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Filipovský J, Seidlerová J, Ceral J, Vysočanová P, Špác J, Souček M, Řiháček I, Mateřánková M, König P, Rosolová H. A multicentre study on unattended automated office blood pressure measurement in treated hypertensive patients. Blood Press 2018; 27:188-193. [PMID: 29334262 DOI: 10.1080/08037051.2018.1425606] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Unattended automated office blood pressure (uAutoOBP) may eliminate white-coat effect. In the present study, we studied its relationships to attended office blood pressure (BP) and ambulatory BP monitoring (ABPM). MATERIAL AND METHODS Stable treated hypertensive subjects were examined in four Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP was measured six times: three times with auscultatory method (AuscOBP) by the physician followed optionally by three oscillometric measurements (OscOBP). ABPM was performed within one week from the clinical visit. RESULTS Data on 172 subjects aged 63.7 ± 12.4 years with AuscOBP 127.6 ± 12.1/77.6 ± 10.0 mm Hg are reported. uAutoOBP was by 8.5 ± 9.0/3.0 ± 6.1 mm Hg lower than AuscOBP. The AuscOBP-uAutoOBP difference increased with the AuscOBP level and it did not depend on any other factor. OscOBP differed by 8.6 ± 8.6/1.9 ± 5.7 mm Hg from uAutoOBP. 24-hour mean BP was by 4.2 ± 12.1/3.5 ± 7.8 mm Hg lower than AuscOBP and by 4.3 ± 11.0/0.5 ± 6.9 mm Hg higher than uAutoOBP; the correlation coefficients of 24-hour mean BP with AuscOBP and with uAutoOBP did not differ (p for difference ≥.13). In the lowest BP group (systolic AuscOBP <120 mm Hg or diastolic AuscOBP <70 mm Hg), both AuscOBP and uAutoOBP were lower than 24-hour mean BP, while in the highest BP group (systolic AuscOBP ≥140 mm Hg or diastolic AuscOBP ≥90 mm Hg), they were higher. CONCLUSIONS Compared to uAutoOBP, attended BP measurement gives higher values, both when measured with auscultatory or oscillometric method. Inter-individual variability of AutoOBP - uAuscOBP difference, as well of uAutoOBP - ABPM difference, is large. We did not prove that uAutoOBP would be associated to 24-hour ambulatory BP more closely than attended BP.
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Affiliation(s)
- Jan Filipovský
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Jitka Seidlerová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic.,b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Jiří Ceral
- c Department of Cardiology , Faculty Hospital Hradec Králové , Hradec Králové , Czech Republic
| | - Petra Vysočanová
- d Department of Cardiology , Faculty Hospital Bohunice , Brno , Czech Republic
| | - Jiří Špác
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Miroslav Souček
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Ivan Řiháček
- e 2nd Department of Internal Medicine , Faculty of Medicine, Masaryk University, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Markéta Mateřánková
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Petr König
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
| | - Hana Rosolová
- a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Plzen , Czech Republic
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Biel V, Novák J, Pluháček L, Špác J. Endothelial function, its relation to arterial hypertension and the possibility of its modulation. Vnitr Lek 2018; 64:762-770. [PMID: 30441984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Endothelium has both a protective and a very complex para-, endo- and autocrine functions. Vascular tone is determined as a balance between the production of vasodilating and vasoconstrictive substances. Among the most important vasodilators are nitric oxide (NO), PGI2, endothelial-derived hyperpolarizing factor (EDHF), adenosine and others, among the most important vasoconstrictors, endothelin-1 and angiotensin-2. Therapeutic goal of improving endothelial secretory function should be maximizing production of vasodilators and minimizing production of vasoconstrictors. Improvement of endothelial function can be achieved most effectively by following a healthy lifestyle (changing the diet to a Mediterranean type, sufficient physical activity, weight reduction and smoking cessation) and by initiating the treatment with ACE inhibitors and statins, when indicated. Large number of trials have shown that all of these interventions improve the prognosis of patients and a part of this effect may be mediated by improving endothelial dysfunction. Key words: endothelial dysfunction - endothelium - hypertension.
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Špác J. [Clinical significance of natriuretic peptides in the differential diagnosis of dyspnea]. Vnitr Lek 2016; 62:640-645. [PMID: 27627091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Acute dyspnea is one of the most common emergency department symptoms. But early diagnosis and treatment could be e challenging because of multiple potential causes. The gold standard biomarkers in cardiac dyspnea are B-type natriuretic peptide (BNP) and N-terminal pro-B-type (natriuretic peptide NT-pro BNP), which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. The purpose of this review is to analyze diagnostic potential of BNP and NT-pro BNP biomarkers use in patients with acute dyspnea. BNP and NT-proBNP are markers of cardiac stress but are not cardiac-specific. They have comparable clinical utility, and both help in excluding acute cardiac dyspnea but they cannot reliably discriminate systolic from diastolic HF.Key word: acute dyspnea - natriuretic peptide - heart failure.
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