Blood Pressure Monitoring最新文献

Background: This study aimed to validate the accuracy of the YuWell YE990 automated oscillometric upper-arm blood pressure (BP) monitor in pregnant adults according to the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Common Criteria Universal Standard (ISO 81060-2:2018 + Amd.1:2020).

Methods: Participants with normotension, hypertension without proteinuria, or pre-eclampsia were enrolled in this study. BP measurements were performed using a calibrated mercury sphygmomanometer (reference) and a YE990 device (test) following a same-arm sequential protocol conducted by two trained observers.

Results: A total of 46 participants (138 paired readings) were included in the final analysis. For criterion 1 of the standard, the mean difference between the test and reference devices was -2.9 ± 6.9 mmHg for systolic BP (SBP) and 0.0 ± 6.5 mmHg for diastolic BP (DBP), both within the required limits. For criterion 2, the subject-level SDs were 5.6 mmHg for SBP and 5.7 mmHg for DBP, also satisfying the ISO thresholds of 6.30 and 6.95 mmHg, respectively.

Conclusion: YuWell YE990 met all accuracy criteria specified by the ISO 81060-2:2018 + Amd.1:2020 standard and is recommended for clinical use in pregnant populations.

This study aimed to assess the accuracy of the CONTEC08C automated oscillometric upper-arm sphygmomanometer in adults for clinical use in accordance with the ISO 81060-2:2018 standard. A total of 90 normotensive and hypertensive participants aged 18-75 years were recruited, and 85 were analyzed to evaluate the accuracy of the CONTEC08C oscillometric upper-arm sphygmomanometer using the same arm sequential validation method and a standardized protocol. The mean ± standard deviation (SD) of the differences between the test device and reference blood pressure (BP) measurements was 0.5 ± 3 mmHg for SBP and 0.4 ± 3.5 mmHg for DBP, meeting validation criterion 1. For validation criterion 2, the SD of the averaged differences between the test device and reference BP measurements per subject was 1.81/2.41 mmHg (systolic/diastolic). The CONTEC08C oscillometric upper-arm blood pressure monitor fulfilled the requirements of the ISO 81060-2:2018 standard in adults in the clinical setting and can therefore be recommended for safe clinical use.

Background: Isometric exercise has emerged as an effective strategy for blood pressure (BP) management, offering potential advantages over traditional exercise modalities; however, evidence regarding its 24-h effects in medicated hypertensive postmenopausal women remains limited.

Objective: This study investigated the effects of a single session of multijoint isometric exercise on 24-h ambulatory hemodynamic variables in medicated hypertensive postmenopausal women.

Methods: In this randomized crossover trial, 10 medicated hypertensive postmenopausal women (59 7 years) completed two experimental sessions: an isometric exercise session and a control session. The isometric exercise consisted of six multijoint exercises (upper and lower limbs), each performed for three sets of 1 min at 30% of 1-repetition maximum, with 2-min rest intervals. The control session involved sitting at rest for an equivalent duration. Following each session, 24-h ambulatory BP monitoring was conducted.

Results: Significant systolic BP reductions were observed following the isometric exercise session compared with the control session at 1 h ( P < 0.05), 6 h ( P < 0.05), and 24 h ( P < 0.05). Diastolic BP was also reduced at 1 h ( P < 0.05) and 12 h ( P < 0.05). Both awake and asleep periods showed significant BP reductions for systolic and diastolic BP (all, P < 0.05).

Conclusion: A single session of multijoint isometric exercise effectively reduces ambulatory BP over a 24-h period in medicated hypertensive postmenopausal women, including both awake and asleep periods. These findings support the potential clinical utility of isometric exercise as an adjunctive strategy for BP management in this population.

Objective: Arterial hypertension is a major global cause of cardiovascular disease, a risk heightened by postmenopausal physiological changes. Although aerobic exercise is protective, its optimal intensity, duration, and supervision for hypertensive postmenopausal women remain unclear. This study, therefore, compares a supervised intensive aerobic program with a home-based regimen, assessing their effects on key cardiac health indicators in this population.

Methods: In this single-center pilot randomized controlled trial, we enrolled 31 postmenopausal women. Participants were divided into two groups: one underwent a 6-week supervised intensive aerobic exercise program, and the other followed a home-based exercise regimen. Key outcome measures included cardiorespiratory endurance, heart rate variability, and blood pressure variability. Outcome measures were evaluated at weeks 6 and 12. Intra-group and inter-group comparisons were evaluated using appropriate statistical methods.

Results: After 12 weeks, the supervised exercise group showed significant improvements in VO 2 max ( P  = 0.003), metabolic equivalents (METs) ( P  = 0.002), and standard deviation of normal-to-normal intervals (SDNN) values ( P  = 0.034) at both the 6th and 12th weeks. However, the sole significant inter-group difference was a greater reduction in 24-hour SBP variability (SBP-SD) in the supervised arm (Δ -0.95 ± 1.15 vs. + 1.54 ± 0.94 mmHg; P  = 0.041), driven mainly by the week 6-12 interval ( P  = 0.004).

Conclusion: Supervised intensive aerobic exercise produced clear within-group gains in VO₂ max, METs, and SDNN, and it reduced 24-hour SBP variability relative to home-based walking. Although between-group differences for the primary fitness and autonomic outcomes were not statistically significant in this pilot, the pattern suggests that a supervised, tailored program may confer additional clinical benefit and merits evaluation in a larger trial.

