Blood Pressure Monitoring最新文献

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.

Objective: Uscom BP+ is a cuff-based blood pressure (BP) device designed to noninvasively estimate central BP as distinct from conventional brachial BP. This study aimed to assess the accuracy of the Uscom BP+ device compared with invasively measured BP.

Methods: Automated noninvasive cuff central BP (using the Uscom BP+ device) and invasive central aortic BP were recorded simultaneously in 191 participants (65% male, aged 66 ± 11 years) receiving coronary angiography at three independent research sites in Australia, Poland, and Italy. Validation procedures were undertaken according to the Artery Society recommendations and with a minimally acceptable error (mean ± SD) of ≤5 ± ≤8 mmHg as pass criteria.

Results: Using the device default calibration technique [brachial cuff systolic blood pressure (SBP) and diastolic blood pressure (DBP)], cuff central SBP underestimated invasive central SBP [mean (SD) difference: -10.2 (11.2) mmHg] and cuff central DBP overestimated invasive central DBP [mean (SD) difference: 9.8 (8.5) mmHg]. When calibrating by brachial cuff mean arterial pressure and DBP, SBP accuracy was improved, but variability remained high [mean (SD) difference: -6.3 (14.4) mmHg, P  = 0.004 vs. default calibration, whereas DBP accuracy and variability remained similar [mean (SD) difference: 10.9 (8.5) mmHg, P  = 0.19 vs. default calibration].

Conclusion: The Uscom BP+ cuff device does not pass the Artery Society accuracy criteria compared with invasively measured central BP.

Objective: Renal artery stenosis (RAS) which is a potentially reversible cause of hypertension and renal insufficiency is associated with poor prognosis in ischemic stroke patients. The inter-arm blood pressure difference (IABD) is independently related to the atherosclerosis of the arteries. This study was to evaluate the relationship of RAS with IABD in ischemic stroke patients.

Materials and methods: This study was a cross-sectional observational study of consecutive patients with ischemic stroke who had not a history of RAS. Abdominal aortography was performed to screen for RAS after the cerebrovascular diagnostic procedure. RAS was defined as the presence of ≥50% stenosis in either renal artery. Univariate and multivariate analysis were performed to investigate the association of the clinical variables including IABD with RAS.

Results: RAS and systolic IABD ≥ 10 mmHg were detected in 62 (14.7%) and 142 (33.6%) of all ischemic stroke patients ( n  = 422), respectively. Patients with systolic IABD ≥ 10 mmHg were more likely to have RAS than patients without (59.7 vs 29.2%, P   <  0.001). The logistic regression analysis showed that systolic IABD ≥ 10 mmHg was independently associated with RAS (odds ratio, 3.67; 95% confidence interval: 2.02-6.65; P   <  0.001).

Conclusion: Measuring SBP between arms may help identify individuals with RAS in ischemic stroke patients.

To validate the accuracy of the YuWell YE990 automated oscillometric upper-arm medical blood pressure (BP) monitor in adults according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal standards (ISO 81060-2:2018 and Amendment 1:2020). Participants were recruited to meet the age, sex, BP, and cuff distribution criteria of the AAMI/ESH/ISO standards. BP was measured using a mercury sphygmomanometer (reference device) and YE990 (test device) following a same-arm sequential protocol with two trained observers and a supervisor. Bland-Altman plots were used to assess agreement, and scatter plots were used to assess the performance across varying arm sizes. Ninety-nine subjects were recruited and 85 were analyzed. The YE990 passed the accuracy requirements of the AAMI/ESH/ISO standards, with mean differences of 0.4 ± 6.31 mmHg for systolic BP and -0.9 ± 6.28 mmHg for diastolic BP for validation criterion 1. For validation criterion 2, the SD of the average BP difference between the test device and reference BP per subject was 5.00/5.70 mmHg (systolic/diastolic). YuWell YE990 meets the AAMI/ESH/ISO universal accuracy standard (ISO 81060-2:2018+Amd.1:2020) and is recommended for clinical use.

Objective: The discrepancy in blood pressure (BP) measurements while in a supine position using an upper-arm automated sphygmomanometer equipped with cuffs of varying sizes remains unresolved.

Methods: In this single-center, randomized crossover trial, a total of 223 inpatients from the Affiliated Hospital of Putian University were enrolled between August and September 2023. Three sets of triplicate BP measurements were obtained while the participants were in a supine position using an automated sphygmomanometer with randomly assigned appropriately sized, undersized, or oversized BP cuffs.

Results: The average age of the subjects was 65.1 ± 18.4 years, with 109 (48.9%) being male and 78 (35%) having coexisting hypertension. Based on the measured mid-arm circumference, a small-sized, regular-sized, and large-sized BP cuff was deemed appropriate for 50, 113, and 60 participants, respectively. In patients requiring small-sized cuffs, the use of regular and large-sized cuffs resulted in a significant reduction in systolic BP by -4.0 [95% confidence interval (CI): -9.8 to 1.9] mmHg and -6.9 (95% CI: -8.0 to -5.8) mmHg, respectively, as well as diastolic BP by -3.4 (95% CI: -8.0 to 1.2) mmHg and -4.1 (95% CI: -5.3 to 2.8) mmHg, respectively. In contrast, among patients requiring large-sized cuffs, the use of small and regular-sized cuffs increased systolic BP by 6.2 (95% CI: 4.2 to 8.2) mmHg and 2.3 (95% CI: -1.4 to 6.1) mmHg, respectively, and diastolic BP increased by 2.6 (95% CI: 1.5 to 3.7) mmHg and 0.2 (95% CI: -4.7 to 5.2) mmHg, respectively.

