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Automated office blood pressure.
Myers, Martin G; Godwin, Marshall
Manual blood pressure (BP) is gradually disappearing from clinical practice with the mercury sphygmomanometer now considered to be an environmental hazard. Manual BP is also subject to measurement error on the part of the physician/nurse and patient-related anxiety which can result in poor quality BP measurements and office-induced (white coat) hypertension. Automated office (AO) BP with devices such as the BpTRU (BpTRU Medical Devices, Coquitlam, BC) has already replaced conventional manual BP in many primary care practices in Canada and has also attracted interest in other countries where research studies using AOBP have been undertaken. The basic principles of AOBP include multiple readings taken with a fully automated recorder with the patient resting alone in a quiet room. When these principles are followed, office-induced hypertension is eliminated and AOBP exhibits a much stronger correlation with the awake ambulatory BP as compared with routine manual BP measurements. Unlike routine manual BP, AOBP correlates as well with left ventricular mass as does the awake ambulatory BP. AOBP also simplifies the definition of hypertension in that the cut point for a normal AOBP (< 135/85 mm Hg) is the same as for the awake ambulatory BP and home BP. This article summarizes the currently available evidence supporting the use of AOBP in routine clinical practice and proposes an algorithm in which AOBP replaces manual BP for the diagnosis and management of hypertension. PMID:22265230
Automated Blood Pressure Measurement
NASA Technical Reports Server (NTRS)
The Vital-2 unit pictured is a semi-automatic device that permits highly accurate blood pressure measurement, even by untrained personnel. Developed by Meditron Instrument Corporation, Milford, New Hampshire, it is based in part on NASA technology found in a similar system designed for automatic monitoring of astronauts' blood pressure. Vital-2 is an advancement over the familiar arm cuff, dial and bulb apparatus customarily used for blood pressure checks. In that method, the physician squeezes the bulb to inflate the arm cuff, which restricts the flow of blood through the arteries. As he eases the pressure on the arm, he listens, through a stethoscope, to the sounds of resumed blood flow as the arteries expand and contract. Taking dial readings related to sound changes, he gets the systolic (contracting) and diastolic (expanding) blood pressure measurements. The accuracy of the method depends on the physician's skill in interpreting the sounds. Hospitals sometimes employ a more accurate procedure, but it is "invasive," involving insertion of a catheter in the artery.
Automated blood pressure measurement (ABPM) in the elderly.
Trenkwalder, P
Application and feasibility of automated ambulatory blood pressure measurement (ABPM) in the elderly are comparable to younger age groups. Major side-effects are sleep disturbances and pain during cuff-inflation. The main indications for ABPM are diagnosis and control of treatment in hypertensive patients. Further indications are the diagnosis of syncope or hypotensive disorders and the diagnostic work-up of symptoms like vertigo, dizziness and dyspnea. In hypertensives, ABPM can easily assess the "white coat" effect and cases of "white coat" hypertension (prevalence in the elderly 15-25%). The prognostic implications of "white coat" hypertensions remain to be determined. Recording of the total 24-h blood pressure profile with analysis of circadian blood pressure changes, the day-night difference and the early morning surge raises the possibility to assess age-specific patterns. The drop in blood pressure at night (during sleep) is usually decreased and less frequently observed in elderly hypertensives. Possible explanations include decreased daytime activity, an altered sleep pattern in the elderly and secondary forms of hypertension. So-called "non-dippers", with no adequate drop in night-time blood pressure, show a significant increase in cardiovascular complications. Control of treatment via ABPM can assess non-responders and cases of overtreatment, and permits a fairly objective analysis of side-effects. Episodes of transient myocardial ischemia and possible trigger mechanisms can be assessed by simultaneous application of ABPM and Holter monitoring. The insufficient control of hypertension in the majority of elderly patients and the current lower target blood pressures in the elderly call for new methods to improve the level and quality of antihypertensive treatment. Although ABPM provides a closer correlation to target organ damage than measurement of office (casual) blood pressure, and ABPM frequently improves or at least facilitates the care of elderly
Automated compared to manual office blood pressure and to home blood pressure in hypertensive patients.
Filipovský, Jan; Seidlerová, Jitka; Kratochvíl, Zdeněk; Karnosová, Petra; Hronová, Markéta; Mayer, Otto
We studied the relationships of automated blood pressure (BP), measured in the healthcare centre, with manual office BP and home BP. Stable outpatients treated for hypertension were measured automatically, seated alone in a quiet room, six times after a 5 min rest with the BpTRU device, and immediately afterwards using the auscultatory method. Home BP was measured in a subgroup during 7 days preceding the visit. The automated, office and home BP values were 131.2 ± 21.8/77.8 ± 12.1 mmHg, 146.9 ± 20.8/85.8 ± 12.4 mmHg and 137.7 ± 17.7/79.4 ± 8.2 mmHg, respectively. Limits of agreement between office and automated BP (2 SDs in Bland-Altman plots) were +42.6 to -12.6/+22.6 to -6.6 mmHg for systolic/diastolic BP; for home and automated BP they were +45.8 to -25.8/+20.8 to -12.6 mmHg. For patients with two visits, intraclass correlation coefficients of BP values measured during the first and second visits were 0.66/0.72 for systolic/diastolic automated BP and 0.68/0.74 for systolic/diastolic office BP. Automated BP was lower than home BP and no more closely related to home BP than to office BP. It did not show better repeatability than office BP. Whether automated BP and the "white-coat effect", calculated cas the office BP-automated BP difference, have clinical and prognostic importance deserves further studies. PMID:26852625
Why use automated office blood pressure measurements in clinical practice?
Andreadis, Emmanuel A; Angelopoulos, Epameinondas T; Agaliotis, Gerasimos D; Tsakanikas, Athanasios P; Mousoulis, George P
Automated office blood pressure (AOBP) measurement with the patient resting alone in a quiet examining room can eliminate the white-coat effect associated with conventional readings taken by manual sphygmomanometer. The key to reducing the white-coat response appears to be multiple blood pressure (BP) readings taken in a non-observer office setting, thus eliminating any interaction that could provoke an office-induced increase in BP. Furthermore, AOBP readings have shown a higher correlation with the mean awake ambulatory BP compared with BP readings recorded in routine clinical practice. Although there is a paucity of studies connecting AOBP with organ damage, AOBP values were recently found to be equally associated with left ventricular mass index as those of ambulatory BP. This concludes that in contrast to routine manual office BP, AOBP readings compare favourably with 24-hour ambulatory BP measurements in the appraisal of cardiac remodelling and, as such, could be complementary to ambulatory readings in a way similar to home BP measurements. PMID:21950780
Automated analysis of blood pressure measurements (Korotkov sound)
NASA Technical Reports Server (NTRS)
Golden, D. P.; Hoffler, G. W.; Wolthuis, R. A.
Automatic system for noninvasive measurements of arterial blood pressure is described. System uses Korotkov sound processor logic ratios to identify Korotkov sounds. Schematic diagram of system is provided to show components and method of operation.
Thresholds for Diagnosing Hypertension Based on Automated Office Blood Pressure Measurements and Cardiovascular Risk.
Myers, Martin G; Kaczorowski, Janusz; Paterson, J Michael; Dolovich, Lisa; Tu, Karen
The risk of cardiovascular events in relation to blood pressure is largely based on readings taken with a mercury sphygmomanometer in populations which differ from those of today in terms of hypertension severity and drug therapy. Given replacement of the mercury sphygmomanometer with electronic devices, we sought to determine the blood pressure threshold for a significant increase in cardiovascular risk using a fully automated device, which takes multiple readings with the subject resting quietly alone. Participants were 3627 community-dwelling residents aged >65 years untreated for hypertension. Automated office blood pressure readings were obtained in a community pharmacy with subjects seated and undisturbed. This method for recording blood pressure produces similar readings in different settings, including a pharmacy and family doctor's office providing the above procedures are followed. Subjects were followed for a mean (SD) of 4.9 (1.0) years for fatal and nonfatal cardiovascular events. Adjusted hazard ratios (95% confidence intervals) were computed for 10 mm Hg increments in blood pressure (mm Hg) using Cox proportional hazards regression and the blood pressure category with the lowest event rate as the reference category. A total of 271 subjects experienced a cardiovascular event. There was a significant (P=0.02) increase in the hazard ratio of 1.66 (1.09, 2.54) at a systolic blood pressure of 135 to 144 and 1.72 (1.21, 2.45; P=0.003) at a diastolic blood pressure of 80 to 89. A significant (P=0.03) increase in hazard ratio of 1.73 (1.04, 2.86) occurred with a pulse pressure of 80 to 89. These findings are consistent with a threshold of 135/85 for diagnosing hypertension in older subjects using automated office blood pressure. PMID:26269653
Comparison of an in-pharmacy automated blood pressure kiosk to daytime ambulatory blood pressure in hypertensive subjects.
Padwal, Raj S; Townsend, Raymond R; Trudeau, Luc; Hamilton, Peter G; Gelfer, Mark
The objective of this study was to compare serial readings from an in-pharmacy automated blood pressure (BP) kiosk to mean daytime ambulatory BP. A total of 100 community-dwelling adults with hypertension underwent (1) three baseline automated office readings; (2) three in-pharmacy readings on each of four visits (12 total) using the PharmaSmart PS-2000 kiosk; and (3) 24-hour ambulatory BP monitoring between in-pharmacy visits two and three. Paired t-tests, Bland-Altman plots, and Pearson correlation coefficients were used for analysis. Mean BPs were 137.8 ± 13.7/81.9 ± 12.2 mm Hg for in-pharmacy and 135.5 ± 11.7/79.7 ± 10.0 mm Hg for daytime ambulatory (difference of 2.3 ± 9.5/2.2 ± 6.9 mm Hg [P ≤ .05]). Bland-Altman plots depicted a high degree of BP variability but did not show clinically important systematic BP differences. With ambulatory BP as the reference standard, in-pharmacy device results were similar to automated office results. The PharmaSmart PS-2000 closely approximated mean daytime ambulatory BP, supporting the use of serial readings from this device in the assessment of BP. PMID:25600420
MedlinePlus Videos and Cool Tools
Normal blood pressure is important for proper blood flow to the body's organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart ...
MedlinePlus Videos and Cool Tools
Normal blood pressure is important for proper blood flow to the body's organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both ...
A simulator for oscillometric blood-pressure signals to test automated noninvasive sphygmomanometers
NASA Astrophysics Data System (ADS)
Riedel, W.; Mieke, S.; Seemann, R.; Ittermann, B.
A device was developed allowing to generate simulated human blood pressure signals for the purpose of testing the performance of automated noninvasive sphygmomanometers. The apparatus reproducibly generates blood-pressure oscillations synthesized from prerecorded measurements on human subjects. These real-life data allow for a much better evaluation of the accuracy of blood-pressure measurements than the existing simulators using artificial and thus less realistic waveforms. To assess the performance of a given sphygmomanometer under both stable and varying conditions, generated signals can be repeated in their original shape or distorted by well-defined artifacts. In comparison to clinical tests, the procedural influences on the performance testing of sphygmomanometers are largely reduced when the simulator is used.
Automated measurement of office, home and ambulatory blood pressure in atrial fibrillation.
Kollias, Anastasios; Stergiou, George S
1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives. PMID:23647092
Replacing manual sphygmomanometers with automated blood pressure measurement in routine clinical practice.
Myers, Martin G
1. Conventional manual measurement of blood pressure (BP) in clinical practice is no longer considered to be the best method for evaluating a patient's BP status. Home BP and 24 h ambulatory BP monitoring are now recommended for the diagnosis and management of hypertension. 2. Recent studies provide an alternative to conventional office BP, namely automated office (AO) BP, which involves multiple BP readings taken with a fully automated device with the patient resting quietly alone. Automated office BP is preferable to routine manual office BP in that it exhibits improved accuracy and a stronger relationship to both ambulatory BP and target organ damage. 3. Having the patient alone eliminates conversation between the patient and the observer, a cause of 'white coat hypertension'. The use of an automated device improves accuracy, reduces digit preference, minimizes observer bias and facilitates the recording of multiple BP readings. 4. Comparative BP data obtained in clinical studies in both research settings and routine community practice support the use of a cut-off point of 135/85 mmHg for defining hypertension using AOBP, which is the same cut-off point currently recommended for awake ambulatory BP and home BP. 5. Reduction of the white coat response using AOBP should reduce the need to monitor patients with ambulatory BP and home BP after initiation of antihypertensive therapy. There is now sufficient evidence to consider replacing manual office BP with AOBP in routine clinical practice. PMID:23819734
A randomized controlled trial of an automated telephone intervention to improve blood pressure control.
Harrison, Teresa N; Ho, Timothy S; Handler, Joel; Kanter, Michael H; Goldberg, Ruthie A; Reynolds, Kristi
The objective of this study was to evaluate the effectiveness of a telephonic outreach program to improve blood pressure (BP) control among patients with hypertension. The authors identified adults 18 years and older with uncontrolled BP within the previous 12 months. Patients received either an automated telephone call advising them to have a walk-in BP check (n=31,619) or usual care (n=33,154). The primary outcome was BP control at 4 weeks. Significantly more patients who received the intervention achieved BP control compared with the usual care group (32.5% vs 23.7%; P<.0001). Patients in the intervention arm with cardiovascular disease, chronic kidney disease, or diabetes mellitus achieved better BP control. Older age, female sex, and having a household income above the median were associated with BP control. When designing quality-improvement interventions to increase BP control rates, health care organizations should consider utilizing an automated telephone outreach campaign. PMID:24034658
Screening for atrial fibrillation with automated blood pressure measurement: Research evidence and practice recommendations.
Verberk, Willem J; Omboni, Stefano; Kollias, Anastasios; Stergiou, George S
Several guidelines recommend opportunistic screening for atrial fibrillation (AF) in subjects aged ≥ 65 years using pulse palpation during routine blood pressure (BP) measurement. However, this method has limited diagnostic accuracy. A specific algorithm for AF detection during automated BP measurement was developed and implemented in a novel oscillometric device (Microlife WatchBP Home-A). In 2013, the UK National Institute for Health and Care Excellence (NICE) recommended this device for AF screening during routine office BP measurement in primary care in subjects ≥ 65 years. A review and meta-analysis of the evidence on the diagnostic accuracy of this algorithm were performed. Six studies (n=2332) investigated the accuracy of AF detection using the Microlife BP monitor and estimated a pooled sensitivity at 0.98 (95% CI 0.95, 1.00) and specificity 0.92 (0.88, 0.96). Analysis of 4 studies (n=1126) showed more readings to improve specificity (from 0.86 to 0.91) and sensitivity (from 0.97 to 0.99). Taking 3 sequential readings with at least 2 detecting AF gave the highest diagnostic accuracy. A single study (n=139) of paroxysmal AF screening with home BP monitoring (3316 days) showed sensitivity 99% and specificity 93%. Another study (n=46) of AF screening with 24h ambulatory BP monitoring showed that AF detected in >15% of all readings has high probability of AF diagnosis requiring confirmation by 24h electrocardiography. AF detection with routine automated BP measurement is a reliable screening tool in the elderly, which requires confirmation by electrocardiography. Paroxysmal AF might also be detected by routine automated home or ambulatory BP monitoring. PMID:26547741
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Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The ...
Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... your health care provider will wrap the blood pressure cuff snugly around your upper arm. The lower ...
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Understanding Blood Pressure Readings
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High Blood Pressure (Hypertension)
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High Blood Pressure in Pregnancy
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High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, heart failure, ... failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight and ...
Hypertension (High Blood Pressure)
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Hypertension (High Blood Pressure)
... blood pressure with the development of a practical method to measure it. Physicians began to note associations between hypertension and risk of heart failure, stroke, and kidney failure. Although scientists had yet to prove that lowering blood pressure ...
High Blood Pressure (Hypertension)
... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing options ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...
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Development of o.a.s.i.s., a new automated blood culture system in which detection is based on measurement of bottle headspace pressure changes.
Stevens, C M; Swaine, D; Butler, C; Carr, A H; Weightman, A; Catchpole, C R; Healing, D E; Elliott, T S
o.a.s.i.s. (Unipath Ltd., Basingstoke, United Kingdom) is a new automated blood culture system. The metabolism of microorganisms is detected by measuring changes in the pressure of the headspace of blood culture bottles. These changes are measured by monitoring the position of a flexible sealing septum, every 5 min, with a scanning laser sensor. This noninvasive system can detect both gas absorption and production and does not rely solely on measuring increasing carbon dioxide levels. A research prototype instrument was used to carry out an evaluation of the media, the detection system, and its associated detection algorithm. In simulated blood cultures, o.a.s.i.s. supported growth and detected a range of clinical isolates. Times to positivity were significantly shorter in o.a.s.i.s. than in the BACTEC 460 system. Results of a clinical feasibility study, with a manual blood culture system as a control, confirmed that o.a.s.i.s. was able to support the growth and detection of a variety of clinically significant organisms. On the basis of these findings, full-scale comparative clinical trials of o.a.s.i.s. with other automated blood culture systems are warranted. PMID:7929769
Accuracy of the blood pressure measurement.
Rabbia, F; Del Colle, S; Testa, E; Naso, D; Veglio, F
Blood pressure measurement is the cornerstone for the diagnosis, the treatment and the research on arterial hypertension, and all of the decisions about one of these single aspects may be dramatically influenced by the accuracy of the measurement. Over the past 20 years or so, the accuracy of the conventional Riva-Rocci/Korotkoff technique of blood pressure measurement has been questioned and efforts have been made to improve the technique with automated devices. In the same period, recognition of the phenomenon of white coat hypertension, whereby some individuals with an apparent increase in blood pressure have normal, or reduced, blood pressures when measurement is repeated away from the medical environment, has focused attention on methods of measurement that provide profiles of blood pressure behavior rather than relying on isolated measurements under circumstances that may in themselves influence the level of blood pressure recorded. These methodologies have included repeated measurements of blood pressure using the traditional technique, self-measurement of blood pressure in the home or work place, and ambulatory blood pressure measurement using innovative automated devices. The purpose of this review to serve as a source of practical information about the commonly used methods for blood pressure measurement: the traditional Riva-Rocci method and the automated methods. PMID:17016412
... more often referred to as a blood pressure cuff. The cuff is wrapped around your upper arm and inflated ... flow of blood in your artery. As the cuff is slowly deflated, your doctor uses a stethoscope ...
NASA Technical Reports Server (NTRS)
Engineering Development Laboratory developed a system for the cardiovascular study of weightless astronauts. This was designed to aid people with congestive heart failure and diabetes. While in space, astronauts' blood pressure rises, heart rate becomes unstable, and there are sometimes postflight lightheadedness or blackouts. The Baro-Cuff studies the resetting of blood pressure. When a silicone rubber chamber is strapped to the neck, the Baro-Cuff stimulates the carotid arteries by electronically controlled pressure application. Blood pressure controls in patients may be studied.
Fuzzy blood pressure measurement
NASA Astrophysics Data System (ADS)
Cuce, Antonino; Di Guardo, Mario; Sicurella, Gaetano
In this paper, an intelligent system for blood pressure measurement is posed together with a possible implementation using an eight bit fuzzy processor. The system can automatically determine the ideal cuff inflation level eliminating the discomfort and misreading caused by incorrect cuff inflation. Using statistics distribution of the systolic and diastolic blood pressure, in the inflation phase, a fuzzy rule system determine the pressure levels at which checking the presence of heart beat in order to exceed the systolic pressure with the minimum gap. The heart beats, characterized through pressure variations, are recognized by a fuzzy classifier.
NASA Technical Reports Server (NTRS)
An estimated 30 million people in the United States have high blood pressure, or hypertension. But a great many of them are unaware of it because hypertension, in its initial stages, displays no symptoms. Thus, the simply-operated blood pressure checking devices now widely located in public places are useful health aids. The one pictured above, called -Medimax 30, is a direct spinoff from NASA technology developed to monitor astronauts in space. For manned space flights, NASA wanted a compact, highly-reliable, extremely accurate method of checking astronauts' blood pressure without the need for a physician's interpretive skill. NASA's Johnson Space Center and Technology, Inc., a contractor, developed an electronic sound processor that automatically analyzes blood flow sounds to get both systolic (contracting arteries) and diastolic (expanding arteries) blood pressure measurements. NASA granted a patent license for this technology to Advanced Life Sciences, Inc., New York City, manufacturers of Medimax 30.
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Blood pressure monitors for home
... on its own. The screen will show a digital readout of your systolic and diastolic blood pressure. After showing your blood pressure, the cuff will deflate on its own. ... again. A digital blood pressure monitor will not be as accurate ...
Prevention of High Blood Pressure
... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...
High Blood Pressure in Pregnancy
... health of you and your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ... Some pregnant women with high blood pressure develop preeclampsia. It's a sudden increase in blood pressure after ...
Living with High Blood Pressure
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Stroke and High Blood Pressure
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What Causes High Blood Pressure?
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Home monitoring of blood pressure
McGrath, Barry P
Summary Home blood pressure monitoring is the self-measurement of blood pressure by patients. In the diagnosis and management of high blood pressure it is complementary to 24-hour ambulatory blood pressure monitoring and clinic blood pressure measurements. Home monitoring can also help to identify white-coat and masked hypertension. Home monitoring has good reproducibility, is well tolerated and relatively inexpensive. It is superior to blood pressure taken in the clinic in predicting cardiovascular events and mortality. Twice-daily measurements are recommended, usually in the morning and evening for a minimum of five days. The threshold for defining hypertension is an average home blood pressure of 135/85 mmHg or above. Patients are engaged with their management when they monitor their own blood pressure. This results in increased adherence to therapy and lower blood pressure. PMID:26648605
NASA Technical Reports Server (NTRS)
Engineering Development Lab., Inc.'s E-2000 Neck Baro Reflex System was developed for cardiovascular studies of astronauts. It is regularly used on Space Shuttle Missions, and a parallel version has been developed as a research tool to facilitate studies of blood pressure reflex controls in patients with congestive heart failure, diabetes, etc. An advanced version, the PPC-1000, was developed in 1991, and the technology has been refined substantially. The PPC provides an accurate means of generating pressure for a broad array of laboratory applications. An improved version, the E2010 Barosystem, is anticipated.
Embedded programmable blood pressure monitoring system
NASA Astrophysics Data System (ADS)
Hasan, Md. Mahmud-Ul; Islam, Md. Kafiul; Shawon, Mehedi Azad; Nowrin, Tasnuva Faruk
A more efficient newer algorithm of detecting systolic and diastolic pressure of human body along with a complete package of an effective user-friendly embedded programmable blood pressure monitoring system has been proposed in this paper to reduce the overall workload of medical personals as well as to monitor patient's condition more conveniently and accurately. Available devices for measuring blood pressure have some problems and limitations in case of both analog and digital devices. The sphygmomanometer, being analog device, is still being used widely because of its reliability and accuracy over digital ones. But it requires a skilled person to measure the blood pressure and obviously not being automated as well as time consuming. Our proposed system being a microcontroller based embedded system has the advantages of the available digital blood pressure machines along with a much improved form and has higher accuracy at the same time. This system can also be interfaced with computer through serial port/USB to publish the measured blood pressure data on the LAN or internet. The device can be programmed to determine the patient's blood pressure after each certain interval of time in a graphical form. To sense the pressure of human body, a pressure to voltage transducer is used along with a cuff in our system. During the blood pressure measurement cycle, the output voltage of the transducer is taken by the built-in ADC of microcontroller after an amplifier stage. The recorded data are then processed and analyzed using the effective software routine to determine the blood pressure of the person under test. Our proposed system is thus expected to certainly enhance the existing blood pressure monitoring system by providing accuracy, time efficiency, user-friendliness and at last but not the least the 'better way of monitoring patient's blood pressure under critical care' all together at the same time.
Controlling your high blood pressure
Your blood pressure can be measured at many places, including: Home Your doctor's office Your local fire station Some pharmacies Your doctor may ask you to keep track of your blood pressure at home. Make ...
High Blood Pressure Fact Sheet
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Diagnosis of High Blood Pressure
MedlinePlus Videos and Cool Tools
... above. Confirming High Blood Pressure A blood pressure test is easy and painless and can be done ... provider's office or clinic. To prepare for the test: Don't drink coffee or smoke cigarettes for ...
High Blood Pressure in Pregnancy
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21 CFR 864.9245 - Automated blood cell separator.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Automated blood cell separator. 864.9245 Section... Blood and Blood Products § 864.9245 Automated blood cell separator. (a) Identification. An automated blood cell separator is a device that uses a centrifugal or filtration separation principle...
21 CFR 864.9245 - Automated blood cell separator.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Automated blood cell separator. 864.9245 Section... Blood and Blood Products § 864.9245 Automated blood cell separator. (a) Identification. An automated blood cell separator is a device that uses a centrifugal or filtration separation principle...
21 CFR 864.9245 - Automated blood cell separator.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Automated blood cell separator. 864.9245 Section... Blood and Blood Products § 864.9245 Automated blood cell separator. (a) Identification. An automated blood cell separator is a device that uses a centrifugal or filtration separation principle...
21 CFR 864.9245 - Automated blood cell separator.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood cell separator. 864.9245 Section... Blood and Blood Products § 864.9245 Automated blood cell separator. (a) Identification. An automated blood cell separator is a device that uses a centrifugal or filtration separation principle...
21 CFR 864.9245 - Automated blood cell separator.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Automated blood cell separator. 864.9245 Section... Blood and Blood Products § 864.9245 Automated blood cell separator. (a) Identification. An automated blood cell separator is a device that uses a centrifugal or filtration separation principle...
Achieving Goal Blood Pressure.
Laurent, Stéphane
Both monotherapy and combination therapy options are appropriate for antihypertensive therapy according to the 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) guidelines. Most patients require more than one agent to achieve blood pressure (BP) control, and adding a second agent is more effective than doubling the dose of existing therapy. The addition of a third agent may be required to achieve adequate BP reductions in some patients. Single-pill fixed-dose combinations (FDCs) allow multiple-drug regimens to be delivered without any negative impact on patient compliance or persistence with therapy. FDCs also have documented beneficial clinical effects and use of FDCs containing two or three agents is recommended by the 2013 ESH/ESC guidelines. PMID:26002423
Risk Factors for High Blood Pressure
... the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... can increase your risk for developing high blood pressure. Age Blood pressure tends to rise with age. About 65 ...
Hypertension - diet ... diet is a proven way to help control high blood pressure . These changes can also help you lose weight ... DIET The low-salt Dietary Approaches to Stop Hypertension (DASH) diet is proven to help lower blood ...
Blood pressure monitors for home
... MANUAL BLOOD PRESSURE MONITORS Manual devices include a cuff that wraps around your arm, a rubber squeeze ... needle moves around and the pressure in the cuff rises or falls. When used correctly, manual devices ...
[Acute blood pressure elevations].
Chamontin, B; Amar, J; Chollet, F; Rouge, P; Bonetti-d'Esteve, L; Guittard, J; Salvador, M
Blood pressure (BP) elevations may correspond to different clinical situations. Hypertensives emergencies are situations that require immediate reduction in BP because of acute or rapidly progressing target organ damage: accelerated malignant hypertension, hypertensive encephalopathy, acute myocardial infarction, acute aortic dissection, acute left ventricular failure, and eclampsia. Hypertensive urgencies are those with marked elevated BP in which it is desirable to reduce BP progressively within few hours, such as severe hypertension, progressive target organ damage, perioperative hypertension. Cerebrovascular accidents have to be individualized. In most patients in the immediate post-stroke period, BP should not be lowered. Caution is advised in lowering BP in these patients because excessive falls may precipitate cerebral ischemia. In situations without symptoms or progressive target organ it is necessary to exclude proximate causes of elevated BP such as pain and elevated BP alone rarely requires antihypertensive treatment. Among parenteral antihypertensive (AH) drugs labetalol, nicardipine, urapidil, and nitroprussiate are generally used, and the choice of AH drug depends on the clinical situation. It is not required to normalize BP immediately but to reduce mean BP no more than 25%, then toward 160/100 mmHg as recommended by JNC VI, in order to avoid an impairment of renal, cerebral or coronary ischemia. Oral long-acting dihydropyridines are often subsequently administrated, except in myocardial ischemia. Therapeutic attitudes vary considerably according to the clinical situation: abstention, immediate decrease or progressive decrease in BP have to be decided. PMID:11190294
Serotonin and Blood Pressure Regulation
Morrison, Shaun F.; Davis, Robert Patrick; Barman, Susan M.
5-Hydroxytryptamine (5-HT; serotonin) was discovered more than 60 years ago as a substance isolated from blood. The neural effects of 5-HT have been well investigated and understood, thanks in part to the pharmacological tools available to dissect the serotonergic system and the development of the frequently prescribed selective serotonin-reuptake inhibitors. By contrast, our understanding of the role of 5-HT in the control and modification of blood pressure pales in comparison. Here we focus on the role of 5-HT in systemic blood pressure control. This review provides an in-depth study of the function and pharmacology of 5-HT in those tissues that can modify blood pressure (blood, vasculature, heart, adrenal gland, kidney, brain), with a focus on the autonomic nervous system that includes mechanisms of action and pharmacology of 5-HT within each system. We compare the change in blood pressure produced in different species by short- and long-term administration of 5-HT or selective serotonin receptor agonists. To further our understanding of the mechanisms through which 5-HT modifies blood pressure, we also describe the blood pressure effects of commonly used drugs that modify the actions of 5-HT. The pharmacology and physiological actions of 5-HT in modifying blood pressure are important, given its involvement in circulatory shock, orthostatic hypotension, serotonin syndrome and hypertension. PMID:22407614
Diabetes and blood pressure (image)
People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ... People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ...
Paediatric blood pressure and anaesthesia.
Mather, C M
One percent of children have appreciably and consistently raised arterial blood pressure. A 7-year-old girl admitted for routine tonsillectomy, had unrecognised hypertension which put her at increased risk. Should anaesthetic practice take more note of paediatric blood pressures? PMID:2035786
Controlling your high blood pressure
Controlling hypertension ... when you wake up. For people with very high blood pressure, this is when they are most at risk ... 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed ...
High blood pressure and eye disease
Hypertensive retinopathy is damage to the retina from high blood pressure. The retina is the layer of tissue at ... High blood pressure can damage blood vessels in the retina. The higher the blood pressure and the longer it ...
21 CFR 864.5240 - Automated blood cell diluting apparatus.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 864.5240 Automated blood cell diluting apparatus. (a) Identification. An automated blood cell...
21 CFR 864.5240 - Automated blood cell diluting apparatus.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 864.5240 Automated blood cell diluting apparatus. (a) Identification. An automated blood cell...
21 CFR 864.5240 - Automated blood cell diluting apparatus.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 864.5240 Automated blood cell diluting apparatus. (a) Identification. An automated blood cell...
21 CFR 864.5240 - Automated blood cell diluting apparatus.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 864.5240 Automated blood cell diluting apparatus. (a) Identification. An automated blood cell...
21 CFR 864.5240 - Automated blood cell diluting apparatus.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood cell diluting apparatus. 864.5240 Section 864.5240 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... § 864.5240 Automated blood cell diluting apparatus. (a) Identification. An automated blood cell...
Medications for High Blood Pressure
... Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hypertension tends to worsen with age and you cannot ...
Types of Blood Pressure Medications
... inhibitors These medications reduce blood pressure by blocking neurotransmitters in the brain. This blocks the smooth muscles ... Monitoring of HBP • Prevention & Treatment of HBP Introduction Diet - Shaking the Salt Habit - Potassium - Alcohol Physical Activity ...
Potassium and High Blood Pressure
... in blood pressure to certain patterns of food consumption. For example, the D.A.S.H. (Dietary Approaches ... are good natural sources of potassium. Potassium-rich foods include: Sweet ... Levels Mean * ...
Genes That Influence Blood Pressure
... than 230 researchers across 6 continents scanned the genomes of over 200,000 European people to identify ... blood pressure. They followed up by analyzing the genomes of 70,000 people of East Indian, South ...
Indirect Blood Pressure Measuring Device
NASA Technical Reports Server (NTRS)
Hum, L.; Cole, C. E.
Design and performance of a blood pressure recording device for pediatric use are reported. A strain gage transducer with a copper-beryllium strip as force sensing element is used to monitor skin movements and to convert them into electrical signals proportional to those displacements. Experimental tests with this device in recording of force developed above the left femoral artery of a dog accurately produced a blood pressure curve.
Questions and Answers about High Blood Pressure
... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... you have high blood pressure. How can I control or prevent high blood pressure? High blood pressure ...
How Is High Blood Pressure Treated?
... blood pressure and maintain normal blood pressure readings. Healthy Eating To help treat high blood pressure, health care ... Read more about the DASH eating plan. Heart-Healthy Eating Your health care provider also may recommend heart- ...
High Blood Pressure: Medicines to Help You
... For Consumers Consumer Information by Audience For Women High Blood Pressure--Medicines to Help You Share Tweet Linkedin Pin ... Click here for the Color Version (PDF 533KB) High blood pressure is a serious illness. High blood pressure is ...
Avoid the Consequences of High Blood Pressure
... Tools & Resources Stroke More Avoid the Consequences of High Blood Pressure Infographic Updated:Jun 19,2014 View a downloadable version of this infographic High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...
Elderly Benefit from Intensive Blood Pressure Treatment
... nih.gov/medlineplus/news/fullstory_158958.html Elderly Benefit From Intensive Blood Pressure Treatment No greater risk ... may suffer complications of high blood pressure can benefit from intensive blood pressure lowering and it is ...
MedlinePlus: High Blood Pressure
... Pressure (Hypertension) (Food and Drug Administration) Also in Spanish High Blood Pressure (Hypertension) (Mayo Foundation for Medical Education and Research) Questions and Answers about High Blood ...
Automated blood sampling systems for positron emission tomography
Eriksson, L.; Holte, S.; Bohm, C.; Kesselberg, M.; Hovander, B.
An automated blood sampling system has been constructed and evaluated. Two different detector units in the blood sampling system are compared. Results from studies of blood-brain barrier transfer of a C-11 labelled receptor antagonist will be discussed.
