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Stergiou GS, Menti A, Asayama K, De La Sierra A, Wang J, Kinoshita H, Sawanoi Y, Yamashita S, Kollias A, Wu CO, Ichikawa T, Alpert B. Accuracy of automated cuff blood pressure monitors in special populations: International Organization for Standardization (ISO) Task Group report and call for research. J Hypertens 2023; 41:811-818. [PMID: 36883464 DOI: 10.1097/hjh.0000000000003403] [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: 03/09/2023]
Abstract
OBJECTIVE Automated cuff blood pressure (BP) devices are widely used for ambulatory, home, and office BP measurement. However, an automated device, which is accurate in the general adult population may be inaccurate in some special populations. A 2018 Collaborative Statement by the US Association for the Advancement of Medical Instrumentation, the European Society of Hypertension, and the International Organization for Standardization (ISO) considered three special populations requiring separate validation (age <3 years, pregnancy, and atrial fibrillation). An ISO Task Group was appointed to identify evidence for additional special populations. METHOD Evidence on potential special populations was identified from the STRIDE BP database, which performs systematic PubMed searches for published validation studies of automated cuff BP monitors. Devices that passed in a general population, but failed in potential special populations were identified. RESULTS Of 338 publications (549 validations, 348 devices) in the STRIDE BP database, 29 publications (38 validations, 25 devices) involved 4 potential special populations: (i) age 12-18 years: 3 of 7 devices failed but passed in a general population; (ii) age more than 65 years: 1 of 11 devices failed but passed in a general population; (iii) diabetes type-2: 4 devices (all passed); (iv) chronic kidney disease: 2 of 7 devices failed but passed in a general population. CONCLUSION Some evidence suggest that the automated cuff BP devices may have different accuracy in adolescents and in patients with chronic kidney disease than in the general population. More research is needed to confirm these findings and investigate other potential special populations.
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Affiliation(s)
- George S Stergiou
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Ariadni Menti
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Alejandro De La Sierra
- Hypertension Unit, Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain
| | - Jiguang Wang
- Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | | | | - Anastasios Kollias
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Colin O Wu
- Office of Biostatistics Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Bruce Alpert
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis (Retired), Tennessee, USA, Convenor ISO JWG7 Committee
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2
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Li LY, Tian L, Gao B, Ming J, Liu K, Jiang J, Han ZY, Zhao LY, Chen CS, Wan Y. Validation of the G.LAB MD41A0 upper arm blood pressure monitor in patients with diabetes mellitus according to the AAMI/ESH/ISO 81060-2:2018 Universal Standard. Blood Press Monit 2022; 27:280-284. [PMID: 35258022 DOI: 10.1097/mbp.0000000000000595] [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: 11/27/2022]
Abstract
OBJECTIVE The objective of this study is to determine the accuracy of the G.LAB MD41A0 upper-arm oscillometric blood pressure (BP) monitor for self/home BP measurement in patients with diabetes according to the Association for the Advancement of Medical Instrumentation /European Society of Hypertension /International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018). METHODS Patients with diabetes were recruited according to AAMI/ESH/ISO Universal Standard using the same arm sequential BP measurement method. The standard cuff of the test device was used for arm circumference 22-44 cm. RESULTS A total of 92 patients with diabetes were recruited and 85 were analyzed with an average age of 55.1 ± 17.7 years, 48 men, and arm circumference of 32.0 ± 6.0 cm. For the validation Criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 0.89 ± 6.04/-0.84 ± 5.11 mmHg (systolic/diastolic). For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 4.23/4.19 mmHg (systolic/diastolic). CONCLUSION The G.LAB MD41A0 upper arm BP monitor fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in patients with diabetes and can be recommended for self/home use.
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Affiliation(s)
| | - Li Tian
- Department of Endocrinology, Tangdu Hospital, Fourth Military Medical University
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Fourth Military Medical University
| | - Jie Ming
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University
| | - Kui Liu
- Department of Health Services
| | | | | | | | - Chang-Sheng Chen
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, China
| | - Yi Wan
- Department of Health Services
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3
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Parati G, Stergiou GS, Bilo G, Kollias A, Pengo M, Ochoa JE, Agarwal R, Asayama K, Asmar R, Burnier M, De La Sierra A, Giannattasio C, Gosse P, Head G, Hoshide S, Imai Y, Kario K, Li Y, Manios E, Mant J, McManus RJ, Mengden T, Mihailidou AS, Muntner P, Myers M, Niiranen T, Ntineri A, O’Brien E, Octavio JA, Ohkubo T, Omboni S, Padfield P, Palatini P, Pellegrini D, Postel-Vinay N, Ramirez AJ, Sharman JE, Shennan A, Silva E, Topouchian J, Torlasco C, Wang JG, Weber MA, Whelton PK, White WB, Mancia G. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension. J Hypertens 2021; 39:1742-1767. [PMID: 34269334 PMCID: PMC9904446 DOI: 10.1097/hjh.0000000000002922] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/23/2021] [Indexed: 02/06/2023]
Abstract
The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.
