Automated blood pressure monitoring

Evaluation of two automatic sphygmomanometers in Hong Kong: implications for the future development of automated blood pressure monitors in clinical practice

The application of automated devices in measuring patients' blood pressure has been widely adopted in nursing practice. This study compared blood pressure recordings of two automated blood pressure monitors which were commonly used in clinical settings in Hong Kong. Single-arm recordings were obtained from 31 subjects with both devices. Ten blood pressure recordings were obtained for each subject, with half of the subjects taking five measurements from one device first and five measurements from the other device second, and vice versa. A total of 155 sets of measurements were available for analysis. The results indicated that there was no significant difference in the variation of systolic, diastolic, mean arterial pressure and heart rate between these two devices. Implications for future research and development of an improved automated blood pressure device are made.

A practical guideline for management of hypertension in patients with diabetes

Hypertension is common in patients with non-insulin-dependent diabetes mellitus and is also an early sign of diabetic nephropathy in those with insulin-dependent diabetes. Hypertension contributes to the progression of both macrovascular disease and nephropathy in patients with diabetes. Certain antihypertensive agents can adversely affect carbohydrate and lipid metabolism. Angiotensin-converting enzyme inhibitors and calcium channel blockers may slow the progression of renal complications in patients with diabetes. The pharmacologic approaches to treatment of hypertension in patients with diabetes potentially differ from those in nondiabetic persons. On the basis of a review of the recent literature related to antihypertensive therapy for patients with diabetes, we describe an empiric approach to treatment of hypertension in such patients. The proposed approach must be modified as new data from randomized clinical trials become available.

Almost misdiagnosed: utilization of Romhilt-Estes electrocardiographic criteria for left ventricular hypertrophy

The diagnosis of hypertension is based on explicit guidelines presented by the Joint National Committee on Hypertension, but the methodology one uses to obtain the necessary data is up to the individual practitioner. The following case study demonstrates the necessity for the use of the most accurate and precise equipment and criteria to ensure a correct diagnosis of hypertension.