Clinical Assessment of Central Blood Pressure
Miyashita, Hiroshi
Central aortic blood pressure (CBP) is increasingly considered a better cardiovascular prognostic marker than conventional cuff brachial blood pressure. Because CBP cannot be directly measured noninvasively, it has to be estimated from peripheral pressure pulses. To assess estimated CBP appropriately, the accuracy and features of the estimation method should be considered. The aim of this review is to provide basic knowledge and information useful for interpreting and assessing estimated CBP from a methodological point of view. Precise peripheral pressure pulse recording has been enabled by the introduction of arterial applanation tonometry, for which the radial artery may be the optimal site. An automated tonometry device utilizing a sensor array is preferable in terms of reproducibility and objectivity. Calibration of a peripheral pressure waveform has unresolved problems for any estimation method, due to imperfect brachial sphygmomanometry. However, if central and peripheral pressure calibrations are equivalent, two major methods to estimate CBP—those based on generalized pressure transfer function or radial late systolic pressure—may be comparable in their accuracy of CBP parameter estimation. PMID:22866025
High Blood Pressure and Metabolic Syndrome
... Pressure High Blood Pressure Tools & Resources Stroke More High Blood Pressure and Metabolic Syndrome Updated:Aug 12,2014 Metabolic ... content was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) Introduction What ...
Automatic blood pressure measuring system (M092)
NASA Technical Reports Server (NTRS)
Nolte, R. W.
The Blood Pressure Measuring System is described. It measures blood pressure by the noninvasive Korotkoff sound technique on a continual basis as physical stress is imposed during experiment M092, Lower Body Negative Pressure, and experiment M171, Metabolic Activity.
Reactor pressure vessel stud management automation strategies
Biach, W.L.; Hill, R.; Hung, K. )
The adoption of hydraulic tensioner technology as the standard for bolting and unbolting the reactor pressure vessel (RPV) head 35 yr ago represented an incredible commitment to new technology, but the existing technology was so primitive as to be clearly unacceptable. Today, a variety of approaches for improvement make the decision more difficult. Automation in existing installations must meet complex physical, logistic, and financial parameters while addressing the demands of reduced exposure, reduced critical path, and extended plant life. There are two generic approaches to providing automated RPV stud engagement and disengagement: the multiple stud tensioner and automated individual tools. A variation of the latter would include the handling system. Each has its benefits and liabilities.
Cornélissen, G.; Halberg, F.; Bakken, E. E.; Wang, Z.; Tarquini, R.; Perfetto, F.; Laffi, G.; Maggioni, C.; Kumagai, Y.; Homolka, P.; Havelková, A.; Dušek, J.; Svačinová, H.; Siegelová, J.; Fišer, B.
BIOCOS, the project aimed at studying BIOlogical systems in their COSmos, has obtained a great deal of expertise in the fields of blood pressure (BP) and heart rate (HR) monitoring and of marker rhythmometry for the purposes of screening, diagnosis, treatment, and prognosis. Prolonging the monitoring reduces the uncertainty in the estimation of circadian parameters; the current recommendation of BIOCOS requires monitoring for at least 7 days. The BIOCOS approach consists of a parametric and a non-parametric analysis of the data, in which the results from the individual subject are being compared with gender- and age-specified reference values in health. Chronobiological designs can offer important new information regarding the optimization of treatment by timing its administration as a function of circadian and other rhythms. New technological developments are needed to close the loop between the monitoring of blood pressure and the administration of antihypertensive drugs. PMID:19122770
Elderly Benefit from Intensive Blood Pressure Treatment
... fullstory_158958.html Elderly Benefit From Intensive Blood Pressure Treatment No greater risk of complications such as ... 2016 (HealthDay News) -- Intensive treatment of high blood pressure reduces older adults' risk of heart disease without ...
High Blood Pressure: Unique to Older Adults
... below to read more. High Blood Pressure and Edema : You may notice swelling in some parts of ... blood pressure. This buildup of fluids, called peripheral edema, usually occurs in your ankles, feet, lower legs, ...
High blood pressure and eye disease
... this page: //medlineplus.gov/ency/article/000999.htm High blood pressure and eye disease To use the sharing features ... Hypertensive retinopathy is damage to the retina from high blood pressure. The retina is the layer of tissue at ...
Smog Can Make Blood Pressure Soar
... news/fullstory_159115.html Smog Can Make Blood Pressure Soar: Studies Pay attention to air quality, researchers ... with increased risk of developing dangerous high blood pressure. The findings stem from a review of 17 ...
Perioperative Blood Pressure Control and Management.
Duke-Novakovski, Tanya; Carr, Anthony
Blood pressure monitoring and management is a vital part of the perianesthetic period. Disturbances in blood pressure, especially hypotension, can have significant impacts on the well-being of small animal patients. There are a variety of mechanisms present to control blood pressure, including ultra-short-, short-, and long-term mechanisms. Several conditions can contribute to decreased blood pressure, including anesthetics, tension pneumothorax, intermittent positive pressure ventilation, hypoxemia, hypercapnia, surgical positioning, and abdominal distension. If hypotension is encountered, the initial response is to provide appropriate fluid therapy. If this is inadequate, other interventions can be used to increase blood pressure and thereby increase perfusion. PMID:26076581
Cuff for Blood-Vessel Pressure Measurements
NASA Technical Reports Server (NTRS)
Shimizu, M.
Pressure within blood vessel is measured by new cufflike device without penetration of vessel. Device continuously monitors blood pressure for up to 6 months or longer without harming vessel. Is especially useful for vessels smaller than 4 or 5 millimeters in diameter. Invasive methods damage vessel wall, disturb blood flow, and cause clotting. They do not always give reliable pressure measurements over prolonged periods.
Blood pressure reprogramming adapter assists signal recording
NASA Technical Reports Server (NTRS)
Vick, H. A.
Blood pressure reprogramming adapter separates the two components of a blood pressure signal, a dc pressure signal and an ac Korotkoff sounds signal, so that the Korotkoff sounds are recorded on one channel as received while the dc pressure signal is converted to FM and recorded on a second channel.
Relation of blood volume and blood pressure in orthostatic intolerance
NASA Technical Reports Server (NTRS)
Jacob, G.; Biaggioni, I.; Mosqueda-Garcia, R.; Robertson, R. M.; Robertson, D.
A complex but crucial relationship exists between blood volume and blood pressure in human subjects; it has been recognized that in essential hypertension, renovascular hypertension, and pheochromocytoma, the relationship between plasma volume and diastolic blood pressure is an inverse one. This phenomenon has not been studied in individuals with low normal and reduced blood pressures. Orthostatic intolerance is a commonly encountered abnormality in blood pressure regulation often associated with tachycardia in the standing position. Most of these patients have varying degrees of reduced blood volume. We tested the hypothesis that the relationship previously found between plasma volume and diastolic blood pressure in pressor states would also hold in orthostatic intolerance. We studied 16 patients with a history of symptomatic orthostatic intolerance associated with an elevation in plasma norepinephrine in the upright posture and hypovolemia in 9 patients and normovolemia in 7 patients. Our studies demonstrate an inverse relationship between plasma volume and diastolic blood pressure in patients with orthostatic intolerance. This finding also holds for the change in diastolic blood pressure in response to upright posture. In this relationship, patients with orthostatic intolerance with high plasma norepinephrine resemble those with essential hypertension, renovascular hypertension, and pheochromocytoma. We conclude that in a variety of conditions at both ends of the blood pressure spectrum, the seemingly paradoxical association of hypovolemia and diastolic blood pressure is preserved.
Central blood pressure and chronic kidney disease
Ohno, Yoichi; Kanno, Yoshihiko; Takenaka, Tsuneo
In this review, we focused on the relationship between central blood pressure and chronic kidney diseases (CKD). Wave reflection is a major mechanism that determines central blood pressure in patients with CKD. Recent medical technology advances have enabled non-invasive central blood pressure measurements. Clinical trials have demonstrated that compared with brachial blood pressure, central blood pressure is a stronger risk factor for cardiovascular (CV) and renal diseases. CKD is characterized by a diminished renal autoregulatory ability, an augmented direct transmission of systemic blood pressure to glomeruli, and an increase in proteinuria. Any elevation in central blood pressure accelerates CKD progression. In the kidney, interstitial inflammation induces oxidative stress to handle proteinuria. Oxidative stress facilitates atherogenesis, increases arterial stiffness and central blood pressure, and worsens the CV prognosis in patients with CKD. A vicious cycle exists between CKD and central blood pressure. To stop this cycle, vasodilator antihypertensive drugs and statins can reduce central blood pressure and oxidative stress. Even in early-stage CKD, mineral and bone disorders (MBD) may develop. MBD promotes oxidative stress, arteriosclerosis, and elevated central blood pressure in patients with CKD. Early intervention or prevention seems necessary to maintain vascular health in patients with CKD. PMID:26788468
Continuous Blood Pressure Monitoring in Daily Life
NASA Astrophysics Data System (ADS)
Lopez, Guillaume; Shuzo, Masaki; Ushida, Hiroyuki; Hidaka, Keita; Yanagimoto, Shintaro; Imai, Yasushi; Kosaka, Akio; Delaunay, Jean-Jacques; Yamada, Ichiro
Continuous monitoring of blood pressure in daily life could improve early detection of cardiovascular disorders, as well as promoting healthcare. Conventional ambulatory blood pressure monitoring (ABPM) equipment can measure blood pressure at regular intervals for 24 hours, but is limited by long measuring time, low sampling rate, and constrained measuring posture. In this paper, we demonstrate a new method for continuous real-time measurement of blood pressure during daily activities. Our method is based on blood pressure estimation from pulse wave velocity (PWV) calculation, which formula we improved to take into account changes in the inner diameter of blood vessels. Blood pressure estimation results using our new method showed a greater precision of measured data during exercise, and a better accuracy than the conventional PWV method.
Noninvasive continuous blood pressure monitoring
NASA Astrophysics Data System (ADS)
Poghosyan, Armen; Mouradian, Vahram; Hovhannisyan, Levon
We are presenting a novel photoplethysmographic (PPG) optical sensor and device with ambient optical, electrical and electromagnetic noises cancellation, thus allowing only the useful optical signals to be received by the health monitoring device. We are also presenting a new processing technique for canceling the ambient noises contributed by optical, electrical and electromagnetic artifacts in the measured PPG signals. Such a device and method allow the enhancement of the performance of the PPG sensors compared to conventional apparatus and methods. The presented sensor and methodology have been integrated into a prototype standalone device for noninvasive, continuous, wearable, remote and mobile monitoring of blood pressure and other human vital signs, such as heart rate, oxygen saturation, respiration rate, etc This small device allows the user to read, store, process and transmit all the measurements made using the PPG optical sensor and the electronic unit to a remote location.
Blood Pressure Measurements Taken by Patients are Similar to Home and Ambulatory Blood Pressure Measurements
Pierin, Angela M. G.; Ignez, Edna C.; Filho, Wilson Jacob; Barbato, Alfonso Júlio Guedes; Mion, Décio
OBJECTIVE To compare blood pressure measurements taken at home by physicians, nurses, and patients with office blood pressure measurement , ambulatory blood pressure monitoring and home blood pressure measurement. METHODS A total of 44 patients seen by a home care program were studied. Protocol 1 a) blood pressure was measured by the patient, a physician and a nurse during a regular home visit (Home1); b) home blood pressure measurement was measured for 4 days (HBPM1); c) office blood pressure measurement was measured by a physician, a nurse, and the patient; and by 24-hour ambulatory blood pressure monitoring. Protocol 2 blood pressure was measured by the patient, a physician, and a nurse during a special home visit in the presence of a physician and a nurse only (Home2); and b) home blood pressure measurement was taken for the second time (HBPM2). Echocardiography, guided by a two-dimensional echocardiograph, was performed. RESULTS Protocol 1: a) office blood pressure measurement and Home1 were significantly higher than ambulatory blood pressure monitoring, except for systolic and diastolic office blood pressure measurement taken by the patient or a family member, systolic blood pressure taken by a nurse, and diastolic blood pressure taken by a physician. b) ambulatory blood pressure monitoring and HBPM1 were similar. Protocol 2: a) HBPM2 and Home2 were similar. b) Home2 was significantly lower than Home1, except for diastolic blood pressure taken by a nurse or the patient. There were significant relationships between: a) diastolic blood pressure measured by the patient and the thickness of the interventricular septum, posterior wall, and left ventricular mass; and b) ambulatory and HBPM2 diastolic and systolic blood pressure taken by a physician (home2) and left ventricular mass. Therefore, the data indicate that home blood pressure measurement and ambulatory blood pressure monitoring had good prognostic values relative to "office measurement." CONCLUSION
Measuring Time-Averaged Blood Pressure
NASA Technical Reports Server (NTRS)
Rothman, Neil S.
Device measures time-averaged component of absolute blood pressure in artery. Includes compliant cuff around artery and external monitoring unit. Ceramic construction in monitoring unit suppresses ebb and flow of pressure-transmitting fluid in sensor chamber. Transducer measures only static component of blood pressure.
Automated measurement of retinal blood vessel tortuosity
NASA Astrophysics Data System (ADS)
Joshi, Vinayak; Reinhardt, Joseph M.; Abramoff, Michael D.
Abnormalities in the vascular pattern of the retina are associated with retinal diseases and are also risk factors for systemic diseases, especially cardiovascular diseases. The three-dimensional retinal vascular pattern is mostly formed congenitally, but is then modified over life, in response to aging, vessel wall dystrophies and long term changes in blood flow and pressure. A characteristic of the vascular pattern that is appreciated by clinicians is vascular tortuosity, i.e. how curved or kinked a blood vessel, either vein or artery, appears along its course. We developed a new quantitative metric for vascular tortuosity, based on the vessel's angle of curvature, length of the curved vessel over its chord length (arc to chord ratio), number of curvature sign changes, and combined these into a unidimensional metric, Tortuosity Index (TI). In comparison to other published methods this method can estimate appropriate TI for vessels with constant curvature sign and vessels with equal arc to chord ratios, as well. We applied this method to a dataset of 15 digital fundus images of 8 patients with Facioscapulohumeral muscular dystrophy (FSHD), and to the other publically available dataset of 60 fundus images of normal cases and patients with hypertensive retinopathy, of which the arterial and venous tortuosities have also been graded by masked experts (ophthalmologists). The method produced exactly the same rank-ordered list of vessel tortuosity (TI) values as obtained by averaging the tortuosity grading given by 3 ophthalmologists for FSHD dataset and a list of TI values with high ranking correlation with the ophthalmologist's grading for the other dataset. Our results show that TI has potential to detect and evaluate abnormal retinal vascular structure in early diagnosis and prognosis of retinopathies.
Managing Blood Pressure with a Heart-Healthy Diet
... Blood Pressure Tools & Resources Stroke More Managing Blood Pressure with a Heart-Healthy Diet Updated:Apr 8, ... last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...
Let's Talk about High Blood Pressure and Stroke
... Tools & Resources Stroke More Let's Talk About High Blood Pressure and Stroke Updated:Dec 9,2015 What is ... Blood Pressure? How Can I Reduce High Blood Pressure? High Blood Pressure and Stroke What Is Diabetes and How ...
Blood Pressure Matters: Keep Hypertension in Check
... Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health. Normal blood flow delivers nutrients and oxygen to all parts of your body, including important ...
Preeclampsia and High Blood Pressure During Pregnancy
... thrombophilia , or lupus • are obese •had in vitro fertilization What are the risks for my baby if ... blood cells. Hypertension: High blood pressure. In Vitro Fertilization: A procedure in which an egg is removed ...
Biofeedback With Implanted Blood-Pressure Device
NASA Technical Reports Server (NTRS)
Rischell, Robert E.
Additional uses found for equipment described in "Implanted Blood-Pressure-Measuring Device" (GSC-13042). Implanted with device electronic circuitry that measures, interprets, and transmits data via inductive link through patient's skin to external receiver. Receiver includes audible alarm generator activated when patient's blood pressure exceeds predetermined threshold. Also included in receiver a blood-pressure display, recorder, or both, for use by patient or physician.
Pressure natriuresis and the renal control of arterial blood pressure
Ivy, Jessica R; Bailey, Matthew A
The regulation of extracellular fluid volume by renal sodium excretion lies at the centre of blood pressure homeostasis. Renal perfusion pressure can directly regulate sodium reabsorption in the proximal tubule. This acute pressure natriuresis response is a uniquely powerful means of stabilizing long-term blood pressure around a set point. By logical extension, deviation from the set point can only be sustained if the pressure natriuresis mechanism is impaired, suggesting that hypertension is caused or sustained by a defect in the relationship between renal perfusion pressure and sodium excretion. Here we describe the role of pressure natriuresis in blood pressure control and outline the cascade of biophysical and paracrine events in the renal medulla that integrate the vascular and tubular response to altered perfusion pressure. Pressure natriuresis is impaired in hypertension and mechanistic insight into dysfunction comes from genetic analysis of blood pressure disorders. Transplantation studies in rats show that blood pressure is determined by the genotype of the kidney and Mendelian hypertension indicates that the distal nephron influences the overall natriuretic efficiency. These approaches and the outcomes of genome-wide-association studies broaden our view of blood pressure control, suggesting that renal sympathetic nerve activity and local inflammation can impair pressure natriuresis to cause hypertension. Understanding how these systems interact is necessary to tackle the global burden of hypertension. PMID:25107929
Blood pressure and blood lead concentration in bus drivers
Sharp, D.S.; Osterloh, J.; Becker, C.E.; Bernard, B.; Smith, A.H.; Fisher, J.M.; Syme, S.L.; Holman, B.L.; Johnston, T.
San Francisco bus drivers have an increased prevalence of hypertension. This study examined relationships between blood lead concentration and blood pressure in 342 drivers. The analysis reported in this study was limited to subjects not on treatment for hypertension (n = 288). Systolic and diastolic pressure varied from 102 to 173 mm Hg and from 61 to 105 mm Hg, respectively. The blood lead concentration varied from 2 to 15 ..mu..g/dL. The relationship between blood pressure and the logarithm of blood lead concentration was examined using multiple regression analysis. Covariates included age, body mass index, sex, race, and caffeine intake. The largest regression coefficient relating systolic blood pressure and blood lead concentration was 1.8 mm Hg/ln (..mu..g/dL). The coefficient for diastolic blood pressure was 2.5 mm Hg/ln (..mu..g/dL). These findings suggest effects of lead exposure at lower blood lead concentrations than those concentrations that have previously been linked with increases in blood pressure.
Ambulatory blood pressure monitoring in hypertensive adolescents.
Fixler, D E; Wallace, J M; Thornton, W E; Dimmitt, P
The purpose of this study was to determine the ability of ambulatory blood pressure monitoring to identify youths with chronic blood pressure elevation. Nineteen adolescent boys were studied, ten had 5-year average systolic or diastolic pressures above the 95th percentile, nine had normal pressure. A Del Mar Avionics Pressurometer III system recorded an average of 121 readings on each subject. The coefficients of variation for pressure were similar for hypertensive and normotensive individuals. During classes, eight of the ten hypertensive youths had elevated pressures in over half of the measurements. Also during these classes eight of ten hypertensive boys had average systolic or diastolic pressure above the 95th percentile, whereas only one of nine normotensive boys had average pressures above this level. We suggest that schooltime ambulatory pressures may be most useful in classifying the blood pressure trend in a youth. PMID:2346634
Nutraceuticals for blood pressure control.
Sirtori, Cesare R; Arnoldi, Anna; Cicero, Arrigo F G
Significant effects on blood pressure (BP) have been reported from large nutritional interventions, particularly the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet. In more recent years, numerous studies have investigated the possible BP-lowering effect of different nutraceuticals; these range from specific foods to minerals, lipids, whole proteins, peptides, amino acids, probiotics, and vitamins. While a very large body of evidence supports the use of potassium, L-arginine, vitamins C and D, cocoa flavonoids, beetroot juice, some probiotics, coenzyme Q10, controlled-release melatonin, aged garlic extract, and coffee, the use of other nutraceuticals, such as green tea, flaxseed, and resveratrol, has not as yet been supported by adequate evidence. In some cases, e.g. proteins/peptides, the responsible component needs also to be fully uncovered. Finally, while for most of the products only short-term studies are available, with no specific end-points, an ongoing very large prospective study on chocolate flavanols will answer the question whether this may reduce cardiovascular risk. Thus, in addition to data on long-term safety, further clinical research is advisable in order to identify, among active nutraceuticals, those with the best cost-effectiveness and risk-benefit ratio for a wide use in the general population with a raised cardiovascular risk consequent to uncomplicated hypertension. PMID:26362125
[Ambulatory invasive and noninvasive blood pressure monitoring].
Bachmann, K; Wortmann, A; Engels, G
Indirect arterial blood pressure measurement has not changed substantially since its introduction by Riva-Rocci in 1986, Korotkoff in 1905 and Recklinghausen in 1906. Random measurements in the clinic or practice reflect only incompletely the dynamic nature of the blood pressure. Blood pressure recordings by patients themselves have provided more information through better temporal resolution, however, exact characterization of the pressure response throughout the entire day and, in particular, during physical exertion are not enabled; the latter are especially important with regard to diagnosis and treatment of hypertension. In 1966, therefore, radiotelemetric transmission of direct, continuously-measured arterial blood pressure was developed which enabled beat-to-beat registration of blood pressure, outside the laboratory, during normal daily life and sport activities. The initial results showed a marked variability of the blood pressure during the course of the day (Figure 1). Excessive blood pressure increases were observed during exposure to cold, static and dynamic exercise and to a lesser degree during automobile driving and exposure to heat (Figure 3). Recording of the pressure curves via transmission by radiotelemetry shows a high degree of accuracy and temporal resolution, spatial and situational freedom but is invasive and costly in terms of personnel. The same holds true for direct continuous blood pressure registration and storage on a portable tape recorder. Portable, automatic blood pressure measuring units for ambulatory monitoring employ indirect auscultatory or oscillometric recording with a cuff. As compared with the radiotelemetric direct continuous blood pressure measuring method, the indirect method has subordinate temporal resolution, that is, the measurements are only intermittent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2676813
Determinants of Blood Pressure in Navajo Adolescents.
ERIC Educational Resources Information Center
Coulehan, John L.; And Others
Among 580 Navajo adolescents, 11.1 percent of males and 1.6 percent of females had high blood pressure. Blood pressure was related to age in males and to body mass index in females but was not related to level of acculturation or traditionality. Contains 17 references. (SV)
"Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease
... Pressure "Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease Past Issues / Winter 2010 Table of ... Articles "Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease / Women and Heart Disease / Blood Pressure ...
Twenty four hour intermittent, ambulatory blood pressure monitoring.
Egger, M; Bianchetti, M G; Gnädinger, M; Kobelt, R; Oetliker, O
Blood pressure and heart rate were measured every 30 minutes during the day and every hour during the night in 43 children (20 girls and 23 boys, aged 10 to 16) with a portable automated monitor. The apparatus was better accepted in girls than in boys, and the failure rate was lower during the day. The overall failure rate was 22%, which corresponds with comparable studies in adults. During the night blood pressure and heart rate fell by 10% and 14% of the daytime values, respectively. Mean (SD) blood pressure was significantly higher in boys than in girls (126/72 (17/8) v 109/64 (9/5) mm Hg) and measurements correlated positively with age, body weight, and height of the subjects. Heart rate was not significantly influenced by gender or age. A positive correlation between heart rate and blood pressure was found when expressed as standard normal deviations or hourly variations. In children intermittent monitoring of ambulatory blood pressure and heart rate is a suitable method for measuring individual diurnal patterns. PMID:3688917
Beat-to-Beat Blood Pressure Monitor
NASA Technical Reports Server (NTRS)
Lee, Yong Jin
This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes. Photoplethysmography, which measures changes in arterial blood volume, is commonly used to obtain heart rate and blood oxygen saturation. The digitized PPG signals are used as inputs into the beat-to-beat blood
Health Behavior Change after Blood Pressure Feedback.
Pu, Jia; Chewning, Betty A; Johnson, Heather M; Vanness, David J; Young, Henry N; Kreling, David H
Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA) repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (p<0.05). We found no evidence of differences in health behavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing blood pressure
Home and ambulatory blood pressure monitoring: when? who?
Kantarci, Gülçin
Blood pressure measurement in the diagnosis and management of hypertension, including the technique required for ambulatory blood pressure monitoring and home blood pressure monitoring, will be reviewed in this article. Home and ambulatory measurements are widely used, both to confirm the diagnosis and to improve adherence to therapy. The major advantage of out-of-office blood pressure monitoring is that it provides a large number of blood pressure measurements away from the medical environment, which represents a more reliable assessment of actual blood pressure than office blood pressure. The advantage of ambulatory blood pressure monitoring is its unique ability to measure nocturnal blood pressure. Although not fully validated in large-scale clinical trials, ambulatory blood pressure monitoring appears to correlate best with prognosis. Ambulatory blood pressure monitoring and home blood pressure monitoring provide somewhat different information on the subject's blood pressure status, and the two methods should thus be regarded as complementary, rather than competitive or alternative. PMID:25019016
Dietary fiber and blood pressure control.
Aleixandre, A; Miguel, M
In the past few years, new strategies to control blood pressure levels are emerging by developing new bioactive components of foods. Fiber has been linked to the prevention of a number of cardiovascular diseases and disorders. β-Glucan, the main soluble fiber component in oat grains, was initially linked to a reduction in plasma cholesterol. Several studies have shown afterward that dietary fiber may also improve glycaemia, insulin resistance and weight loss. The effect of dietary fiber on arterial blood pressure has been the subject of far fewer studies than its effect on the above-mentioned variables, but research has already shown that fiber intake can decrease arterial blood pressure in hypertensive rats. Moreover, certain fibers can improve arterial blood pressure when administered to hypertensive and pre-hypertensive subjects. The present review summarizes all those studies which attempt to establish the antihypertensive effects of dietary fiber, as well as its effect on other cardiovascular risk factors. PMID:26923351
High Blood Pressure and Kidney Disease
... Information Center National Kidney Foundation Smokefree.gov MedlinePlus Kidney and Urologic Disease Organizations Many organizations provide support ... Alternate Language URL Español High Blood Pressure and Kidney Disease Page Content On this page: What is ...
Booze, High Blood Pressure a Dangerous Mix
... in New York City. Until published in a peer-reviewed medical journal, the results should be considered preliminary. One-third of U.S. adults have high blood pressure, also called hypertension. It contributes to more than ...
Birth weight and childhood blood pressure.
Edvardsson, Vidar O; Steinthorsdottir, Sandra D; Eliasdottir, Sigridur B; Indridason, Olafur S; Palsson, Runolfur
A large body of literature suggests an inverse relationship between birth weight and blood pressure in children, adolescents and adults. The most persistent findings have been observed in children with a history of low birth weight or intrauterine growth restriction, while a large number of studies carried out in populations with normally distributed birth weight have shown conflicting results. A recently reported strong direct association between high birth weight and blood pressure, and the significant positive effect of postnatal growth on blood pressure suggests that the fetal origins of adult disease hypothesis should be expanded to include the role of excessive fetal and postnatal growth. In this paper, we review recent studies on the relationship between birth weight and blood pressure in childhood, with a focus on confounding variables that may explain the conflicting results of published work in this field. PMID:23054892
Automatic blood pressure measuring system (M091)
NASA Technical Reports Server (NTRS)
The Leg Volume Measuring System is used to measure leg calf girth changes that occur during exposure to lower body negative pressure as a result of pooling of blood and other fluids in the lower extremities.
High Blood Pressure (Hypertension) (For Parents)
... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... when the sounds disappear. When a blood pressure reading is taken, the higher number represents the systolic ...
Booze, High Blood Pressure a Dangerous Mix
... nih.gov/medlineplus/news/fullstory_158828.html Booze, High Blood Pressure a Dangerous Mix Study links moderate drinking to heart damage in people with hypertension To use the sharing features on this page, ...
Blood Pressure Patterns May Predict Stroke Risk
... fullstory_158731.html Blood Pressure Patterns May Predict Stroke Risk Odds increase with rapid rise in middle ... overall pattern to predict a patient's risk of stroke or early death, new research suggests. "Our study ...
Blood Pressure Patterns May Predict Stroke Risk
... at Erasmus University Medical Center in Rotterdam, the Netherlands. High blood pressure is the number one risk ... of epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Andrew Rogove, M.D., Ph.D., medical director, ...
Principles and techniques of blood pressure measurement
Ogedegbe, Gbenga; Pickering, Thomas
Although the mercury sphygmomanometer is widely regarded as the "gold standard" for office blood pressure measurement, the ban on use of mercury devices continues to diminish their role in office and hospital settings. To date, mercury devices have largely been phased out in US hospitals. This has led to the proliferation of non-mercury devices and has changed (probably for ever) the preferable modality of blood pressure measurement in clinic and hospital settings. In this article, the basic techniques of blood pressure measurement and the technical issues associated with measurements in clinical practice are discussed. The devices currently available for hospital and clinic measurements and their important sources of error are presented. Practical advice is given on how the different devices and measurement techniques should be used. Blood pressure measurements in different circumstances and in special populations such as infants, children, pregnant women, elderly persons, and obese subjects are discussed. PMID:20937442
Correlates of Blood Pressure in Elementary Schoolchildren.
ERIC Educational Resources Information Center
Melby, Christopher L.; And Others
This cross-sectional study determined which anthropometric, dietary, and physical fitness variables were the best predictors of blood pressure in 323 white elementary school children. Results are discussed. (Author/MT)
Pragmatic Method Using Blood Pressure Diaries to Assess Blood Pressure Control
Sharman, James E.; Blizzard, Leigh; Kosmala, Wojciech; Nelson, Mark R.
PURPOSE Twenty-four–hour ambulatory blood pressure (ABP) is the reference standard of blood pressure control. Home blood pressure (HBP) is superior to clinic blood pressure for assessing control, but a barrier to its use is the need for physicians to calculate average blood pressure from patient diaries. We sought to develop a quick and pragmatic method to assess blood pressure control from patients' HBP diaries. METHODS Seven-day HBP and 24-hour ABP were measured in 286 patients with uncomplicated treated hypertension (aged 64 ± 8 years; 53% female). We determined the optimal ratio of home systolic blood pressure readings above threshold (≥135 mm Hg) for the last 10 recorded that would best predict elevated 24-hour ABP. Uncontrolled blood pressure was defined as 24-hour ABP systolic blood pressure ≥130 mm Hg or 24-hour ABP daytime systolic blood pressure ≥135 mm Hg. Validation by corroborative evidence was tested by association with markers of end-organ disease. RESULTS The best predictor of 24-hour ABP systolic blood pressure above treatment/target threshold was having 3 or more (≥30%) of the last 10 home systolic blood pressure readings ≥135 mm Hg (area under the receiver operating characteristic curve = 0.71). Importantly, patients meeting this criterion had evidence of target organ disease, with significantly higher aortic stiffness, left ventricular relative wall thickness, and left atrial area, and lower left ventricular ejection fraction, compared with those who did not meet this criterion. CONCLUSIONS To facilitate uptake of HBP monitoring, we propose that physicians can determine the percentage of the last 10 home systolic blood pressure values ≥135 mm Hg for a patient and tailor management accordingly. PMID:26755785
Wearable Monitor Helps Spot 'Masked' High Blood Pressure
... fullstory_158860.html Wearable Monitor Helps Spot 'Masked' High Blood Pressure Black people with undetected problem twice as likely ... doctors spot black people with "masked," or undetected, high blood pressure, a new study suggests. "Masked" high blood pressure ...
What about African Americans and High Blood Pressure?
ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? The prevalence of high blood pressure in African Americans is among the highest in ...
[Clinical significance of nocturnal blood pressure and blood pressure variability: analysis of 522 cases].
Palatini, P; Mormino, P; Martina, S; Businaro, R; Penzo, M; Racioppa, A; Guzzardi, G; Anaclerio, M; Pessina, A C
Purpose of the study was to investigate whether and to what extent blood pressure variability and average night-time blood pressure are related to cardiovascular complications in hypertension. To this aim 60 normotensive and 462 hypertensive subjects were studied by means of non-invasive 24 hour blood pressure monitoring, using either the Avionics, or the ICR Spacelabs, or the Takeda system. Each subject was attributed a target organ damage score on the basis of 12-lead electrocardiogram, chest X-ray and fundoscopy, starting from 0 (no damage) up to 5 (maximum degree of damage). The 522 subjects were subsequently subdivided into 5 classes of increasing average daytime diastolic blood pressure. In each class a higher degree of cardiovascular complications was present in the subjects with the higher blood pressure variability and the higher average night-time blood pressure. From these results it may be inferred that both blood pressure variability and night-time blood pressure are related to the degree of target organ damage in hypertension. This stresses the importance of recording blood pressure throughout the 24 hours. PMID:2147124
Beat-to-Beat Blood Pressure Monitor
NASA Technical Reports Server (NTRS)
Lee, Yong Jin
This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes.
Talk with Your Health Care Provider about High Blood Pressure
... mean? Blood pressure is measured by two numbers. systolic pressure 120 80 diastolic pressure Your provider will ... 120 over 80" The first (or top) number—"systolic"—is the pressure in your blood vessels when ...
`Sausage string' patterns in blood vessels at high blood pressures
NASA Astrophysics Data System (ADS)
Alstrøm, Preben; Eguíluz, Victor M.; Gustafsson, Finn; Holstein-Rathlou, Niels-Henrik
A new Rayleigh-type instability is proposed to explain the `sausage-string' pattern of alternating constrictions and dialtations formed in blood vessels at high blood pressure conditions. Our theory involves the nonlinear stress-strain characteristics of the vessel wall, and provides predictions for the conditions under which the normal cylindrical geometry of a blood vessel becomes unstable. The theory explains key features observed experimentally, e.g. the limited occurrence of the sausage-string pattern to small arteries and large arterioles, and only in those with small wall-to-lumen ratios.
Occupational lead exposure and blood pressure.