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Affiliation(s)
- Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - George S. Stergiou
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Grzegorz Bilo
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Anastasios Kollias
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Martino Pengo
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences
| | - Juan Eugenio Ochoa
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences
| | - Rajiv Agarwal
- Division of Nephrology, Department of Medicine, Indiana University School of Medicine and Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
- Tohoku Institute for the Management of Blood Pressure, Sendai, Japan
| | | | - Michel Burnier
- Service of Nephrology and Hypertension, University Hospital, Lausanne, Switzerland
| | - Alejandro De La Sierra
- Hypertension Unit, Department of Internal Medicine, Hospital Mútua Terrassa, University of Barcelona, Barcelona, Spain
| | - Cristina Giannattasio
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Cardiology IV, ‘A. De Gasperis” Department, ASTT GOM Niguarda Ca’ Granda
| | - Philippe Gosse
- Cardiology/Hypertension Unit Saint André Hospital. University Hospital of Borfeaux, France
| | - Geoffrey Head
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yutaka Imai
- Tohoku Institute for the Management of Blood Pressure, Sendai, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yan Li
- Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Efstathios Manios
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Athens, Greece
| | - Jonathan Mant
- Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Richard J. McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Thomas Mengden
- Kerckhoff Clinic, Rehabilitation, ESH Excellence Centre, Bad Nauheim, Germany
| | - Anastasia S. Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Paul Muntner
- Hypertension Research Center, Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Martin Myers
- Schulich Heart Program, Sunnybrook Health Sciences Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Teemu Niiranen
- Department of Medicine, Turku University Hospital and University of Turku
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Angeliki Ntineri
- Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece
| | - Eoin O’Brien
- The Conway Institute, University College Dublin, Dublin, Ireland
| | - José Andres Octavio
- Experimental Cardiology, Department of Tropical Medicine Institute, Universidad Central de Venezuela, Venezuela
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
- Tohoku Institute for the Management of Blood Pressure, Sendai, Japan
| | - Stefano Omboni
- Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy
- Department of Cardiology, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Paul Padfield
- Department of Medical Sciences, University of Edinburgh, Edinburgh, UK
| | - Paolo Palatini
- Studium Patavinum, Department of Medicine. University of Padova, Padua
| | - Dario Pellegrini
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Agustin J. Ramirez
- Arterial Hypertension and Metabolic Unit, University Hospital, Fundacion Favaloro, Argentina
| | - James E. Sharman
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Andrew Shennan
- Department of Women and Children's Health, School of Life Course Sciences, FoLSM, Kings College London, UK
| | - Egle Silva
- Research Institute of Cardiovascular Diseases of the University of Zulia, Venezuelan Foundation of Arterial Hypertension. Maracaibo, Venezuela
| | - Jirar Topouchian
- Diagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hotel Dieu, Paris, France
| | - Camilla Torlasco
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Department of Cardiovascular Neural and Metabolic Sciences
| | - Ji Guang Wang
- Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Michael A. Weber
- Division of Cardiovascular Medicine, Downstate College of Medicine, State University of New York, Brooklyn, New York, USA
| | - Paul K. Whelton
- Department of Epidemiology, Tulane University, School of Public Health and Tropical Medicine, New Orleans, Lousiana
| | - William B. White
- Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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Evans RW, Shackleton CL, West S, Derman W, Laurie Rauch HG, Baalbergen E, Albertus Y. Robotic Locomotor Training Leads to Cardiovascular Changes in Individuals With Incomplete Spinal Cord Injury Over a 24-Week Rehabilitation Period: A Randomized Controlled Pilot Study. Arch Phys Med Rehabil 2021; 102:1447-1456. [PMID: 33839105 DOI: 10.1016/j.apmr.2021.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/09/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe the effect of robotic locomotor training (RLT) and activity-based training (ABT) on cardiovascular indices during various physiological positions in individuals with spinal cord injury. DESIGN Randomized controlled pilot study. SETTING Private practice: Therapy & Beyond Centre - Walking with Brandon Foundation, Sports Science Institute of South Africa, Cape Town, South Africa. PARTICIPANTS Participants with chronic traumatic motor incomplete tetraplegia (N=16) who resided in the Western Cape, South Africa. INTERVENTION Robotic locomotor training (Ekso GT) and activity-based training over a 24-week intervention. MAIN OUTCOME MEASURES Brachial and ankle blood pressure, heart rate, heart rate variability, and cardiovascular efficiency during 4 physiological positions. RESULTS No differences between groups or over time were evident in resting systolic and diastolic blood pressure, ankle systolic pressure, ankle brachial pressure index, and heart rate variability. Standing heart rate at 24 weeks was significantly higher in the ABT group (95.58±12.61 beats/min) compared with the RLT group (75.14±14.96 beats/min) (P=.05). In the RLT group, no significant changes in heart rate variability (standard deviation R-R interval and root mean square of successive differences) was found between the standing and 6-minute walk test physiological positions throughout the intervention. Cardiovascular efficiency in the RLT group during the 6-minute walk test improved from 11.1±2.6 at baseline to 7.5±2.8 beats per meter walked at 6 weeks and was maintained from 6 to 24 weeks. CONCLUSIONS Large effect sizes and significant differences between groups found in this pilot study support the clinical effectiveness of RLT and ABT for changing cardiovascular indices as early as 6 weeks and up to 24 weeks of rehabilitation. RLT may be more effective than ABT in improving cardiac responses to orthostatic stress. Based on heart rate variability metrics, the stimulus of standing has comparable effects to RLT on the parasympathetic nervous system. Cardiovascular efficiency of exoskeleton walking improved, particularly over the first 6 weeks. Both the RLT and ABT interventions were limited in their effect on brachial and ankle blood pressure. A randomized controlled trial with a larger sample size is warranted to further examine these findings.
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Affiliation(s)
- Robert W Evans
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town
| | - Claire L Shackleton
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town
| | - Sacha West
- Department of Sport Management, Cape Peninsula University of Technology, Cape Town
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town; IOC Research Centre, South Africa
| | - H G Laurie Rauch
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town
| | - Ed Baalbergen
- Rehabilitation Unit, Life Vincent Pallotti Hospital, Cape Town, South Africa
| | - Yumna Albertus
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town.
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5
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Silva ALD, de Oliveira SN, Vieira BA, Leite C, Martins DM, Moro ARP, Gerage AM, Delevatti RS. Acute effect of bodyweight-based strength training on blood pressure of hypertensive older adults: A randomized crossover clinical trial. Clin Exp Hypertens 2021; 43:223-229. [PMID: 33198514 DOI: 10.1080/10641963.2020.1847130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Strength Training (ST) reduces the cardiovascular risk of hypertensive elderly people; however, there is a need for efficient and low-cost ST programs that aim to reduce blood pressure (BP) in elderly people with adherence and affectivity in this population. Objective: Evaluate the acute effect on BP and satisfaction with the practice of bodyweight-based strength training (BWST) in hypertensive older adults. Methods: Participants performed a BWST session and a control session (CS). The BWST consisted of six exercises, with three sets of 30 seconds. In the CS, no activity was performed. BP was measured before and at 0, 10, 20, and 30 minutes post-session. Participants' satisfaction was assessed. Results: Eleven older adults (65.8 ± 4.6 years; 7 men) participated in the study. There was an increase (p = .028) in systolic BP immediately after BWST, returning to baseline values in the intervals 10, 20, and 30 post-section. In the CS there was an increase (p = .009) 30 minutes post-session compared to 20 minutes. Between sessions, a lower systolic BP was found in BWST (-6.54 ± 3.31; p = .048) 30 minutes post-sessions. For satisfaction, 82% of participants were "totally satisfied" with BWST. Conclusion: The SBP is lower 30 minutes after BWST session than control session, and BWST promoted a pleasant affective response in hypertensive older adults.
