Blood Pressure Monitoring最新文献

Background and objective: Ambulatory blood pressure monitoring (ABPM) requires automatic measurement and the use of a validated device, according to current guidelines and international standardization. The TM-2441 (A&D Co. Ltd, Tokyo, Japan) ABPM device is small, lightweight, and suitable for use in ambulatory settings. It was validated against the ISO 81060-2:2013 standard in the general population. This study investigated the reliability of the ABPM device for patients with type 2 diabetes.

Methods: Individuals aged more than 12 years affected with type 2 diabetes were recruited by our outpatient clinic. The blood pressure assessment was performed using the opposite limb simultaneous measurement according to the updated ISO 81060-2:2018.

Results: Forty-five subjects were included in the clinical investigation. The mean difference between blood pressure values measured by the TM-2441 ABPM device and the reference sphygmomanometer was within limits allowed by the ISO standard. Bland-Altman plots of the measurements and differences between the values obtained from the study device and those from the reference device showed no systematic variations in error. It was not possible to perform a stress test in most patients due to refusal or poor physical condition.

Conclusion: The TM-2441 ABPM device fulfilled all the requirements of the ISO standard for ambulatory testing not only in a general population but also in the subgroup of subjects with type 2 diabetes.

Objective: The objective of this study was to investigate the efficacy of the nitrendipine/atenolol combination in comparison with standard-dose nitrendipine or atenolol monotherapy in reducing blood pressure (BP) and blood pressure variability (BPV) as assessed by ambulatory BP monitoring.

Methods: In a randomized, crossover trial, 32 patients (30-65 years) with grade 1 hypertension and elevated daytime reading-to-reading BPV were randomly assigned to receive either the nitrendipine/atenolol combination (10/20 mg) or standard-dose nitrendipine (10 mg) or atenolol (25 mg) monotherapy for 6 weeks, followed by a crossover to another treatment for 6 weeks.

Results: The final analysis included 31 patients (mean [±SD] age, 49.2 ± 9.6 years) and 12 men. The nitrendipine/atenolol combination significantly reduced from baseline clinic and ambulatory BP and pulse rate ( P  ≤ 0.002), and 24 h and daytime systolic and diastolic BPV as assessed by SD and average real variability ( P  ≤ 0.042), but not the coefficient of variation nor nighttime BPV indices ( P  ≥ 0.06). Significant differences between the nitrendipine/atenolol combination and nitrendipine or atenolol monotherapy at the end of treatment were observed in clinic BP and pulse rate ( P  ≤ 0.042), but not in 24 h, daytime and nighttime blood pressure and pulse rate, except for daytime DBP and 24 h and daytime pulse rate ( P  ≤ 0.049). There were no significant differences in BPV between the combination and monotherpy groups at the end of treatment ( P  ≥ 0.25).

Conclusion: The nitrendipine/atenolol combination reduced daytime reading-to-reading BPV, but did not show superiority to nitrendipine or atenolol monotherapy.

Objective: This study aimed to evaluate the accuracy of the ANDON KD-7920 oscillometric wrist blood pressure monitor in general population according to the ISO 81060-2:2018+AMD1:2020.

Methods: The same arm sequential method was used for blood pressure measurement among qualified participants according to the ISO 81060-2:2018+AMD1:2020. The validation results were assessed following the criteria of the protocol, and the Bland-Altman scatter plot was used to present the difference between the test device and reference results.

Results: A total of 90 participants were included in the study. According to criterion 1 of the validation protocol, the mean ± SD of the differences between the test device and reference readings was 0.76 ± 6.23 mmHg and -0.13 ± 5.57 mmHg for systolic and diastolic blood pressure, respectively, which met the requirements of less than 5 ± 8 mmHg. According to the criterion 2, the average differences between the test device and reference readings per participant were 0.76 ± 5.56 mmHg and -0.13 ± 5.27 mmHg for systolic and diastolic blood pressure, respectively, which also met the requirements.

Conclusion: The ANDON KD-7920 wrist blood pressure monitor passed all the requirements of the ISO 81060-2:2018+AMD1:2020 and can be recommended for clinical use and self-measurement in general population.

Background: Accurate measurement of blood pressure (BP) is crucial for the diagnosis and ongoing management of hypertension. Only devices that have been validated using an established protocol should be used to measure BP. The aim of this study was to validate the Microlife BP3T01-1B, an automated upper-arm BP measuring device, according to the DIN EN ISO 81060-2:2018-11 (ANSI/AAMI/ISO 81060-2:2018) standard protocol.

Methods: BP measurements were performed in 85 adults and adolescents (age range: 13-86 years) using the same-arm sequential method of the DIN EN ISO 81060-2:2018-11 protocol, alternating between the test device and a reference mercury sphygmomanometer.