Parkinson, D K; Hodgson, M J; Bromet, E J; Dew, M A; Connell, M M
Recent community studies have suggested that low level lead exposure is significantly associated with blood pressure in the general population. This finding is inconsistent with the results of recent occupational studies of lead exposed workers, although the occupational studies contained serious methodological weaknesses. The present study examined the relation between occupational lead exposure and diastolic and systolic blood pressure in randomly selected samples of 270 exposed and 158 non-exposed workers. Four exposure indicators were examined: employment at a lead battery plant nu a control plant, current blood lead value, current zinc protoporphyrin value, and time weighted average blood lead value. After controlling for other known risk factors such as age, education, income, cigarette usage, alcohol consumption, and exercise, the associations between exposure and blood pressure were small and non-significant. In the absence of a biologically feasible hypothesis regarding the mechanism by which low level lead exposure would influence blood pressure the present findings challenge the validity of the general population association. PMID:3689706
Lipids, blood pressure and kidney update 2015.
Banach, Maciej; Aronow, Wilbert S; Serban, Maria-Corina; Rysz, Jacek; Voroneanu, Luminita; Covic, Adrian
The most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2015 were reviewed. In lipid research, the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial revalidated the concept "lower is better" for low density lipoprotein (LDL)-cholesterol as a target for therapy, increasing the necessity of treatment the high-risk patients to achieve LDL-C goals. After these results, ezetimibe might become the preferred additional drug in the combination therapy of lipid disorders because of oral dosage form and lower acquisition cost. However, for the statin-intolerant patients and those patients requiring essential reductions in LDL-C to achieve their goals, new therapies, including PCSK9 inhibitors remain promising drugs. In blood pressure research, American Heart Association (AHA)/American College of Cardiology (ACC) 2015 guidelines recommended a target for blood pressure below 140/90 mmHg in stable or unstable coronary artery disease patients and below 150/90 mmHg in patients older than 80 years of age, however the recent results of the Systolic Blood Pressure Intervention Trial (SPRINT) trial have suggested that there might be significant benefits, taking into account cardiovascular risk, for hypertensive patients over 50 without diabetes and blood pressure levels <120/80. In kidney research, reducing the progression of chronic kidney disease and related complications such as anemia, metabolic acidosis, bone and mineral diseases, acute kidney injury and cardiovascular disease is still a goal for clinicians. PMID:26718096
Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring
Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An
Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0
Automated Telephone Calls Improved Completion of Fecal Occult Blood Testing
Mosen, David M.; Feldstein, Adrianne C.; Perrin, Nancy; Rosales, A. Gabriela; Smith, David H.; Liles, Elizabeth G.; Schneider, Jennifer L.; Lafata, Jennifer E.; Myers, Ronald E.; Kositch, Michael; Hickey, Thomas; Glasgow, Russell E.
BACKGROUND Although colorectal cancer (CRC) prognosis is improved by early diagnosis, screening rates remain low. OBJECTIVE To determine the effect of an automated telephone intervention on completion of fecal occult blood testing (FOBT). RESEARCH DESIGN Subjects In this randomized controlled trial conducted at Kaiser Permanente Northwest, a not-for-profit health maintenance organization, 5,905 eligible patients aged 51–80, at average risk for CRC and due for CRC screening, were randomly assigned to an automated telephone intervention (n=2,943) or usual care (UC; n=2,962). The intervention group received up to 3 one-minute automated telephone calls that provided a description and health benefits of FOBT. During the call, patients could request that an FOBT kit be mailed to their home. Those who requested but did not return the cards received an automated reminder call. Measures Cox proportional hazard method was used to determine the independent effect of automated telephone calls on completion of an FOBT, after adjusting for age, gender, and prior CRC screening. RESULTS By 6 months post call initiation, 22.5% in the intervention and 16.0% in UC had completed an FOBT. Those in the intervention group were significantly more likely to complete an FOBT (HR = 1.31, 95% CI = 1.10–1.56) compared to UC. Older patients (aged 71–80 vs. aged 51–60) were also more likely to complete FOBT (HR = 1.48, 95% CI=1.07–2.04). CONCLUSIONS Automated telephone calls increased completion of FOBT. Further research is needed to evaluate automated telephone interventions among diverse populations and in other clinical settings. PMID:20508529
Effect of Occupational Exposure on Blood Cell Counts, Electrocardiogram and Blood Pressure in Rice Mill Workers
Aithala, Manjunatha; Das, Kusal Kanti
Introduction Under normal conditions, parasympathetic and sympathetic nervous systems interact to regulate the heart rate of about 70 beats per minute. Activation of sympathetic nervous system by emotional or physical stress increases heart rate and the force of heart beat. There are many factors which alter the heart rate. The chemical and mechanical stimulation of receptors can also cause change in blood pressure through autonomic nervous system. Exposure to dust also causes alteration in blood cell counts. This can be due to allergic reactions and inflammation which in turn evoked by dust entering the lungs. Objectives Aim of the study was to evaluate the effect of occupational exposure on haematological and cardiovascular parameters of rice mill workers by analysing Blood Cell Counts, ECG and Blood Pressure. Materials and Methods This cross-sectional study was carried on 134 rice mill workers and an equal number of age and sex matched healthy individual. The blood cell counts were determined by automated cell counter machine, ECG was recorded by using ECG machine and Blood Pressure was measured by using mercurial sphygmomanometer. Results Neurtrophil, Eosinophil and Lymphocyte count among haematological parameters were significantly increased in exposed individuals. Marked variation was seen in ECG and Blood pressure among cardiovascular parameters of exposed individuals compared with control group. Conclusion The findings of our study clearly indicate that the rice mill workers are under high level of dust exposure which has deleterious effects on their blood and tissues. It is due to high oxidative stress. There are abnormalities seen in cardiovascular system. PMID:26674852
Oscillometric blood pressure: a review for clinicians.
Alpert, Bruce S; Quinn, David; Gallick, David
Oscillometric devices for the non-invasive estimation of blood pressure (BP) have become the "clinical standard" because of training requirements for determination of BP by auscultation, cost, and the phasing-out/banning of mercury in many states and countries. Analysis of recent publications reveals a lack of understanding of the "meaning" of oscillometric blood pressure (OBP) measurements by authors, journal editors, and clinicians. We were invited to submit a review of OBP methodology written for clinicians. We hope that the material contained herein will clarify how clinicians should interpret OBP values for their patients. PMID:25492837
Blood pressure in head‐injured patients
Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R
Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594
An implantable blood pressure and flow transmitter.
NASA Technical Reports Server (NTRS)
Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.
A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.
Signal quality measures for unsupervised blood pressure measurement.
Sukor, J Abdul; Redmond, S J; Chan, G S H; Lovell, N H
Accurate systolic and diastolic pressure estimation, using automated blood pressure measurement, is difficult to achieve when the transduced signals are contaminated with noise or interference, such as movement artifact. This study presents an algorithm for automated signal quality assessment in blood pressure measurement by determining the feasibility of accurately detecting systolic and diastolic pressures when corrupted with various levels of movement artifact. The performance of the proposed algorithm is compared to a manually annotated reference scoring (RS). Based on visual representations and audible playback of Korotkoff sounds, the creation of the RS involved two experts identifying sections of the recorded sounds and annotating sections of noise contamination. The experts determined the systolic and diastolic pressure in 100 recorded Korotkoff sound recordings, using a simultaneous electrocardiograph as a reference signal. The recorded Korotkoff sounds were acquired from 25 healthy subjects (16 men and 9 women) with a total of four measurements per subject. Two of these measurements contained purposely induced noise artifact caused by subject movement. Morphological changes in the cuff pressure signal and the width of the Korotkoff pulse were extracted features which were believed to be correlated with the noise presence in the recorded Korotkoff sounds. Verification of reliable Korotkoff pulses was also performed using extracted features from the oscillometric waveform as recorded from the inflatable cuff. The time between an identified noise section and a verified Korotkoff pulse was the key feature used to determine the validity of possible systolic and diastolic pressures in noise contaminated Korotkoff sounds. The performance of the algorithm was assessed based on the ability to: verify if a signal was contaminated with any noise; the accuracy, sensitivity and specificity of this noise classification, and the systolic and diastolic pressure
21 CFR 870.2850 - Extravascular blood pressure transducer.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
21 CFR 870.2850 - Extravascular blood pressure transducer.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
21 CFR 870.2850 - Extravascular blood pressure transducer.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
21 CFR 870.2850 - Extravascular blood pressure transducer.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
21 CFR 870.2850 - Extravascular blood pressure transducer.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Extravascular blood pressure transducer. 870.2850... blood pressure transducer. (a) Identification. An extravascular blood pressure transducer is a device used to measure blood pressure by changes in the mechanical or electrical properties of the device....
Blood Pressure in Infants, Children and Adolescents
Moss, Arthur J.
In infants the flush and Doppler methods of blood pressure measurement are usually used. The flush method measures mean pressure; the Doppler method, systolic and diastolic pressures. Normal flush values from 1 to 12 months of age do not exceed 100 mm of mercury; Doppler systolic levels do not exceed 113 mm of mercury. Data concerning normal limits for children and adolescents are conflicting. For practical purposes, a persistent pressure of 140 mm of mercury systolic or 90 mm of mercury diastolic in patients more than 10 years of age is indicative of hypertension. In those younger than 10 years, systolic pressure does not normally exceed 130 mm of mercury and diastolic pressure does not normally exceed 85 mm of mercury. Primary hypertension is relatively infrequent in pediatric patients and diagnosis should be made with deliberation and caution. Antihypertensive drug therapy is indicated only for severe hypertension and in selected cases of moderate hypertension. PMID:7245735
21 CFR 864.9175 - Automated blood grouping and antibody test system.
Code of Federal Regulations, 2010 CFR
...) Identification. An automated blood grouping and antibody test system is a device used to group erythrocytes (red blood cells) and to detect antibodies to blood group antigens. (b) Classification. Class II (performance... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood grouping and antibody test...
21 CFR 864.9175 - Automated blood grouping and antibody test system.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Automated blood grouping and antibody test system... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9175 Automated blood grouping and antibody test system....
21 CFR 864.9175 - Automated blood grouping and antibody test system.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Automated blood grouping and antibody test system... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9175 Automated blood grouping and antibody test system....
21 CFR 864.9175 - Automated blood grouping and antibody test system.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Automated blood grouping and antibody test system... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9175 Automated blood grouping and antibody test system....
21 CFR 864.9175 - Automated blood grouping and antibody test system.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Automated blood grouping and antibody test system... SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Products Used In Establishments That Manufacture Blood and Blood Products § 864.9175 Automated blood grouping and antibody test system....
Comparison of indirect and direct blood pressure monitoring in normotensive swine.
Gladczak, A K; Shires, P K; Stevens, K A; Clymer, J W
The gold standard for blood pressure measurement in pigs is direct monitoring of arterial pressure, but this is an invasive technique adding complexity to surgical procedures. We sought to compare direct measurements obtained via catheterization to more easily-obtained indirect measurements using a sphygmomanometer with an automated cuff. Simultaneous measurements via an arterial pressure transducer and a child-size cuff were performed in pigs undergoing abdominal surgical procedures under normotensive conditions. Correlation between direct and indirect measurements was good (r=0.881). Systolic blood pressures for the cuff were higher than those for arterial measurements, while diastolic pressures were lower for the cuff than arterial. A Bland-Altman analysis confirmed this bias at the extremes of the normotensive range. For highly accurate readings, especially under stressed conditions, direct arterial catheterization remains the preferred method of measuring blood pressure. When monitoring surgical procedures, the more convenient blood pressure cuff can provide reliable measurements. PMID:23790711
Could Spuds Be Bad for Blood Pressure?
... Español You Are Here: Home → Latest Health News → Article URL of this page: https://www.nlm.nih.gov/medlineplus/news/fullstory_158878.html Could Spuds Be Bad for Blood Pressure? Eating potatoes 4 or more ...
Blood pressure measurement and display system
NASA Technical Reports Server (NTRS)
Farkas, A. J.
System is described that employs solid state circuitry to transmit visual display of patient's blood pressure. Response of sphygmomanometer cuff and microphone provide input signals. Signals and their amplitudes, from turn-on time to turn-off time, are continuously fed to data transmitter which transmits to display device.
Neighborhood Disadvantage and Variations in Blood Pressure
ERIC Educational Resources Information Center
Cathorall, Michelle L.; Xin, Huaibo; Peachey, Andrew; Bibeau, Daniel L.; Schulz, Mark; Aronson, Robert
Purpose: To examine the extent to which neighborhood disadvantage accounts for variation in blood pressure. Methods: Demographic, biometric, and self-reported data from 19,261 health screenings were used. Addresses of participants were geocoded and located within census block groups (n = 14,510, 75.3%). Three hierarchical linear models were…
DASH diet to lower high blood pressure
... Karanja N, Lin PH; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH)diet. DASH-Sodium Collaborative Research Group. N Engl J Med . 2001 Jan 4;344( ...
The use of ambulatory blood pressure measurement.
Hodgkinson, James A; Tucker, Katherine L; Martin, Una; Beesley, Louise; McManus, Richard J
Measurement of ambulatory blood pressure is recommended by the National Institute for Health and Care Excellence guidelines to confirm the diagnosis of hypertension in the UK. This article describes the use of ambulatory devices, and discusses the benefits and disadvantages of their use in clinical practice. PMID:26551492
Alcohol drinking and blood pressure among adolescents.
Jerez, S J; Coviello, A
The purpose of this study was to evaluate alcohol consumption among adolescents from Tucuman, Argentina, and to determine its possible relationship with increased levels of blood pressure. Three hundred fifty-six students aged 13-18 included in the study were asked to answer questionnaires anonymously. Two blood pressures measures were then taken. Differences between both sexes were found in quantity and frequency of alcohol consumption. Enjoyment was determined to be the main reason for drinking. There was an association between frequency and alcohol-related problems, and smoking habits. There were also differences in blood pressure among males and females. A weak, but significant, relationship between quantity/frequency index and diastolic blood pressure was found. A greater prevalence of hypertension in male heavy drinkers was noted as well. Because this addiction implies multiple social problems and it also accounts for a hypertension risk factor, the importance of aiming at developing prevention strategies for alcohol abuse among adolescents is stressed. PMID:9650629
The Effect of Anthocyanins on Blood Pressure
Zhu, Yongjian; Bo, Yacong; Wang, Xi; Lu, Wenjie; Wang, Xule; Han, Zhanying; Qiu, Chunguang
Abstract The findings of clinical studies concerning the association between anthocyanins supplementation and blood pressure (BP) are inconsistent. In order to provide a more precise estimate of the overall effect of anthocyanins on systolic blood pressure (SBP) and diastolic blood pressure (DBP), we conducted a meta-analysis of clinical trials about anthocyanins supplementation and BP. PubMed, Web of Science, Wanfang Database, and China National Knowledge Infrastructure (CNKI) (until October 2015) were searched to identify potential studies with information on anthocyanins extract supplementation and arterial BP. The weighted mean difference (WMD) and 95% confidence interval (CI) were used as a summary statistic. Net changes in SBP and DBP between anthocyanins supplementation and placebo groups were calculated by subtracting the values at end of follow-up from those at baseline. Meta regression was used to explore the potential moderators of effect size. The publication bias was assessed using Begger's Funnel plots and Egger's tests; P < 0.05 was considered to be statistically significant. Finally, 6 clinical studies with 472 participants for the effect of anthocyanins consumption on BP were included in the present meta-analysis. There is no significant effect on either SBP (WMD: 1.15 mm Hg, 95% CI: −3.17 to 5.47, I2 = 56%) or DBP (WMD: 1.06 mm Hg, 95% CI: −0.71 to 2.83, I2 = 0%) following supplementation with anthocyanins. In summary, results from this meta-analysis do not favor any clinical efficacy of supplementation with anthocyanins in improving blood pressure. Further well-designed large randomized controlled trials (RCTs) with long follow-up period are needed to verify the association of anthocyanins supplementation and blood pressure. PMID:27082604
Oscillometric blood pressure measurements: A signal analysis
NASA Astrophysics Data System (ADS)
Barbé, K.; Van Moer, W.; Lauwers, L.
In this paper, the oscillometric waveform measured by automatic non-invasive blood pressure meters (NIBP) is analyzed by transforming the data from the time domain to the frequency domain. The signal's spectrum of the oscillometric waveform is in current literature badly understood or explored. The only known link between the oscillometric waveform and the blood pressure is the maximum of the oscillometry's envelope equalling the mean arterial pressure (MAP). This link is established under the assumption that the oscillometry is an AM-signal. Unfortunately, computing the MAP is difficult in practice due to the non-sinusoidal nature of the actual measured signals. In this paper, we construct the best AM-signal approximation of the oscillometry and explore its use to compute the MAP.
A computer-based monitoring system for follow-up of elevated blood pressure.
Barnett, G O; Winickoff, R N; Morgan, M M; Zielstorff, R D
An automated surveillance system utilizing a computer-based medical record system (COSTAR) was designed to improve the follow-up of patients with newly identified elevated diastolic blood pressure. A population of patients was selected where, in the 6-month period following the initial measurement of an elevated diastolic blood pressure, there were fewer than two visits during which blood pressure was recorded. In a randomized controlled clinical trial, this poor follow-up population was divided into two groups, with computer-generated reminders being automatically generated for only patients in the experimental group. Follow-up was significantly improved in the group receiving the reminders, both in terms of rate of follow-up attempted or achieved by the responsible physician and in the repeated recording of blood pressure. We conclude that a computer-based reminder system improves follow-up of newly discovered elevation in diastolic blood pressure. PMID:6341724
Blood Pressure Modifies Retinal Susceptibility to Intraocular Pressure Elevation
He, Zheng; Nguyen, Christine T. O.; Armitage, James A.; Vingrys, Algis J.; Bui, Bang V.
Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP) is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP). An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine) Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion), moderate (∼100 mmHg, saline), or high levels (∼160 mmHg, angiotensin II) of mean arterial pressure (MAP, n = 5–10 per group) were subjected to IOP challenge (10–120 mmHg, 5 mmHg steps every 3 minutes). Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave) and inner retinal function (scotopic threshold response or STR). Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow. PMID:22359566
Oscillometric blood pressure measurements: differences between measured and calculated mean arterial pressure.
Kiers, H D; Hofstra, J M; Wetzels, J F M
Mean arterial pressure (MAP) is often used as an index of overall blood pressure. In recent years, the use of automated oscillometric blood pressure measurement devices is increasing. These devices directly measure and display MAP; however, MAP is often calculated from systolic blood pressure (SBP) and diastolic blood pressure (DBP) as displayed by the device. In this study we have analysed measured and calculated MAP, obtained by two different oscillometric BP measurement devices in two different patient cohorts. The first cohort included 242 healthy subjects (male 40.5%, 50+/-13 years). BP measurements were performed with a Welch Allyn 5300P device. We found a small but significant difference between measured MAP and calculated MAP (MAP(m-c:) -1.8 mmHg, range -5.7 to 12.9 mmHg, p < 0.001). MAP(m-c) showed a significant, but weak correlation with DBP and SBP. The second cohort included included 134 patients with glomerular diseases (male 63%, 50+/14 years). BP measurements were performed with a Dinamap 487210 device. In this group we also observed a small difference between measured MAP and calculated MAP (+1.7 mmHg, range -15.3 to 28.2 mmHg, p<0.001). MAP (m-c) correlated with age, all blood pressure indices and heart rate. An overall analysis showed that age, SBP, DBP, and type of device are all independently related to MAP (m-c). There is a significant difference between measured and calculated MAP. The difference is small on average; however, this MAP(m-c) can be large in the individual patient. Moreover, there are differences of reported MAP between devices. Our data suggest that calculated and measured MAP cannot be used interchangeably. PMID:19075313
Changes in blood lipids and blood pressure during adolescence.
Orchard, T J; Rodgers, M; Hedley, A J; Mitchell, J R
A total of 625 adolescents from three general practices participated in a cross-sectional study of cardiovascular disease risk factors. The girls had higher serum total and high density lipoprotein (HDL) cholesterol concentrations than the boys, while the boys had higher serum triglyceride concentrations. Smoking (equally prevalent in both sexes) was associated with lower HDL cholesterol concentrations, particularly in boys, while in girls use of oral contraceptives was associated with higher total cholesterol and lower HDL cholesterol concentrations showed striking associations with age, height, and sexual maturation in boys, but not in girls. Triglyceride concentrations were associated with age in boys. Systolic blood pressure and serum urate concentrations were higher in boys and rose steeply with age, but no age association was seen for urate concentrations or systolic blood pressure in girls or for diastolic pressures in either sex. Girls, however, had higher diastolic pressures. There was a strong association between urate concentration and the other cardiovascular disease risk factors, especially HDL cholesterol. Adolescence is associated with considerable changes in cardiovascular disease risk factors, and there are striking sex differences in these changes. PMID:6968612
21 CFR 870.1100 - Blood pressure alarm.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood...
21 CFR 870.1100 - Blood pressure alarm.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood...
21 CFR 870.1100 - Blood pressure alarm.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood...
21 CFR 870.1100 - Blood pressure alarm.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood...
21 CFR 870.1100 - Blood pressure alarm.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure alarm. 870.1100 Section 870.1100...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm. (a) Identification. A blood pressure alarm is a device that accepts the signal from a blood...
Manual versus automated blood sampling: impact of repeated blood sampling on stress parameters and behavior in male NMRI mice
Kalliokoski, Otto; Sørensen, Dorte B; Hau, Jann; Abelson, Klas S P
Facial vein (cheek blood) and caudal vein (tail blood) phlebotomy are two commonly used techniques for obtaining blood samples from laboratory mice, while automated blood sampling through a permanent catheter is a relatively new technique in mice. The present study compared physiological parameters, glucocorticoid dynamics as well as the behavior of mice sampled repeatedly for 24 h by cheek blood, tail blood or automated blood sampling from the carotid artery. Mice subjected to cheek blood sampling lost significantly more body weight, had elevated levels of plasma corticosterone, excreted more fecal corticosterone metabolites, and expressed more anxious behavior than did the mice of the other groups. Plasma corticosterone levels of mice subjected to tail blood sampling were also elevated, although less significantly. Mice subjected to automated blood sampling were less affected with regard to the parameters measured, and expressed less anxious behavior. We conclude that repeated blood sampling by automated blood sampling and from the tail vein is less stressful than cheek blood sampling. The choice between automated blood sampling and tail blood sampling should be based on the study requirements, the resources of the laboratory and skills of the staff. PMID:24958546
Association of maternal blood pressure in pregnancy with blood pressure of their offspring through adolescence.
Royal-Thomas, Tamika; McGee, Daniel; Sinha, Debajyoti; Osmond, Clive; Forrester, Terrence
This article looks at the association of maternal blood pressure with the blood pressure of the offspring from birth to childhood. The Barker hypothesis states that maternal and "in utero" attributes during pregnancy affect a child's cardiovascular health throughout life. We present an analysis of a unique dataset that consists of three distinct developmental processes: maternal cardiovascular health during pregnancy; fetal development; and child's cardiovascular health from birth to 14 years. This study explored whether a mother's blood pressure reading in pregnancy predicts fetal development and determines if this in turn is related to the future cardiovascular health of the child. This article uses data that have been collected prospectively from a Jamaican cohort which involves the following three developmental processes: (1) maternal cardiovascular health during pregnancy which is the blood pressure and anthropometric measurements at seven time-points on the mother during pregnancy; (2) fetal development which consists of ultrasound measurements of the fetus taken at six time-points during pregnancy; and (3) child's cardiovascular health which consists of the child's blood pressure measurements at 24 time-points from birth to 14 years. The inter-relationship of these three processes was examined using linear mixed effects models. Our analyses indicated that attributes later in childhood development, such as child's weight, child's baseline systolic blood pressure (SBP), age and sex, predict the future cardiovascular health of children. The results also indicated that maternal attributes in pregnancy, such as mother's baseline SBP and SBP change, predicted significantly child's SBP over time. PMID:25178900
Utility of home blood pressure monitoring to evaluate postprandial blood pressure in treated hypertensive patients.
Alfie, José
Postprandial hypotension, defined as a fall in systolic blood pressure (SBP) of 20 mmHg or greater within 2 hours after a meal, is a risk factor for stroke, coronary events and mortality. The clinical suspicion is typically raised by episodes of postprandial syncope or falls, whereas asymptomatic postprandial hypotension is mostly neglected. The magnitude of the postprandial fall in SBP, as detected by 24-hour recording in apparently healthy middle-aged to elderly subjects, was proportional to the severity of the silent cerebrovascular damage. Postprandial hypotension can also be detected by self-measured blood pressure before and within 2 hours after meals using automatic devices. The review highlights the value of home blood pressure monitoring (HBPM) as a screening test for asymptomatic postprandial hypotension in hypertensive patients. Using a HBPM protocol that included duplicated blood pressure measurements before and after three consecutive lunches, we detected unsuspected postprandial hypotension in 27.4% of the 230 hypertensive patients screened. The prevalence of postprandial hypotension was 13.2% in controlled and 42.2% in uncontrolled hypertensive patients (p < 0.001), raising the dilemma of further lowering blood pressure in the setting of postprandial hypotension. The inclusion of preprandial and postprandial measurements in the protocol of HBPM is useful to identify hypertensive patients with postprandial hypotension and may guide adjustments in antihypertensive treatment according to postprandial blood pressure. PMID:26187907
Health Instruction Packages: How to Take a Blood Pressure.
ERIC Educational Resources Information Center
Lancaster, Carolyn; And Others
Text, illustrations, and exercises are utilized in these four learning modules to teach dental hygiene students, nursing students, and the general public how to measure blood pressure. The first module, "Can You Take a Blood Pressure?" by Carolyn Lancaster, defines blood pressure, distinguishes between systolic and diastolic pressure and lists the…
Numerical simulation of noninvasive blood pressure measurement.
Hayashi, Satoru; Hayase, Toshiyuki; Shirai, Atsushi; Maruyama, Masaru
In this paper, a simulation model based on the partially pressurized collapsible tube model for reproducing noninvasive blood pressure measurement is presented. The model consists of a collapsible tube, which models the pressurized part of the artery, rigid pipes connected to the collapsible tube, which model proximal and distal region far from the pressurized part, and the Windkessel model, which represents the capacitance and the resistance of the distal part of the circulation. The blood flow is simplified to a one-dimensional system. Collapse and expansion of the tube is represented by the change in the cross-sectional area of the tube considering the force balance acting on the tube membrane in the direction normal to the tube axis. They are solved using the Runge-Kutta method. This simple model can easily reproduce the oscillation of inner fluid and corresponding tube collapse typical for the Korotkoff sounds generated by the cuff pressure. The numerical result is compared with the experiment and shows good agreement. PMID:16995754
[Reducing blood pressure with Dipyron (novaminsulfone sodium)].
Zoppi, M; Hoigné, R; Keller, M F; Streit, F; Hess, T
A fall in systolic blood pressure without other symptoms of anaphylactic shock has been described following the administration of drugs containing dipyrone. This adverse reaction was first observed in 4 patients by the same team in 1972-1973. Ten further cases with a fall in systolic blood pressure by at least 20 mm Hg occurring within minutes to 6 hours after intravenous administration of dipyrone are presented in this paper. In each of them this adverse reaction was considered to be probable or even definite. During the years 1976-1981 drug exposure was registered for all 15 678 patients of the two medical divisions of Comprehensive Hospital Drug Monitoring Berne. This adverse reaction was found in 7, representing 0.34% of the 2053 patients who received intravenous treatment with a dipyrone preparation. PMID:6658424
[Blood pressure control in eldery hypertension].
Shimamoto, Kazuaki
Case of diabetes mellitus associated with essential hypertension are mostly type 2 diabetes mellitus(NIDDM) in elderly patients. In the JNC VI and JSH 2004, it is recommended that the therapeutic target blood pressure level should be lower then 130/80 mmHg in hypertension complicated with diabetes mellitus, and this target has recently obtained wide acceptance. On the other hand, the target blood pressure in elderly is recommended below 140/90 mmHg. Accordingly, diabetes mellitus in elderly hypertensives should be treated similarly as in the young and middle-aged. Because ACE inhibitors/ARBs or Ca blockers increase insulin sensitivity, these drugs should be used as the first choice in cases of elderly hypertensive patients complicated with diabetes mellitus. PMID:16408451
Optimal perioperative management of arterial blood pressure
Lonjaret, Laurent; Lairez, Olivier; Minville, Vincent; Geeraerts, Thomas
Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation. PMID:25278775
Lipids, blood pressure and kidney update 2014.
Banach, Maciej; Aronow, Wilbert S; Serban, Corina; Sahabkar, Amirhossein; Rysz, Jacek; Voroneanu, Luminita; Covic, Adrian
This paper is an effort to review all the most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2014. Irrespective of advances, the options for improving simultaneous hypercholesterolemia and hypertension management (as well as its complication - chronic kidney disease) remain a problem. Recommending hypolidemic, hypotensive and kidney disease drugs to obtain therapy targets in cardiovascular, diabetic, elderly and kidney disease (=high risk) patients might strengthen risk factor control, improve compliance and the therapy efficacy, and in the consequence reduce the risk of cardiovascular events and mortality rate. That is why the authors have decided to summary and discuss the recent scientific achievements in the field of lipid, blood pressure and kidney. PMID:25819754
Multiscale analysis of blood pressure signals
NASA Astrophysics Data System (ADS)
Marrone, A.; Polosa, A. D.; Scioscia, G.; Stramaglia, S.; Zenzola, A.
We describe the multiresolution wavelet analysis of blood pressure waves in vasovagal syncope-affected patients compared with those in healthy people, using Haar and Gaussian bases. A comparison between scale-dependent and scale-independent measures discriminating the two classes of subjects is made. What emerges is a sort of equivalence between these two methodological approaches, that is, both methods reach the same statistical significance of separation between the two classes.
Blood Pressure Management Controversies in Neurocritical Care.
McNett, Molly; Koren, Jay
Blood pressure (BP) management is essential in neurocritical care settings to ensure adequate cerebral perfusion and prevent secondary brain injury. Despite consensus on the importance of BP monitoring, significant practice variations persist regarding optimal methods for monitoring and treatment of BP values among patients with neurologic injuries. This article provides a summary of research investigating various approaches for BP management in neurocritical care. Evidence-based recommendations, areas for future research, and current technological advancements for BP management are discussed. PMID:26873756
Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond
Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob
Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological 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 risk for 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 the 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 two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624
The effect of nutrition on blood pressure.
Savica, Vincenzo; Bellinghieri, Guido; Kopple, Joel D
The incidence and severity of hypertension are affected by nutritional status and intake of many nutrients. Excessive energy intake and obesity are major causes of hypertension. Obesity is associated with increased activity of the renin-angiotensin-aldosterone and sympathetic nervous systems, possibly other mineralcorticoid activity, insulin resistance, salt-sensitive hypertension and excess salt intake, and reduced kidney function. High sodium chloride intake strongly predisposes to hypertension. Increased alcohol consumption may acutely elevate blood pressure. High intakes of potassium, polyunsaturated fatty acids, and protein, along with exercise and possibly vitamin D, may reduce blood pressure. Less-conclusive studies suggest that amino acids, tea, green coffee bean extract, dark chocolate, and foods high in nitrates may reduce blood pressure. Short-term studies indicate that specialized diets may prevent or ameliorate mild hypertension; most notable are the Dietary Approaches to Stop Hypertension (DASH) diet, which is high in fruits, vegetables, and low-fat dairy products, and the DASH low-sodium diet. Long-term compliance to these diets remains a major concern. PMID:20645853
Ethanol and blood pressure in rats
Hatton, D.C.; Edgar, S.; McCarron, D.A. )
Epidemiologists have identified alcohol as a risk factor in hypertension. Attempts to increase blood pressure in rats with chronic alcohol ingestion have met with mixed results. Some investigators have reported increases in blood pressure while others have reported decreases. Most investigators have given alcohol in the drinking water which produced differences in food intake across groups. To control for food intake, Wister rats were simultaneously pair fed a liquid diet with either ethanol as 35% of calories or a control diet using ARF/Israel pair-feeding devices. At 5 weeks of age, animals on ethanol diets had lower systolic blood pressure than control animals (145 (n-19) vs. 121 (n-19) mmHg). There was no difference in weight between ethanol and control animals. The same pattern of results was apparent at 7 weeks (143 (n-13) vs. 119 (n-13) mmHg) and 9 weeks (147 (n-7) vs. 124 (n-7)). The data indicate that ethanol produces hypotension in rats when food intake is controlled.
Blood pressure control for diabetic retinopathy
Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N
Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial
Ambulatory Blood Pressure Monitoring in Clinical Practice: A Review
Viera, Anthony J.; Shimbo, Daichi
Ambulatory blood pressure monitoring offers the ability to collect blood pressure readings several times an hour across a 24-hour period. Ambulatory blood pressure monitoring facilitates the identification of white-coat hypertension, the phenomenon whereby certain individuals who are not on antihypertensive medication show elevated blood pressure in a clinical setting but show non-elevated blood pressure averages when assessed by ambulatory blood pressure monitoring. Additionally, readings can be segmented into time windows of particular interest, e.g., mean daytime and nighttime values. During sleep, blood pressure typically decreases, or dips, such that mean sleep blood pressure is lower than mean awake blood pressure. A non-dipping pattern and nocturnal hypertension are strongly associated with increased cardiovascular morbidity and mortality. Approximately 70% of individuals dip ≥10% at night, while 30% have non-dipping patterns, when blood pressure remains similar to daytime average, or occasionally rises above daytime average. The various blood pressure categorizations afforded by ambulatory blood pressure monitoring are valuable for clinical management of high blood pressure since they increase accuracy for diagnosis and the prediction of cardiovascular risk. PMID:25107387
Algorithmic Summaries of Perioperative Blood Pressure Fluctuations.