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Affiliation(s)
- Adriano L da Silva
- Centro de Desportos, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Silas N de Oliveira
- Laboratório de Biomecânica, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Bruno A Vieira
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Chayana Leite
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Doglas M Martins
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Antônio R P Moro
- Laboratório de Biomecânica, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Aline M Gerage
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
| | - Rodrigo S Delevatti
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Universidade Federal de Santa Catarina , Florianópolis, Brazil
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6
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Mazoteras-Pardo V, Becerro-De-Bengoa-Vallejo R, Losa-Iglesias ME, López-López D, Calvo-Lobo C, Rodríguez-Sanz D, Martínez-Jiménez EM, Palomo-López P. An Automated Blood Pressure Display for Self-Measurement in Patients With Chronic Kidney Disease (iHealth Track): Device Validation Study. JMIR Mhealth Uhealth 2020; 8:e14702. [PMID: 32238337 PMCID: PMC7163421 DOI: 10.2196/14702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/08/2019] [Accepted: 01/27/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hypertension is a global public health issue and is closely related to chronic kidney disorder (CKD). In people with CKD, strict monitoring of blood pressure is an important part of therapy. OBJECTIVE The aim of this research was to validate the iHealth Track blood pressure monitoring device for patients with CKD according to the European Society of Hypertension International Protocol 2010 (ESH-IP2). METHODS In total, 33 patients who received hemodialysis in Plasencia participated in the study. There were 9 successive measurements made, which conformed to the ESH-IP2. We calculated the differences between the standard reference device (Omron M3 Intellisense) and the test device (iHealth Track) for blood pressure and heart rate values. For 99 total comparisons of paired measurements, we classified differences into various categories (≤5 mmHg, ≤10 mmHg, and ≤15 mmHg for blood pressure; ≤3, ≤5, and ≤8 beats per minute for heart rate). RESULTS In 90 of 99 systolic blood pressure and 89 of 99 diastolic blood pressure comparisons between the devices, measurement differences were within 5 mmHg. In 81 of 99 heart rate comparisons between the devices, measurement differences were within 3 beats per minute. The mean differences between the test and reference standard measurements were 3.27 (SD 2.99) mmHg for systolic blood pressure, 3.59 (SD 4.55) mmHg for diastolic blood pressure, and 2.18 (SD 2.75) beats per minute for heart rate. We also observed that for both systolic and diastolic blood pressure, 31 of 33 participants had at least two of three comparisons between the devices with measurement differences less than 5 mmHg. For heart rate, 28 of 33 patients had at least two of three comparisons between the devices with measurement differences less than 3 beats per minute. CONCLUSIONS To our knowledge, this is the first study to show that iHealth Track meets the requirements of the ESH-IP2 in patients with CKD. Therefore, the iHealth Track is suitable for use in renal patients.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad de Complutense de Madrid, Madrid, Spain
| | | | | | - Daniel López-López
- Research, Health and Podiatry Group, Faculty of Nursing and Podiatry, Departament of Health Sciences, Universidade da Coruña, Ferrol, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad de Complutense de Madrid, Madrid, Spain
| | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad de Complutense de Madrid, Madrid, Spain
| | - Eva María Martínez-Jiménez
- Facultad de Fisioterapia y Enfermería, Departamento de Enfermería, Universidad Castilla la Mancha, Toledo, Spain
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7
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Ushigome E, Kitagawa N, Kitae A, Kimura T, Iwai K, Oyabu C, Ushigome H, Yokota I, Hamaguchi M, Asano M, Yamazaki M, Fukui M. Seasonal variation in home blood pressure and its relationship with room temperature in patients with type 2 diabetes. Diab Vasc Dis Res 2020; 17:1479164119883986. [PMID: 31726868 PMCID: PMC7510363 DOI: 10.1177/1479164119883986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Our aim was to examine the seasonal variations in home blood pressure measurements and the relationship of ambient temperature or room temperature with the seasonal variations in home blood pressure measurements using a home blood pressure telemonitoring system in patients with type 2 diabetes. The home blood pressure measurements of 41 patients with type 2 diabetes were self-measured. Patients performed triplicate morning and evening blood pressure measurements at least 5 days per month for 12 consecutive months. The lowest values of both systolic blood pressure and diastolic blood pressure were observed in August (126.3 and 70.4 mmHg, respectively), and the highest systolic and diastolic blood pressure values were observed in January (140.3 and 76.9 mmHg, respectively). The root mean squared error between the mean systolic blood pressure and room temperature was 6.50 mmHg and between mean systolic blood pressure and ambient temperature was 6.55 mmHg. Using a home blood pressure telemonitoring system, this study revealed for the first time that home blood pressure varied seasonally, with the highest values observed in January and the lowest values observed in August, and that the seasonal variations in home blood pressure were related to room temperature as well as ambient temperature.
