Canada
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2
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Rossing P, Hansen TW, Kümler T. Cardiovascular and non-renal complications of chronic kidney disease: Managing risk. Diabetes Obes Metab 2024. [PMID: 38982587 DOI: 10.1111/dom.15747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 07/11/2024]
Abstract
Chronic kidney disease (CKD) currently affects approximately 850 million people globally and is continuing to increase in prevalence as well as in importance as a cause of death. The excess mortality related to CKD is mostly caused by an increase in cardiovascular disease. This includes atherosclerotic cardiovascular disease as many promoters of atherosclerosis, such as blood pressure, lipid levels and hypercoagulation, are increased in people with CKD. Diabetes is a leading cause of CKD contributing to the risk of CVD, and obesity is also increasingly prevalent. Management of these risk factors is therefore very important in CKD, and to reduce risk of CKD progression. Heart failure is also more prevalent in CKD and, again, many risk factors are shared. The concept of foundational pillars in the management of heart failure has been adapted to the treatment of CKD, with many organ-protective interventions, such renin-angiotensin system blockade, sodium-glucose cotransporter-2 inhibition and mineralocorticoid receptor antagonism, reducing the risk for mortality in heart failure with reduced ejection fraction, but also for progression of CKD. Atrial fibrillation is also more common with CKD and affects the management of the former. In this review these non-renal complications of CKD are discussed, along with how the risk of these complications should be managed. Many new opportunities have demonstrated heart and kidney organ protection, but implementation is a challenge.
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Affiliation(s)
- Peter Rossing
- Clinical Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Tine Willum Hansen
- Clinical Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Kümler
- Clinical Translational Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Knoll L, Elwell J, Arcari-Couture J, Alexander N. The Standardization of Home Blood Pressure Monitoring in Primary Care: A Quality Improvement Project. J Ambul Care Manage 2024; 47:14-21. [PMID: 37994510 DOI: 10.1097/jac.0000000000000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Current guidelines recommend the use of home blood pressure monitoring (HBPM) to screen for and manage hypertension. In this study, a quality improvement project was designed to standardize the use of HBPM in a primary care setting and demonstrate improved blood pressure outcomes. Initial systolic and diastolic values were compared to averages from patient logs. Patient and provider feedback was collected. Only 40% of patients enrolled presented to follow-up with actionable HBPM data. Patients encountered logistical challenges in obtaining and presenting HBPM data. Interprofessional collaboration and improved information technology systems would improve outcomes. This will require increased policy and insurer support to make this possible in small settings.
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Affiliation(s)
- Lisa Knoll
- Prime Healthcare, PC, West Hartford, Connecticut (Drs Knoll and Alexander); University of Connecticut School of Nursing, Storrs (Drs Elwell and Arcari-Couture); and Orthopedics and Sports Medicine, UCONN Health, Farmington, Connecticut (Dr Arcari-Couture)
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Wang TD, Ohkubo T, Bunyi ML, Chadachan VM, Chia YC, Kario K, Kim CH, Lin HJ, Matsushita N, Park S, Salman E, Sukonthasarn A, Tay JC, Tien HA, Tomar I, Turana Y, Van Minh H, Verma N, Wander GS, Wang JG, Zhou Y, Imai Y. Current realities of home blood pressure monitoring from physicians' perspectives: results from Asia HBPM survey 2020. Hypertens Res 2023; 46:1638-1649. [PMID: 37041412 PMCID: PMC10319632 DOI: 10.1038/s41440-023-01259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/07/2023] [Accepted: 02/19/2023] [Indexed: 04/13/2023]
Abstract