Toddenroth, Dennis; Ganslandt, Thomas; Drescher, Caroline; Weith, Thomas; Prokosch, Hans-Ulrich; Schuettler, Juergen; Muenster, Tino
Automated perioperative measurements such as cardiovascular monitoring data are commonly compared to established upper and lower thresholds, but could also allow for more complex interpretations. Analyzing such time series in extensive electronic medical records for research purposes may itself require customized automation, so we developed a set of algorithms for quantifying different aspects of temporal fluctuations. We implemented conventional measures of dispersion, summaries of absolute gradients between successive values, and Poincaré plots. We aggregated the severity and duration of hypotensive episodes by calculating the average area under different mean arterial pressure (MAP) thresholds. We applied these methods to 30,452 de-identified MAP series, and analyzed the similarity between alternative indices via hierarchical clustering. To explore the potential utility of these propositional metrics, we computed their statistical association with presumed complications due to cardiovascular instability. We observed that hierarchical clustering reliably segregated features that had been designed to quantify dissimilar aspects. Summaries of temporary hypotension turned out to be significantly increased among patient subgroups with subsequent signs of a complicated recovery. These associations were even stronger for measures that were specifically geared to capturing short-term MAP variability. These observations suggest the potential capability of our proposed algorithms for quantifying heterogeneous aspects of short-term MAP fluctuations. Future research might also target a wider selection of outcomes and other attributes that may be subject to intraoperative variability. PMID:27577440
High blood pressure and visual sensitivity
NASA Astrophysics Data System (ADS)
Eisner, Alvin; Samples, John R.
The study had two main purposes: (1) to determine whether the foveal visual sensitivities of people treated for high blood pressure (vascular hypertension) differ from the sensitivities of people who have not been diagnosed with high blood pressure and (2) to understand how visual adaptation is related to standard measures of systemic cardiovascular function. Two groups of middle-aged subjects-hypertensive and normotensive-were examined with a series of test/background stimulus combinations. All subjects met rigorous inclusion criteria for excellent ocular health. Although the visual sensitivities of the two subject groups overlapped extensively, the age-related rate of sensitivity loss was, for some measures, greater for the hypertensive subjects, possibly because of adaptation differences between the two groups. Overall, the degree of steady-state sensitivity loss resulting from an increase of background illuminance (for 580-nm backgrounds) was slightly less for the hypertensive subjects. Among normotensive subjects, the ability of a bright (3.8-log-td), long-wavelength (640-nm) adapting background to selectively suppress the flicker response of long-wavelength-sensitive (LWS) cones was related inversely to the ratio of mean arterial blood pressure to heart rate. The degree of selective suppression was also related to heart rate alone, and there was evidence that short-term changes of cardiovascular response were important. The results suggest that (1) vascular hypertension, or possibly its treatment, subtly affects visual function even in the absence of eye disease and (2) changes in blood flow affect retinal light-adaptation processes involved in the selective suppression of the flicker response from LWS cones caused by bright, long-wavelength backgrounds.
Snapshot: Blood Pressure in the U.S.
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Blood Pressure Problems During Pregnancy, Heart Trouble Later?
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Orthostatic Hypotension (Low Blood Pressure) and Parkinson's Disease
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Wearable Monitor Helps Spot 'Masked' High Blood Pressure
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High blood pressure - what to ask your doctor
What to ask your doctor about high blood pressure; Hypertension - what to ask your doctor ... problems? What medicines am I taking to treat high blood pressure? Do they have any side effects? What should ...
A Nutritional Strategy for the Treatment of High Blood Pressure.
ERIC Educational Resources Information Center
Podell, Richard N.
Some physicians wonder if high blood pressure can be controlled without the use of drugs and their potential side effects. Current findings concerning nutrition and high blood pressure are presented. (RM)
Methods of Blood Pressure Measurement in the ICU
Lehman, Li-wei H.; Saeed, Mohammed; Talmor, Daniel; Mark, Roger; Malhotra, Atul
Objective Minimal clinical research has investigated the significance of different blood pressure monitoring techniques in the ICU and whether systolic vs. mean blood pressures should be targeted in therapeutic protocols and in defining clinical study cohorts. The objectives of this study are to compare real-world invasive arterial blood pressure with noninvasive blood pressure, and to determine if differences between the two techniques have clinical implications. Design We conducted a retrospective study comparing invasive arterial blood pressure and noninvasive blood pressure measurements using a large ICU database. We performed pairwise comparison between concurrent measures of invasive arterial blood pressure and noninvasive blood pressure. We studied the association of systolic and mean invasive arterial blood pressure and noninvasive blood pressure with acute kidney injury, and with ICU mortality. Setting Adult intensive care units at a tertiary care hospital. Patients Adult patients admitted to intensive care units between 2001 and 2007. Interventions None. Measurements and Main Results Pairwise analysis of 27,022 simultaneously measured invasive arterial blood pressure/noninvasive blood pressure pairs indicated that noninvasive blood pressure overestimated systolic invasive arterial blood pressure during hypotension. Analysis of acute kidney injury and ICU mortality involved 1,633 and 4,957 patients, respectively. Our results indicated that hypotensive systolic noninvasive blood pressure readings were associated with a higher acute kidney injury prevalence (p = 0.008) and ICU mortality (p < 0.001) than systolic invasive arterial blood pressure in the same range (≤70 mm Hg). Noninvasive blood pressure and invasive arterial blood pressure mean arterial pressures showed better agreement; acute kidney injury prevalence (p = 0.28) and ICU mortality (p = 0.76) associated with hypotensive mean arterial pressure readings (≤60 mm Hg) were independent of
Lipid, blood pressure and kidney update 2013.
Banach, Maciej; Serban, Corina; Aronow, Wilbert S; Rysz, Jacek; Dragan, Simona; Lerma, Edgar V; Apetrii, Mugurel; Covic, Adrian
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year. PMID:24573394
Ambulatory blood pressure monitoring (ABPM) in nonagenarians.
Formiga, Francesc; Ferrer, Assumpta; Sobrino, Javier; Coca, Antonio; Riera, Antoni; Pujol, Ramón
The objective of the study is to investigate ambulatory blood pressure monitoring (ABPM) in a sample of Spanish nonagenarians. We also analyzed the misdiagnosis of hypertension and investigated blood pressure (BP) control in treated hypertensive nonagenarians. Twenty-four-hour ABPM was undertaken in a group of 42 nonagenarians. The 24-h mean, daytime BP, nighttime BP and heart rate (HR) were extracted from the ABPM. Sociodemographic data, the ability to perform basic daily activities, measured by the Barthel index (BI) or instrumental activities revealed by the Lawton and Brody index (LI), cognition, and comorbidity were evaluated. Thirty-one subjects were receiving antihypertensive drug treatment. Twenty-four hour, daytime and sleeping pressures averaged 130/65, 131/68 and 128/63mmHg, respectively. Seventeen (40.5%) of the 42 patients had a daytime BP of 135/85 or higher. In terms of the BP pattern, 8 (19%) subjects were dippers, 19 (45%) non-dippers, and 15 (36%) were risers. Five (45.46%) out of 11 patients with no evidence of hypertension (normotensive patients) had a daytime BP of 135/85 or higher. The mean daytime BP was 135/85 or higher in 12 (38.7%) out of 31 nonagenarians who had previously received therapy for hypertension. In, conclusion a high prevalence of hypertension, misdiagnosis and inadequate BP control was found in nonagenarians treated for hypertension. PMID:18423650
21 CFR 870.1140 - Venous blood pressure manometer.
Code of Federal Regulations, 2014 CFR
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21 CFR 870.1140 - Venous blood pressure manometer.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a...
21 CFR 870.1140 - Venous blood pressure manometer.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a...
21 CFR 870.1120 - Blood pressure cuff.
Code of Federal Regulations, 2013 CFR
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21 CFR 870.1120 - Blood pressure cuff.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...
21 CFR 870.1130 - Noninvasive blood pressure measurement system.
Code of Federal Regulations, 2010 CFR
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21 CFR 870.1140 - Venous blood pressure manometer.
Code of Federal Regulations, 2011 CFR
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21 CFR 870.1120 - Blood pressure cuff.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...
21 CFR 870.1120 - Blood pressure cuff.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...
21 CFR 870.1140 - Venous blood pressure manometer.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a...
From blood pressure to physical disability: the role of cognition.
Elias, Merrill F; Dore, Gregory A; Davey, Adam; Robbins, Michael A; Elias, Penelope K
We examined the hypothesis that lowered cognitive performance plays a role in the relation between elevated blood pressure and physical disability in performing basic physical tasks. A community-based sample (N=1025) free from stroke and dementia (mean age: 61.1 years; SD: 13.0 years; 59.8% women) was used. Using path analysis, systolic and diastolic blood pressures (predictor variable) measured over multiple longitudinal examinations were averaged and related to multiple measures of cognition (intermediate variable) and physical ability (PA; outcome variable) measured at wave 6 of the Maine-Syracuse Study. PA was indexed by time required to execute standing, walking, and turning tests. A best-fit path model including blood pressure and multiple demographic and cardiovascular disease covariates was used. Paths from systolic blood pressure to global performance, verbal memory, and abstract reasoning (Similarities test) were significant (P<0.05), as were paths from diastolic blood pressure to global performance, executive functioning, visual spatial organization/memory, verbal memory, working memory, and abstract reasoning. Regardless of the blood pressure predictor, lower cognitive performance (intermediate variable) was related to lower PA (outcome) in the path from blood pressure to PA. The direct path from blood pressure to PA was significant only for systolic blood pressure. Cognitive performance mediates between blood pressure and PA. As compared with systolic blood pressure, more domains of cognitive functioning intervene between diastolic blood pressure and PA. PMID:20404216
Real-Life Stories about High Blood Pressure
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Heart and Artery Damage and High Blood Pressure
... Resources Stroke More Heart and Artery Damage and High Blood Pressure Updated:Oct 22,2015 There are several harmful ... content was last reviewed on 08/04/2014. High Blood Pressure • Home • About High Blood Pressure (HBP) • Why HBP ...
21 CFR 870.1120 - Blood pressure cuff.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure cuff. 870.1120 Section 870.1120...) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff. (a) Identification. A blood pressure cuff is a device that has an inflatable bladder in an...
Results of Blood Pressure Screening in White College Students.
ERIC Educational Resources Information Center
Hahn, William K.; And Others
This report presents blood pressure norms for 18- to 24-year-old White college students, as well as data on the prevalence of high blood pressure for this group. Results were obtained from voluntary blood pressure screening of 1,660 men and 953 women. (IAH)
Blood pressure targets and absolute cardiovascular risk.
Odutayo, Ayodele; Rahimi, Kazem; Hsiao, Allan J; Emdin, Connor A
In the Eighth Joint National Committee guideline on hypertension, the threshold for the initiation of blood pressure-lowering treatment for elderly adults (≥60 years) without chronic kidney disease or diabetes mellitus was raised from 140/90 mm Hg to 150/90 mm Hg. However, the committee was not unanimous in this decision, particularly because a large proportion of adults ≥60 years may be at high cardiovascular risk. On the basis of Eighth Joint National Committee guideline, we sought to determine the absolute 10-year risk of cardiovascular disease among these adults through analyzing the National Health and Nutrition Examination Survey (2005-2012). The primary outcome measure was the proportion of adults who were at ≥20% predicted absolute cardiovascular risk and above goals for the Seventh Joint National Committee guideline but reclassified as at target under the Eighth Joint National Committee guideline (reclassified). The Framingham General Cardiovascular Disease Risk Score was used. From 2005 to 2012, the surveys included 12 963 adults aged 30 to 74 years with blood pressure measurements, of which 914 were reclassified based on the guideline. Among individuals reclassified as not in need of additional treatment, the proportion of adults 60 to 74 years without chronic kidney disease or diabetes mellitus at ≥20% absolute risk was 44.8%. This corresponds to 0.8 million adults. The proportion at high cardiovascular risk remained sizable among adults who were not receiving blood pressure-lowering treatment. Taken together, a sizable proportion of reclassified adults 60 to 74 years without chronic kidney disease or diabetes mellitus was at ≥20% absolute cardiovascular risk. PMID:26056340
The relationship of blood lead to blood pressure in a longitudinal study of working men.
Weiss, S T; Muñoz, A; Stein, A; Sparrow, D; Speizer, F E
The relationship of lead exposure to blood pressure has been examined in a longitudinal study of a cohort of 89 Boston, Massachusetts, policemen. At the baseline examination, subjects had a blood lead determination and three consecutive blood pressure measurements. Triplicate blood pressure measurements were also taken at years 3, 4, and 5. Multivariate analysis revealed that, after correction for previous systolic blood pressure, body mass index, age, and smoking, a high level of blood lead was a significant predictor of subsequent elevation of systolic pressure. Bootstrap simulations of these models provided supporting evidence for the observed associations. These data suggest that lead exposure can significantly affect systolic pressure. PMID:3485920
Relationship of blood lead to blood pressure in a longitudinal study of working men
Weiss, S.T.; Munoz, A.; Stein, A.; Sparrow, D.; Speizer, F.E.
The relationship of lead exposure to blood pressure has been examined in a longitudinal study of a cohort of 89 Boston, Massachusetts, policemen. At the baseline examination, subjects had a blood lead determination and three consecutive blood pressure measurements. Triplicate blood pressure measurements were also taken at years 3, 4, and 5. Multivariate analysis revealed that, after correction for previous systolic blood pressure, body mass index, age, and smoking, a high level of blood lead was a significant predictor of subsequent elevation of systolic pressure. Bootstrap simulations of these models provided supporting evidence for the observed associations. These data suggest that lead exposure can significantly affect systolic pressure.
Blood pressure management in mechanical circulatory support
Adatya, Sirtaz
Durable mechanical support has become widely available for end stage heart failure as destination therapy and as bridge to transplantation. The accurate measurement of blood pressure (BP) as well as the recognition and management of hypertension in patients with continuous flow left ventricular assist devices (CF-VADs) is an essential component of optimal clinical care. Strategies for the control of BP in CF-VAD patients are increasingly important as there is an evolving understanding of the connection between hypertension, pump output, and adverse outcomes. As clinical experience grows, optimal BP targets, as well as methods to measure BP in CF-VAD patients have been further defined. PMID:26793332
Clinical aspects of blood pressure autorhythmometry
NASA Technical Reports Server (NTRS)
Levine, H.; Halberg, F.
Self-measurements made by a 55-year-old physician with mild to moderate hypertension of ten years' duration are considered. The physician had been in excellent health until age 45 when sustained elevation of blood pressure up to 180/100 mmHg and a slight aortic diastolic murmur were noted. On the basis of the investigation it is suggested that physical and mental performance measures provide an objective basis for assessing the desirability of a given physiological change. Such studies will have to be complemented by a search for long-term effects.
Cerebral blood flow in normal pressure hydrocephalus
Mamo, H.L.; Meric, P.C.; Ponsin, J.C.; Rey, A.C.; Luft, A.G.; Seylaz, J.A.
A xenon-133 method was used to measure cerebral blood flow (CBF) before and after cerebrospinal fluid (CSF) removal in patients with normal pressure hydrocephalus (NPH). Preliminary results suggested that shunting should be performed on patients whose CBF increased after CSF removal. There was a significant increase in CBF in patients with NPH, which was confirmed by the favorable outcome of 88% of patients shunted. The majority of patients with senile and presenile dementia showed a decrease or no change in CBF after CSF removal. It is suggested that although changes in CBF and clinical symptoms of NPH may have the same cause, i.e., changes in the cerebral intraparenchymal pressure, there is no simple direct relation between these two events. The mechanism underlying the loss of autoregulation observed in NPH is also discussed.
Automatic Blood Pressure Measurements During Exercise
NASA Technical Reports Server (NTRS)
Weaver, Charles S.
Microprocessor circuits and a computer algorithm for automatically measuring blood pressure during ambulatory monitoring and exercise stress testing have been under development at SRI International. A system that records ECG, Korotkov sound, and arm cuff pressure for off-line calculation of blood pressure has been delivered to NASA, and an LSLE physiological monitoring system that performs the algorithm calculations in real-time is being constructed. The algorithm measures the time between the R-wave peaks and the corresponding Korotkov sound on-set (RK-interval). Since the curve of RK-interval versus cuff pressure during deflation is predictable and slowly varying, windows can be set around the curve to eliminate false Korotkov sound detections that result from noise. The slope of this curve, which will generally decrease during exercise, is the inverse of the systolic slope of the brachial artery pulse. In measurements taken during treadmill stress testing, the changes in slopes of subjects with coronary artery disease were markedly different from the changes in slopes of healthy subjects. Measurements of slope and O2 consumption were also made before and after ten days of bed rest during NASA/Ames Research Center bed rest studies. Typically, the maximum rate of O2 consumption during the post-bed rest test is less than the maximum rate during the pre-bed rest test. The post-bed rest slope changes differ from the pre-bed rest slope changes, and the differences are highly correlated with the drop in the maximum rate of O2 consumption. We speculate that the differences between pre- and post-bed rest slopes are due to a drop in heart contractility.
Poor elevated-blood-pressure recognition in the outpatient setting
Brady, Tammy M.
Question Among pediatric outpatient care centers, what is the rate of elevated blood pressure recognition? Design Retrospective single cohort study. Setting Single tertiary-care pediatric outpatient center. Participants 20 000 patients (2–17 years old). Intervention Blood pressure measurement. Outcomes Recognition rate of elevated blood pressures. Main Results Among those with ≥3 elevated blood pressure measurements, the median frequency of identification by division/service was 17%. Conclusions The identification of patients with elevated blood pressure measurements was low. PMID:26319926
E-health blood pressure control program.
Ahern, David K; Stinson, Lynda J; Uebelacker, Lisa A; Wroblewski, Joseph P; McMurray, Jerome H; Eaton, Charles B
Both technological and human factors design requirements for integration of home blood pressure monitoring (HBPM) into a patient centered medical home (PCMH) model primary care practice are described. Patients with uncontrolled hypertension were given home blood pressure (BP) monitors, and after a three-month run-in period introduced to either a high-tech only (HBPM connectivity to personal health record and tailored Web portal access) or a high-tech/"high-touch" (high-tech solution plus patient navigator [PN]) solution. Features of the Web portal included: BP graphing function, traffic-light feedback system of BP goal attainment, economic incentives for self-monitoring, and dual patient-facing and care-team-facing dashboard functions. The e-health BP control system with PN support was well received by patients, providers, and the healthcare team. Current e-health technology and limited technological literacy of many patients suggest that a PN or some other personnel resource may be required for the adoption of patient-facing technology in primary care. PMID:23167022
Previous blood pressure measurement and associated factors in student adolescents
Magalhães, Marina Gabriella Pereira de Andrada; Farah, Breno Quintella; de Barros, Mauro Virgilio Gomes; Ritti-Dias, Raphael Mendes
Objective To identify prevalence of previous blood pressure measurement and analyze some associated factors in adolescents. Methods This cross-sectional study included 6,077 adolescents aged 14 to 19 years. Demographic characteristics included (sex, age, period of study, region of residence, work, skin color, and economic) status, history of blood pressure measurement within last 12 months, local of blood pressure measurement, and reading obtained. To assess associations between previous blood pressure measurement with demographic characteristics and high blood pressure we used descriptive statistics and logistic regression analysis. Results Out of the adolescents, 56.8% reported no blood pressure measurement within the last 12 months. The health centers and the physician's office were most mentioned places for blood pressure measurement (28.3% and 36.9%, respectively). Boys (odds ratio of 1.64 95%CI: 1.46-1.84) aged 14 to 16 years (odds ratio of 1.12; 95%CI: 1.01-1.25), whose economic status was unfavorable (odds ratio of 1.48; 95%CI: 1.32-1.67) were significantly associated with no blood pressure measurement. Working was a protective factor for was not blood pressure measurement (odds ratio of 0.84; 95%CI: 0.73-0.97). Conclusion Most of adolescents did not have their blood pressure measured within the last 12 months. Boys aged 14 to 16 years and those with unfavorable economic status had higher chance of not having their blood pressure measured. PMID:26466061
Blood pressure monitor with a position sensor for wrist placement to eliminate hydrostatic pressure effect on blood pressure measurement.
Sato, Hironori; Koshimizu, Hiroshi; Yamashita, Shingo; Ogura, Toshihiko
Accurate measurement of blood pressure at wrist requires the heart and wrist to be kept at the same level to avoid the effects of hydrostatic pressure. Although a blood pressure monitor with a position sensor that guides appropriate forearm angle without use of a chair and desk has already been proposed, a similar functioning device for measuring upper arm blood pressure with a chair and desk is needed. In this study, a calculation model was first used to explore design of such a system. The findings were then implemented into design of a new blood pressure monitor. Results of various methods were compared. The calculation model of the wrist level from arthrosis angles and interarticulars lengths was developed and considered using published anthropometric dimensions. It is compared with 33 volunteer persons' experimental results. The calculated difference of level was -4.1 to 7.9 (cm) with a fixed chair and desk. The experimental result was -3.0 to 5.5 (cm) at left wrist and -2.1 to 6.3(cm) at right wrist. The absolute difference level equals ±4.8 (mmHg) of blood pressure readings according to the calculated result. This meets the AAMI requirements for a blood pressure monitor. In the conclusion, the calculation model is able to effectively evaluate the difference between the heart and wrist level. Improving the method for maintaining wrist to heart level will improve wrist blood pressure measurement accuracy when also sitting in the chair at a desk. The leading angle of user's forearm using a position sensor is shown to work for this purpose. PMID:24110067
Relationship of blood lead to systolic blood pressure in a longitudinal study of policemen
Weiss, S.T.; Munoz, A.; Stein, A.; Sparrow, D.; Speizer, F.E.
We examined the relationship of blood lead level to systolic and diastolic blood pressure in a longitudinal study of 89 Boston, MA, policemen. At the second examination blood lead level and blood pressure were measured in triplicate. Blood pressure measurements were taken in a similar fashion in years 3, 4, and 5. Multivariate analysis using a first-order autoregressive model revealed that after adjusting for previous systolic blood pressure, body mass index, age, and cigarette smoking, an elevated blood lead level was a significant predictor of subsequent systolic blood pressure. Bootstrap simulations of these models provided supporting evidence for the observed association. These data suggest that blood lead level can influence systolic blood pressure even within the normal range.
Effect of respiration on Korotkoff sounds and oscillometric cuff pressure pulses during blood pressure measurement.
Zheng, Dingchang; Di Marco, Luigi Yuri; Murray, Alan
Blood pressure (BP) measurement accuracy depends on consistent changes in Korotkoff sounds (KorS) for manual measurement and oscillometric pulses for automated measurement, yet little is known about the direct effect of respiration on these physiological signals. The aim of this research was to quantitatively assess the modulation effect of respiration on Korotkoff sounds and oscillometric pulses. Systolic and diastolic blood pressures were measured manually from 30 healthy subjects (age 41 ± 12 years). Three static cuff pressure conditions were studied for two respiratory rates. Cuff pressure [with oscillometric pulses (OscP)], ECG, chest motion respiration [respiration signal (Resp), from magnetometer] and Korotkoff sounds (KorS, from digital stethoscope) were recorded twice for 20 s. The physiological data were evenly resampled. Respiratory frequency was calculated from Resp (fR), OscP (fO) and KorS (fK) from peak spectral frequency. There was no statistically significant difference between fR and fO or fK. Respiratory modulation was observed in all subjects. OscP amplitude modulation changed significantly between the two respiratory rates (p < 0.05) and between the three cuff pressures (p < 0.0001), and decreased significantly with decreasing cuff pressure (p < 0.05). The phase shift between Resp and modulation of OscP was statistically significant with respiratory rates (p < 0.05), but not with cuff pressures. It is accepted that BP in individuals is variable and that this relates to respiration; we now show that this respiration modulates oscillometric pulse and Korotkoff sound amplitudes from which BP is measured. PMID:24668326
A fully automated immunoassay from whole blood on a disc.
Lee, Beom Seok; Lee, Jung-Nam; Park, Jong-Myeon; Lee, Jeong-Gun; Kim, Suhyeon; Cho, Yoon-Kyoung; Ko, Christopher
A portable, disc-based, and fully automated enzyme-linked immuno-sorbent assay (ELISA) system is developed to test infectious diseases from whole blood. The innovative laser irradiated ferrowax microvalves and centrifugal microfluidics were utilized for the full integration of microbead-based suspension ELISA assays on a disc starting from whole blood. The concentrations of the antigen and the antibody of Hepatitis B virus (HBV), HBsAg and Anti-HBs respectively, were measured using the lab-on-a-disc (LOD). All the necessary reagents are preloaded on the disc and the total process of the plasma separation, incubation with target specific antigen or antibody coated microbeads, multiple steps of washing, enzyme reaction with substrates, and the absorbance detection could be finished within 30 minutes. Compared to the conventional ELISA, the operation time was dramatically reduced from over 2 hours to less than 30 minutes while the limit of detection was kept similar; e.g. the limit of detection of Anti-HBs tests were 8.6 mIU mL(-1) and 10 mIU mL(-1) for the disc-based and the conventional ELISA respectively. PMID:19458861
The importance of penile blood pressure in cases of impotence
Gaskell, Peter
It appears that the normal penile systolic blood pressure, as measured by a spectroscopic method, is equal to or greater than the calculated brachial mean blood pressure. A pressure definitely lower than this in impotent patients indicates obstruction to blood flow in the main vessels supplying the penis. On this basis, obstruction to blood flow was identified as a cause of impotence in patients with little other evidence of peripheral vascular disease. PMID:5150208
A survey of blood pressure in Lebanese children and adolescence
Merhi, Bassem Abou; Al-Hajj, Fatima; Al-Tannir, Mohamad; Ziade, Fouad; El-Rajab, Mariam
Background: Blood pressure varies between populations due to ethnic and environmental factors. Therefore, normal blood pressure values should be determined for different populations. Aims: The aim of this survey was to produce blood pressure nomograms for Lebanese children in order to establish distribution curves of blood pressure by age and sex. Subjects and Methods: We conducted a survey of blood pressure in 5710 Lebanese schoolchildren aged 5 to 15 years (2918 boys and 2792 girls), and studied the distribution of systolic and diastolic blood pressure in these children and adolescents. Blood pressure was measured with a mercury sphygmomanometer using a standardized technique. Results: Both systolic and diastolic blood pressure had a positive correlation with weight, height, age, and body mass index (r= 0.648, 0.643, 0.582, and 0.44, respectively) (P < .001). There was no significant difference in the systolic and diastolic blood pressure in boys compared to girls of corresponding ages. However, the average annual increase in systolic blood pressure was 2.86 mm Hg in boys and 2.63 mm Hg in girls, whereas the annual increase in diastolic blood pressure was 1.72 mm Hg in boys and 1.48 mm Hg in girls. The prevalence of high and high-normal blood pressure at the upper limit of normal (between the 90th and 95th percentile, at risk of future hypertension if not managed adequately), was 10.5% in boys and 6.9% in girls, with similar distributions among the two sexes. Conclusions: We present the first age-specific reference values for blood pressure of Lebanese children aged 5 to 15 years based on a good representative sample. The use of these reference values should help pediatricians identify children with normal, high-normal and high blood pressure. PMID:22540059
Correlates of blood pressure in Yanomami Indians of northwestern Brazil.
Crews, D E; Mancilha-Carvalho, J J
We determined associations of measures of body habitus with blood pressure for 100 adult Yanomami Indians (61 men, 39 women) examined during February and March 1990. Measurements included body weight and height, four skinfolds (triceps, subscapular, suprailiac, abdomen), four circumferences (wrist, upper arm, abdomen, hip), systolic and diastolic blood pressures, pulse rate, and estimated age. Various indices of fat distribution were determined from the measurements of skinfolds, circumferences, weight, and height. Estimated age averaged 35.0 years in men and 33.4 years in women (range: 15 to 63 years). Mean systolic and diastolic blood pressures were low in both men (104.8/70.4 mm Hg) and women (94.8/63.5 mm Hg), as was body mass index (men: 20.7; women: 21.4 kg/m2). In Yanomami women, all four skinfolds, wrist circumference, and the indices of hip and abdominal fat were significant correlates of systolic blood pressure, while the abdominal skinfold and wrist and hip circumferences correlated significantly with diastolic blood pressure. Among men, there was a negative correlation between estimated age and systolic blood pressure and a positive correlation between BMI and upper arm and hip circumferences and systolic blood pressure. There was a significant positive correlation between wrist, upper arm, and hip circumferences and diastolic blood pressure among Yanomami men. We used stepwise regression to generate sex-specific predictive equations for blood pressure. For men, estimated age and hip circumference, and for women, abdominal skinfold measurement and age were included in the model for systolic blood pressure. Among men, wrist circumference and height, and among women, wrist circumference alone entered the model for diastolic blood pressure. On the basis of these results, we suggest that even in a low-blood pressure, low-body fat, no-salt setting, systolic blood pressure is associated with the amount and placement of adipose tissue. However, diastolic blood
[Riva-Rocci and blood pressure].
van Gijn, Jan; Gijselhart, Joost P
Scipione Riva-Rocci (1863-1937) was educated in Turin as a physician and later as a doctor of internal medicine. In 1896 and 1897 he published a series of four articles (in Italian) on a new method for measuring blood pressure. Previous non-invasive methods were all based on compression of the radial pulse, in keeping with centuries of medical tradition, but they were cumbersome and unreliable. Riva-Rocci's innovation consisted in compressing the brachial artery instead, at the level of the upper arm. For this purpose he devised an inflatable rubber tube, which was rigid on the outside. Disappearance of the radial pulse on palpation indicated the systolic arterial pressure, as Riva-Rocci confirmed by calibration experiments in animals and with human cadavers. His instrument was introduced world-wide after a chance visit by the American neurosurgeon Harvey Cushing (1869-1939). The Russian surgeon Nikolai Korotkoff (1874-1920) was the first to apply auscultation of the artery below the cuff (in 1905), a method that allowed determination of diastolic arterial pressure. Riva-Rocci was Chief of Medicine at the municipal hospital in Varese from 1900 to 1928, where he developed a special interest in paediatrics. PMID:23328024
Grollman, A
The vapor pressures of dog's blood and blood plasma were determined at 37.5 degrees by the dynamic method and the osmotic pressures calculated from the experimental data. The vapor pressures calculated from experimentally determined freezing point data agreed, within the experimental error, with the values obtained from direct measurement. The vapor pressure lowering produced by the colloid constituents of the blood was also determined and found to be minimal compared to that of the other constituents. PMID:19872415
Automated high pressure cell for pressure jump x-ray diffraction
Brooks, Nicholas J.; Gauthe, Beatrice L. L. E.; Templer, Richard H.; Ces, Oscar; Seddon, John M.; Terrill, Nick J.; Rogers, Sarah E.
A high pressure cell for small and wide-angle x-ray diffraction measurements of soft condensed matter samples has been developed, incorporating a fully automated pressure generating network. The system allows both static and pressure jump measurements in the range of 0.1-500 MPa. Pressure jumps can be performed as quickly as 5 ms, both with increasing and decreasing pressures. Pressure is generated by a motorized high pressure pump, and the system is controlled remotely via a graphical user interface to allow operation by a broad user base, many of whom may have little previous experience of high pressure technology. Samples are loaded through a dedicated port allowing the x-ray windows to remain in place throughout an experiment; this facilitates accurate subtraction of background scattering. The system has been designed specifically for use at beamline I22 at the Diamond Light Source, United Kingdom, and has been fully integrated with the I22 beamline control systems.
Predicting Out-of-Office Blood Pressure in the Clinic (PROOF-BP)
Stevens, Richard; Gill, Paramjit; Martin, Una; Godwin, Marshall; Hanley, Janet; Heneghan, Carl; Hobbs, F.D. Richard; Mant, Jonathan; McKinstry, Brian; Myers, Martin; Nunan, David; Ward, Alison; Williams, Bryan; McManus, Richard J.
Patients often have lower (white coat effect) or higher (masked effect) ambulatory/home blood pressure readings compared with clinic measurements, resulting in misdiagnosis of hypertension. The present study assessed whether blood pressure and patient characteristics from a single clinic visit can accurately predict the difference between ambulatory/home and clinic blood pressure readings (the home–clinic difference). A linear regression model predicting the home–clinic blood pressure difference was derived in 2 data sets measuring automated clinic and ambulatory/home blood pressure (n=991) using candidate predictors identified from a literature review. The model was validated in 4 further data sets (n=1172) using area under the receiver operator characteristic curve analysis. A masked effect was associated with male sex, a positive clinic blood pressure change (difference between consecutive measurements during a single visit), and a diagnosis of hypertension. Increasing age, clinic blood pressure level, and pulse pressure were associated with a white coat effect. The model showed good calibration across data sets (Pearson correlation, 0.48–0.80) and performed well-predicting ambulatory hypertension (area under the receiver operator characteristic curve, 0.75; 95% confidence interval, 0.72–0.79 [systolic]; 0.87; 0.85–0.89 [diastolic]). Used as a triaging tool for ambulatory monitoring, the model improved classification of a patient's blood pressure status compared with other guideline recommended approaches (93% [92% to 95%] classified correctly; United States, 73% [70% to 75%]; Canada, 74% [71% to 77%]; United Kingdom, 78% [76% to 81%]). This study demonstrates that patient characteristics from a single clinic visit can accurately predict a patient's ambulatory blood pressure. Usage of this prediction tool for triaging of ambulatory monitoring could result in more accurate diagnosis of hypertension and hence more appropriate treatment. PMID:27001299
Design of an automated algorithm for labeling cardiac blood pool in gated SPECT images of radiolabeled red blood cells
Hebert, T.J. |; Moore, W.H.; Dhekne, R.D.; Ford, P.V.; Wendt, J.A.; Murphy, P.H.; Ting, Y.
The design of an automated computer algorithm for labeling the cardiac blood pool within gated 3-D reconstructions of the radiolabeled red blood cells is investigated. Due to patient functional abnormalities, limited resolution, and noise, certain spatial and temporal features of the cardiac blood pool that one would anticipate finding in every study are not present in certain frames or with certain patients. The labeling of the cardiac blood pool requires an algorithm that only relies upon features present in all patients. The authors investigate the design of a fully-automated region growing algorithm for this purpose.
Sodium intake and blood pressure in children.