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Affiliation(s)
- Emi Ushigome
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Nobuko Kitagawa
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Aya Kitae
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Tomonori Kimura
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Keiko Iwai
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Chikako Oyabu
- Department of Endocrinology and
Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Hidetaka Ushigome
- Department of Organ Transplantation and
General Surgery, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate
School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Mai Asano
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and
Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of
Medicine, Kyoto, Japan
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8
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Mazoteras-Pardo V, Becerro-De-Bengoa-Vallejo R, Losa-Iglesias ME, López-López D, Rodríguez-Sanz D, Casado-Hernández I, Calvo-Lobo C, Palomo-López P. QardioArm Upper Arm Blood Pressure Monitor Against Omron M3 Upper Arm Blood Pressure Monitor in Patients With Chronic Kidney Disease: A Validation Study According to the European Society of Hypertension International Protocol Revision 2010. J Med Internet Res 2019; 21:e14686. [PMID: 31789600 PMCID: PMC6915457 DOI: 10.2196/14686] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/17/2019] [Accepted: 10/22/2019] [Indexed: 01/20/2023] Open
Abstract
Background Hypertension is considered as a main risk factor for chronic kidney disease development and progression. Thus, the control and evaluation of this disease with new software and devices are especially important in patients who suffer from chronic kidney disease. Objective This study aimed to validate the QardioArm mobile device, which is used for blood pressure (BP) self-measurement in patients who suffer from chronic kidney disease, by following the European Society of Hypertension International Protocol 2 (ESH-IP2) guidelines. Methods A validation study was carried out by following the ESH-IP2 guidelines. A sample of 33 patients with chronic kidney disease self-measured their BP by using the QardioArm and Omron M3 Intellisense devices. Heart rate (HR), diastolic BP, and systolic BP were measured. Results The QardioArm fulfilled the ESH-IP2 validation criteria in patients who suffered from chronic kidney disease. Conclusions Thus, this study is considered as the first validation using a wireless upper arm oscillometric device connected to an app to measure BP and HR meeting the ESH-IP2 requirements in patients who suffer from chronic kidney disease. New validation studies following the ESH-IP2 guidelines should be carried out using different BP devices in patients with specific diseases.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- School of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Daniel López-López
- Research, Health, and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | - David Rodríguez-Sanz
- School of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Israel Casado-Hernández
- School of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Cesar Calvo-Lobo
- School of Nursing, Physiotherapy, and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
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Mazoteras-Pardo V, Becerro-De-Bengoa-Vallejo R, Losa-Iglesias ME, López-López D, Palomo-López P, Rodríguez-Sanz D, Calvo-Lobo C. Validation in the General Population of the iHealth Track Blood Pressure Monitor for Self-Measurement According to the European Society of Hypertension International Protocol Revision 2010: Descriptive Investigation. JMIR Mhealth Uhealth 2019; 7:e13137. [PMID: 30888331 PMCID: PMC6444211 DOI: 10.2196/13137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/02/2019] [Accepted: 01/03/2019] [Indexed: 01/24/2023] Open
Abstract
Background High blood pressure is one of the most common reasons why patients seek assistance in daily clinical practice. Screening for hypertension is fundamental and, because hypertension is identified only when blood pressure is measured, accurate measurements are key to the diagnosis and management of this disease. The European Society of Hypertension International Protocol revision 2010 (ESH-IP2) was developed to assess the validity of automatic blood pressure measuring devices that are increasingly being used to replace mercury sphygmomanometers. Objective We sought to determine whether the iHealth Track blood pressure monitor meets ESH-IP2 requirements for self-measurement of blood pressure and heart rate at the brachial level and is appropriate for use in the general population. Methods This study was a descriptive investigation. ESH-IP2 requires a total number of 33 participants. For each measure, the difference between observer and device blood pressure and heart rate values is calculated. In all, 99 pairs of blood pressure differences are classified into 3 categories (≤5, ≤10, and ≤15 mm Hg), and 99 pairs of heart rate differences are classified into 3 categories (≤3, ≤5, and ≤8 beats/min). We followed these protocol procedures in a convenience sample of 33 participants. Results iHealth Track fulfilled ESH-IP2 requirements and passed the validation process successfully. We observed an absolute difference within 5 mm Hg in 75 of 99 comparisons for systolic blood pressure, 78 of 99 comparisons for diastolic blood pressure, and 89 of 99 comparisons for heart rate. The mean differences between the test and standard readings were 4.19 (SD 4.48) mm Hg for systolic blood pressure, 3.74 (SD 4.55) mm Hg for diastolic blood pressure, and 1.95 (SD 3.27) beats/min for heart rate. With regard to part 2 of ESH-IP2, we observed a minimum of 2 of 3 measurements within a 5-mm Hg difference in 29 of 33 participants for systolic blood pressure and 26 of 33 for diastolic blood pressure, and a minimum of 2 of 3 measurements within a 3-beat/min difference in 30 of 33 participants for heart rate. Conclusions iHealth Track readings differed from the standard by less than 5, 10, and 15 mm Hg, fulfilling ESH-IP2 requirements. Consequently, this device is suitable for use in the general population.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.,Faculty of Sports, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine, Faculty of Health Sciences, Universidad de León, Ponferrada, Spain
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10
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Costa VRS, Costa PDR, Nakano EY, Apolinário D, Santana ANC. Functional health literacy in hypertensive elders at primary health care. Rev Bras Enferm 2019; 72:266-273. [DOI: 10.1590/0034-7167-2018-0897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/09/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to assess the relationship between inadequate functional health literacy and inadequate blood pressure control in older people with hypertension in Primary Health Care. Method: a cross-sectional study with sample calculated at 392. SAHLPA-18 tool was used for functional health literacy; blood pressure was measured; sociodemographic and clinical data were collected. Hierarchical logistic regression was used. Results: (high) inadequate blood pressure and (low) functional inadequate health literacy were present in 41.6% and 54.6% of the people, respectively. Factors associated with inadequate blood pressure were: inadequate functional health literacy, black-brown skin color, overweight-obesity, hypertension diagnosis time, non-adherence to exercise/diet, drug treatment. Schooling had no association with inadequate blood pressure Conclusion: hypertensive elderly people with inadequate health literacy were more likely to have inadequate blood pressure. Thus, health professionals need to value functional health literacy as a possible component to control blood pressure.