Uncontrolled hypertension is a significant problem in many parts of Asia. Effective management is essential to reduce the burden of hypertension. Home blood pressure monitoring (HBPM) is a promising tool that can aid in the diagnosis and management of hypertension. Experts from 11 countries/regions in Asia conceptualized a large-scale survey to examine the current realities of HBPM. A cross-sectional survey was conducted among health care professionals from China, India, Indonesia, Japan, Malaysia, the Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam between November 2019 and June 2021. Physicians' responses were summarized using descriptive statistics. A total of 7945 physicians participated in the survey. Among all respondents, 50.3% and 33.5% viewed HBPM as highly recognized by physicians and patients in their country/region, respectively. Lack of understanding of HBPM and concern with the accuracy and reliability of HBPM devices were identified as key barriers to HBPM recognition. Nearly all physicians (95.9%) reported recommending HBPM to their patients; however, they reported less than 50% of their patients measured home blood pressure (HBP). Among physicians who recommended HBPM, only 22.4% and 54.1% cited HBP diagnostic threshold values and timing of taking antihypertensive drugs that were consistent with available guidelines, respectively. The survey reveals that the recognition of HBPM as a valuable tool to diagnose and manage hypertension is suboptimal in most parts of Asia. Despite high recommendation of HBPM to hypertensive patients by physicians, there are considerable discrepancies between guidelines recommendations and practice realities. The recognition of HBPM as a valuable tool for the diagnosis and management of hypertension is suboptimal among both physicians and patients in Asia. A clear and consistent guidance for proper HBPM practice and use of validated and calibrated HBP monitors are among the top priorities to support the integration of HBPM into daily patient care. HBPM: home blood pressure monitoring, HBP: home blood pressure.
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Affiliation(s)
- Tzung-Dau Wang
- Cardiovascular Center and Divisions of Hospital Medicine and Cardiology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhong-Shan South Road, 100225, Taipei City, Taiwan, ROC.
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Ma Lourdes Bunyi
- Dr. HB Calleja Heart and Vascular Institute, St. Luke's Medical Center, 279 E. Rodriguez Sr. Avenue, Quezon City, 1102, Philippines
| | | | - Yook Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, 5 Jalan Universiti, Bandar Sunway, 47500, Selangor Darul Ehsan, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50910, Kuala Lumpur, Malaysia
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Cheol-Ho Kim
- Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
- Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173 (baekchilsipsam) beo, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea
| | - Hung-Ju Lin
- Cardiovascular Center and Divisions of Hospital Medicine and Cardiology, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Zhong-Shan South Road, 100225, Taipei City, Taiwan, ROC
| | - Noriko Matsushita
- Asia Pacific Global Medical Affairs, Omron Healthcare Singapore, Pte. Ltd., 438B Alexandra Road #08-01/02, Alexandra TechnoPark, 119968, Singapore
| | - Sungha Park
- Yonsei University College of Medicine, Severance Cardiovascular Hospital, Division of Cardiology, 50-1 Yonsei Ro Seodaemungu Ludlow Faculty Building, Seoul, 03722, Republic of Korea
| | - Ebtehal Salman
- Asia Pacific Global Medical Affairs, Omron Healthcare Co., Ltd., 53, Kunotsubo, Terado-cho, Muko, Kyoto, 617-0002, Japan
| | - Apichard Sukonthasarn
- Department of Medicine, Bangkok Hospital Chiang Mai, 88/8 Moo6, Tumbol Nong Pa Khrang, Amphur Muang Chiang Mai, Chiang Mai, 50000, Thailand
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, 308433, Singapore
| | - Hoang Anh Tien
- Cardiovascular Department, Hue University of Medicine and Pharmacy, Hue university, Hue, 06 Ngo Quyen, Vinh Ninh District, Hue city, Thua Thien Hue province, 52000, Vietnam
| | - Isha Tomar
- Asia Pacific Global Medical Affairs, Omron Healthcare India Private Ltd., 6th Floor, B-Block, Sewa Tower, Plot No. 19, Sector-18, Udyog Vihar, Gurugram, Haryana, 122008, India
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Pluit Raya no 2, North Jakarta, 14440, Indonesia
| | - Huynh Van Minh
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen, Vinh Ninh District, Hue city, Thua Thien Hue province, 52000, Vietnam
| | - Narsingh Verma
- Professor Department of Physiology, Officiating Head Department of Family Medicine, King George's Medical University Lucknow, Lucknow, 226003, India
| | - Gurpreet Singh Wander
- Professor & Head of Cardiology, Dayanand Medical College & Hospital Unit Hero DMC Heart Institute, Ludhiana, 141001, Punjab, India
| | - Ji-Guang Wang
- Department of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Yi Zhou