Hanevold, Coral D
Elevation of blood pressure (BP) and the risk for progression to hypertension (HTN) is of increasing concern in children and adolescents. Indeed, it is increasingly recognized that target organ injury may begin with even low levels of BP elevation. Sodium intake has long been recognized as a modifiable risk factor for HTN. While it seems clear that sodium impacts BP in children, its effects may be enhanced by other factors including obesity and increasing age. Evidence from animal and human studies indicates that sodium may have adverse consequences on the cardiovascular system independent of HTN. Thus, moderation of sodium intake over a lifetime may reduce risk for cardiovascular morbidity in adulthood. An appetite for salt is acquired, and intake beyond our need is almost universal. Considering that eating habits in childhood have been shown to track into adulthood, modest sodium intake should be advocated as part of a healthy lifestyle. PMID:23949320
How to measure blood pressure manually.
Rushton, Melanie; Smith, Joyce
Rationale and key points This article aims to help nurses to measure blood pressure (BP) manually using an aneroid sphygmomanometer. ▶ BP measurement is an essential clinical skill, and nurses must be competent in performing this procedure and taking accurate readings. ▶ Nurses should be aware of manual BP measurement techniques and understand the patient and environmental factors that may result in inaccurate readings that could compromise patient care. ▶ Nurses should regularly undertake manual BP measurement to ensure they remain competent to perform the procedure. Reflective activity Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. Further learning needs to extend your professional development. Subscribers can upload their reflective accounts at: rcni.com/portfolio . PMID:26786460
Dysregulated Blood Pressure: Can Regulating Emotions Help?
Trudel-Fitzgerald, Claudia; Gilsanz, Paola; Mittleman, Murray A; Kubzansky, Laura D
Despite having identified key physiological and behavioral risk factors, the prevalence of hypertension continues to rise, affecting two thirds of American adults 60 years or older. An important condition in its own right, hypertension is also a leading risk factor for cardiovascular diseases; thus, identifying additional modifiable determinants remains a public health priority. Psychological states and negative emotions more specifically have been proposed as risk factors, but the research findings are inconsistent. Additional prospective studies have recently been published increasing the availability of longitudinal data. The aim of this literature review is to evaluate these findings focusing on those from the last 3 years. We synthesize current research on whether negative (e.g., depression, anxiety) or positive (e.g., optimism) emotion-related factors are associated with high blood pressure onset. We discuss discrepant findings and propose considering emotion regulation as a novel approach to explain inconsistencies. Finally, we provide thoughts on future research directions. PMID:26520446
Comparisons of automated blood pressures in a primary health care setting with self-measurements at the office and at home using the Omron i-C10 device
Al-Karkhi, Isam; Al-Rubaiy, Raad; Rosenqvist, Ulf; Falk, Magnus
Objective We aimed to compare blood pressure (BP) levels recorded using the semiautomatic oscillometric Omron i-C10 BP device in patients with or without hypertension in three different settings: (a) when used by a doctor or a nurse at the office (OBP); (b) when used for self-measurement by the patient at the office (SMOBP); and (c) when used for 7 consecutive days at home (HBP). Materials and methods A total of 247 individuals were invited to participate, but 78 of these individuals declined and a further seven were excluded, leaving a final cohort of 162 participants. Results The mean OBP was higher than HBP (difference 8.1±14/3.1±8.8 mmHg, P<0.0001) and so was SMOBP compared with HBP (difference 7.0±13/4.2±7.3 mmHg, P<0.0001). Sixteen participants (9.9%) had at least 10 mmHg higher systolic SMOBP than OBP and 28 (17%) participants had at least 10 mmHg lower systolic SMOBP than OBP. Participants who were current smokers had a larger mean difference between systolic OBP and SMOBP than nonsmokers (OBP−SMOBP in smokers: 6.6±9.4 mmHg, OBP−SMOBP in nonsmokers: 0.5±9.2 mmHg, P=0.011 between groups). Conclusion Self-measurement of BP in the office does not preclude an increase in BP when levels in the individual patients are compared with HBP using the same equipment. Thus, SMOBP with a semiautomatic device does not lead to a reduction in the white-coat effect in the same manner as fully automatic devices. PMID:25341027
Blood Pressure: Return of the Sympathetics?
Joyner, Michael J; Limberg, Jacqueline K
This brief review highlights new ideas about the role of the sympathetic nervous system in human blood pressure regulation. We emphasize how this role varies with age and sex and use our findings to raise questions about the sympathetic nervous system and hypertension in humans. We also focus on three additional areas, including (1) novel ideas about the carotid body and sympathoexcitation as it relates to hypertension, (2) clinical trials of renal denervation that attempted to treat hypertension by reducing ongoing sympathoexcitation, and (3) new ideas about resistant hypertension and cerebral blood flow. We further highlight that success of device-based therapy to modulate the sympathetic nervous system relies heavily on patient selection. Furthermore, data suggest that the majority of patients respond to anti-hypertensive therapy and the major cause of "resistant" hypertension is poor patient adherence. While the enthusiasm for device therapy or perhaps even "precision medicine" is high, it is likely that by far the most benefit to the most patients will occur via better screening, more aggressive therapy, and the development of strategies that improve patient adherence to medication regimens and lifestyle changes. PMID:26743069
Reproducibility of ambulatory blood pressure load.
Zachariah, P K; Sheps, S G; Bailey, K R; Wiltgen, C M; Moore, A G
Twenty-two hypertensive patients were monitored during two separate drug-free occasions with a Del Mar Avionics ambulatory device. Blood pressure loads (percentage of systolic and diastolic readings more than 140 and 90 mmHg, respectively) and mean BP were measured both to determine their reproducibility and to examine how they correlate with each other. The systolic and diastolic mean awake BPs for day 1 and day 2 were 140/93 mmHg and 140/91 mmHg, respectively, and BP loads were 45%/55% and 43%/54%. Moreover, mean BP loads correlated highly (r = 0.93) with mean BP values taken on the same day. Both ambulatory mean SBP and BP load were highly reproducible (r = 0.87 and 0.80, respectively, during the awake hours), and mean DBP and load were fairly reproducible (r = 0.59 and 0.39, respectively, during the awake hours). Clinically, however, both were consistent from day 1 to day 2. Mean and individual standard deviations also were reproducible for both systolic and diastolic pressures and loads. PMID:2096203
A novel SCFA receptor, the microbiota, and blood pressure regulation
Pluznick, Jennifer
The maintenance of blood pressure homeostasis is a complex process which is carefully regulated by a variety of inputs. We recently identified two sensory receptors (Olfactory receptor 78 and G protein couple receptor 41) as novel regulators of blood pressure. Both Olfr78 and Gpr41 are receptors for short chain fatty acids (SCFAs), and we showed that propionate (a SCFA) modifies blood pressure in a manner which is differentially modulated by the absence of either Olfr78 or Gpr41. In addition, propionate modifies renin release in an Olfr78-dependent manner. Our study also demonstrated that antibiotic treatment modulates blood pressure in Olfr78 null mice, indicating that SCFAs produced by the gut microbiota likely influence blood pressure regulation. In this addendum, we summarize the findings of our recent study and provide a perspective on the implications of the interactions between the gut microbiota and blood pressure control. PMID:24429443
Announcement: National High Blood Pressure Education Month - May 2016.
May is National High Blood Pressure Education Month. High blood pressure (hypertension) is a major contributor to heart disease and stroke, two leading causes of death in the United States.* High blood pressure affects one third of U.S. adults, or approximately 75 million persons, yet approximately 11 million of these persons are not aware they have hypertension, and approximately 18 million are not being treated (unpublished data) (1,2). PMID:27227822
[Student diagnostic vignette. How to measure office blood pressure].
Krzesinski, J-M; Saint-Remy, A
Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of error in the estimation of the true blood pressure level. Accuracy of such measure is, however, of paramount importance to be useful in daily medical practice. This methodology paper more specifically written for medical students recalls the essential principles of blood pressure measurement at the medical office, but also at home. PMID:23115851
Blood pressure and social class in a Jamaican community.
Dressler, W W; Grell, G A; Gallagher, P N; Viteri, F E
A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females. PMID:3369609
[Usefulness for detection of inappropriate blood pressure variability using 'wearable blood pressure sensor'].
Iijima, Katsuya
In the clinical settings, it has frequently seen that the elderly have rapid blood pressure (BP) elevation and decline, leading to such as orthostatic disorders and post-urination syncope. Excessive blood pressure variability (BPV) according to aging leads to aggravation of hypertensive target organ damage due to both disturbed baroreflex function and arterial stiffening. We developed continuous BP monitoring sensor using newly developing device 'wearable BP sensor', as our advantageous approach of without a cuff-stress. The new mobile device could reflect continuous beat-to-beat systolic BP, heart rate(HR), these very close changes and double product(sBPX HR) as a major indicator of cardiac lead, in consistent with cuff-based BP value. Our new challenge using this device might approach to the potential to achieve the quality-up of treatment strategy with consideration for very short-term BPV. PMID:26619673
High Blood Pressure and Kidney Disease
... in the urine. A urine albumin-to-creatinine ratio above 30 mg/g may be a sign of kidney disease. Blood Test A blood test involves having blood drawn at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. A health care provider may order a blood ...
Methods for assessing blood pressure values in humans.
Mancia, G
In clinical medicine and epidemiology, measurements of blood pressure largely rely upon the use of cuff inflation and Korotkoff sounds. Although still the most practical, this method has been recognized to have important limitations. This paper focuses on two limitations of the cuff method that have been found while recording 24-hour intraarterial blood pressure in free-living normotensive and hypertensive patients. First, the 24-hour blood pressure is characterized by large long- and short-term variabilities whose magnitudes vary according to the patient's basal blood pressure and age. This is likely to reduce the possibility that a few isolated cuff measurements are accurate and representative of the patient's average blood pressure. Second, during cuff blood pressure assessment by the doctor (and to a lesser degree by the nurse), the patient's blood pressure normally rises due to an alarm reaction, with a large peak within the first 4 minutes and a subsequent decline. The magnitude of the peak rise, as well as its large and unpredictable difference among subjects may be responsible for seriously and variably overestimating the blood pressure. A 10-minute wait from the beginning of the doctor's visit usually avoids this inconvenience. Finally, the paper briefly considers alternative methods to the cuff method, including invasive intraarterial 24-hour recording in ambulatory subjects, which provides a large amount of information but is impractical, and noninvasive automatic blood pressure devices, which offer a promising practical approach but must wait for technical validation. PMID:6629462
A new method of non-invasive blood pressure measurement
NASA Astrophysics Data System (ADS)
Gu, Liangling; Yang, Yongming; Yu, Chengbo; Guo, Qiaohui; Zhu, Gang
Blood pressure reflects a person's health.It is proposed here that the method of detecting blood pressure may be the key to improving the precision of blood pressure measurements. The oscillometric blood pressure measurement technique is widely used in automatic blood pressure measurement instruments correctly. A method of blood pressure measurement by oscillometric method is first presented. In the oscillometric method, the basic principle of the "feature point" method and the "amplitude characteristic ratios" method is also explained and discussed here. A new method of blood pressure measurement, namely the coefficient difference comparative method, is proposed here,which is based on the feature point method and amplitude characteristic ratios method. The method is proved both effective and reliable through the analysis of many cases and clinical tests. Utilizing Visual C++, software for this new and novel method was developed and passed criterion simulation apparatus test. When applied in hospital situation, its error was +/-5%. It is concluded that the oscillometric blood pressure measurement method can provide better means of blood pressure measurements reference for doctors.
Augmented blood pressure measurement through the noninvasive estimation of physiological arterial pressure variability.
Soueidan, Karen; Chen, Silu; Dajani, Hilmi R; Bolic, Miodrag; Groza, Voicu
Current noninvasive blood pressure (BP) measurement methods, such as the oscillometric method, estimate the systolic and diastolic blood pressure (SBP and DBP) at two random instants in time and do not take into account the natural variability in BP. The standard for automated BP devices sets a maximum allowable system error of ±5 mmHg, even though natural BP variability often exceeds these limits. This paper proposes a new approach using simultaneous recordings of the oscillometric and continuous arterial pulse waveforms to augment the conventional noninvasive measurement by providing (1) the mean SBP and DBP over the measurement interval and the associated confidence intervals of the mean, (2) the standard deviation of SBP and DBP over the measurement interval, which indicates the degree of fluctuation in BP and (3) an indicator as to whether or not the oscillometric reading is an outlier. Recordings with healthy subjects demonstrate the potential utility of this approach to characterize BP, to detect outlier measurements, and that it does not suffer from bias relative to the conventional oscillometric method. PMID:22551623
Gastric emptying, postprandial blood pressure, glycaemia and splanchnic flow in Parkinson's disease
Trahair, Laurence G; Kimber, Thomas E; Flabouris, Katerina; Horowitz, Michael; Jones, Karen L
AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in Parkinson's disease. METHODS: Twenty-one subjects (13 M, 8 F; age 64.2 ± 1.6 years) with mild to moderate Parkinson's disease (Hoehn and Yahr score 1.4 ± 0.1, duration of known disease 6.3 ± 0.9 years) consumed a 75 g glucose drink, labelled with 20 MBq 99mTc-calcium phytate. Gastric emptying was quantified with scintigraphy, blood pressure and heart rate with an automated device, superior mesenteric artery blood flow by Doppler ultrasonography and blood glucose by glucometer for 180 min. Autonomic nerve function was evaluated with cardiovascular reflex tests and upper gastrointestinal symptoms by questionnaire. RESULTS: The mean gastric half-emptying time was 106 ± 9.1 min, gastric emptying was abnormally delayed in 3 subjects (14%). Systolic and diastolic blood pressure fell (P < 0.001) and mesenteric blood flow and blood glucose (P < 0.001 for both) increased, following the drink. Three subjects (14%) had definite autonomic neuropathy and 8 (38%) had postprandial hypotension. There were no significant relationships between changes in blood pressure, heart rate or mesenteric artery blood flow with gastric emptying. Gastric emptying was related to the score for autonomic nerve function (R = 0.55, P < 0.01). There was an inverse relationship between the blood glucose at t = 30 min (R = -0.52, P < 0.05), while the blood glucose at t = 180 min was related directly (R = 0.49, P < 0.05), with gastric emptying. CONCLUSION: In mild to moderate Parkinson's disease, gastric emptying is related to autonomic dysfunction and a determinant of the glycaemic response to oral glucose. PMID:27239112
Does Schumann resonance affect our blood pressure?
Mitsutake, G.; Otsuka, K.; Hayakawa, M.; Sekiguchi, M.; Cornélissen, G.; Halberg, F.
Objectives To investigate whether Schumann resonance (SR) affects blood pressure (BP), heart rate (HR), and depression and, if so, whether the putative BP reactivity to SR (BPR-SR) is associated with health-related lifestyle (HLS), disease-related illnesses (DRI), and depression. Methods A sample of 56 adults in Urausu, Hokkaido, Japan, wore an ambulatory BP monitor, except for the time in the shower, for seven consecutive days. They completed the Geriatric Depression Scale-Short Form and a health survey questionnaire on HLS and DRI. Group mean differences and within-individual differences in systolic (S) and diastolic (D) BP, mean arterial pressure (MAP), double product (DP), and HR were, respectively, compared between normal and enhanced SR days, using Student's t-test. Correlations between BPR-SR and other characteristics (i.e. age, gender, HLS, DRI, subjective health, and depression) were analyzed, using Pearson's product moment correlation. Results and discussion Group mean SBP, DBP, MAP, and DP for enhanced SR days were lower than those for normal days (P = 0.005-0.036). DRI was negatively associated with BPR-SR in SBP, DBP, MAP, and DP (P = 0.003-0.024), suggesting a better health status for those who showed lower BP on enhanced SR days. HLS was negatively associated with BPR-SR in DBP and MAP (P = 0.016-0.029). Males showed higher BPR-SR in DBP and MAP than females (P = 0.0044-0.016). Neither subjective health nor depression was significantly associated with BPR-SR. Future studies based on larger sample sizes are planned to see whether possible health effects can be generalized. PMID:16275477
Optic Nerve Head Blood Flow Response to Reduced Ocular Perfusion Pressure by alteration of either the Blood Pressure or Intraocular Pressure
Wang, Lin; Cull, Grant A; Fortune, Brad
Purpose To test the hypothesis that blood flow autoregulation in the optic nerve head has less reserve to maintain normal blood flow in the face of blood pressure-induced ocular perfusion pressure decrease than a similar magnitude intraocular pressure-induced ocular perfusion pressure decrease. Materials and Methods Twelve normal nonhuman primates were anesthetized by continuous intravenous infusion of pentobarbital. Optic nerve blood flow was monitored by laser speckle flowgraphy. In the first group of animals (n=6), the experimental eye intraocular pressure was maintained at 10 mmHg using a saline reservoir connected to the anterior chamber. The blood pressure was gradually reduced by a slow injection of pentobarbital. In the second group (n=6), the intraocular pressure was slowly increased from 10 mmHg to 50 mmHg by raising the reservoir. In both experimental groups, optic nerve head blood flow was measured continuously. The blood pressure and intraocular pressure were simultaneously recorded in all experiments. Results The optic nerve head blood flow showed significant difference between the two groups (P = 0.021, repeat measures analysis of variance). It declined significantly more in the blood pressure group compared to the intraocular pressure group when the ocular perfusion pressure was reduced to 35 mmHg (P<0.045) and below. There was also a significant interaction between blood flow changes and the ocular perfusion pressure treatment (P=0.004, adjusted Greenhouse & Geisser univariate test), indicating the gradually enlarged blood flow difference between the two groups was due to the ocular perfusion pressure decrease. Conclusions The results show that optic nerve head blood flow is more susceptible to an ocular perfusion pressure decrease induced by lowering the blood pressure compared with that induced by increasing the intraocular pressure. This blood flow autoregulation capacity vulnerability to low blood pressure may provide experimental evidence
[Effect of lipril on the level of blood pressure in rats with spontaneus blood hypertention].
Zahorodnyĭ, M I
The author studied influence of Ukrainian antyhypertensive drug--Lipril (Uzynopryl) on the level of blood pressure in rats with spontaneus blood hypertention. It was sound that daily (during 90 days) application of Lipril at 10 mg/kg per os decreases considerably blood pressure in rats. PMID:17682519
[Management of blood pressure for stroke prevention].
Tanahashi, Norio
Hypertension is a major risk factor for both cerebral infarction and intracerebral hemorrhage. The relationship between blood pressure (BP) and stroke risk is strong and continuous. Throughout the usual range of BPs, including the nonhypertensive range, the higher the BP is, the greater the risk of stroke. Regular BP screening and appropriate treatment of patients with hypertension, including life style modification and pharmacotherapy, are recommended. Patients who have hypertension should be treated with antihypertensive drugs to a target BP of < 140/90 mmHg. Successful reduction of BP is more important in reducing stroke risk than the choice of a specific agent, and treatment should be individualized on the basis of other patient characteristics and medication tolerance. In hypertensive patients with stroke, subjects to be treated with antihypertensive drugs and the target level of BP control are determined on the basis of clinical disease type, interval after onset, severity, age, and the use of antithrombotic. drugs. According to the guideline of the Japanese Society of Hypertension (JSH 2014), in the chronic phase of cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage, target BP should be < 140/ 90 mmHg. In patients with lacunar infarction, those taking antithrombotic drugs, cerebral hemorrhage and subarachnoid hemorrhage, a lower level, < 130/80 mmHg should be targeted if possible. Oral antihypertensive drugs such as Ca channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diuretics are recommended for patients with stroke. PMID:27333760
Blood Pressure Management in Intracerebral Hemorrhage.
Mohammad, Yousef; Qureshi, Adnan
Intracerebral hemorrhage (ICH) is associated with devastating outcomes. Admission to the intensive care unit has been the only proven course to improve outcomes. All other treatment modalities have failed so far. The majority of patients presenting with ICH have an elevated blood pressure (BP). Initial data on the safety and efficacy of BP treatment in acute ICH have been conflicting. This has led to large prospective and randomized clinical trials to assess the safety and efficacy of early BP lowering in acute ICH. These trials showed safety and a tendency toward improved functional outcomes. In fact, the results of three subsequent meta-analyses also showed safety and possible efficacy of early lowering of BP in ICH. Based on the results of the published clinical trials and meta-analyses, the American Heart Association and the European Stroke Association concluded that early intensive treatment of BP in acute ICH is safe and might improve functional outcome. The authors advocate that-pending additional data from ongoing trials-health care professionals should maintain the SBp < 140 mm Hg in patients presenting with acute ICH. PMID:27214702
Does nicotinic acid (niacin) lower blood pressure?
Bays, H E; Rader, D J
Nicotinic acid (niacin) is a well-established treatment for dyslipidaemia - an important cardiovascular disease (CVD) risk factor. However, niacin may also reduce blood pressure (BP), which is another important CVD risk factor. This review examines the limited publicly available data on niacin's BP effects. Acute administration of immediate-release niacin may lower BP because of niacin's acute vasodilatory effects. Although not always supported by clinical trial data, the package insert of a prescription, extended-release niacin describes niacin-induced acute hypotension. From a chronic standpoint, larger studies, such as the Coronary Drug Project, suggest that niacin may lower BP when administered over a longer period of time. Post hoc analyses of some of the more recent niacin clinical trials also support a more chronic, dose-dependent, BP-lowering effect of niacin. Because laropiprant [a prostaglandin D(2) (PGD(2)) type 1 (DP1) receptor antagonist] does not attenuate niacin's BP-lowering effects, it is unlikely that any chronic lowering of BP by niacin is due to dilation of dermal vessels through activation of the DP1 receptor by PGD(2.) Further research is warranted to evaluate the extent and mechanisms of niacin's effects on BP. PMID:19054161
Predicting increased blood pressure using machine learning.
Golino, Hudson Fernandes; Amaral, Liliany Souza de Brito; Duarte, Stenio Fernando Pimentel; Gomes, Cristiano Mauro Assis; Soares, Telma de Jesus; Dos Reis, Luciana Araujo; Santos, Joselito
The present study investigates the prediction of increased blood pressure by body mass index (BMI), waist (WC) and hip circumference (HC), and waist hip ratio (WHR) using a machine learning technique named classification tree. Data were collected from 400 college students (56.3% women) from 16 to 63 years old. Fifteen trees were calculated in the training group for each sex, using different numbers and combinations of predictors. The result shows that for women BMI, WC, and WHR are the combination that produces the best prediction, since it has the lowest deviance (87.42), misclassification (.19), and the higher pseudo R (2) (.43). This model presented a sensitivity of 80.86% and specificity of 81.22% in the training set and, respectively, 45.65% and 65.15% in the test sample. For men BMI, WC, HC, and WHC showed the best prediction with the lowest deviance (57.25), misclassification (.16), and the higher pseudo R (2) (.46). This model had a sensitivity of 72% and specificity of 86.25% in the training set and, respectively, 58.38% and 69.70% in the test set. Finally, the result from the classification tree analysis was compared with traditional logistic regression, indicating that the former outperformed the latter in terms of predictive power. PMID:24669313
Blood pressure and mortality: using offspring blood pressure as an instrument for own blood pressure in the HUNT study
Wade, Kaitlin H; Carslake, David; Ivar Nilsen, Tom; Timpson, Nicholas J; Davey Smith, George; Romundstad, Pål
Given that observational associations may be inaccurate, we used offspring blood pressure (BP) to provide alternative estimates of the associations between own BP and mortality. Observational associations between BP and mortality, estimated as hazard ratios (HRs) from Cox regression, were compared to HRs obtained using offspring BP as an instrumental variable (IV) for own BP (N = 32,227 mother-offspring and 27,535 father-offspring pairs). Observationally, there were positive associations between own BP and mortality from all-causes, cardiovascular disease (CVD), coronary heart disease (CHD), stroke and diabetes. Point estimates of the associations between BP and mortality from all-causes, CVD and CHD were amplified in magnitude when using offspring BP as an IV. For example, the HR for all-cause mortality per standard deviation (SD) increase in own systolic BP (SBP) obtained in conventional observational analyses increased from 1.10 (95% CI: 1.09–1.12; P < 0.0001) to 1.31 (95% CI: 1.19–1.43; P < 0.0001). Additionally, SBP was positively associated with diabetes and cancer mortality (HRs: 2.00; 95% CI: 1.12–3.35; P = 0.02 and 1.20; 95% CI: 1.02–1.42; P = 0.03, respectively), and diastolic BP (DBP) with stroke mortality (HR: 1.30; 95% CI: 1.02–1.66; P = 0.03). Results support positive associations between BP and mortality from all-causes, CVD, and CHD, SBP on cancer mortality, and DBP on stroke mortality. PMID:26198310
Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans
Song, Bo Mi; Shim, Jee-Seon; Lee, Myung Ha; Choi, Dong Phil
Background and Objectives We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. Subjects and Methods A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. Results The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. Conclusion Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure. PMID:27275174
Prenatal Air Pollution Exposure and Newborn Blood Pressure
Rifas-Shiman, Sheryl L.; Melly, Steven J.; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Mittleman, Murray A.; Oken, Emily; Gillman, Matthew W.; Koutrakis, Petros; Gold, Diane R.
Background Air pollution exposure has been associated with increased blood pressure in adults. Objective: We examined associations of antenatal exposure to ambient air pollution with newborn systolic blood pressure (SBP). Methods: We studied 1,131 mother–infant pairs in a Boston, Massachusetts, area pre-birth cohort. We calculated average exposures by trimester and during the 2 to 90 days before birth for temporally resolved fine particulate matter (≤ 2.5 μm; PM2.5), black carbon (BC), nitrogen oxides, nitrogen dioxide, ozone (O3), and carbon monoxide measured at stationary monitoring sites, and for spatiotemporally resolved estimates of PM2.5 and BC at the residence level. We measured SBP at a mean age of 30 ± 18 hr with an automated device. We used mixed-effects models to examine associations between air pollutant exposures and SBP, taking into account measurement circumstances; child's birth weight; mother's age, race/ethnicity, socioeconomic position, and third-trimester BP; and time trend. Estimates represent differences in SBP associated with an interquartile range (IQR) increase in each pollutant. Results: Higher mean PM2.5 and BC exposures during the third trimester were associated with higher SBP (e.g., 1.0 mmHg; 95% CI: 0.1, 1.8 for a 0.32-μg/m3 increase in mean 90-day residential BC). In contrast, O3 was negatively associated with SBP (e.g., –2.3 mmHg; 95% CI: –4.4, –0.2 for a 13.5-ppb increase during the 90 days before birth). Conclusions: Exposures to PM2.5 and BC in late pregnancy were positively associated with newborn SBP, whereas O3 was negatively associated with SBP. Longitudinal follow-up will enable us to assess the implications of these findings for health during later childhood and adulthood. Citation: van Rossem L, Rifas-Shiman SL, Melly SJ, Kloog I, Luttmann-Gibson H, Zanobetti A, Coull BA, Schwartz JD, Mittleman MA, Oken E, Gillman MW, Koutrakis P, Gold DR. 2015. Prenatal air pollution exposure and newborn blood pressure
The role of ambulatory blood pressure monitoring in clinical practice.
Zanchetti, A
The introduction of noninvasive techniques for the repetitive measurement of blood pressure in ambulant subjects has permitted improved precision in the assessment of hypertension during normal daily life. The traditional clinic (or "office") method of blood pressure measurement has the advantages of simplicity and low cost, and forms the basis of the current operational definitions of hypertension, but it is limited by the normal variability of blood pressure and the "white coat effect." By contrast, ambulatory blood pressure provides information on circadian variations in blood pressure and alterations due to changes in behavior, and may, therefore, be more appropriate for diagnosing hypertension. However, it is important to note that the values used to define normotension and hypertension for clinic blood pressure are not appropriate for ambulatory blood pressure. Recent population studies have proposed that the upper limit for 24-h ambulatory pressure should be 119 to 126/75 to 80 mm Hg, and failure to recognize this may account for at least some cases of "white-coat hypertension." There is increasing evidence that ambulatory blood pressure is more effective than clinic blood pressure in predicting the organ damage associated with hypertension, whereas data from intervention studies indicate that a reduction in ambulatory pressure is correlated with a reduction in left ventricular (LV) mass. Finally, ambulatory blood pressure measurements may provide a number of advantages in the development of antihypertensive therapies: by permitting better identification of trough and peak effects, by confirming that the efficacy of formulations for once-daily dosing is maintained throughout the 24-h period, and by minimizing the placebo effect. PMID:9324116
Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model
Background The oscillometric method of measuring blood pressure with an automated cuff yields valid estimates of mean pressure but questionable estimates of systolic and diastolic pressures. Existing algorithms are sensitive to differences in pulse pressure and artery stiffness. Some are closely guarded trade secrets. Accurate extraction of systolic and diastolic pressures from the envelope of cuff pressure oscillations remains an open problem in biomedical engineering. Methods A new analysis of relevant anatomy, physiology and physics reveals the mechanisms underlying the production of cuff pressure oscillations as well as a way to extract systolic and diastolic pressures from the envelope of oscillations in any individual subject. Stiffness characteristics of the compressed artery segment can be extracted from the envelope shape to create an individualized mathematical model. The model is tested with a matrix of possible systolic and diastolic pressure values, and the minimum least squares difference between observed and predicted envelope functions indicates the best fit choices of systolic and diastolic pressure within the test matrix. Results The model reproduces realistic cuff pressure oscillations. The regression procedure extracts systolic and diastolic pressures accurately in the face of varying pulse pressure and arterial stiffness. The root mean squared error in extracted systolic and diastolic pressures over a range of challenging test scenarios is 0.3 mmHg. Conclusions A new algorithm based on physics and physiology allows accurate extraction of systolic and diastolic pressures from cuff pressure oscillations in a way that can be validated, criticized, and updated in the public domain. PMID:22913792
Multiphasic effects of blood pressure on survival in hemodialysis patients.
Hannedouche, Thierry; Roth, Hubert; Krummel, Thierry; London, Gérard M; Jean, Guillaume; Bouchet, Jean-Louis; Drüeke, Tilman B; Fouque, Denis
Dialysis patients exhibit an inverse, L- or U-shaped association between blood pressure and mortality risk, in contrast to the linear association in the general population. We prospectively studied 9333 hemodialysis patients in France, aiming to analyze associations between predialysis systolic, diastolic, and pulse pressure with all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular endpoints for a median follow-up of 548 days. Blood pressure components were tested against outcomes in time-varying covariate linear and fractional polynomial Cox models. Changes throughout follow-up were analyzed with a joint model including both the time-varying covariate of sequential blood pressure and its slope over time. A U-shaped association of systolic blood pressure was found with all-cause mortality and of both systolic and diastolic blood pressure with cardiovascular mortality. There was an L-shaped association of diastolic blood pressure with all-cause mortality. The lowest hazard ratio of all-cause mortality was observed for a systolic blood pressure of 165 mm Hg, and of cardiovascular mortality for systolic/diastolic pressures of 157/90 mm Hg, substantially higher than currently recommended values for the general population. The 95% lower confidence interval was approximately 135/70 mm Hg. We found no significant correlation for either systolic, diastolic, or pulse pressure with myocardial infarction or nontraumatic amputations, but there were significant positive associations between systolic and pulse pressure with stroke (per 10-mm Hg increase: hazard ratios 1.15, 95% confidence interval 1.07 and 1.23; and 1.20, 1.11 and 1.31, respectively). Thus, whereas high pre-dialysis blood pressure is associated with stroke risk, low pre-dialysis blood pressure may be both harmful and a proxy for comorbid conditions leading to premature death. PMID:27521114
Taking blood pressure: too important to trust to humans?
Vidt, Donald G; Lang, Richard S; Seballos, Raul J; Misra-Hebert, Anita; Campbell, John; Bena, James F
The measurement of blood pressure in the physician's office is subject to a number of observer errors and also to the "white-coat effect." Automatic devices that measure blood pressure without a human observer in the room can eliminate many of these problems. We argue for greater use of these devices in the physician's office. PMID:20889806
High Blood Pressure in Pregnancy - Multiple Languages: MedlinePlus
... Are Here: Home → Multiple Languages → All Health Topics → High Blood Pressure in Pregnancy URL of this page: https://www.nlm.nih. ... V W XYZ List of All Topics All High Blood Pressure in Pregnancy - Multiple Languages To use the sharing features on ...
Even Poorer Nations Not Immune to High Blood Pressure
... 160306.html Even Poorer Nations Not Immune to High Blood Pressure Researchers cite aging populations, diet, inactivity and lack ... 2016 (HealthDay News) -- For the first time ever, high blood pressure rates are higher in low- and middle-income ...
21 CFR 870.1110 - Blood pressure computer.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...
21 CFR 870.1110 - Blood pressure computer.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...
21 CFR 870.1110 - Blood pressure computer.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...
21 CFR 870.1110 - Blood pressure computer.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...
21 CFR 870.1110 - Blood pressure computer.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal...
Social Support, Assimilation and Biological Effective Blood Pressure Levels.
ERIC Educational Resources Information Center
Walsh, Anthony; Walsh, Patricia Ann
The twin processes of migration and assimilation are highly stressful. This stress can be manifested in elevated blood pressure. According to this study, immigrants receiving high levels of social support had significantly lower blood pressure levels than those receiving less social support. (VM)
Blood pressure variability: a novel and important risk factor.
Floras, John S
Blood pressure is a continuous, not a static, variable. Individuals exhibiting similar clinic or home blood pressure can differ considerably with respect to their average day and nighttime values, beat-by-beat blood pressure variation during wakefulness and sleep, responses to mental and physical stimuli, and intersession and seasonal variation. There now is evidence that several such representations of blood pressure variability, if augmented, increase cardiovascular risk independent of the average of conventionally acquired blood pressure readings. As well, recent retrospective analyses of published trial data have concluded that antihypertensive drug classes differ in their effects on intersession blood pressure variability and associated risk of stroke. If the goal of the hypertension community is to optimize personalized cardiovascular risk assessment and to attenuate fully such risk, future efforts should be directed at determining which representation of blood pressure variability estimates individual cardiovascular risk best, establishing "normal" and "high- risk" variability distributions, testing the hypothesis that attenuating such variability specifically through drug or device therapy reduces cardiovascular risk more than blood pressure reduction per se, and integrating such data into clinical practice. PMID:23618505
Peripheral vascular effects on auscultatory blood pressure measurement.