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11
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Mazoteras-Pardo V, Becerro-De-Bengoa-Vallejo R, Losa-Iglesias ME, López-López D, Palomo-López P, Rodríguez-Sanz D, Calvo-Lobo C. The QardioArm Blood Pressure App for Self-Measurement in an Obese Population: Validation Study Using the European Society of Hypertension International Protocol Revision 2010. JMIR Mhealth Uhealth 2018; 6:e11632. [PMID: 30361193 PMCID: PMC6229517 DOI: 10.2196/11632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 01/16/2023] Open
Abstract
Background Obesity and high blood pressure (HBP) pose high cardiovascular risks, and they are frequent causes of cardiovascular disease. Objective The aim of this study was to validate the mobile app QardioArm for high blood pressure monitoring in obese subjects (body mass index ≥30 kg/m2) according to guidelines in the European Society of Hypertension-International Protocol 2 (ESH-IP2). Methods We recruited 33 obese subjects and measured their blood pressure using QardioArm (test device) and Omron M3 Intellisense (Omron Healthcare, Kyoto, Japan; standard device). We compared systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) according to the ESH-IP2. Results A total of 95 of 99 differences for SBP and 91 of 99 for DBP displayed absolute differences within 10 mm Hg. A total of 98 of 99 differences for SBP and 98 of 99 for DBP exhibited absolute differences within 15 mm Hg. This result satisfied requirements for part 1 of the ESH-IP2. A total of 27 out of 33 individuals for SBP and 30 out of 33 individuals for DBP had a minimum of 2 of 3 comparisons within 5 mm Hg difference. None of the subjects had 3 differences outside 5 mm Hg for SBP and DBP, satisfying part 2 of the ESH-IP2. For HR measurements, a total of 90 of 99 differences had absolute differences within 3 beats per minute (bpm), and a total of 94 or 99 differences had absolute differences within 5 bpm. A total of 98 of 99 differences had absolute differences within 8 bpm. Therefore, the test device satisfied part 1 of ESH-IP2 criteria for HR. For part 2 of ESH-IP2, 31 of 33 individuals had a minimum of 2 of 3 comparisons within 3 bpm difference for HR. Only 1 of 33 subjects had 3 differences outside 3 bpm. Conclusions To the best of our knowledge, this was the first study to show that an app that measures blood pressure and HR meets the requirements of the ESH-IP2 in an obese population. We believe the ESH-IP2 should publish explicit criteria for validation of blood pressure devices in specific populations.