- Department of Hypertension, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Ruijin 2nd Road 197, Shanghai, 200025, China
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, 13-18, Station Plaza Building, Futsukamachi, Aobaku, Sendai, Miyagi, 980-0802, Japan
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Sel K, Osman D, Huerta N, Edgar A, Pettigrew RI, Jafari R. Continuous cuffless blood pressure monitoring with a wearable ring bioimpedance device. NPJ Digit Med 2023; 6:59. [PMID: 36997608 PMCID: PMC10063561 DOI: 10.1038/s41746-023-00796-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/10/2023] [Indexed: 04/01/2023] Open
Abstract
Smart rings provide unique opportunities for continuous physiological measurement. They are easy to wear, provide little burden in comparison to other smart wearables, are suitable for nocturnal settings, and can be sized to provide ideal contact between the sensors and the skin at all times. Continuous measuring of blood pressure (BP) provides essential diagnostic and prognostic value for cardiovascular health management. However, conventional ambulatory BP measurement devices operate using an inflating cuff that is bulky, intrusive, and impractical for frequent or continuous measurements. We introduce ring-shaped bioimpedance sensors leveraging the deep tissue sensing ability of bioimpedance while introducing no sensitivity to skin tones, unlike optical modalities. We integrate unique human finger finite element model with exhaustive experimental data from participants and derive optimum design parameters for electrode placement and sizes that yields highest sensitivity to arterial volumetric changes, with no discrimination against varying skin tones. BP is constructed using machine learning algorithms. The ring sensors are used to estimate arterial BP showing peak correlations of 0.81, and low error (systolic BP: 0.11 ± 5.27 mmHg, diastolic BP: 0.11 ± 3.87 mmHg) for >2000 data points and wide BP ranges (systolic: 89-213 mmHg and diastolic: 42-122 mmHg), highlighting the significant potential use of bioimpedance ring for accurate and continuous estimation of BP.
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Affiliation(s)
- Kaan Sel
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Deen Osman
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Noah Huerta
- Department of Mechanical Engineering, Texas A&M University, College Station, TX, USA
| | - Arabella Edgar
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | | | - Roozbeh Jafari
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA.
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA.
- School of Engineering Medicine, Texas A&M University, Houston, TX, USA.
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, USA.
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6
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Woolf EK, Terwoord JD, Litwin NS, Vazquez AR, Lee SY, Ghanem N, Michell KA, Smith BT, Grabos LE, Ketelhut NB, Bachman NP, Smith ME, Le Sayec M, Rao S, Gentile CL, Weir TL, Rodriguez-Mateos A, Seals DR, Dinenno FA, Johnson SA. Daily blueberry consumption for 12 weeks improves endothelial function in postmenopausal women with above-normal blood pressure through reductions in oxidative stress: a randomized controlled trial. Food Funct 2023; 14:2621-2641. [PMID: 36847333 DOI: 10.1039/d3fo00157a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Estrogen-deficient postmenopausal women have oxidative stress-mediated suppression of endothelial function that is exacerbated by high blood pressure. Previous research suggests blueberries may improve endothelial function through reductions in oxidative stress, while also exerting other cardiovascular benefits. The objective of this study was to examine the efficacy of blueberries to improve endothelial function and blood pressure in postmenopausal women with above-normal blood pressure, and to identify potential mechanisms for improvements in endothelial function. A randomized, double-blind, placebo-controlled, parallel-arm clinical trial was performed, where postmenopausal women aged 45-65 years with elevated blood pressure or stage 1-hypertension (total n = 43, endothelial function n = 32) consumed 22 g day-1 of freeze-dried highbush blueberry powder or placebo powder for 12 weeks. Endothelial function was assessed at baseline and 12 weeks through ultrasound measurement of brachial artery flow-mediated dilation (FMD) normalized to shear rate area under the curve (FMD/SRAUC) before and after intravenous infusion