Conclusion: Our findings suggest that miscuffing affects supine BP measured by an automated sphygmomanometer.

Objective: Home blood pressure (BP) measurement is important for adequate BP control in patients with hypertension. BP targets for frail older adults need to be determined on an individual basis. This study aimed to examine the effect of frailty on home BP measurement status.

Methods: This study enrolled 682 older participants from a community cohort study conducted in Tarumizu City in 2019. We explained that home BP monitors could be lent free of charge to participants who wished to measure their BP at home. We evaluated frailty and daily living functions, such as technology usage, information practice, life management, and social engagement. We investigated how these indicators were associated with the desire to borrow home BP monitors and adherence to home BP measurements.

Results: A total of 304 participants agreed to borrow the home BP monitors. Multivariable logistic analysis revealed that the presence of frailty, low technology usage, and information practice were negatively associated with borrowing a home BP monitor, independent of age, sex, BMI, smoking history, and the presence of hypertension, diabetes, and dyslipidaemia. In contrast, the presence of prefrailty and frailty was positively associated with daily home BP measurements, independent of age, sex, BMI, smoking history, presence of hypertension, diabetes, and dyslipidaemia.

Conclusion: Frailty is associated with a lower desire to monitor home BP, but is associated with higher adherence to home BP monitoring once it is initiated.

Background: Noninvasive assessment of cardiac function is useful in the management of heart failure (HF).

Objectives: We developed a novel pulse waveform index, 'Sf/Am', from cuff-oscillometric ambulatory blood pressure (BP) monitoring (ABPM), to estimate cardiac function. This study aimed to investigate the usefulness of square forward pulse wave/amplitude measure pulse wave (Sf/Am), which reflects cardiac systolic function in ambulatory settings, for estimating echocardiographic left ventricular ejection fraction (LVEF) in patients with HF.

Methods: A cuff volumetric waveform was obtained from the diastolic phase of each BP measurement with a multisensor-ABPM (TM-2441, A&D). The area of the ejection is the Sf. Sf is divided by the Am, that is, Sf/Am, to eliminate the effects of arterial and cuff compliance. This index was hypothesized to represent left ventricular systolic function. LVEF was determined using the modified Simpson's method.

Results: A total of 195 participants with HF completed ABPM and echocardiogram. After excluding 76 participants with atrial fibrillation, 119 participants (mean age, 70.0 ± 15.9 years; 58.8% male) were included in the analysis. Sf/Am was correlated with LVEF (r = 0.550, P < 0.001). This relationship remained significant in a multivariable linear regression model adjusted for BP level and other confounders (β = 0.603, P < 0.001). The area under the curve values 95% confidence interval (CI) for Sf/Am in predicting LVEF < 40% and <30% were 0.814 (0.738-0.890) and 0.897 (0.840-0.953), respectively.

Conclusion: Pulse waveform analysis using ABPM has potential for noninvasive estimation of echocardiographic LVEF.

To determine the accuracy of the Hingmed Q06B monitor for upper arm blood pressure (BP) measurement according to the new International Organization for Standardization (ISO) 81060-2:2018/Amd1:2020/Amd2:2024 protocol ('Universal Protocol'). The Q06B device, an oscillometric fully automatic BP monitor for BP measurement at home, has a single wide-range cuff for arm circumferences ranging from 22 to 41 cm. The device was tested in 85 subjects from the general population with a mean age of 53.6 ± 11.7 years. The mean device-observer difference was in agreement with criterion one of the protocol standard requirements (≤5 ± 8 mmHg), being -0.7 ± 3.7 mmHg for systolic BP and -1.6 ± 3.6 mmHg for diastolic BP. The measurement errors had a similar magnitude across the entire range of arm sizes. Criterion two of the ISO 81060-2:2018/Amd1:2020/Amd2:2024 protocol is satisfied. The SD of systolic and diastolic BPs were 2.1 and 2.8 mmHg, respectively, well below the maximum values required by the protocol (6.90 and 6.76 mmHg for systolic and diastolic BPs, respectively). These data show that the Hingmed BP monitor Q06B satisfied the requirements of the ISO 81060-2:2018/Amd1:2020/Amd2:2024 protocol for the general population, demonstrating that a single wide-range cuff can provide reliable measurements across a wide range of arm circumferences.

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-provided 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 aim of this study was to evaluate the accuracy of the CONTEC08A oscillometric upper-arm blood pressure (BP) monitor for BP measurement in adults according to the International Organization for Standardization (ISO) 81060-2:2018 and amendment (Amd)1:2020 standard.

Methods: Eighty-five subjects (male 40 and female 45) were recruited to fulfill the age, sex, BP, and cuff distribution criteria of the ISO standard in the general population, and had a mean age of 40.2 years. The same arm sequential BP measurement method was used with three differently sized cuffs for the arm circumference ranging from 18 to 26 cm (small), 22-32 cm (medium), and 22-43 cm (large), respectively, for the test device, and two differently sized cuffs for the arm circumference ≤32 cm (standard) and >32 cm (large), respectively, for the mercury sphygmomanometer.

Results: Two hundred and fifty-five comparison pairs were obtained for analysis. For validation criterion 1, the mean ± SD of the differences between the test device and reference SBP/DBP readings was 1.1 ± 6.7/3.0 ± 5.3 mmHg. For validation criterion 2, the SD of the averaged SBP/DBP differences between the test device and reference BP per subject was 5.63/4.68 mmHg.

Conclusion: The automated upper-arm BP monitor CONTEC08A has passed the requirements of the ISO Universal Standard in the general population, and can be recommended for BP measurement in adults.