We aimed to evaluate the accuracy of B.Well PRO-33 (B.Well, Widnau, Switzerland) oscillometric device for professional office measurement of blood pressure (BP) on the upper arm in the general population in accordance with the Amendment 2.2024-01 of the Standard 81060-2:2018 by the International Organization for Standardization (ISO 81060-2:2018/AMD 2:2024). Study participants were recruited according to the age, gender, BP, and cuff distribution requirements of the ISO 81060-2:2018/AMD 2:2024 in the general population using the sequential BP measurement method on the same arm. The test device was used with one universal cuff for arm circumferences of 22-42 cm. We chose aneroid sphygmomanometers Riester Big Ben Square Desk (Rudolf Riester, Jungingen, Germany) with small, medium and large cuffs and Welch Allyn 767 Desk (Welch Allyn, Skaneateles Falls, NY, USA) with a large adult cuff for arm circumferences of 22-37 and 38-42 cm, respectively, as control devices. We enrolled 112 study subjects, of whom 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the readings of the tested device and reference BP (systolic/diastolic; threshold ≤5 ± 8 mmHg; N  = 255) was 1.7 ± 5.4/1.8 ± 5.7 mmHg. For validation criterion 2, the SD of the mean BP difference between the tested device and reference BP readings per subject (systolic/diastolic; threshold ≤ 6.73/6.71 mmHg; N  = 85) was 4.7/4.7 mmHg. B.Well PRO-33 professional office BP monitor met the requirements of the ISO 81060-2:2018/AMD 2:2024 for the general population, and therefore can be recommended for clinical use.

Objectives: Nocturnal hypertension, especially with well-controlled daytime blood pressure (BP), has emerged as a significant risk factor for cardiovascular disease. This study investigated its prevalence by morning home BP cut-off values and examined associated patient characteristics using data from the Japan Morning Surge-Home Blood Pressure (J-HOP) study.

Methods: This post hoc analysis included 2675 participants from the J-HOP study who had complete data on nighttime home BP, measured using validated automatic oscillometric devices. Nocturnal hypertension was defined as a nighttime systolic BP greater than or equal to 120 mmHg and diastolic BP greater than or equal to 70 mmHg.

Results: Among the participants, 60.5% had nocturnal hypertension. The proportion of patients with nocturnal hypertension decreased as the cut-off value for morning home BP was lowered: 40.5, 32.1, 23.7, and 14.6% for less than 135/85 mmHg, less than 130/80 mmHg, less than 125/75 mmHg, and less than 120/70 mmHg, respectively. The prevalence of nocturnal hypertension was significantly higher in individuals with diabetes compared with those without, at morning home BP thresholds of less than 135/85 mmHg (48.1 vs. 39.3%; P = 0.03) and less than 130/80 mmHg (41.0 vs. 30.6%; P = 0.01). Individuals taking diuretics had a significantly lower prevalence of nocturnal hypertension compared with those not taking diuretics, at a morning home BP threshold of less than 135/85 mmHg (35.3 vs. 42.9%; P = 0.01).

Conclusion: A considerable number of patients continued to show nocturnal hypertension even at lower morning home BP thresholds. Diabetes may contribute to nocturnal hypertension despite well-controlled morning BP, while diuretic use may help prevent it.

Aim: To examine the effect of excess body weight on the blood pressure (BP) of children aged 6-12 years.

Methods: This was a prospective longitudinal study conducted with 187 children at the participants' home in southern Brazil. BP was measured using the auscultatory method. Generalized linear mixed models, including fixed and random effects and adjusted for important covariates, were used to estimate the relative risk (RR) of excess body weight on the incidence of high BP in children throughout the three follow-ups of the study (at ages 6, 9, and 12 years).

Results: The prevalence of high BP increased from 25.0 to 66.7% in children with excess body weight from 6 to 12 years of age. For every 1 kg/m 2 increase in the child's BMI, there was an 8% increase (RR = 1.08, 95% confidence interval: 1.00-1.16, P  = 0.042) in the risk of the child having high BP from 6 to 12 years of age, even after adjusting for prepregnancy BMI.

Conclusion: Excessive BMI in children increased the risk of high BP in Brazilian children from 6 to 12 years of age. Special attention must be paid to children under 12 years of age with excess body weight to mitigate the onset of cardiovascular diseases throughout life.

Objective: Auscultation is the reference standard for validating automated blood pressure monitoring. However, its inherent variability may compromise validation reliability. This study aimed to quantify the variability in repeated auscultatory measurements and determine the relative contributions of the underlying factors.

Methods: Data were analyzed from an accuracy validation study (n = 85) conducted under the International Organization for Standardization 81060-2 : 2018+Amd 1 : 2020 standard, wherein two trained observers performed simultaneous auscultatory measurements. Using the Guide to the Expression of Uncertainty in Measurement framework, the total variability of repeated auscultatory measurements was decomposed into the proportional contributions of the blood pressure determination methodology (inherent uncertainty of identifying Korotkoff sounds during cuff deflation), observer, and participant.

Results: A total of 85 participants (55.3% female), including 13 receiving antihypertensive medications, were analyzed. The mean age was 59.5 ± 10.2 years. Mean systolic/diastolic blood pressure were 124.9 ± 24.1/76.5 ± 14.2 mmHg. Repeated auscultatory measurements showed variability with SDs of 4.91 mmHg for systolic and 3.26 mmHg for diastolic blood pressure (n = 255). The analysis identified methodology as the largest contributor to variability (systolic: 47.4%, diastolic: 46.0%), while observer and participant factors contributed less (systolic: 5.3% and 7.1%; diastolic: 16.4% and 6.8%).

Conclusion: Substantial variability exists in auscultatory blood pressure measurements, even when performed under the International Organization for Standardization standard, with the determination methodology being the primary source. Our findings suggest that the inherent variability of the auscultatory method should be acknowledged as a limiting factor in identifying accurate blood pressure in clinical and research settings.