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Affiliation(s)
- Victoria Mazoteras-Pardo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | | | - Daniel López-López
- Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Ferrol, Spain
| | | | - David Rodríguez-Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain.,Faculty of Sports, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - César Calvo-Lobo
- Institute of Biomedicine, Department of Nursing and Physical Therapy, Faculty of Health Sciences, Universidad de León, Ponferrada, Spain
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12
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A strategy utilizing ambulatory monitoring and home and clinic blood pressure measurements to optimize the safety evaluation of noncardiovascular drugs with potential for hemodynamic effects: a report from the SYNERGY trial. Blood Press Monit 2018; 23:153-163. [PMID: 29578880 PMCID: PMC5959217 DOI: 10.1097/mbp.0000000000000320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Supplemental Digital Content is available in the text. Objective The aim of this study was to perform a blood pressure (BP) safety evaluation in patients with an overactive bladder receiving solifenacin (an antimuscarinic agent), mirabegron (a β3-adrenoceptor agonist), or both compared with placebo in the SYNERGY trial. Patients and methods Patients were randomized to receive solifenacin 5 mg+mirabegron 50 mg (combination 5+50 mg); solifenacin 5 mg+mirabegron 25 mg (combination 5+25 mg); solifenacin 5 mg; mirabegron 50 mg; mirabegron 25 mg; or placebo for a double-blind 12-week treatment period. Systolic BP, diastolic BP, and heart rate were measured by ambulatory BP monitoring, and in the clinic or home. Results A total of 715 patients were analyzed in an ambulatory BP monitoring substudy. At the end of treatment, ambulatory BP monitoring measurements showed no consistent increases from baseline in the mean 24-h systolic BP or diastolic BP for combination versus monotherapy groups or for monotherapy groups versus placebo. Analysis of 1-h BP averages during the 6 h range that included the Tmax values of both study drugs showed no significant BP effects. Shift analysis (switch between different normotension/hypertension stages) did not show differences among the active and placebo groups, nor did outlier analysis of major BP changes differ between placebo and active treatment. Similarly, there were no significant signals in the 24-h heart rate. Office and home measurements were consistent with ambulatory BP monitoring findings. Conclusions A paradigm of ambulatory BP monitoring analysis designed to test BP safety of noncardiovascular drugs showed that solifenacin plus mirabegron combination therapy during 12 weeks produced no meaningful changes in BP or heart rate.
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13
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Ushigome E, Matsumoto S, Oyabu C, Ushigome H, Yokota I, Hasegawa G, Nakamura N, Tanaka M, Yamazaki M, Fukui M. Olmesartan with azelnidipine versus with trichlormethiazide on home blood pressure variability in patients with type II diabetes mellitus. ACTA ACUST UNITED AC 2017; 11:140-147. [PMID: 28089902 DOI: 10.1016/j.jash.2016.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 12/12/2016] [Accepted: 12/15/2016] [Indexed: 11/18/2022]
Abstract
The aim of the present study was to compare the effects of olmesartan combined with azelnidipine versus olmesartan combined with trichlormethiazide, on home blood pressure (BP) and pressure variability in type II diabetes mellitus patients using home BP telemonitoring system. We performed an open-label cross-over pilot study of 28 patients with type II diabetes mellitus. Patients received combination treatment with either olmesartan 20 mg plus azelnidipine 16 mg or olmesartan 20 mg plus trichlormethiazide 1 mg for more than 6 weeks each in a cross-over method. The coefficient of morning systolic BP variability in the olmesartan plus azelnidipine group was significantly lower than that in the olmesartan plus trichlormethiazide group (6.4 ± 1.9 vs. 7.5 ± 2.6, P = .004). There were no significant differences in mean morning systolic BP between the two groups. Using home BP telemonitoring for hypertensive patients with type II diabetes, this study revealed for the first time that the olmesartan with azelnidipine combination is superior to the olmesartan with trichlormethiazide combination in reducing home BP variability.
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Affiliation(s)
- Emi Ushigome
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Shinobu Matsumoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chikako Oyabu
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hidetaka Ushigome
- Department of Organ Transplantation and General Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Goji Hasegawa
- Department of Endocrinology and Metabolism, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | | | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masahiro Yamazaki
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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14
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Cohen JB, Wong TC, Alpert BS, Townsend RR. Assessing the accuracy of the OMRON HEM-907XL oscillometric blood pressure measurement device in patients with nondialytic chronic kidney disease. J Clin Hypertens (Greenwich) 2017; 19:296-302. [PMID: 28079300 DOI: 10.1111/jch.12961] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/19/2016] [Accepted: 10/01/2016] [Indexed: 12/01/2022]
Abstract
The OMRON HEM-907XL is a commercial oscillometric blood pressure (BP) monitor that was used in the Systolic Blood Pressure Intervention Trial (SPRINT), in which 28% of participants had chronic kidney disease (CKD). This study examined the accuracy of the monitor in nondialytic patients with CKD. Eighty-seven patients met inclusion criteria. The authors used a modified Association for the Advancement of Medical Instrumentation (AAMI) protocol, with one observer recording measurements from the monitor and two blinded physicians obtaining simultaneous aneroid values by auscultation. Using AAMI method 1, there was a 2.5±9.5 mm Hg difference in OMRON and aneroid systolic BP, and a -1.6±6.5 mm Hg difference in diastolic BP. Using AAMI method 2, there was a 5.1±7.4 mm Hg difference in systolic BP and a -0.2±5.4 mm Hg difference in diastolic BP. In patients with CKD, the OMRON HEM-907XL appears to be accurate for measuring diastolic BP, but did not perform as well for systolic BP.