Rabbany, S Y; Drzewiecki, G M; Noordergraaf, A
Experiments were conducted to examine the accuracy of the conventional auscultatory method of blood pressure measurement. The influence of the physiologic state of the vascular system in the forearm distal to the site of Korotkoff sound recording and its impact on the precision of the measured blood pressure is discussed. The peripheral resistance in the arm distal to the cuff was changed noninvasively by heating and cooling effects and by induction of reactive hyperemia. All interventions were preceded by an investigation of their effect on central blood pressure to distinguish local effects from changes in central blood pressure. These interventions were sufficiently moderate to make their effect on central blood pressure, recorded in the other arm, statistically insignificant (i.e., changes in systolic [p < 0.3] and diastolic [p < 0.02]). Nevertheless, such alterations were found to modify the amplitude of the Korotkoff sound, which can manifest itself as an apparent change in arterial blood pressure that is readily discerned by the human ear. The increase in diastolic pressure for the cooling experiments was statistically significant (p < 0.001). Moreover, both measured systolic (p < 0.004) and diastolic (p < 0.001) pressure decreases during the reactive hyperemia experiments were statistically significant. The findings demonstrate that alteration in vascular state generates perplexing changes in blood pressure, hence confirming experimental observations by earlier investigators as well as predictions by our model studies. PMID:8463815
A Ubiquitous Blood Pressure Sensor Worn at the Ear
NASA Astrophysics Data System (ADS)
Koizumi, Hiroshi; Shimada, Junichi; Uenishi, Yuji; Tochikubo, Osamu
Blood pressure (BP) measurement and BP control are important for the prevention of lifestyle diseases, especially hypertension, which can lead to more serious conditions, such as cardiac infarction and cerebral apoplexy. The purpose of our study is to develop a ubiquitous blood pressure sensor that is more comfortable and less disruptive of users' daily activities than conventional blood pressure sensors. Our developed sensor is worn at an ear orifice and measures blood pressure at the tragus. This paper describes the concept, configuration, and the optical and electronic details of the developed ear-worn blood pressure sensor and presents preliminary evaluation results. The developed sensor causes almost no discomfort and produces signals whose quality is high enough for detecting BP at an ear, making it suitable for ubiquitous usage.
Strength training reduces arterial blood pressure but not sympathetic neural activity in young normotensive subjects
NASA Technical Reports Server (NTRS)
Carter, Jason R.; Ray, Chester A.; Downs, Emily M.; Cooke, William H.
The effects of resistance training on arterial blood pressure and muscle sympathetic nerve activity (MSNA) at rest have not been established. Although endurance training is commonly recommended to lower arterial blood pressure, it is not known whether similar adaptations occur with resistance training. Therefore, we tested the hypothesis that whole body resistance training reduces arterial blood pressure at rest, with concomitant reductions in MSNA. Twelve young [21 +/- 0.3 (SE) yr] subjects underwent a program of whole body resistance training 3 days/wk for 8 wk. Resting arterial blood pressure (n = 12; automated sphygmomanometer) and MSNA (n = 8; peroneal nerve microneurography) were measured during a 5-min period of supine rest before and after exercise training. Thirteen additional young (21 +/- 0.8 yr) subjects served as controls. Resistance training significantly increased one-repetition maximum values in all trained muscle groups (P < 0.001), and it significantly decreased systolic (130 +/- 3 to 121 +/- 2 mmHg; P = 0.01), diastolic (69 +/- 3 to 61 +/- 2 mmHg; P = 0.04), and mean (89 +/- 2 to 81 +/- 2 mmHg; P = 0.01) arterial blood pressures at rest. Resistance training did not affect MSNA or heart rate. Arterial blood pressures and MSNA were unchanged, but heart rate increased after 8 wk of relative inactivity for subjects in the control group (61 +/- 2 to 67 +/- 3 beats/min; P = 0.01). These results indicate that whole body resistance exercise training might decrease the risk for development of cardiovascular disease by lowering arterial blood pressure but that reductions of pressure are not coupled to resistance exercise-induced decreases of sympathetic tone.
Exercise blood pressure: clinical relevance and correct measurement.
Sharman, J E; LaGerche, A
Blood pressure (BP) is a mandatory safety measure during graded intensity clinical exercise stress testing. While it is generally accepted that exercise hypotension is a poor prognostic sign linked to severe cardiac dysfunction, recent meta-analysis data also implicate excessive rises in submaximal exercise BP with adverse cardiovascular events and mortality, irrespective of resting BP. Although more data is needed to derive submaximal normative BP thresholds, the association of a hypertensive response to exercise with increased cardiovascular risk may be due to underlying hypertension that has gone unnoticed by conventional resting BP screening methods. Delayed BP decline during recovery is also associated with adverse clinical outcomes. Thus, above and beyond being used as a routine safety measure during stress testing, exercise (and recovery) BP may be useful for identifying high-risk individuals and also as an aid to optimise care through appropriate follow-up after exercise stress testing. Accordingly, careful attention should be paid to correct measurement of exercise stress test BP (before, during and after exercise) using a standardised approach with trained operators and validated BP monitoring equipment (manual or automated). Recommendations for exercise BP measurement based on consolidated international guidelines and expert consensus are presented in this review. PMID:25273859
Strategies to reduce pitfalls in measuring blood pressure.
Badeli, Hamidreza; Assadi, Farahnak
Errors in blood pressure (BP) measurement are common in the clinical practice. Inaccurate measurements of BP may lead to misdiagnosis and inappropriate treatment of hypertension. The preferred method of BP measurement in the clinical setting is auscultation, using the first and the fifth Korotkoff sounds. However, the use of mercury sphygmomanometer is declining. Automated oscillometric devices are an acceptable alternative method of BP measurements if the proper cuff size is used. Aneroid devices are suitable, but they require frequent calibration. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. At 24 h ambulatory monitoring is also useful for diagnosing white-coat hypertension and resistance hypertension. There is increasing evidence that lack of nocturnal BP dipping during the night may be associated with increased cardiovascular event. This report attempts to address the need for accurate BP measurements in children and adolescents by reducing human and equipment errors and providing clinicians with the accurate measurement of BP, which is essential to classify individuals, to ascertain BP-related CV risks and to guide management. PMID:24791186
A Discussion on the Regulation of Blood Flow and Pressure.
Wolff, Christopher B; Collier, David J; Shah, Mussadiq; Saxena, Manish; Brier, Timothy J; Kapil, Vikas; Green, David; Lobo, Melvin
This paper discusses two kinds of regulation essential to the circulatory system: namely the regulation of blood flow and that of (systemic) arterial blood pressure. It is pointed out that blood flow requirements sub-serve the nutritional needs of the tissues, adequately catered for by keeping blood flow sufficient for the individual oxygen needs. Individual tissue oxygen requirements vary between tissue types, while highly specific for a given individual tissue. Hence, blood flows are distributed between multiple tissues, each with a specific optimum relationship between the rate of oxygen delivery (DO2) and oxygen consumption (VO2). Previous work has illustrated that the individual tissue blood flows are adjusted proportionately, where there are variations in metabolic rate and where arterial oxygen content (CaO2) varies. While arterial blood pressure is essential for the provision of a sufficient pressure gradient to drive blood flow, it is applicable throughout the arterial system at any one time. Furthermore, It is regulated independently of the input resistance to individual tissues (local arterioles), since they are regulated locally, that being the means by which the highly specific adequate local requirement for DO2 is ensured. Since total blood flow is the summation of all the individually regulated tissue blood flows cardiac inflow (venous return) amounts to total tissue blood flow and as the heart puts out what it receives cardiac output is therefore determined at the tissues. Hence, regulation of arterial blood pressure is independent of the distributed independent regulation of individual tissues. It is proposed here that mechanical features of arterial blood pressure regulation will depend rather on the balance between blood volume and venous wall tension, determinants of venous pressure. The potential for this explanation is treated in some detail. PMID:26782204
The effects of feedback on blood pressure discrimination.
Cinciripini, P M; Epstein, L H; Martin, J E
Discrimination of blood pressure in the natural environment as a function of feedback was assessed. Seventeen normotensives screened for blood pressure lability were randomly assigned to two groups. These subjects were then asked to estimate their systolic and diastolic blood pressure values two times per day over a 4-week period. Feedback for accuracy of blood pressure discriminations was implemented across the two groups in a multiple baseline fashion, using a feedback withdrawal condition in Group I to assess maintenance effects over time. Results showed improvement in discrimination accuracy for subjects in both groups when feedback was used, and no decrement in performance over a 2-week period after feedback was removed for subjects in Group I. Discrimination of systolic pressures improved at a slightly faster rate than discrimination of diastolic pressures. PMID:511803
Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring: The GUSTO Birth Cohort Study.
Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D; Godfrey, Keith M; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An
Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother-offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00-0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01-0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (-0.03 to 0.13; P = 0.21), 0.03 (-0.04 to 0.10; P = 0.35), and 0.05 (-0
Blood pressure monitoring during exercise: comparison of pulse transit time and volume clamp methods.
Wibmer, Thomas; Denner, Coy; Fischer, Christoph; Schildge, Benedikt; Rüdiger, Stefan; Kropf-Sanchen, Cornelia; Rottbauer, Wolfgang; Schumann, Christian
During physical exercise, pulse transit time (PTT), expressed as the interval between ventricular electrical activity and peripheral pulse wave, may provide a surrogate estimate for blood pressure by the use of specific calibration procedures. The objective of this study was to determine systolic blood pressure (SBP) values derived from the PTT method and from an established method of non-invasive continuous blood pressure measurement based on the volume clamp technique, and to compare their agreement with sphygmomanometry during exercise tests. In 18 subjects, electrocardiogram (ECG) and finger-photoplethysmography were continuously recorded during maximal cycle exercise tests. Intermittent and continuous blood pressure measurements were simultaneously taken using automated sphygmomanometry and a Portapres Model-2 device, respectively. PTT was calculated for each ECG R-wave and the corresponding steepest upstroke slope in the photoplethysmogram, and was transformed to a continuous blood pressure estimate using multipoint nonlinear regression calibration based on the individual subject's sphygmomanometer readings. Bland-Altman limits of agreement between PTT-derived SBP estimates and sphygmomanometer values were -24.7 to 24.1 mmHg, and between Portapres and sphygmomanometer SBP values were -42.0 to 70.1 mmHg. For beat-to-beat SBP estimation during exercise, PTT measurement combined with multipoint nonlinear regression calibration based on intermittent sphygmomanometry may be an alternative to volume clamp devices. PMID:26286887
Ambulatory Blood Pressure Monitoring-Derived Short-Term Blood Pressure Variability in Primary Aldosteronism.
Grillo, Andrea; Bernardi, Stella; Rebellato, Andrea; Fabris, Bruno; Bardelli, Moreno; Burrello, Jacopo; Rabbia, Franco; Veglio, Franco; Fallo, Francesco; Carretta, Renzo
The aim of this study was to investigate the short-term blood pressure (BP) variability (BPV) derived from ambulatory blood pressure monitoring (ABPM) in patients with primary aldosteronism (PA), either idiopathic hyperaldosteronism (IHA) or aldosterone-producing adenoma (APA), in comparison with patients with essential hypertension (EH) and normotensive (NT) controls. Thirty patients with PA (16 with IHA and 14 with APA), 30 patients with EH, and 30 NT controls, matched for sex, age, body mass index, and antihypertensive therapy, were studied. The standard deviation (SD) of 24-hour, daytime, and nighttime BP; 24-hour weighted SD of BP; and 24-hour BP average real variability were not different between patients with PA and those with EH (P=not significant). All BPV indices were higher in patients with PA, either IHA or APA subtypes, and patients with EH, compared with NT controls (P<.001 to P<.05). ABPM-derived short-term BPV is increased in patients with PA, and it may represent an additional cardiovascular risk factor in this disease. The role of aldosterone excess in BPV has to be clarified. PMID:25880017
Effects of tamsulosin on resting urethral pressure and arterial blood pressure in anaesthetized female dogs.
Ohtake, Akiyoshi; Sato, Shuichi; Sasamata, Masao; Miyata, Keiji
The purposes of the present study were to investigate the effects of the alpha1-adrenoceptor antagonists tamsulosin, prazosin and urapidil on resting urethral pressure in anaesthetized female dogs, and to compare the results with their effects on arterial blood pressure. Tamsulosin decreased resting maximal urethral pressure in the urethral pressure profile in a dose-dependent fashion, whereas it had almost no effect on mean arterial blood pressure. Prazosin and urapidil also dose-dependently decreased resting maximal urethral pressure, but these effects were accompanied by decreases in mean arterial blood pressure. Thus, of these three compounds, tamsulosin dose-dependently decreased resting maximal urethral pressure with negligible effect on mean arterial blood pressure in female dogs. These results suggest that tamsulosin will be useful in the treatment of voiding dysfunction associated with bladder outlet obstruction in women, with little hypotensive effect. PMID:16536901
Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease
Schrier, Robert W.; Abebe, Kaleab Z.; Perrone, Ronald D.; Torres, Vicente E.; Braun, William E.; Steinman, Theodore I.; Winklhofer, Franz T.; Brosnahan, Godela; Czarnecki, Peter G.; Hogan, Marie C.; Miskulin, Dana C.; Rahbari-Oskoui, Frederic F.; Grantham, Jared J.; Harris, Peter C.; Flessner, Michael F.; Bae, Kyongtae T.; Moore, Charity G.; Chapman, Arlene B.
BACKGROUND Hypertension is common in autosomal dominant polycystic kidney disease (ADPKD) and is associated with increased total kidney volume, activation of the renin–angiotensin–aldosterone system, and progression of kidney disease. METHODS In this double-blind, placebo-controlled trial, we randomly assigned 558 hypertensive participants with ADPKD (15 to 49 years of age, with an estimated glomerular filtration rate [GFR] >60 ml per minute per 1.73 m2 of body-surface area) to either a standard blood-pressure target (120/70 to 130/80 mm Hg) or a low blood-pressure target (95/60 to 110/75 mm Hg) and to either an angiotensin-converting–enzyme inhibitor (lisinopril) plus an angiotensin-receptor blocker (telmisartan) or lisinopril plus placebo. The primary outcome was the annual percentage change in the total kidney volume. RESULTS The annual percentage increase in total kidney volume was significantly lower in the low-blood-pressure group than in the standard-blood-pressure group (5.6% vs. 6.6%, P = 0.006), without significant differences between the lisinopril–telmisartan group and the lisinopril–placebo group. The rate of change in estimated GFR was similar in the two medication groups, with a negative slope difference in the short term in the low-blood-pressure group as compared with the standard-blood-pressure group (P<0.001) and a marginally positive slope difference in the long term (P = 0.05). The left-ventricular-mass index decreased more in the low-blood-pressure group than in the standard-blood-pressure group (−1.17 vs. −0.57 g per square meter per year, P<0.001); urinary albumin excretion was reduced by 3.77% with the low-pressure target and increased by 2.43% with the standard target (P<0.001). Dizziness and light-headedness were more common in the low-blood-pressure group than in the standard-blood-pressure group (80.7% vs. 69.4%, P = 0.002). CONCLUSIONS In early ADPKD, the combination of lisinopril and telmisartan did not significantly
Influence of genetic variance on sodium sensitivity of blood pressure.
Luft, F C; Miller, J Z; Weinberger, M H; Grim, C E; Daugherty, S A; Christian, J C
To examine the effect of genetic variance on blood pressure, sodium homeostasis, and its regulatory determinants, we studied 37 pairs of monozygotic twins and 18 pairs of dizygotic twins under conditions of volume expansion and contraction. We found that, in addition to blood pressure and body size, sodium excretion in response to provocative maneuvers, glomerular filtration rate, the renin-angiotensin system, and the sympathetic nervous system are influenced by genetic variance. To elucidate the interaction of genetic factors and an environmental influence, namely, salt intake, we restricted dietary sodium in 44 families of twin children. In addition to a modest decrease in blood pressure, we found heterogeneous responses in blood pressure indicative of sodium sensitivity and resistance which were normally distributed. Strong parent-offspring resemblances were found in baseline blood pressures which persisted when adjustments were made for age and weight. Further, mother-offspring resemblances were observed in the change in blood pressure with sodium restriction. We conclude that the control of sodium homeostasis is heritable and that the change in blood pressure with sodium restriction is familial as well. These data speak to the interaction between the genetic susceptibility to hypertension and environmental influences which may result in its expression. PMID:3553721
The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.
Daskalopoulou, Stella S; Rabi, Doreen M; Zarnke, Kelly B; Dasgupta, Kaberi; Nerenberg, Kara; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; McKay, Donald W; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Ramesh Prasad, G V; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Brian Penner, S; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Stone, James A; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Fournier, Anne; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Benoit, Geneviève; Feber, Janusz; Harris, Kevin C; Poirier, Luc; Padwal, Raj S
The Canadian Hypertension Education Program reviews the hypertension literature annually and provides detailed recommendations regarding hypertension diagnosis, assessment, prevention, and treatment. This report provides the updated evidence-based recommendations for 2015. This year, 4 new recommendations were added and 2 existing recommendations were modified. A revised algorithm for the diagnosis of hypertension is presented. Two major changes are proposed: (1) measurement using validated electronic (oscillometric) upper arm devices is preferred over auscultation for accurate office blood pressure measurement; (2) if the visit 1 mean blood pressure is increased but < 180/110 mm Hg, out-of-office blood pressure measurements using ambulatory blood pressure monitoring (preferably) or home blood pressure monitoring should be performed before visit 2 to rule out white coat hypertension, for which pharmacologic treatment is not recommended. A standardized ambulatory blood pressure monitoring protocol and an update on automated office blood pressure are also presented. Several other recommendations on accurate measurement of blood pressure and criteria for diagnosis of hypertension have been reorganized. Two other new recommendations refer to smoking cessation: (1) tobacco use status should be updated regularly and advice to quit smoking should be provided; and (2) advice in combination with pharmacotherapy for smoking cessation should be offered to all smokers. The following recommendations were modified: (1) renal artery stenosis should be primarily managed medically; and (2) renal artery angioplasty and stenting could be considered for patients with renal artery stenosis and complicated, uncontrolled hypertension. The rationale for these recommendation changes is discussed. PMID:25936483
Tobacco exposure, weight status, and elevated blood pressure in adolescents.
Huntington-Moskos, Luz; Turner-Henson, Anne; Rice, Marti
The pathogenesis of hypertension begins in youth. An estimated 4% of US adolescents have diagnosed hypertension and 17% have elevated blood pressures, predisposing them to hypertension and cardiovascular disease (CVD) later in life. There is limited research on the clustering of CVD risk factors such as tobacco exposure and weight status that may be associated with high blood pressure in adolescents. The aim of this exploratory study was to determine the relationships between total smoke exposure (TSE; cigarette smoking and secondhand smoke), waist circumference, and blood pressure in a sample of rural adolescents, ages 15-18. A convenience sample of 148 adolescents ages 15-18 was recruited from two rural high schools (88 female and 60 male, all Caucasian). Adolescents were assessed for tobacco exposure (self-report, salivary cotinine), weight status (body mass index, waist circumference), and blood pressure. Self-report measures of tobacco exposure included the Uptake Continuum and Peer and Family Smoking measure. Age, gender, waist circumference and salivary cotinine contributed to 35% of the variance in systolic blood pressure and 18% in diastolic blood pressure. One-fourth (25%) of adolescent males and 11% of adolescent females had elevated systolic blood pressures. Approximately one-fifth of the sample (22%) had elevated salivary cotinine levels indicative of tobacco use and secondhand smoke exposure. TSE and waist circumference were predictors of elevated blood pressure in adolescents. Public health measures need to address clusters of risk factors including blood pressure, tobacco exposure, and weight status among adolescents in order to reduce CVD. PMID:24519179
Smog Can Make Blood Pressure Soar
... May 31, 2016 (HealthDay News) -- More evidence links air pollution with increased risk of developing dangerous high blood ... term, he noted, a few days of increased air pollution could lead to more emergency hospital visits due ...
Ion channels and the control of blood pressure
Baker, Emma H
Ion channels exist in all cells and are enormously varied in structure, function and regulation. Some progress has been made in understanding the role that ion channels play in the control of blood pressure, but the discipline is still in its infancy. Ion channels provide many different targets for intervention in disorders of blood pressure and exciting advances have been made in this field. It is possible that new drugs, as well as antisense nucleotide technology or gene therapy directed towards ion channels, may form a new class of treatments for high and low blood pressure in the future. PMID:10718773
Goat Meat Does Not Cause Increased Blood Pressure
Sunagawa, Katsunori; Kishi, Tetsuya; Nagai, Ayako; Matsumura, Yuka; Nagamine, Itsuki; Uechi, Shuntoku
While there are persistent rumors that the consumption of goat meat dishes increases blood pressure, there is no scientific evidence to support this. Two experiments were conducted to clarify whether or not blood pressure increases in conjunction with the consumption of goat meat dishes. In experiment 1, 24 Dahl/Iwai rats (15 weeks old, body weight 309.3±11.1 g) were evenly separated into 4 groups. The control group (CP) was fed a diet containing 20% chicken and 0.3% salt on a dry matter basis. The goat meat group (GM) was fed a diet containing 20% goat meat and 0.3% salt. The goat meat/salt group (GS) was fed a diet containing 20% goat meant and 3% to 4% salt. The Okinawan mugwort (Artemisia Princeps Pampan)/salt group (GY) was fed a diet containing 20% goat meat, 3% to 4% salt and 5% of freeze-dried mugwort powder. The experiment 1 ran for a period of 14 weeks during which time the blood pressure of the animals was recorded. The GS, and GY groups consumed significantly more water (p<0.01) than the CP and GM groups despite the fact that their diet consumption levels were similar. The body weight of animals in the CP, GM, and GS groups was similar while the animals in the GY group were significantly smaller (p<0.01). The blood pressure in the GM group was virtually the same as the CP group throughout the course of the experiment. In contrast, while the blood pressure of the animals in the GS and GY group from 15 to 19 weeks old was the same as the CP group, their blood pressures were significantly higher (p<0.01) after 20 weeks of age. The GY group tended to have lower blood pressure than the GS group. In experiment 2, in order to clarify whether or not the increase in blood pressure in the GS group and the GY group in experiment 1 was caused by an excessive intake of salt, the effects on blood pressure of a reduction of salt in diet were investigated. When amount of salt in the diet of the GS and GY group was reduced from 4% to 0.3%, the animal's blood pressure
Specific Blood Pressure Targets for Patients With Diabetic Nephropathy?
Grassi, Guido; Mancia, Giuseppe; Nilsson, Peter M
Diabetic nephropathy represents a condition frequently detected in current clinical practice characterized by a very high cardiovascular risk profile. Blood pressure reduction via antihypertension drug treatment represents a therapeutic approach capable of exerting favorable effects on renal and cardiovascular outcomes. The purpose of this article is to review the current literature and results of key clinical trials pertaining to blood pressure goals of antihypertension treatment in these patients. The pros and cons of a less or a more intensive blood pressure goal in diabetic nephropathy will be discussed, with particular emphasis on the cardiovascular and renal effects of each therapeutic strategy. PMID:27440837
[Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].
Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B
Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly
Orthostatic blood pressure regulation predicts classroom effort in children.
Carapetian, Stephanie; Siedlarz, Monika; Jackson, Sandra; Perlmuter, Lawrence C
The increase in orthostatic systolic blood pressure associated with the shift in posture from lying to standing requires several compensatory mechanisms to ensure adequate cerebral perfusion. Decreased efficiency in the various mechanisms controlling orthostatic blood pressure regulation can result in dizziness, lightheadedness, and syncope. The degree of effectiveness of orthostatic systolic blood pressure regulation (OBPR) serves as a marker for a variety of problems including fatigue, depression, anxiety, reduced attention, impulsive behavior and reduced volition. In normal children, an insufficient increase in systolic blood pressure in response to upright posture is predictive of mild cognitive and affective problems. The present study examined orthostatic systolic blood pressure regulation in relation to yearlong teachers' evaluations of academic grades and effort in 7-11 year old children. Poorer systolic blood pressure regulation in response to orthostasis was associated with reduced levels of classroom effort, while academic grades were spared. Converging evidence from clinical as well as experimental studies suggests that the linkage between (OBPR) and effort may be partially mediated by sympathetic dysfunction, altered release of neurotransmitters, or reduced cerebral blood flow. PMID:18280600
[Current clinical aspects of ambulatory blood pressure monitoring].
Sauza-Sosa, Julio César; Cuéllar-Álvarez, José; Villegas-Herrera, Karla Montserrat; Sierra-Galán, Lilia Mercedes
Systemic arterial hypertension is the prevalentest disease worldwide that significantly increases cardiovascular risk. An early diagnosis together to achieve goals decreases the risk of complications significatly. Recently have been updated the diagnostic criteria for hypertension and the introduction of ambulatory blood pressure monitoring. The introduction into clinical practice of ambulatory blood pressure monitoring was to assist the diagnosis of «white coat hypertension» and «masked hypertension». Today has also shown that ambulatory blood pressure monitoring is better than the traditional method of recording blood pressure in the office, to the diagnosis and to adequate control and adjustment of drug treatment. Also there have been introduced important new concepts such as isloted nocturnal hypertension, morning blood pressure elevation altered and altered patterns of nocturnal dip in blood pressure; which have been associated with increased cardiovascular risk. Several studies have shown significant prognostic value in some stocks. There are still other concepts on which further study is needed to properly establish their introduction to clinical practice as hypertensive load variability, pulse pressure and arterial stiffness. In addition to setting values according to further clinical studies in populations such as elderly and children. PMID:26794338
New Approaches to Evaluating and Monitoring Blood Pressure.
Goldberg, Elizabeth M; Levy, Phillip D
Digital health innovations for hypertension include cuffless blood pressure sensors, wireless smartphone-enabled upper arm blood pressure monitors, mobile applications, and remote monitoring technologies. Wearable trackers have drawn interest from medical professionals and patients alike. They have the potential to improve hypertension control and medication adherence through easier logging of repeated blood pressure measurements, better connectivity with health-care providers, and medication reminder alerts. With increasing emphasis on home and ambulatory blood pressure monitoring to confirm hypertension prior to treatment, such devices also can help improve the diagnostic landscape. However, privacy, accuracy, and cost concerns have prevented widespread clinical uptake. To foster implementation, device designers and clinical researchers should collaborate on development of rigorous clinical trials that test cardiovascular outcomes associated with emerging technologies. We review the current literature on mobile health technologies and novel diagnostic and management protocols and make recommendations on how to incorporate these innovations into practice. PMID:27137524
Racial differences in hypertension: implications for high blood pressure management.
Lackland, Daniel T
The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African Americans with greater risks than Caucasians. Blood pressure levels have consistently been higher for African Americans with an earlier onset of hypertension. Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure. The reasons for the racial disparities in elevated blood pressure and hypertension-related outcomes risk remain unclear. However, the implications of the disparities of hypertension for prevention and clinical management are substantial, identifying African American men and women with excel hypertension risk and warranting interventions focused on these differences. In addition, focused research to identify the factors attributed to these disparities in risk burden is an essential need to address the evidence gaps. PMID:24983758
Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease
Magnussen, Costan G.; Smith, Kylie J.
A high blood pressure level in adults is considered the single most important modifiable risk factor for global disease burden, especially those of cardiovascular (CV) origin such as stroke and ischemic heart disease. Because blood pressure levels have been shown to persist from childhood to adulthood, elevations in pediatric levels have been hypothesized to lead to increased CV burden in adulthood and, as such, might provide a window in the life course where primordial and primary prevention could be focused. In the absence of substantive data directly linking childhood blood pressure levels to overt adult CV disease, this review outlines the available literature that examines the association between pediatric blood pressure and adult preclinical markers of CV disease. PMID:27168729
Dietary Mineral Could Be One Key to Blood Pressure Control
... https://medlineplus.gov/news/fullstory_159836.html Dietary Mineral Could Be One Key to Blood Pressure Control ... 2016 (HealthDay News) -- Sufficient dietary levels of the mineral nutrient magnesium might be a boon to good ...
Treating High Blood Pressure in People with Diabetes
... Audio CME Program Point of Care Searching and Learning Other Opportunities Treating High Blood Pressure in People with Diabetes - English Patient education library Open in new window Download PDF Follow us on Twitter , Facebook , and YouTube Twitter ...
Blood pressure, ethnic group, and salt intake in Belize.
Simmons, D
A total of 1316 individuals were studied in seven villages in Belize, Central America. This represented 92% of the area population aged over 18. Generally, they were members of three ethnic groups--Maya, Spanish, and Creole. The systolic and diastolic IV and V blood pressures were recorded using standardised procedure. Significant differences in blood pressure, weight, and obesity were found between ethnic groups in both sexes, Creoles having higher means than the other groups. Significant relationships with blood pressure were found with obesity, age, and number of children. An early morning urine specimen was obtained from a random 50% of the men, and only in Creoles was there an association between raised blood pressure and sodium/potassium urinary excretion ratio. PMID:6875443
More Support for Aggressive Blood Pressure Treatment for Elderly
... gov/news/fullstory_158851.html More Support for Aggressive Blood Pressure Treatment for Elderly Latest findings from ... SPRINT trial tested that approach against a more aggressive one, aiming to get patients of all ages ...
1 in 4 Medicare Patients Uses Blood Pressure Meds Incorrectly
... page: https://medlineplus.gov/news/fullstory_160930.html 1 in 4 Medicare Patients Uses Blood Pressure Meds ... year in the United States, accounting for about one out of every three deaths, Frieden said. Uncontrolled ...
[Secondary prevention of stroke through arterial blood pressure reduction].
Mancia, G; Grassi, G
Large scale observational studies have conclusively demonstrated that systolic and diastolic blood pressure values are linearly related to the incidence of cerebrovascular diseases and that high blood pressure is an important risk factor for both primary and secondary development of stroke. Interventional studies have shown that blood pressure lowering by antihypertensive treatment reduces the incidence of stroke in hypertensive patients without a history of previous stroke. Whether this is the case also for the secondary prevention of cerebral ischemic attacks has not been unequivocally shown, however. The PROGRESS ("Perindopril Protection Against Recurrent Stroke Study") study has been designed and is under way to collect information on this important issue of the antihypertensive treatment, its purpose being to evaluate the blood pressure lowering effects with an ACE-inhibitor on recurrent stroke in an overall population of 6000 patients with a positive history of previous cerebral ischemic attacks or stroke. PMID:9340173
Variability of arterial blood pressure in normal and hypertensive pregnancy.
Oney, T; Meyer-Sabellek, W
In normal pregnancy the circadian blood pressure rhythm is similar to that in the non-pregnant state, with the highest blood pressure values in the morning and the lowest at midnight. This rhythm is lost in patients with pre-eclampsia. Women with severe pre-eclampsia show a reversed circadian rhythm, with a nocturnal increase in blood pressure during the sleeping phase. Although the reasons for this nocturnal hypertension in severe pre-eclampsia are poorly understood, the results suggest that pre-eclamptic women are endangered by hypertensive emergencies, mostly at night. Therefore blood pressure measurement should be extended to the night, and antihypertensive treatment must be adapted to the demands of a reversed circadian rhythm in relevant subgroups of patients. PMID:2082002
Effect of overtime work on 24-hour ambulatory blood pressure.
Hayashi, T; Kobayashi, Y; Yamaoka, K; Yano, E
Recently, the adverse effects of long working hours on the cardiovascular systems of workers in Japan, including "Karoshi" (death from overwork), have been the focus of social concern. However, conventional methods of health checkups are often unable to detect the early signs of such adverse effects. To evaluate the influence of overtime work on the cardiovascular system, we compared 24-hour blood pressure measurements among several groups of male white-collar workers. As a result, for those with normal blood pressure and those with mild hypertension, the 24-hour average blood pressure of the overtime groups was higher than that of the control groups; for those who periodically did overtime work, the 24-hour average blood pressure and heart rate during the busy period increased. These results indicate that the burden on the cardiovascular system of white-collar workers increases with overtime work. PMID:8899576
Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry
Kang, In Sook; Shin, Jinho; Ihm, Sang-Hyun; Kim, Ju Han; Park, Sungha; Kim, Kwang-Il; Kim, Woo-Shik; Kim, Soon Gil; Shin, Gil Ja
Background and Objectives Blood pressure variability (BPV) was recently shown to be a risk factor of stroke. White coat hypertension (WCH) used to be regarded as innocuous, but one long-term follow-up study reported that WCH increased stroke rate compared to normotension (NT). In this study, we aimed to evaluate the relationship between WCH and BPV. Subjects and Methods We analyzed 1398 subjects from the Korean Ambulatory Blood Pressure Registry, who were divided into NT (n=364), masked hypertension (n=122), white coat hypertension (n=254), and sustained hypertension (n=658) groups. Results Baseline characteristics were similar among groups. The average real variability (ARV), a highly sensitive BPV parameter, was highest in the WCH group, followed by the sustained hypertension, masked hypertension, and NT groups. The results persisted after being adjusted for covariates. The WCH vs. sustained hypertension results (adjusted mean±standard error) were as follows: 24-h systolic ARV, 22.9±0.8 vs. 19.4±0.6; 24-h diastolic ARV, 16.8±0.6 vs. 14.3±0.5; daytime systolic ARV, 21.8±0.8 vs. 16.8±0.6; and daytime diastolic ARV, 16.2±0.6 vs. 13.4±0.5 (p<0.001 for all comparisons). Conclusion From the registry data, we found that subjects with WCH or masked hypertension had higher BPV than NT. However, long-term follow-up data assessing the clinical influences of WCH on stroke are needed.