of a supraphysiologic dose of ascorbic acid to evaluate whether FMD improvements were mediated by reduced oxidative stress. Hemodynamics, arterial stiffness, cardiometabolic blood biomarkers, and plasma (poly)phenol metabolites were assessed at baseline and 4, 8, and 12 weeks, and venous endothelial cell protein expression was assessed at baseline and 12 weeks. Absolute FMD/SRAUC was 96% higher following blueberry consumption compared to baseline (p < 0.05) but unchanged in the placebo group (p > 0.05), and changes from baseline to 12 weeks were greater in the blueberry group than placebo (+1.09 × 10-4 ± 4.12 × 10-5vs. +3.82 × 10-6 ± 1.59 × 10-5, p < 0.03, respectively). The FMD/SRAUC response to ascorbic acid infusion was lower (p < 0.05) at 12 weeks compared to baseline in the blueberry group with no change in the placebo group (p > 0.05). The sum of plasma (poly)phenol metabolites increased at 4, 8, and 12 weeks in the blueberry group compared to baseline, and were higher than the placebo group (all p < 0.05). Increases in several plasma flavonoid and microbial metabolites were also noted. No major differences were found for blood pressure, arterial stiffness, blood biomarkers, or endothelial cell protein expression following blueberry consumption. These findings suggest daily consumption of freeze-dried blueberry powder for 12 weeks improves endothelial function through reduced oxidative stress in postmenopausal women with above-normal blood pressure. The clinical trial registry number is NCT03370991 (https://clinicaltrials.gov).
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Affiliation(s)
- Emily K Woolf
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Janée D Terwoord
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Nicole S Litwin
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Allegra R Vazquez
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Sylvia Y Lee
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Nancy Ghanem
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Kiri A Michell
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Brayden T Smith
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Lauren E Grabos
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Nathaniel B Ketelhut
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Nate P Bachman
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Meghan E Smith
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Melanie Le Sayec
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, England, UK
| | - Sangeeta Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Christopher L Gentile
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Tiffany L Weir
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
| | - Ana Rodriguez-Mateos
- Department of Nutritional Sciences, School of Life Course and Population Sciences, King's College London, London, England, UK
| | - Douglas R Seals
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - Frank A Dinenno
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Sarah A Johnson
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, USA.
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Deng Z, Guo L, Chen X, Wu W. Smart Wearable Systems for Health Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23052479. [PMID: 36904682 PMCID: PMC10007426 DOI: 10.3390/s23052479] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 06/12/2023]
Abstract
Smart wearable systems for health monitoring are highly desired in personal wisdom medicine and telemedicine. These systems make the detecting, monitoring, and recording of biosignals portable, long-term, and comfortable. The development and optimization of wearable health-monitoring systems have focused on advanced materials and system integration, and the number of high-performance wearable systems has been gradually increasing in recent years. However, there are still many challenges in these fields, such as balancing the trade-off between flexibility/stretchability, sensing performance, and the robustness of systems. For this reason, more evolution is required to promote the development of wearable health-monitoring systems. In this regard, this review summarizes some representative achievements and recent progress of wearable systems for health monitoring. Meanwhile, a strategy overview is presented about selecting materials, integrating systems, and monitoring biosignals. The next generation of wearable systems for accurate, portable, continuous, and long-term health monitoring will offer more opportunities for disease diagnosis and treatment.