Results: A total of 255 valid comparisons were available for the analysis of criterion 1. The mean ± SD difference between the test device and the reference device values was -2.56 ± 7.53 mmHg for SBP and -3.10 ± 5.65 mmHg for DBP. The mean differences met the pass criterion of less than or equal to ±5 mmHg and the SD values met the pass criterion of ≤8 mmHg. All 85 participants were included in the analysis of criterion 2. The mean ± SD intraindividual difference between the test and reference devices was -2.56 ± 6.15 mmHg for SBP and -3.10 ± 4.85 mmHg for DBP. Both were within the required pass range of SD ≤6.43 mmHg for SBP and SD ≤6.20 mmHg for DBP.

Conclusion: The Microlife BP3T01-1B BP monitoring device fulfilled the criteria of the DIN EN ISO 81060-2:2018-11 (ANSI/AAMI/ISO 81060-2:2018) protocol in a general population and can be recommended for the measurement of BP in adults and adolescents.

Background: Primary percutaneous coronary intervention (p-PCI) is pivotal in managing ST-segment elevation myocardial infarction (STEMI); however, it introduces potential risks, such as contrast-induced acute kidney injury (CI-AKI). This study aimed to investigate the relationship between pulse pressure (PP) and CI-AKI incidence in diabetic patients.

Methods: In this retrospective study conducted between 2021 and 2022, 590 diabetic STEMI patients undergoing p-PCI were categorized based on the presence of wide PP. Individuals with PP ≥ 65 mmHg were classified as the 'wide PP (+) group', while those with PP < 65 mmHg were classified as the 'wide PP (-) group'. To determine independent predictors of CI-AKI, multivariable logistic regression models were applied. After establishing the base model, blood pressure indices, including PP, SBP, DBP, mean arterial pressure, and pulsatility were added to the model using the stepwise selection method.

Results: Among the patients, 18.3% ( n  = 108) were in the wide PP (+) group, while 81.7% ( n  = 482) were in the wide PP (-) group. The incidence of hypertension, SBP, PP, and the risk of CI-AKI were higher in the wide PP (+) group. Multivariable analysis recognized PP, wide PP, and pulsatility as independent CI-AKI predictors [odds ratio (OR): 1.024, 95% confidence interval (CI): 1.003-1.045, P  = 0.025; OR: 1.684, 95% CI: 1.025-2.769, P  = 0.040; OR: 13.816, 95% CI: 2.069-92.245, P  = 0.007, respectively].

Conclusion: Increased PP emerges as an independent predictor for CI-AKI in diabetic patients undergoing p-PCI.

Objective: This study aimed to investigate the effects of power training (PT) using elastic bands combined with endurance training (ET) on pulse pressure (PP), systolic (SBP) and diastolic blood pressures (DBP), autonomic response (AR), and functional parameters in older adults.

Methods: Thirty participants were randomly assigned to the control group ( n  = 15) and the intervention group (IG) ( n  = 15). IG participants performed PT with elastic bands combined with ET twice weekly for 8 weeks. PP, SBP, DBP, AR, and functional parameters were assessed before and after 8 weeks.

Results: PP, SBP, and functional parameters significantly improved after 8 weeks in the IG ( P  < 0.05). The study also found a clinically significant reduction in the SBP (Δ = -16.5 mmHg; η2p  = 0.36) and DBP (Δ = -4.3 mmHg; η2p  = 0.26), and a clinical reduction in the 5-Repetition Sit-To-Stand test ( η2p  = 0.63) and the elbow flexion test ( η2p  = 0.51).

Conclusion: Our findings indicate that PT with elastic bands combined with ET improves PP, SBP, and functional parameters in older adults. Hence, our combined training protocol can be an easily accessible, low-cost, nonpharmacological strategy for strength, and conditioning professionals to prescribe as an exercise intervention to older adults.

Background: A possible chronic effect of exercise training is the attenuation of the acute decrease in blood pressure (BP) observed after the execution of a session of exercise [i.e. called postexercise hypotension (PEH)]. However, there are few empirical data regarding this issue, and the possible mechanisms involved in this blunted response have not been studied.

Aim: The study aimed to evaluate the effects of dynamic resistance training (DRT) on PEH and its systemic, vascular, and autonomic mechanisms.

Methods: Data from 16 middle-aged treated hypertensive men who underwent DRT (eight exercises, 50% of 1RM, three sets until moderate fatigue) three times/week for 10 weeks were analyzed. Before and after the training period, the participants underwent an experimental session in which BP (auscultation), systemic hemodynamics (CO 2 rebreathing), vascular function (duplex ultrasound), and cardiovascular autonomic modulation (spectral analysis of heart rate and BP variabilities) were assessed before and after a session of DRT.