Gene Silencing and Haploinsufficiency of Csk Increase Blood Pressure
Kim, Sung-Moon; Ji, Su-Min; Park, So-Yon; Kim, Marina E.; Jigden, Baigalmaa; Lim, Ji Eun; Hwang, Sue-Yun; Lee, Young-Ho; Oh, Bermseok
Objective Recent genome-wide association studies have identified 33 human genetic loci that influence blood pressure. The 15q24 locus is one such locus that has been confirmed in Asians and Europeans. There are 21 genes in the locus within a 1-Mb boundary, but a functional link of these genes to blood pressure has not been reported. We aimed to identify a causative gene for blood pressure change in the 15q24 locus. Methods and Results CSK and ULK3 were selected as candidate genes based on eQTL analysis studies that showed the association between gene transcript levels and the lead SNP (rs1378942). Injection of siRNAs for mouse homologs Csk, Ulk3, and Cyp1a2 (negative control) showed reduced target gene mRNA levels in vivo. However, Csk siRNA only increased blood pressure while Ulk3 and Cyp1a2 siRNA did not change it. Further, blood pressure in Csk+/- heterozygotes was higher than in wild-type, consistent with what we observed in Csk siRNA-injected mice. We confirmed that haploinsufficiency of Csk increased the active form of Src in Csk+/- mice aorta. We also showed that inhibition of Src by PP2, a Src inhibitor decreased high blood pressure in Csk+/- mice and the active Src in Csk+/- mice aorta and in Csk knock-down vascular smooth muscle cells, suggesting blood pressure regulation by Csk through Src. Conclusions Our study demonstrates that Csk is a causative gene in the 15q24 locus and regulates blood pressure through Src, and these findings provide a novel therapeutic target for the treatment of hypertension. PMID:26751575
Socioeconomic Status Modifies the Seasonal Effect on Blood Pressure
Cois, Annibale; Ehrlich, Rodney
Abstract Seasonal variations in blood pressure have been consistently reported. However, uncertainty remains about the size of the seasonal effect in different regions, and about factors that explain the differences observed across and within populations. Using data from a national panel study, we investigated seasonal variations in blood pressure in the South African adult population, and whether these variations differed across socioeconomic strata. We estimated age-specific seasonal effects on blood pressure using a multilevel structural equation model, with repeated measurements nested within subjects. Effect modification by socioeconomic status was assessed by repeating the analyses in the subpopulations defined by levels of education, household income per capita, and type of housing. In men and women, season had a statistically significant effect on blood pressure, with higher levels in winter and lower levels in summer. For systolic blood pressure, the magnitude of the seasonal effect was 4.25/4.21 mmHg (women/men) and was higher in the older age groups. For diastolic blood pressure, the effect size was 4.00/4.01 mmHg, with no evident age trend. Seasonal effects were higher among subjects in the lowest socioeconomic classes than in the highest, with differences between 2.4 and 7.7 mmHg, depending on gender, whether systolic or diastolic blood pressure, and socioeconomic status indicator. In the South African adult population, blood pressure shows seasonal variation modified by age and socioeconomic status. These variations have epidemiological, clinical, and public health implications, including the prospect of population level intervention to reduce elevated risk of cold weather cardiovascular morbidity. PMID:26334893
What Is High Blood Pressure Medicine?
... Use a medicine calendar. • Set a reminder on your smartphone. What types of drugs are there? • D IURETICS rid the ... by heart Lifestyle + Risk Reduction High Blood ... types may cause side effects. Tell your doctor if you have side effects, but don' ...
Can hibiscus tea lower blood pressure
Technology Transfer Automated Retrieval System (TEKTRAN)
Hibiscus sabdariffa is a common ingredient found in blended herbal teas, and beverages made from the dried calyces of this plant are popular worldwide. In vitro studies have shown that H. sabdariffa has antioxidant properties and, in animal models of hypertension, extracts of this plant lower blood ...
Effect on blood pressure of daily lemon ingestion and walking.
Kato, Yoji; Domoto, Tokio; Hiramitsu, Masanori; Katagiri, Takao; Sato, Kimiko; Miyake, Yukiko; Aoi, Satomi; Ishihara, Katsuhide; Ikeda, Hiromi; Umei, Namiko; Takigawa, Atsusi; Harada, Toshihide
Background. Recent studies suggest that the daily intake of lemon (Citrus limon) has a good effect on health, but this has not been confirmed in humans. In our previous studies, it was observed that people who are conscious of their health performed more lemon intake and exercise. An analysis that took this into account was required. Methodology. For 101 middle-aged women in an island area in Hiroshima, Japan, a record of lemon ingestion efforts and the number of steps walked was carried out for five months. The change rates (Δ%) of the physical measurements, blood test, blood pressure, and pulse wave measured value during the observation period were calculated, and correlations with lemon intake and the number of steps walked were considered. As a result, it was suggested that daily lemon intake and walking are effective for high blood pressure because both showed significant negative correlation to systolic blood pressure Δ%. Conclusions. As a result of multiple linear regression analysis, it was possible that lemon ingestion is involved more greatly with the blood citric acid concentration Δ% and the number of steps with blood pressure Δ%, and it was surmised that the number of steps and lemon ingestion are related to blood pressure improvement by different action mechanisms. PMID:24818015
Short Term Effects of Cocoa Consumption on Blood Pressure
Alleyne, T; Alleyne, A; Arrindell, D; Balleram, N; Cozier, D; Haywood, R; Humphrey, C; Pran, L; Rampersad, K; Reyes, D; Bahall, S; Holder, R; Ignacio, D
Hypertension, defined as diastolic pressure ≥ 90 mmHg and systolic pressure ≥ 140 mmHg, is a major cause of morbidity and mortality among black populations globally. Several studies have shown that prolonged consumption of cocoa or cocoa containing products leads to decreased blood pressure (BP) in hypertensives. In this study, we investigated the flavonoid content of the top selling cocoa/cocoa based products in Trinidad and Tobago and attempted to determine if consumption of cocoa had any immediate impact on blood pressure levels. The flavonoid content of three 100% cocoa powder products and four cocoa-based formulas was measured using a modified Folin-Ciocalteu procedure. The brand with the highest flavonoid content, 372 gallic acid equivalents, was selected to evaluate the short-term impact of cocoa consumption on blood pressure. Thirty-six participants comprising nineteen hypertensives and seventeen persons with normal blood pressure had their blood pressure recorded on three separate days using ambulatory blood pressure monitors; the blood pressure was recorded every half hour for eight hours. On the first day, the participants received no intervention but on the second and third days, they received either the intervention (5 g cocoa in 125 ml water) or a placebo, in any order. Statistical analysis conducted using t-test statistic and a 95% confidence interval revealed that whether participants regularly took antihypertensive medication or not, a single intervention of cocoa induced decreases in both the diastolic and systolic BPs that were significant (p = 0.0001). Mean decreases of between 8 mmHg and 18 mmHg were observed. PMID:25429467
Blood pressure and the perception of illusive pain.
Scheuren, Raymonde; Duschek, Stefan; Schulz, André; Sütterlin, Stefan; Anton, Fernand
Numerous studies have documented an inverse relationship between blood pressure and sensitivity to experimental nociceptive stimulation. The present study aimed to investigate possible associations between blood pressure and the occurrence and intensity of paradoxical pain induced by the thermal grill paradigm. Thirty-one healthy subjects were stimulated three times for 1 min with the nonnoxious temperatures of 15°C and 41°C set at the interlaced cold and warm bars of a water bath-driven thermal grill. Blood pressure and heart rate were recorded concomitantly. On account of previous observations of an association between the sensitivity of the cardiac baroreflex and pain perception, this parameter was additionally obtained. Numerical rating scales were used to quantify subjective pain intensity and pain unpleasantness; subjects were classified as responders and nonresponders to thermal grill stimulation based on pain intensity ratings. Responders exhibited lower systolic and diastolic blood pressure than nonresponders, and inverse linear associations arose between blood pressure and pain intensity and unpleasantness. Baroreflex sensitivity was unrelated to pain ratings. The findings confirmed the hypothesis of a blood pressure dependence of paradoxical pain and support the notion that the cardiovascular and pain regulatory systems interact not only in the processing of pain elicited by noxious input, but also in nonnoxiously generated illusive pain. While this finding is not consistent with the assumption of an involvement of the baroreflex system in mediating the observed interaction, psychological traits and neurochemical factors are alternatively considered. PMID:27079150
Techniques for estimating blood pressure variation using video images.
Sugita, Norihiro; Obara, Kazuma; Yoshizawa, Makoto; Abe, Makoto; Tanaka, Akira; Homma, Noriyasu
It is important to know about a sudden blood pressure change that occurs in everyday life and may pose a danger to human health. However, monitoring the blood pressure variation in daily life is difficult because a bulky and expensive sensor is needed to measure the blood pressure continuously. In this study, a new non-contact method is proposed to estimate the blood pressure variation using video images. In this method, the pulse propagation time difference or instantaneous phase difference is calculated between two pulse waves obtained from different parts of a subject's body captured by a video camera. The forehead, left cheek, and right hand are selected as regions to obtain pulse waves. Both the pulse propagation time difference and instantaneous phase difference were calculated from the video images of 20 healthy subjects performing the Valsalva maneuver. These indices are considered to have a negative correlation with the blood pressure variation because they approximate the pulse transit time obtained from a photoplethysmograph. However, the experimental results showed that the correlation coefficients between the blood pressure and the proposed indices were approximately 0.6 for the pulse wave obtained from the right hand. This result is considered to be due to the difference in the transmission depth into the skin between the green and infrared light used as light sources for the video image and conventional photoplethysmogram, respectively. In addition, the difference in the innervation of the face and hand may be related to the results. PMID:26737225
Perceived stress and blood pressure in early adolescent children.
Caputo, J L; Gill, D L; Tseh, W; Jamurtas, A Z; Morgan, D W
The objective of this investigation was to determine the individual contributions of perceived daily, major, and total stressors to blood pressure in early adolescent children. Toward this goal, cardiovascular risk factors were assessed in 74 6th-grade students. Height and body weight, measured in standard fashion, were used to calculate body mass index (BMI). Waist and hip circumferences and triceps and calf skinfolds were taken to determine the distribution and percentage of body fat, respectively. Seated resting blood pressure was obtained using a mercury sphygmomanometer. The dietary sodium-to-potassium ratio was calculated from a food intake questionnaire. Family history of hypertension was self-reported by participant's parents, and physical activity and perceived stress levels were determined by questionnaire. When added to the hierarchical regression models, the perceived stress variables did not significantly predict any additional variance in systolic or diastolic blood pressure in this early adolescent sample. Additionally, bivariate correlations between the stress variables and blood pressure were nonsignificant. The nonpsychological hypertension risk factors accounted for 25%-35% of the total variance in systolic and diastolic blood pressure. Further, regression analyses revealed that with the exception of BMI and the sodium-to-potassium ratio, no other risk factors were independent predictors of systolic or diastolic blood pressure. Further identification and understanding of environmental precursors of childhood hypertension is recommended. PMID:10892530
Optic Nerve Head Blood Flow Autoregulation during Changes in Arterial Blood Pressure in Healthy Young Subjects
Boltz, Agnes; Told, Reinhard; Napora, Katarzyna J.; Palkovits, Stefan; Werkmeister, René M.; Schmidl, Doreen; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold
Aim In the present study the response of optic nerve head blood flow to an increase in ocular perfusion pressure during isometric exercise was studied. Based on our previous studies we hypothesized that subjects with an abnormal blood flow response, defined as a decrease in blood flow of more than 10% during or after isometric exercise, could be identified. Methods A total of 40 healthy subjects were included in this study. Three periods of isometric exercise were scheduled, each consisting of 2 minutes of handgripping. Optic nerve head blood flow was measured continuously before, during and after handgripping using laser Doppler flowmetry. Blood pressure was measured non-invasively in one-minute intervals. Intraocular pressure was measured at the beginning and the end of the measurements and ocular perfusion pressure was calculated as 2/3*mean arterial pressure –intraocular pressure. Results Isometric exercise was associated with an increase in ocular perfusion pressure during all handgripping periods (p < 0.001). By contrast no change in optic nerve head blood flow was seen. However, in a subgroup of three subjects blood flow showed a consistent decrease of more than 10% during isometric exercise although their blood pressure values increased. In addition, three other subjects showed a consistent decline of blood flow of more than 10% during the recovery periods. Conclusion Our data confirm previous results indicating that optic nerve head blood flow is autoregulated during an increase in perfusion pressure. In addition, we observed a subgroup of 6 subjects (15%) that showed an abnormal response, which is in keeping with our previous data. The mechanisms underlying this abnormal response remain to be shown. PMID:24324774
Quiz: Does Your Blood Pressure Pass the Test? | NIH MedlinePlus the Magazine
... please turn Javascript on. Special Section: Healthy Blood Pressure Quiz: Does Your Blood Pressure Pass the Test? Past Issues / Winter 2010 Table of Contents Blood pressure changes throughout the day. It is highest while ...
Treatment: Types of Blood Pressure Medications | NIH MedlinePlus the Magazine
... page please turn Javascript on. Feature: High Blood Pressure Treatment: Types of Blood Pressure Medications Past Issues / Fall 2011 Table of Contents Treatment: Types of Blood Pressure Medications Here's a rundown on the main types ...
"Keep the Beat" Healthy Blood Pressure Helps Prevent Heart Disease | NIH MedlinePlus the Magazine
... Javascript on. Special Section: Healthy Blood Pressure "Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease ... Contents Your blood pressure rises and falls during the day. But when it stays elevated over time, ...
Treatment: Types of Blood Pressure Medications | NIH MedlinePlus the Magazine
... please turn Javascript on. Feature: High Blood Pressure Treatment: Types of Blood Pressure Medications Past Issues / Fall 2011 Table of Contents Treatment: Types of Blood Pressure Medications Here's a rundown ...
More Young Adults at Risk for High Blood Pressure | NIH MedlinePlus the Magazine
... Feature: High Blood Pressure More Young Adults at Risk for High Blood Pressure Past Issues / Fall 2011 ... high blood pressure. NIH-funded analysis indicates higher risk for young adults than previously believed. With more ...
21 CFR 870.1130 - Noninvasive blood pressure measurement system.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... three pressures can be derived through the use of tranducers placed on the surface of the body....
21 CFR 870.1130 - Noninvasive blood pressure measurement system.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... three pressures can be derived through the use of tranducers placed on the surface of the body....
21 CFR 870.1130 - Noninvasive blood pressure measurement system.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... three pressures can be derived through the use of tranducers placed on the surface of the body....
21 CFR 870.1130 - Noninvasive blood pressure measurement system.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Noninvasive blood pressure measurement system. 870.1130 Section 870.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... three pressures can be derived through the use of tranducers placed on the surface of the body....
Anger Expression and Blood Pressure in Adolescents
ERIC Educational Resources Information Center
Starner, Tamie M.; Peters, Rosalind M.
The clinical significance of childhood hypertension is important as elevated pressures during childhood are found to follow a progressively increasing track into adulthood. Little work has been done to examine the relationship of emotions and emotional behavioral factors to the development of hypertension in children. Using the Roy Adaptation…
Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Hypertension
Executive Summary Objective The objective of this health technology assessment was to determine the clinical effectiveness and cost-effectiveness of 24-hour ambulatory blood pressure monitoring (ABPM) for hypertension. Clinical Need: Condition and Target Population Hypertension occurs when either systolic blood pressure, the pressure in the artery when the heart contracts, or diastolic blood pressure, the pressure in the artery when the heart relaxes between beats, are consistently high. Blood pressure (BP) that is consistently more than 140/90 mmHg (systolic/diastolic) is considered high. A lower threshold, greater than 130/80 mmHg (systolic/diastolic), is set for individuals with diabetes or chronic kidney disease. In 2006 and 2007, the age-standardized incidence rate of diagnosed hypertension in Canada was 25.8 per 1,000 (450,000 individuals were newly diagnosed). During the same time period, 22.7% of adult Canadians were living with diagnosed hypertension. A smaller proportion of Canadians are unaware they have hypertension; therefore, the estimated number of Canadians affected by this disease may be higher. Diagnosis and management of hypertension are important, since elevated BP levels are related to the risk of cardiovascular disease, including stroke. In Canada in 2003, the costs to the health care system related to the diagnosis, treatment, and management of hypertension were over $2.3 billion (Cdn). Technology The 24-hour ABPM device consists of a standard inflatable cuff attached to a small computer weighing about 500 grams, which is worn over the shoulder or on a belt. The technology is noninvasive and fully automated. The device takes BP measurements every 15 to 30 minutes over a 24-to 28-hour time period, thus providing extended, continuous BP recordings even during a patient's normal daily activities. Information on the multiple BP measurements can be downloaded to a computer. The main detection methods used by the device are auscultation and
Anharmonic analysis of arterial blood pressure and flow pulses.
Voltairas, P A; Fotiadis, D I; Massalas, C V; Michalis, L K
Fourier analysis is usually employed for the computation of blood flow in arteries. Although the orthogonality of Fourier eigenfunctions guarantees the accurate mathematical modeling of the blood pressure and flow waveforms, the physics behind this objective function is frequently missing. We propose a new method to account for the blood pressure and flow, single-cycle (systole-diastole) waveforms. It is based on the one dimensional hydrodynamic mass and momentum conservation equations for viscous flow. The similarity of the linear problem, under discussion, with related transmission line theory in electromagnetic wave propagation, permits expansion in anharmonic, non-separable eigenfunctions. In some cases one term in the expansion is adequate to fit the main peak of the observed waveforms. Analytical formulas are derived for the dependence of the pressure and flow main peaks on whole blood viscosity and distance from the heart, which interpret observations related to hypertension. PMID:15922753
Recommendations for blood pressure measuring devices for office/clinic use in low resource settings.
Parati, Gianfranco; Mendis, Shanthi; Abegunde, Dele; Asmar, Ronald; Mieke, Stephan; Murray, Alan; Shengelia, Bakuti; Steenvoorden, Gijs; Van Montfrans, Gert; O'Brien, Eoin
This paper, which summarizes the conclusions of a WHO Expert meeting, is aimed at proposing indications to develop technical specifications for an accurate and affordable blood pressure measuring device for office/clinic use in low resource settings. Blood pressure measuring devices to be used in low resource settings should be accurate, affordable, and easily available worldwide. Given the serious inherent inaccuracy of the auscultatory technique, validated and affordable electronic devices, that have the option to select manual readings, seem to be a suitable solution for low resource settings. The agreement on the technical specifications for automated blood pressure measuring devices for office/clinic use in low resource settings included the following features: high accuracy, adoption of electronic transducers and solar batteries for power supply, standard rates of cuff inflation and deflation, adequate cuff size, digital display powered by solar batteries, facilities for adequate calibration, environmental requirements, no need of memory function, resistance to shock and temperature changes, and low cost. Availability of a device with these features should be accompanied by adequate training of health care personnel, who should guarantee implementation of the procedures recommended in recent European and American Guidelines for accurate blood pressure measurement. PMID:15687867
Predicting Out-of-Office Blood Pressure in the Clinic (PROOF-BP): Derivation and Validation of a Tool to Improve the Accuracy of Blood Pressure Measurement in Clinical Practice.
Sheppard, James P; Stevens, Richard; Gill, Paramjit; Martin, Una; Godwin, Marshall; Hanley, Janet; Heneghan, Carl; Hobbs, F D Richard; Mant, Jonathan; McKinstry, Brian; Myers, Martin; Nunan, David; Ward, Alison; Williams, Bryan; McManus, Richard J
Patients often have lower (white coat effect) or higher (masked effect) ambulatory/home blood pressure readings compared with clinic measurements, resulting in misdiagnosis of hypertension. The present study assessed whether blood pressure and patient characteristics from a single clinic visit can accurately predict the difference between ambulatory/home and clinic blood pressure readings (the home-clinic difference). A linear regression model predicting the home-clinic blood pressure difference was derived in 2 data sets measuring automated clinic and ambulatory/home blood pressure (n=991) using candidate predictors identified from a literature review. The model was validated in 4 further data sets (n=1172) using area under the receiver operator characteristic curve analysis. A masked effect was associated with male sex, a positive clinic blood pressure change (difference between consecutive measurements during a single visit), and a diagnosis of hypertension. Increasing age, clinic blood pressure level, and pulse pressure were associated with a white coat effect. The model showed good calibration across data sets (Pearson correlation, 0.48-0.80) and performed well-predicting ambulatory hypertension (area under the receiver operator characteristic curve, 0.75; 95% confidence interval, 0.72-0.79 [systolic]; 0.87; 0.85-0.89 [diastolic]). Used as a triaging tool for ambulatory monitoring, the model improved classification of a patient's blood pressure status compared with other guideline recommended approaches (93% [92% to 95%] classified correctly; United States, 73% [70% to 75%]; Canada, 74% [71% to 77%]; United Kingdom, 78% [76% to 81%]). This study demonstrates that patient characteristics from a single clinic visit can accurately predict a patient's ambulatory blood pressure. Usage of this prediction tool for triaging of ambulatory monitoring could result in more accurate diagnosis of hypertension and hence more appropriate treatment. PMID:27001299
Automated tester permits precise calibration of pressure transducers from 0 to 1050 psi
NASA Technical Reports Server (NTRS)
Brinda, J.; Kristoff, L.; Shaw, J.; Vuckovich, M.
Automated portable checker allows last-minute calibration of pressure transducers before testing. It uses a pressure console and equipment that can produce test pressures of 0-1050 psi. The console can be connected to other apparatus for measurement and visual display of the electrical output.
Continuous and less invasive central hemodynamic monitoring by blood pressure waveform analysis
Xu, Da
Blood pressure waveform analysis may permit continuous (i.e., automated) and less invasive (i.e., safer and simpler) central hemodynamic monitoring in the intensive care unit and other clinical settings without requiring any instrumentation beyond what is already in use or available. This practical approach has been a topic of intense investigation for decades and may garner even more interest henceforth due to the evolving demographics as well as recent trends in clinical hemodynamic monitoring. Here, we review techniques that have appeared in the literature for mathematically estimating clinically significant central hemodynamic variables, such as cardiac output, from different blood pressure waveforms. We begin by providing the rationale for pursuing such techniques. We then summarize earlier techniques and thereafter overview recent techniques by our collaborators and us in greater depth while pinpointing both their strengths and weaknesses. We conclude with suggestions for future research directions in the field and a description of some potential clinical applications of the techniques. PMID:20622106
Relationship of blood lead levels to blood pressure in exhaust battery storage workers.
Fenga, Concettina; Cacciola, Anna; Martino, Lucia Barbaro; Calderaro, Santina Ricciardo; Di Nola, Carmelina; Verzera, Aurelio; Trimarchi, Giuseppe; Germanò, Domenico
Several researches has focused the hypothesis that low blood lead levels could be associated with an increased risk of hypertension. To assess the relation between occupational lead exposure and elevated blood pressure a group of 27 workers, age range from 27 to 62 years, mean (SD) 36.52 (+/- 8.16) yr; length of employment mean (DS) 2.97 (+/- 1.67) yr, were recruited as study subjects. The following variables were measured: blood lead concentration (BPb), delta-Aminolevulinic Acid Dehydratase (ALAD) activity, Zinc Protoporphirin (ZPP), creatinine, hematocrit, Body Mass Index (BMI) and Systolic Blood Pressure (SBP) and Diastolic Blood (DBP) Pressure. The results showed that long term occupational exposure was related to a slight increase of systolic and diastolic blood pressure among workers who had been exposed to higher level of lead with respect to workers exposed to lower level of lead. Furthermore, blood lead concentration (BPb) and ZPP resulted higher among workers exposed to higher level of ambient lead, while in the same group of workers ALAD activity resulted more inhibited. The authors concluded long term cumulative lead exposure can significantly increase blood pressure in low level Pb exposed workers. PMID:16716009
Verapamil buffering effect on the abrupt elevation in blood pressure, linkage with microcirculatory blood flow.
Gmitrov, J
1 We studied the effects of verapamil on sudden elevation in blood pressure, microcirculation and arterial baroreflex sensitivity (BRS). 2 Thirty experiments (10 controls and 20 with verapamil) were performed in rabbits sedated using pentobarbital infusion (5 mg kg(-1) h(-1)). 3 BRS, mean femoral artery blood pressure (MAP), heart rate (HR) and ear lobe skin microcirculatory blood flow, estimated using microphotoelectric plethysmography (MPPG), were simultaneously measured during 30 min of verapamil infusion (20 mug kg(-1) min(-1)). BRS was assessed from HR and MAP responses to intravenous phenylephrine (Ph) and by power spectral analysis using transfer function (TF) from MAP to the HR (BRS(Ph,TF)). 4 Verapamil significantly increased microcirculatory blood flow, and decreased BRS(Ph,TF) and phenylephrine-induced abrupt elevation in MAP (MAP(AE)). 5 A significant inverse correlation was found between verapamil-induced changes in MAP(AE), BRS and in microcirculatory blood flow, measured before phenylephrine blood pressure ramps (DeltaMAP(AE) with DeltaBRS(TF), r = -0.47, P < 0.036; DeltaMAP(AE) with DeltaMPPG, r = -0.49, P < 0.025). 6 These results suggest involvement of the arterial baroreflex and vascular blood pressure-buffering mechanisms, their enhancement by verapamil, and thus a potential benefit of verapamil in cardiovascular conditions where patients present with abrupt high elevations in blood pressure. PMID:18598288
Ethnic Differences in Physical Fitness, Blood Pressure and Blood Chemistry in Women (AGES 20-63)
NASA Technical Reports Server (NTRS)
Ayers, G. W.; Wier, L. T.; Jackson, A. S.; Stuteville, J. E.; Keptra, Sean (Technical Monitor)
This study examined the role of ethnicity on the aerobic fitness, blood pressure, and selected blood chemistry values of women. One hundred twenty-four females (mean age 41.37 +/- 9.0) were medically Examined at the NASA/Johnson Space Center occupational health clinic. Ethnic groups consisted of 23 Black (B), 18 Hispanic (H) and 83 Non-minority (NM). Each woman had a maximum Bruce treadmill stress test (RER greater than or = 1.1) and a negative ECG. Indirect calorimetry, skinfolds, self-report physical activity (NASA activity scale), seated blood pressure, and blood chemistry panel determined VO2max, percent fat, level of physical activity, blood pressure and blood chemistry values. ANOVA revealed that the groups did not differ (p greater than 0.05) in age, VO2 max, weight, percent fat, level of physical activity, total cholesterol, or HDL-C. However, significant differences (p greater than 0.05) were noted in BMI, diastolic blood pressure, and blood chemistries. BMI was 3.17 higher in H than in NM; resting diastolic pressures were 5.69 and 8.05 mmHg. lower in NM and H than in B; triglycerides were 48.07 and 37.21 mg/dl higher in H than in B and NM; hemoglobin was .814 gm/dl higher in NM than B; fasting blood sugar was 15.41 mg/dl higher in H than NM; The results of this study showed that ethnic groups differed in blood pressure and blood chemistry values but not aerobic fitness or physical activity. There was an ethnic difference in BMI but not percent fat.
Blood-Pressure Measuring System Gives Accurate Graphic Output
NASA Technical Reports Server (NTRS)
The problem: To develop an instrument that will provide an external (indirect) measurement of arterial blood pressure in the form of an easily interpreted graphic trace that can be correlated with standard clinical blood-pressure measurements. From sphygmograms produced by conventional sphygmographs, it is very difficult to differentiate the systolic and diastolic blood-pressure pulses and to correlate these indices with the standard clinical values. It is nearly impossible to determine these indices when the subject is under physical or emotional stress. The solution: An electronic blood-pressure system, basically similar to conventional ausculatory sphygmomanometers, employing a standard occluding cuff, a gas-pressure source, and a gas-pressure regulator and valve. An electrical output transducer senses cuff pressure, and a microphone positioned on the brachial artery under the occluding cuff monitors the Korotkoff sounds from this artery. The output signals present the conventional systolic and diastolic indices in a clear, graphical display. The complete system also includes an electronic timer and cycle-control circuit.
Development of a simulator for the validation of noninvasive blood pressure-monitoring devices.
Doh, Il; Lim, Hyun Kyoon; Ahn, Bongyoung
This research aimed to develop a simulator capable of oscillometric pressure pulses recorded from the participants for the validation of oscillometric noninvasive blood pressure (NIBP) devices. The simulator generates the pressure pulses to the cuff connected to NIBP devices depending on the oscillometric waveforms obtained from the participants. Device readings were compared with auscultatory references (systolic and diastolic blood pressures) of the participants. A total of 94 oscillometric waveforms from participants were used in the simulator for the validation of two automated NIBP devices (Omron HEM-7221 and UA-787Plus). For Omron HEM-7221, the differences between device readings and auscultation references for systolic and diastolic blood pressures were 2.82±7.27 and -4.74±6.73 mmHg, respectively. UA-787Plus showed differences of 3.26±5.69 and -3.53±6.61 mmHg, respectively. Although the number of individual measurements did not fulfill the ISO 81060-2 requirement for clinical validation, criterion 1, where the average of the difference and SD should be lower than ±5 and -8 mmHg, was fulfilled. Although the simulator still needs extensive comparative studies to be verified, it could be a potential candidate for a simple and robust tool for the validation and quality control of NIBP devices. PMID:26745850
Blood Pressure over Height Ratios: Simple and Accurate Method of Detecting Elevated Blood Pressure in Children.
Galescu, Ovidiu; George, Minu; Basetty, Sudhakar; Predescu, Iuliana; Mongia, Anil; Ten, Svetlana; Bhangoo, Amrit
Background. Blood pressure (BP) percentiles in childhood are assessed according to age, gender, and height. Objective. To create a simple BP/height ratio for both systolic BP (SBP) and diastolic BP (DBP). To study the relationship between BP/height ratios and corresponding BP percentiles in children. Methods. We analyzed data on height and BP from 2006-2007 NHANES data. BP percentiles were calculated for 3775 children. Receiver-operating characteristic (ROC) curve analyses were performed to calculate sensitivity and specificity of BP/height ratios as diagnostic tests for elevated BP (>90%). Correlation analysis was performed between BP percentiles and BP/height ratios. Results. The average age was 12.54 ± 2.67 years. SBP/height and DBP/height ratios strongly correlated with SBP & DBP percentiles in both boys (P < 0.001, R(2) = 0.85, R(2) = 0.86) and girls (P < 0.001, R(2) = 0.85, R(2) = 0.90). The cutoffs of SBP/height and DBP/height ratios in boys were ≥0.75 and ≥0.46, respectively; in girls the ratios were ≥0.75 and ≥0.48, respectively with sensitivity and specificity in range of 83-100%. Conclusion. BP/height ratios are simple with high sensitivity and specificity to detect elevated BP in children. These ratios can be easily used in routine medical care of children. PMID:22577400
Blood Pressure over Height Ratios: Simple and Accurate Method of Detecting Elevated Blood Pressure in Children
Galescu, Ovidiu; George, Minu; Basetty, Sudhakar; Predescu, Iuliana; Mongia, Anil; Ten, Svetlana; Bhangoo, Amrit
Background. Blood pressure (BP) percentiles in childhood are assessed according to age, gender, and height. Objective. To create a simple BP/height ratio for both systolic BP (SBP) and diastolic BP (DBP). To study the relationship between BP/height ratios and corresponding BP percentiles in children. Methods. We analyzed data on height and BP from 2006-2007 NHANES data. BP percentiles were calculated for 3775 children. Receiver-operating characteristic (ROC) curve analyses were performed to calculate sensitivity and specificity of BP/height ratios as diagnostic tests for elevated BP (>90%). Correlation analysis was performed between BP percentiles and BP/height ratios. Results. The average age was 12.54 ± 2.67 years. SBP/height and DBP/height ratios strongly correlated with SBP & DBP percentiles in both boys (P < 0.001, R2 = 0.85, R2 = 0.86) and girls (P < 0.001, R2 = 0.85, R2 = 0.90). The cutoffs of SBP/height and DBP/height ratios in boys were ≥0.75 and ≥0.46, respectively; in girls the ratios were ≥0.75 and ≥0.48, respectively with sensitivity and specificity in range of 83–100%. Conclusion. BP/height ratios are simple with high sensitivity and specificity to detect elevated BP in children. These ratios can be easily used in routine medical care of children. PMID:22577400
Elevated blood pressure among Southeast Asian refugee children in Minnesota.
Munger, R G; Gomez-Marin, O; Prineas, R J; Sinaiko, A R
The blood pressures and body sizes of children aged 10-15 years in the Minneapolis and St. Paul, Minnesota, public schools were measured during 1986 and 1987. The sample consisted of 1,680 Southeast Asian refugees--including 219 Cambodians, 1,086 Hmong, 149 Lao, and 226 Vietnamese--and 3,424 blacks and 11,336 whites. Mean systolic blood pressure in Hmong boys was higher than that in black boys and white boys. Mean systolic blood pressures of Hmong, Lao, and Vietnamese girls were lower than those of black girls and white girls. The mean diastolic blood pressures of Hmong boys and of Cambodian and Hmong girls were greater than those of blacks and whites of the same sexes. Southeast Asian children were shorter and weighed less than black children and white children. Body size may confound associations between ethnic groups and blood pressures and may obscure the problem of hypertension among the smaller Southeast Asian children. Southeast Asian boys had greater mean systolic blood pressures than did black and white boys across all weight strata; a similar contrast among girls did not reveal this difference. The risk of hypertension, defined by US National Heart, Lung, and Blood Institute guidelines, was assessed in multiple logistic regression analyses that controlled for differences in weight, height, age, and pulse rate. The odds ratios for hypertension, relative to blacks and whites of the same sexes, were 2.69 (95% confidence interval (CI) 1.85-3.65) in Hmong boys, 2.89 (95% CI 1.35-6.21) in Lao boys, 2.10 (95% CI 1.03-4.28) in Cambodian girls, and 1.49 (95% CI 1.00-2.20) in Hmong girls. Hypertension and subsequent cardiovascular disease may emerge as a significant problem among Southeast Asian refugees in the United States. PMID:2063833
Placental programming of blood pressure in Indian children
Winder, Nicola R; Krishnaveni, Ghattu V; Hill, Jacqueline C; Karat, Chitra LS; Fall, Caroline HD; Veena, Sargoor R; Barker, David JP
Aim To determine whether the size and shape of the placental surface predict blood pressure in childhood. Methods We studied blood pressure in 471 nine-year-old Indian children whose placental length, breadth and weight were measured in a prospective birth cohort study. Results In the daughters of short mothers (
[Blood pressure limits--the lower, the better?].