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Affiliation(s)
- Zhiyong Deng
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
- Nuclear Power Institute of China, Huayang, Shuangliu District, Chengdu 610213, China
| | - Lihao Guo
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi’an 710126, China
| | - Ximeng Chen
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou 730000, China
| | - Weiwei Wu
- School of Advanced Materials and Nanotechnology, Interdisciplinary Research Center of Smart Sensors, Xidian University, Xi’an 710126, China
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Asayama K. Importance of reconfirming the validity of the revised blood pressure categories. Hypertens Res 2023; 46:1064-1066. [PMID: 36732669 DOI: 10.1038/s41440-023-01206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. .,Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. .,Tohoku Institute for Management of Blood Pressure, Sendai, Japan.
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9
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Kireev D, Sel K, Ibrahim B, Kumar N, Akbari A, Jafari R, Akinwande D. Continuous cuffless monitoring of arterial blood pressure via graphene bioimpedance tattoos. NATURE NANOTECHNOLOGY 2022; 17:864-870. [PMID: 35725927 DOI: 10.1038/s41565-022-01145-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/03/2022] [Indexed: 05/15/2023]
Abstract
Continuous monitoring of arterial blood pressure (BP) in non-clinical (ambulatory) settings is essential for understanding numerous health conditions, including cardiovascular diseases. Besides their importance in medical diagnosis, ambulatory BP monitoring platforms can advance disease correlation with individual behaviour, daily habits and lifestyle, potentially enabling analysis of root causes, prognosis and disease prevention. Although conventional ambulatory BP devices exist, they are uncomfortable, bulky and intrusive. Here we introduce a wearable continuous BP monitoring platform that is based on electrical bioimpedance and leverages atomically thin, self-adhesive, lightweight and unobtrusive graphene electronic tattoos as human bioelectronic interfaces. The graphene electronic tattoos are used to monitor arterial BP for >300 min, a period tenfold longer than reported in previous studies. The BP is recorded continuously and non-invasively, with an accuracy of 0.2 ± 4.5 mm Hg for diastolic pressures and 0.2 ± 5.8 mm Hg for systolic pressures, a performance equivalent to Grade A classification.
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Affiliation(s)
- Dmitry Kireev
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX, USA
- Microelectronics Research Center, The University of Texas, Austin, TX, USA
| | - Kaan Sel
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Bassem Ibrahim
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Neelotpala Kumar
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX, USA
| | - Ali Akbari
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Roozbeh Jafari
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA.
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA.
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, USA.
| | - Deji Akinwande
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, TX, USA.
- Microelectronics Research Center, The University of Texas, Austin, TX, USA.
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10
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Asayama K, Ohkubo T, Rakugi H, Miyakawa M, Mori H, Katsuya T, Ikehara Y, Ueda S, Ohya Y, Tsuchihashi T, Kario K, Miura K, Ito S, Umemura S. Direct comparison of the reproducibility of in-office and self-measured home blood pressures. J Hypertens 2022; 40:398-407. [PMID: 34620775 PMCID: PMC8728752 DOI: 10.1097/hjh.0000000000003026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to compare short-term and long-term reproducibilities of in-office unattended blood pressure (BP), namely automated office blood pressure (AOBP), conventionally measured attended office BP, and self-measured home BP. METHODS A multicentre, clinical study was conducted in Japan, and 287 Japanese outpatients on antihypertensive drug medication were followed-up for 1 year. RESULTS The intensity of drug treatment was sustained consistently throughout the study period (defined daily doses, 1.62-1.68; P = 0.12). The mean SBP differences between baseline and 1 month later, as well as baseline and 1 year later, were less than 1.5 mmHg, whereas the standard deviations of the differences for home, AOBP, and attended office measurements for the 1-year interval were 7.7, 14.5, and 15.3 mmHg, respectively. The coefficients of variation were significantly smaller for home BP than for AOBP among all patients at both 1-month and 1-year intervals (P < 0.0001). In the 1-month interval, partial correlation coefficients of home BP (r, 0.73/0.88 for systolic/diastolic measures) were significantly higher than of conventional BP (r, 0.47/0.69). However, the correlations converged to the modest level regardless of BP information (r, 0.49-0.54/0.63-0.73) when the 1-year interval was assessed. Results were confirmatory when patients on the same drug regimen (n = 167) were analysed. CONCLUSION A higher reproducibility of home BP was demonstrated compared with in-office BP, including AOBP. However, the modest correlations for the 1-year interval support the importance of regular assessment of BP, regardless of in-office or home measurements for treatment of hypertension.