Results: DRT reduced preexercise systolic BP and mitigated the systolic PEH that occurred before but not after the training period ( P  = 0.017). DRT did not change the diastolic PEH that occurred with similar magnitude before and after the training period ( P  = 0.024). DRT did not change the PEH mechanisms, except for cardiac sympathovagal balance that increased significantly more after the session of DRT conducted in the posttraining evaluation ( P  = 0.017).

Conclusion: In medicated hypertensive men, 10 weeks of DRT decreased preexercise systolic BP, abolished systolic PEH, and induced a greater increase in postdynamic resistance exercise sympathovagal balance.

Background: Individuals with postacute COVID-19 syndrome (PACS) typically exhibit abnormal hemodynamic responses during upright positioning, including orthostatic hypotension and postural orthostatic tachycardia syndrome. The 10-minute NASA lean test (NLT) has been suggested for this condition. However, no comparative study with the head-up tilt table test (HUTT) has been conducted. This study aimed to compare blood pressure and heart rate responses during the 10-minute duration of NLT and HUTT.

Methods: Eighty young individuals (aged 22.0 ± 3.1 years) with PACS underwent both tests, with a 30-minute interval between tests. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured every minute, and the differences between supine and upright positions were analyzed.

Results: There were no significant differences in SBP changes between HUTT and NLT (-7.8 ± 6.2 vs. -7.1 ± 7.5 mmHg) with a mean difference of -0.7 ± 9.0 mmHg. However, DBP changes were significantly lower in HUTT compared to NLT (-0.9 ± 6.4 vs. 1.5 ± 6.9 mmHg for NLT) with a mean difference of -2.4 ± 7.1 mmHg. Maximal HR was significantly lower in HUTT compared to NLT (92.0 ± 11.4 vs. 96.2 ± 10.8 bpm for NLT) with a mean difference of -4.2 ± 6.9 bpm. Additionally, HR changes were significantly lower in HUTT compared to NLT (21.5 ± 8.1 vs. 27.0 ± 9.0 bpm) with a mean difference of -5.4 ± 6.4 bpm.

Conclusion: The NLT demonstrated comparability with the HUTT in detecting SBP changes. However, clinical applications should consider differences in measuring DBP and HR changes.

Background: Blood pressure (BP) control is often challenging. We study whether a pictorial BP log is associated with improved adherence to medical management and BP control.

Method: A sample of mostly Blacks and Hispanics with uncontrolled hypertension were either provided with a pictorial log (n = 75) or recommended to complete a log to record their BP (n = 75). The primary outcome was bringing any BP log to a subsequent follow-up visit. Secondary outcomes were BP values, BP control, and adherence to antihypertensive medication.

Results: The pictorial log-provided group had a significantly greater percentage than the no log-provided group for bringing a log to a visit within 6 months (53.3 versus 8.0%, P < 0.001). The pictorial log group had a significantly (P = 0.03) greater mean reduction of diastolic BP (M = -5.2, SD = 10.98) than the no log provided group (M = -1.0, SD = 9.95). There were no significant differences in BP control or adherence to antihypertensive medication between the groups. Improved adherence to antihypertensive medication was observed in patients who were adherent to bringing any BP log to a visit (odds ratio: 4.59, 95% confidence interval:1.16-18.10, P = 0.03).

Conclusion: Pictorial logs were associated with bringing such logs to subsequent visits and for reduced diastolic BP. However, pictorial logs were not associated with improved BP control or adherence to antihypertensive medication but rather any log was associated with greater adherence to antihypertensive medication. We recommend the use of BP logs of any type for successful BP management.

Objective: The objective of this study is to evaluate the accuracy of the iHealth BP7 wrist blood pressure (BP) monitor for clinical use and self-measurement in general population according to the International Organization for Standardization (ISO) 81060-2:2018/Amendment (Amd) 1:2020 protocol.

Methods: Same arm BP was sequentially measured in 95 qualified participants and compared with a standard mercury sphygmomanometer. A total of 285 comparison pairs were obtained and analyzed according to the ISO 81060-2:2018/Amd 1:2020.

Results: For the validation Criterion 1 of the protocol, the mean ± SD of the differences between the test device and reference BP readings was 0.62 ± 6.18 and -0.20 ± 5.59 mmHg for SBP and DBP, respectively. For Criterion 2, the SDs of the averaged BP differences between the test device and reference BP per subject were 5.79 and 5.28 mmHg (with maximum allowed SDs of 6.90 and 6.95 mmHg) for SBP and DBP, respectively.

Conclusion: The iHealth BP7 wrist BP monitor satisfied all the validation requirements according to the ISO 81060-2:2018/Amd 1:2020 protocol and can be recommended for clinical use and self-measurement in the general population.