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Affiliation(s)
- Jordana B Cohen
- Renal, Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Tiffany C Wong
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bruce S Alpert
- Division of Pediatric Cardiology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Raymond R Townsend
- Renal, Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA
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15
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Erdem E. The effects of passive leg raising and ultrafiltration stopping on blood pressure in hemodialysis patients. Int Urol Nephrol 2016; 48:877-82. [PMID: 26992937 DOI: 10.1007/s11255-016-1261-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/02/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE Hemodialysis-associated hypotension, one of the more serious issues in hemodialysis patients, can be treated by passive leg raising (PLR) and ultrafiltration (UF) stopping. We investigated the effects of PLR and UF stopping on blood pressure in hemodialysis patients. METHODS The study was conducted in 76 end-stage renal disease patients. After the second hour of dialysis, systolic and diastolic blood pressure (SBP and DBP) of the patients who did not develop intradialytic hypotension (IDH) were measured in the supine position. Thereafter, PLR was performed by raising the legs 20°; and after 3 min, SBP and DBP were measured again. UF was then stopped in the PLR position; SBP and DBP were repeated 3 min later. The same procedure was performed during IDH in the patients that developed IDH. RESULTS A mean 5-mmHg (p < 0.05) increase in SBP and a mean 2-mmHg increase in DBP (p < 0.05) were observed by PLR in the supine position. UF stopping during PLR increased SBP by a mean of 1 mmHg (p < 0.05) while no change was observed in DBP (p = ns). IDH occurred in 19 (25 %) patients. PLR positioning increases SBP and DBP by a mean of 8 mmHg (p < 0.05) and 3 mmHg (p < 0.05), respectively, in the supine position during IDH. During IDH, UF stopping in the PLR position did not significantly increase SBP and DBP in patients as compared to the PLR position. CONCLUSIONS SBP and DBP increase during PLR. UF stopping during PLR does not lead to a higher increase in blood pressure as compared to PLR positioning.
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Affiliation(s)
- Emre Erdem
- Diaverum Merzifon Hemodialysis Center, Merzifon, Amasya, Turkey.
- Diaverum Samsun Hemodialysis Center, Samsun, Turkey.
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Drawz PE, Abdalla M, Rahman M. Blood pressure measurement: clinic, home, ambulatory, and beyond. Am J Kidney Dis 2012; 60:449-62. [PMID: 22521624 PMCID: PMC4128481 DOI: 10.1053/j.ajkd.2012.01.026] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 01/23/2012] [Indexed: 01/01/2023]
Abstract
Blood pressure traditionally has been measured in the clinic setting using the auscultatory method and a mercury sphygmomanometer. Technologic 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 the risk of 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 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 2 of the newer methods for assessing blood pressure and hypertension-related target-organ damage.
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Affiliation(s)
- Paul E. Drawz
- Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, OH
- MetroHealth Medical Center, Louis Stokes Cleveland VA Medical Center
| | - Mohamed Abdalla
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, OH
- University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center
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Akpolat T, Kaya C, Utaş C, Arinsoy T, Taşkapan H, Erdem E, Yilmaz ME, Ataman R, Bozfakioğlu S, Özener Ç, Karayaylali I, Kazancioğlu R, Çamsari T, Yavuz M, Ersoy F, Duman S, Ateş K. Arm circumference: its importance for dialysis patients in the obesity era. Int Urol Nephrol 2012; 45:1103-10. [PMID: 22752452 DOI: 10.1007/s11255-012-0219-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 06/04/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE The purposes of this study were to investigate the association between arm circumference and body mass index (BMI) and to discuss problems, mainly arm circumference and cuff size mismatch, that could affect the reliability of home blood pressure monitoring (HBPM) among peritoneal dialysis (PD) and hemodialysis (HD) patients. METHODS 525 PD and 502 HD patients from 16 centers were included in the study. A two-part questionnaire was used to gather information from the participants. Arm circumferences were categorized into four groups according to the British Hypertension Society cuff size recommendations. RESULTS Mean BMI and arm circumference of all participants were 25.0 kg/m(2) and 27.6 cm, respectively. There was a significant correlation between BMI and arm circumference. The mean BMI and arm circumference values were higher in PD patients than in HD patients. Requirement of a large-sized adult cuff was more common among PD patients compared to HD patients (14 % vs 8 %, p = 0.002). CONCLUSIONS Since HBPM is a useful tool for clinicians to improve BP control, nephrologists should be aware of the problems related to HBPM in dialysis patients and take an active role to increase the reliability of HBPM.
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Affiliation(s)
- Tekin Akpolat
- Department of Nephrology, Ondokuz Mayis University School of Medicine, Samsun, 55139, Turkey.
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