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Affiliation(s)
- Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
- KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita
| | | | - Hisao Mori
- Yokohama Sotetsu bldg. Clinic of Internal Medicine, Yokohama
| | - Tomohiro Katsuya
- Katsuya Clinic, Amagasaki
- Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Suita
| | - Yumi Ikehara
- Ryukyu Clinical Research Unit, University of the Ryukyus
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Nishihara
| | - Takuya Tsuchihashi
- Department of Cardiology and Hypertension, Steel Memorial Yawata Hospital, Kitakyushu
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine
- Jichi Medical University Center of Excellence, Cardiovascular Research and Development (JCARD), Shimotsuke
| | - Katsuyuki Miura
- Department of Public Health
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu
| | - Sadayoshi Ito
- Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai
- Department of Medicine, Katta General Hospital, Shiroishi
| | - Satoshi Umemura
- Yokohama Rosai Hospital, Japan Organization of Occupational Health and Safety, Yokohama, Japan
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11
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Ciobanu DM, Bala C, Rusu A, Cismaru G, Roman G. E-Selectin Is Associated with Daytime and 24-Hour Diastolic Blood Pressure Variability in Type 2 Diabetes. Biomedicines 2022; 10:279. [PMID: 35203490 PMCID: PMC8869192 DOI: 10.3390/biomedicines10020279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/17/2022] Open
Abstract
E-selectin is an endothelial cell adhesion molecule involved in vascular inflammation. Elevated E-selectin has been reported in patients with high blood pressure and diabetes. Given the increasing clinical relevance of parameters derived from ambulatory blood pressure monitoring, further investigation of their relationships with E-selectin is of interest. In this study, we aimed to investigate the association between serum E-selectin, office blood pressure and 24 h ambulatory blood pressure parameters in patients with type 2 diabetes. Blood pressure variability was assessed by computing the standard deviation of mean systolic and diastolic blood pressure separately for daytime and nighttime during 24 h ambulatory blood pressure monitoring in a cohort of patients with type 2 diabetes (n = 132). Additionally, were assessed nighttime systolic dipping and pulse pressure separately for daytime, nighttime, and 24 h. Serum E-selectin was measured using the enzyme-linked immunosorbent assay technique. We found that E-selectin was consistently associated with 24 h diastolic blood pressure variability (r = 0.238; p = 0.019) and daytime diastolic blood pressure variability (r = 0.258; p = 0.012), after adjustment for confounding factors. No association of E-selectin with office blood pressure and other 24 h ambulatory blood pressure parameters was observed. In conclusion, endothelial activation indicated by elevated serum E-selectin is associated with increased ambulatory diastolic blood pressure variability in patients with type 2 diabetes.
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Affiliation(s)
- Dana Mihaela Ciobanu
- Diabetes and Nutrition Diseases, Department 6 Medical Specialties, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (D.M.C.); (C.B.); (G.R.)
| | - Cornelia Bala
- Diabetes and Nutrition Diseases, Department 6 Medical Specialties, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (D.M.C.); (C.B.); (G.R.)
| | - Adriana Rusu
- Diabetes and Nutrition Diseases, Department 6 Medical Specialties, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (D.M.C.); (C.B.); (G.R.)
| | - Gabriel Cismaru
- Cardiology-Rehabilitation, Department 5 Internal Medicine, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400437 Cluj-Napoca, Romania;
| | - Gabriela Roman
- Diabetes and Nutrition Diseases, Department 6 Medical Specialties, Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania; (D.M.C.); (C.B.); (G.R.)
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