Leibundgut, Gregor
Arterial hypertension is a widespread risk factor for cardiovascular disease. The benefit of a consistent drug therapy is proportionally associated with the degree of blood pressure reduction. By extrapolating the data, the assumption arose "the lower the better" and was widely accepted. However, several studies found an increase in morbidity and mortality with an excessive reduction of blood pressure (J-curve). This seems to affect mainly cardiac risk, and only at lower blood pressures<60 mmHg also the cerebral risk. An important factor here is the diastolic blood pressure. Others found a linear correlation. Overall, a j-shaped connection remains controversial and is not considered equally for all organ systems. At the same time cardiovascular risk seems not to increase with additional reduction in blood pressure of <140 mm Hg to <120 mmHg. This has led to the latest guidelines of all societies recommending higher target values. Reasons for higher targets in drug therapy of arterial hypertension, are increased adverse drug reactions or increased healthcare costs with few additional benefit. The current recommendations of the ESH/ESC, AHA/ACC/ASH and the JNC 8 set a higher target value for some subgroups, but remain inconsistent among themselves. PMID:26098188
WANDA B.: Weight and Activity with Blood Pressure Monitoring System for Heart Failure Patients
Suh, Myung-kyung; Evangelista, Lorraine S.; Chen, Victor; Hong, Wen-Sao; Macbeth, Jamie; Nahapetian, Ani; Figueras, Florence-Joy; Sarrafzadeh, Majid
Heart failure is a leading cause of death in the United States, with around 5 million Americans currently suffering from congestive heart failure. The WANDA B. wireless health technology leverages sensor technology and wireless communication to monitor heart failure patient activity and to provide tailored guidance. Patients who have cardiovascular system disorders can measure their weight, blood pressure, activity levels, and other vital signs in a real-time automated fashion. The system was developed in conjunction with the UCLA Nursing School and the UCLA Wireless Health Institute for use on actual patients. It is currently in use with real patients in a clinical trial. PMID:20083451
Relating external compressing pressure to mean arterial pressure in non-invasive blood pressure measurements.
Chin, K Y; Panerai, R B
Arterial volume clamping uses external compression of an artery to provide continuous non-invasive measurement of arterial blood pressure. It has been assumed that mean arterial pressure (MAP) corresponds to the point where unloading leads to the maximum oscillation of the arterial wall as reflected by photoplethysmogram (PPG), an assumption that has been challenged. Five subjects were recruited for the study (three males, mean age (SD) = 32 (15) years). The PPG waveform was analysed to identify the relationship between the external compressing pressure, PPG pulse amplitude and MAP. Two separate tests were carried out at compression step intervals of 10 mmHg and 2 mmHg, respectively. No significant differences were found between the two tests. The bias between the compressing pressure and the MAP was -4.7 ± 5.63 mmHg (p < 0.001) showing a normal distribution. Further research is needed to identify optimal algorithms for estimation of MAP using PPG associated with arterial compression. PMID:25429784
Congestive cardiac failure: central role of the arterial blood pressure.
Harris, P
A review of the history of our knowledge and understanding of the peripheral oedema of congestive cardiac failure points to the conclusion that an inability of the heart to maintain the arterial pressure is of central importance in this condition. Although the function of the circulation is to perfuse the tissues, the body monitors the adequacy of its perfusion, not not through metabolic messengers carried from the tissues in the blood stream, but by sensing the arterial pressure; and the mechanisms evoked act to maintain the arterial pressure. In the short term this is achieved by autonomic regulation of the heart and blood vessels; in the longer term the arterial pressure is maintained through an increase in the blood volume by a retention of salt and water by the kidney. To support the latter process, intrinsic renal mechanisms are successively magnified by the renin-angiotensin-aldosterone system and by the activities of the sympathetic system and vasopressin. The natriuretic influence mediated through volume receptors and the release of atrial peptide is overruled by the arterial baroreceptors, so that the body maintains the arterial pressure at the expense of an increase in blood volume. In these ways the syndrome of congestive cardiac failure may be regarded as one which arises when the heart becomes chronically unable to maintain an appropriate arterial pressure without support. PMID:3311096
Relationship between blood manganese and blood pressure in the Korean general population according to KNHANES 2008
Lee, Byung-Kook; Kim, Yangho
Introduction: We present data on the association of manganese (Mn) level with hypertension in a representative sample of the adult Korean population who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) 2008. Methods: This study was based on the data obtained by KNHANES 2008, which was conducted for three years (2007-2009) using a rolling sampling design involving a complex, stratified, multistage, probability-cluster survey of a representative sample of the noninstitutionalized civilian population of South Korea. Results: Multiple regression analysis after controlling for covariates, including gender, age, regional area, education level, smoking, drinking status, hemoglobin, and serum creatinine, showed that the beta coefficients of log blood Mn were 3.514, 1.878, and 2.517 for diastolic blood pressure, and 3.593, 2.449, and 2.440 for systolic blood pressure in female, male, and all participants, respectively. Multiple regression analysis including three other blood metals, lead, mercury, and cadmium, revealed no significant effects of the three metals on blood pressure and showed no effect on the association between blood Mn and blood pressure. In addition, doubling the blood Mn increased the risk of hypertension 1.828, 1.573, and 1.567 fold in women, men, and all participants, respectively, after adjustment for covariates. The addition of blood lead, mercury, and cadmium as covariates did not affect the association between blood Mn and the prevalence of hypertension. Conclusion: Blood Mn level was associated with an increased risk of hypertension in a representative sample of the Korean adult population. - Highlights: {yields} We showed the association of manganese with hypertension in Korean population. {yields} This study was based on the data obtained by KNHANES 2008. {yields} Blood manganese level was associated with an increased risk of hypertension.
Sodium-sensitivity of Blood Pressure in Chinese Populations
Chen, Jing
Clinical trials have demonstrated that a reduced intake of dietary sodium lowers blood pressure. However, blood pressure reduction in response to a decrease in dietary sodium intake varies considerably among different individuals–a phenomenon described as sodium-sensitivity. The Genetic Epidemiology Network of Salt Sensitivity (GenSalt) study was a large family-based dietary-feeding study conducted in rural north China. This study indicated that approximately 39% of Chinese adults were sodium-sensitive. Sodium-sensitivity was more common in women and in persons who were older and had higher usual blood pressure. Sodium-sensitivity was also more common in individuals with higher responses to cold pressor test and in individuals with the metabolic syndrome. Genetic factors might play an important role in determining sodium-sensitivity in the Chinese population. A better understanding of the genetic and environmental determinants of sodium-sensitivity has important public health and clinical implications. PMID:20424958
Clinical Implications of Ambulatory and Home Blood Pressure Monitoring
Because blood pressure (BP) is an ever changing hemodynamic phenomenon, a BP value, once measured at a physician's office (Office BP), is often unrepresentative of an individual's true BP status. Both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) provide more accurate and reproducible estimate of BP, and produce stronger predictive ability for cardiovascular outcome than conventional office BP. Two BP measuring techniques, ABPM and HBPM have been widely in clinical use for the detection and management of hypertension. However, they have different advantages and limitations in practice. At present, it has become crucial to understand the characteristics and clinical implications of these BP measuring techniques for those responsible for the care of hypertensive patients. PMID:20967142
[Thoughts concerning the realms of arterial blood pressure].
Agrest, A
Several realms of arterial blood pressure are analyzed. 1. The realm of physiological regulation of arterial blood pressure is discussed from the point of view of an intelligent design. 2. The realm of biophysical consequences, the adverse effects, wearing off or senilization and the vascular accidents. 3. The realm of biochemical changes leading to cellular changes. The ecological equilibrium and the interpretation of purposeful reactions. From metaphore to purpose. 4. The realm of cellular changes as a result of biophysical factors. The society of cells. 5. The realm of metabolic environment. 6. The realm of adverse effects of increasing arterial blood pressure instead of selecting less risky mechanisms. A politically mistaken decision. PMID:11188910
The effect of ventricular assist devices on cerebral blood flow and blood pressure fractality.
Bellapart, Judith; Chan, Gregory S H; Tzeng, Yu-Chieh; Ainslie, Philip N; Dunster, Kimble R; Barnett, Adrian G; Boots, Rob; Fraser, John F
Biological signals often exhibit self-similar or fractal scaling characteristics which may reflect intrinsic adaptability to their underlying physiological system. This study analysed fractal dynamics of cerebral blood flow in patients supported with ventricular assist devices (VAD) to ascertain if sustained modifications of blood pressure waveform affect cerebral blood flow fractality. Simultaneous recordings of arterial blood pressure and cerebral blood flow velocity using transcranial Doppler were obtained from five cardiogenic shock patients supported by VAD, five matched control patients and five healthy subjects. Computation of a fractal scaling exponent (α) at the low-frequency time scale by detrended fluctuation analysis showed that cerebral blood flow velocity exhibited 1/f fractal scaling in both patient groups (α = 0.95 ± 0.09 and 0.97 ± 0.12, respectively) as well as in the healthy subjects (α = 0.86 ± 0.07). In contrast, fluctuation in blood pressure was similar to non-fractal white noise in both patient groups (α = 0.53 ± 0.11 and 0.52 ± 0.09, respectively) but exhibited 1/f scaling in the healthy subjects (α = 0.87 ± 0.04, P < 0.05 compared with the patient groups). The preservation of fractality in cerebral blood flow of VAD patients suggests that normal cardiac pulsation and central perfusion pressure changes are not the integral sources of cerebral blood flow fractality and that intrinsic vascular properties such as cerebral autoregulation may be involved. However, there is a clear difference in the fractal scaling properties of arterial blood pressure between the cardiogenic shock patients and the healthy subjects. PMID:21775798
Child maltreatment and blood pressure in young adulthood☆
Gooding, Holly C.; Milliren, Carly; McLaughlin, Katie A.; Richmond, Tracy K.; Katz-Wise, Sabra L.; Rich-Edwards, Janet; Austin, S. Bryn
Adverse childhood experiences are associated with hypertension in older adults. This study assessed whether an association between child maltreatment and blood pressure is detectable in young adults and whether any association differs by sex or is modified by genetic polymorphisms known to be involved in stress sensitivity. We examined these patterns in a sample of 12,420 young adults ages 24–32 years who participated in Wave IV of the National Longitudinal Study of Adolescent Health. Participants retrospectively reported history of physical, emotional, or sexual abuse before age 18 years. Participants with a systolic blood pressure (SBP) ≥140 mmHg or a diastolic blood pressure (DBP) ≥90 mmHg were classified as hypertensive. We used sex-stratified linear and logistic regression models to assess associations between each type of childhood maltreatment and SBP, DBP, and hypertension. We created interaction terms to assess for effect modification of any relationship between maltreatment and blood pressure by sex or SLC64A genotype. Fifteen percent of females and 31.5% of males were hypertensive. Frequent physical abuse in childhood was reported by 5%, frequent emotional abuse by 12%, and any sexual abuse by 5%. No association was observed between abuse history and blood pressure in either males or females, nor was effect modification present by SLC64A genotype. Child maltreatment exposure was not associated with blood pressure or hypertension in young adults in this study. Future studies should investigate additional critical windows for the effect of child maltreatment on cardiovascular health. PMID:25245501
Child maltreatment and blood pressure in young adulthood.
Gooding, Holly C; Milliren, Carly; McLaughlin, Katie A; Richmond, Tracy K; Katz-Wise, Sabra L; Rich-Edwards, Janet; Austin, S Bryn
Adverse childhood experiences are associated with hypertension in older adults. This study assessed whether an association between child maltreatment and blood pressure is detectable in young adults and whether any association differs by sex or is modified by genetic polymorphisms known to be involved in stress sensitivity. We examined these patterns in a sample of 12,420 young adults ages 24-32 years who participated in Wave IV of the National Longitudinal Study of Adolescent Health. Participants retrospectively reported history of physical, emotional, or sexual abuse before age 18 years. Participants with a systolic blood pressure (SBP) ≥140 mmHg or a diastolic blood pressure (DBP) ≥90 mmHg were classified as hypertensive. We used sex-stratified linear and logistic regression models to assess associations between each type of childhood maltreatment and SBP, DBP, and hypertension. We created interaction terms to assess for effect modification of any relationship between maltreatment and blood pressure by sex or SLC64A genotype. Fifteen percent of females and 31.5% of males were hypertensive. Frequent physical abuse in childhood was reported by 5%, frequent emotional abuse by 12%, and any sexual abuse by 5%. No association was observed between abuse history and blood pressure in either males or females, nor was effect modification present by SLC64A genotype. Child maltreatment exposure was not associated with blood pressure or hypertension in young adults in this study. Future studies should investigate additional critical windows for the effect of child maltreatment on cardiovascular health. PMID:25245501
Effect of migration on blood pressure: the Yi People Study.
He, J; Tell, G S; Tang, Y C; Mo, P S; He, G Q
The Yi People Study was conducted in Puge County, Sichuan Province, People's Republic of China. Four population groups were surveyed for risk factors for cardiovascular disease. Included were two groups of Yi farmers living either in a high mountainous area in extremely remote villages at or above 2,750 meters elevation, or in a mountainside area at about 1,800 meters elevation. A third study group consisted of Yi farmers who migrated to the county seat during the 1950s. Local residents of the county seat, the Han people, constituted the fourth group. Blood pressure rises very little with age after puberty in Yi farmers, but there was a trend of increasing blood pressure with age in Yi migrants and Han. Mean body mass index (kg/m2) and heart rate were higher in Yi migrants than in Yi farmers. For men, both systolic and diastolic blood pressure were greater among Yi migrants than among Yi farmers. These differences persisted after adjusting for age and body mass index. Among women, after adjusting for age, BMI, and altitude, only diastolic blood pressure was lower among Yi farmers than Yi migrants. Yi migrants and Han had similar blood pressures. In 1986, a sample of men participated in more detailed studies of diet, serum, and urine. The proportion of energy from fat ranged from less than 10% among high-mountain Yi farmers to almost 40% among Yi migrants and Han. Compared with Yi farmers, Yi migrants consumed more sodium and less potassium, calcium, and magnesium, had lower serum potassium, and a greater sodium/potassium ratio. Urinary excretion of sodium, calcium, and the sodium/potassium ratio were all greater in Yi migrants than in Yi farmers, while the reverse was seen for potassium. These data suggest that changes in life-style, including dietary changes, contribute importantly to the higher blood pressure among Yi migrants. PMID:1932320
Renal Nerve Stimulation-Induced Blood Pressure Changes Predict Ambulatory Blood Pressure Response After Renal Denervation.
de Jong, Mark R; Adiyaman, Ahmet; Gal, Pim; Smit, Jaap Jan J; Delnoy, Peter Paul H M; Heeg, Jan-Evert; van Hasselt, Boudewijn A A M; Lau, Elizabeth O Y; Persu, Alexandre; Staessen, Jan A; Ramdat Misier, Anand R; Steinberg, Jonathan S; Elvan, Arif
Blood pressure (BP) response to renal denervation (RDN) is highly variable and its effectiveness debated. A procedural end point for RDN may improve consistency of response. The objective of the current analysis was to look for the association between renal nerve stimulation (RNS)-induced BP increase before and after RDN and changes in ambulatory BP monitoring (ABPM) after RDN. Fourteen patients with drug-resistant hypertension referred for RDN were included. RNS was performed under general anesthesia at 4 sites in the right and left renal arteries, both before and immediately after RDN. RNS-induced BP changes were monitored and correlated to changes in ambulatory BP at a follow-up of 3 to 6 months after RDN. RNS resulted in a systolic BP increase of 50±27 mm Hg before RDN and systolic BP increase of 13±16 mm Hg after RDN (P<0.001). Average systolic ABPM was 153±11 mm Hg before RDN and decreased to 137±10 mm Hg at 3- to 6-month follow-up (P=0.003). Changes in RNS-induced BP increase before versus immediately after RDN and changes in ABPM before versus 3 to 6 months after RDN were correlated, both for systolic BP (R=0.77, P=0.001) and diastolic BP (R=0.79, P=0.001). RNS-induced maximum BP increase before RDN had a correlation of R=0.61 (P=0.020) for systolic and R=0.71 (P=0.004) for diastolic ABPM changes. RNS-induced BP changes before versus after RDN were correlated with changes in 24-hour ABPM 3 to 6 months after RDN. RNS should be tested as an acute end point to assess the efficacy of RDN and predict BP response to RDN. PMID:27432864
Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines.
Egan, Brent M; Li, Jiexiang; Wagner, C Shaun
The Systolic Blood Pressure (SBP, mm Hg) Intervention Trial (SPRINT) showed that targeting SBP <120 mm Hg (intensive treatment, mean SBP: 121.5 mm Hg) versus <140 (standard treatment, mean SBP: 134.6 mm Hg) reduced cardiovascular events 25%. SPRINT has 2 implicit assumptions that could impact future US hypertension guidelines: (1) standard therapy controlled SBP similarly to that in adults with treated hypertension and (2) intensive therapy produced a lower mean SBP than in adults with treated hypertension and SBP <140 mm Hg. To examine these assumptions, US National Health and Nutrition Examination Survey 2009 to 2012 data were analyzed on 3 groups of adults with treated hypertension: group 1 consisted of SPRINT-like participants aged ≥50 years; group 2 consisted of participants all aged ≥18 years; and group 3 consisted of participants aged ≥18 years excluding group 1 but otherwise similar to SPRINT-like participants except high cardiovascular risk. Mean SBPs in groups 1, 2, and 3 were 133.0, 130.1, and 124.6, with 66.2%, 72.2%, and 81.9%, respectively, controlled to SBP <140; 68.3%, 74.8%, and 83.4% of the controlled subset had SBP <130. Mean SBPs in those controlled to <140 were 123.3, 120.9, and 118.9, respectively. Among US adults with treated hypertension, (1) the SPRINT-like group had higher mean SBP than comparison groups, yet lower than SPRINT standard treatment group and (2) among groups 1 to 3 with SBP <140, SBP values were within <3 mm Hg of SPRINT intensive treatment. SPRINT results suggest that treatment should be continued and not reduced when treated SBP is <130, especially for the SPRINT-like subset. Furthermore, increasing the percentage of treated adults with SBP <140 could approximate SPRINT intensive treatment SBP without lowering treatment goals. PMID:27354422
A novel automated discontinuous venous blood monitoring system for ex vivo glucose determination in humans.
Schaller, R; Feichtner, F; Köhler, H; Bodenlenz, M; Plank, J; Wutte, A; Mader, J K; Ellmerer, M; Hellmich, R; Wedig, H; Hainisch, R; Pieber, T R; Schaupp, L
Intensive insulin therapy reduces mortality and morbidity in critically ill patients but imposes great demands on medical staff who must take frequent blood samples for the determination of glucose levels. A solution to this resourcing problem would be provided by an automated blood monitoring system. The aim of the present clinical study was to evaluate such a system comprising an automatic blood sampling unit linked to a glucose biosensor. Our approach was to determine the correlation and system error of the sampling unit alone and of the combined system with respect to reference levels over 12h in humans. Two venous cannulae were inserted to connect the automatic and reference systems to the subjects. Blood samples were taken at 15 and 30 min intervals. The median Pearson coefficient of correlation between manually and automatically withdrawn blood samples was 0.982 for the sampling unit alone and 0.950 for the complete system. The biosensor had a linear range up to 20 mmoll(-1) and a 95% response time of <2 min. Clark Error Grid analysis showed that 96.93% of the data (228 data pairs) was in zone A and 3.07% in zone B. Insulin Titration Error Grid analysis suggested an acceptable treatment in 99.56% of cases. Implementation of a "Keep Vein Open" saline infusion into the automated blood sampling system reduced blood withdrawal failures through occluded catheters fourfold. In summary, automated blood sampling from a peripheral vein coupled with automatic glucose determination is a promising alternative to frequent manual blood sampling. PMID:19135351
Knowledge of accurate blood pressure measurement procedures in chiropractic students
Crosley, Angela M.; Rose, James R. La
Objective Blood pressure measurement is a basic clinical procedure. However, studies have shown that many errors are made when health care providers acquire blood pressure readings. Our study assessed knowledge of blood pressure measurement procedures in chiropractic students. Methods This was an observational, descriptive study. A questionnaire based on one created by the American Heart Association was given to 1st, 2nd, 3rd, and final year students (n = 186). A one way ANOVA was used to analyze the data. Results Of the students 80% were confident that their knowledge of this clinical skill was adequate or better. However, the overall score on the knowledge test of blood pressure–taking skills was 52% (range, 24%–88%). The only significant difference in the mean scores was between the 1st and 2nd year students compared to the 3rd and 4th year students (p < .005). Of the 16 questions given, the following mean scores were: 1st year 10.45, 2nd year 9.75, 3rd year 7.93, and 4th year 8.33. Of the 16 areas tested, 10 were of major concern (test item score <70%), showing the need for frequent retraining of chiropractic students. Conclusion Consistent with studies in other health care disciplines, our research found the knowledge of blood pressure skills to be deficient in our sample. There is a need for subsequent training in our teaching program. PMID:23957320
Does home blood pressure monitoring improve patient outcomes? A systematic review comparing home and ambulatory blood pressure monitoring on blood pressure control and patient outcomes
Breaux-Shropshire, Tonya L; Judd, Eric; Vucovich, Lee A; Shropshire, Toneyell S; Singh, Sonal
Objective Our objective was to compare the clinical effectiveness of home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) on blood pressure (BP) control and patient outcomes. Design A systematic review was conducted. We also appraised the methodological quality of studies. Data sources PubMed, Scopus, CINAHL, and the Cochrane Central Register of Control Trials (CENTRAL). Inclusion criteria Randomized control trials, prospective and retrospective cohort studies, observational studies, and case-control studies published in English from any year to present that describe HBPM and 24-hour ABPM and report on systolic and/or diastolic BP and/or heart attack, stroke, kidney failure and/or all-cause mortality for adult patients. Due to the nature of the question, studies with only untreated patients were not considered. Results Of 1,742 titles and abstractions independently reviewed by two reviewers, 137 studies met predetermined criteria for evaluation. Nineteen studies were identified as relevant and included in the paper. The common themes were that HBPM and ABPM correlated with cardiovascular events and mortality, and targeting HBPM or ABPM resulted in similar outcomes. Associations between BP measurement type and mortality differed by study population. Both the low sensitivity of office blood pressure monitoring (OBPM) to detect optimal BP control by ABPM and the added association of HBPM with cardiovascular mortality supported the routine use of HBPM in clinical practice. There was insufficient data to determine the benefit of using HBPM as a measurement standard for BP control. Conclusion HBPM encourages patient-centered care and improves BP control and patient outcomes. Given the limited number of studies with both HBPM and ABPM, these measurement types should be incorporated into the design of randomized clinical trials within hypertensive populations. PMID:26170715
Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease
Appel, Lawrence J.; Wright, Jackson T.; Greene, Tom; Agodoa, Lawrence Y.; Astor, Brad C.; Bakris, George L.; Cleveland, William H.; Charleston, Jeanne; Contreras, Gabriel; Faulkner, Marquetta L.; Gabbai, Francis B.; Gassman, Jennifer J.; Hebert, Lee A.; Jamerson, Kenneth A.; Kopple, Joel D.; Kusek, John W.; Lash, James P.; Lea, Janice P.; Lewis, Julia B.; Lipkowitz, Michael S.; Massry, Shaul G.; Miller, Edgar R.; Norris, Keith; Phillips, Robert A.; Pogue, Velvie A.; Randall, Otelio S.; Rostand, Stephen G.; Smogorzewski, Miroslaw J.; Toto, Robert D.; Wang, Xuelei
BACKGROUND In observational studies, the relationship between blood pressure and end-stage renal disease (ESRD) is direct and progressive. The burden of hypertension-related chronic kidney disease and ESRD is especially high among black patients. Yet few trials have tested whether intensive blood-pressure control retards the progression of chronic kidney disease among black patients. METHODS We randomly assigned 1094 black patients with hypertensive chronic kidney disease to receive either intensive or standard blood-pressure control. After completing the trial phase, patients were invited to enroll in a cohort phase in which the blood-pressure target was less than 130/80 mm Hg. The primary clinical outcome in the cohort phase was the progression of chronic kidney disease, which was defined as a doubling of the serum creatinine level, a diagnosis of ESRD, or death. Follow-up ranged from 8.8 to 12.2 years. RESULTS During the trial phase, the mean blood pressure was 130/78 mm Hg in the intensive-control group and 141/86 mm Hg in the standard-control group. During the cohort phase, corresponding mean blood pressures were 131/78 mm Hg and 134/78 mm Hg. In both phases, there was no significant between-group difference in the risk of the primary outcome (hazard ratio in the intensive-control group, 0.91; P = 0.27). However, the effects differed according to the baseline level of proteinuria (P = 0.02 for interaction), with a potential benefit in patients with a protein-to-creatinine ratio of more than 0.22 (hazard ratio, 0.73; P = 0.01). CONCLUSIONS In overall analyses, intensive blood-pressure control had no effect on kidney disease progression. However, there may be differential effects of intensive blood-pressure control in patients with and those without baseline proteinuria. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center on Minority Health and Health Disparities, and others.) PMID:20818902
High blood pressure in older subjects with cognitive impairment.
Mossello, Enrico; Simoni, David
High blood pressure and cognitive impairment often coexist in old age, but their pathophysiological association is complex. Several longitudinal studies have shown that high blood pressure at midlife is a risk factor for cognitive impairment and dementia, although this association is much less clear in old age. The effect of blood pressure lowering in reducing the risk of dementia is only borderline significant in clinical trials of older subjects, partly due to the insufficient follow-up time. Conversely, dementia onset is associated with a decrease of blood pressure values, probably secondary to neurodegeneration. Prognostic effect of blood pressure values in cognitively impaired older subjects is still unclear, with aggressive blood pressure lowering being potentially harmful in this patients category. Brief cognitive screening, coupled with simple motor assessment, are warranted to identify frail older subjects who need a more cautious approach to antihypertensive treatment. Values obtained with ambulatory blood pressure monitoring seem more useful than clinical ones to predict the outcome of cognitively impaired older subjects. Future studies should identify the most appropriate blood pressure targets in older subjects with cognitive impairment. RiassuntoIpertensione arteriosa e decadimento cognitivo spesso coesistono in età avanzata, sebbene la loro associazione sia complessa dal punto di vista fisiopatologico. Diversi studi longitudinali hanno mostrato che elevati valori pressori in età adulta rappresentano un fattore di rischio per decadimento cognitivo e demenza, sebbene tale associazione sia molto meno chiara in età avanzata. L'effetto della terapia antiipertensiva è risultato ai limiti della significatività statistica nel ridurre il rischio di demenza negli studi di intervento su soggetti anziani, in parte a causa della durata insufficiente del follow-up. D'altra parte, l'insorgenza di demenza è associata con una riduzione dei valori pressori
Air Pollution from Industrial Swine Operations and Blood Pressure of Neighboring Residents
Horton, Rachel Avery; Rose, Kathryn M.
Background: Industrial swine operations emit odorant chemicals including ammonia, hydrogen sulfide (H2S), and volatile organic compounds. Malodor and pollutant concentrations have been associated with self-reported stress and altered mood in prior studies. Objectives: We conducted a repeated-measures study of air pollution, stress, and blood pressure in neighbors of swine operations. Methods: For approximately 2 weeks, 101 nonsmoking adult volunteers living near industrial swine operations in 16 neighborhoods in eastern North Carolina sat outdoors for 10 min twice daily at preselected times. Afterward, they reported levels of hog odor on a 9-point scale and measured their blood pressure twice using an automated oscillometric device. During the same 2- to 3-week period, we measured ambient levels of H2S and PM10 at a central location in each neighborhood. Associations between systolic and diastolic blood pressure (SBP and DBP, respectively) and pollutant measures were estimated using fixed-effects (conditional) linear regression with adjustment for time of day. Results: PM10 showed little association with blood pressure. DBP [β (SE)] increased 0.23 (0.08) mmHg per unit of reported hog odor during the 10 min outdoors and 0.12 (0.08) mmHg per 1-ppb increase of H2S concentration in the same hour. SBP increased 0.10 (0.12) mmHg per odor unit and 0.29 (0.12) mmHg per 1-ppb increase of H2S in the same hour. Reported stress was strongly associated with BP; adjustment for stress reduced the odor–DBP association, but the H2S–SBP association changed little. Conclusions: Like noise and other repetitive environmental stressors, malodors may be associated with acute blood pressure increases that could contribute to development of chronic hypertension. PMID:23111006
Plasma free cyanide and blood total cyanide: a rapid completely automated microdistillation assay.
Groff, W A; Stemler, F W; Kaminskis, A; Froehlich, H L; Johnson, R P
Techniques are presented which provide direct measurement of both free cyanide (CN-) in plasma and total CN- in whole blood. Loss of total CN- from blood is prevented by conversion to cyanmethemoglobin. Both free and total CN- are assayed by a completely automated method providing readout 17 minutes after sampling. No prior isolation technique is required and sensitivity is adjustable to cover a broad range of CN- concentrations from 1 to 4000 uM. Precision of blood CN- values from 2 to 2500 uM is within +/- 2.3%. No interference results from thiocyanate or thiosulfate at a concentration of approximately 1 mM. PMID:4057310
Fat induced hypertension in rabbits. Effects of dietary fibre on blood pressure and blood lipid concentration.
Burstyn, P G; Husbands, D R
Rabbits were fed diets containing 200 g.kg-1 coconut oil, palm oil, or safflower oil. Some of the diets also contained 200 g.kg-1 cellulose. The blood pressure was measured daily by a non-invasive technique for the 2 month duration of the experiment. Blood samples were drawn after an overnight fast at intervals during the experiment and analysed for lipids. Blood pressure was always increased by a fat-enriched diet. This effect was diminished and delayed by adding cellulose to the diets, though cellulose itself had no effect on the blood pressure in the absence of fat. There was a modest negative correlation between fasting serum triglyceride concentration and the blood pressure in animals fed fat enriched diets without added cellulose, but not in animals fed diets containing both fat and cellulose. These results coupled with those of Wright, Burstyn and Gibney may serve partly to explain the observation that vegetarians have lower blood pressures than omnivores, the latter consuming diets which are relatively richer in fats and poorer in fibre than the former. PMID:6253068
Association of low-level blood lead and blood pressure in NHANES 1999-2006
Scinicariello, Franco; Abadin, Henry G.; Edward Murray, H.
This study investigated whether low blood-lead levels ({<=}10 {mu}g/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and logistic regressions stratified by race/ethnicity and gender were performed. Blood lead levels (BLL) were significantly correlated with higher systolic BP among black men and women, but not white or Mexican-American participants. BLLs were significantly associated with higher diastolic BPs among white men and women and black men, whereas, a negative association was observed in Mexican-American men that had, also, a wider pulse pressure. Black men in the 90th percentile of blood lead distribution (BLL{>=}3.50 {mu}g/dL) compared to black men in the 10th percentile of blood lead distribution (BLL{<=}0.7 {mu}g/dL) had a significant increase of risk of having hypertension (adjusted POR=2.69; 95% CI: 1.08-6.72). In addition, blood cadmium was significantly associated with hypertension and systolic and diastolic blood. This study found that, despite the continuous decline in blood lead in the U.S. population, lead exposure disparities among race and gender still exist.
Relations of blood pressure and head injury to regional cerebral blood flow.
Kisser, Jason E; Allen, Allyssa J; Katzel, Leslie I; Wendell, Carrington R; Siegel, Eliot L; Lefkowitz, David; Waldstein, Shari R
Hypertension confers increased risk for cognitive decline, dementia, and cerebrovascular disease. These associations have been attributed, in part, to cerebral hypoperfusion. Here we posit that relations of higher blood pressure to lower levels of cerebral perfusion may be potentiated by a prior head injury. Participants were 87 community-dwelling older adults - 69% men, 90% white, mean age=66.9years, 27.6% with a history of mild traumatic brain injury (mTBI) defined as a loss of consciousness ≤30min resulting from an injury to the head, and free of major medical (other than hypertension), neurological or psychiatric comorbidities. All engaged in clinical assessment of systolic and diastolic blood pressure (SBP, DBP) and single photon emission computed tomography (SPECT). Computerized coding of the SPECT images yielded relative ratios of blood flow in left and right cortical and select subcortical regions. Cerebellum served as the denominator. Sex-stratified multiple regression analyses, adjusted for age, education, race, alcohol consumption, smoking status, and depressive symptomatology, revealed significant interactions of blood pressure and head injury to cerebral blood flow in men only. Specifically, among men with a history of head injury, higher systolic blood pressure was associated with lower levels of perfusion in the left orbital (β=-3.21, p=0.024) and left dorsolateral (β=-2.61, p=0.042) prefrontal cortex, and left temporal cortex (β=-3.36, p=0.014); higher diastolic blood pressure was marginally associated with lower levels of perfusion in the left dorsolateral prefrontal cortex (β=-2.79, p=0.051). Results indicate that men with a history of head injury may be particularly vulnerable to the impact of higher blood pressure on cerebral perfusion in left anterior cortical regions, thus potentially enhancing risk for adverse brain and neurocognitive outcomes. PMID:27206865
Longitudinal study (32 years) of exercise tolerance, breathing response, blood pressure, and blood lipids in young men.
Gillum, R F; Taylor, H L; Anderson, J; Blackburn, H
Changes in exercise tolerance, blood lipids, and blood pressure from youth to middle age was studied in 106 subjects followed 32 years. In addition, the responses to cold pressor and CO2 stress were studied as correlates of future lipids and blood pressure. Treadmill exercise test, cold pressor test, response to breathing a mixture of 6% CO2, and 21% O2, for 5 minutes, blood pressure, and lipid measurements were performed in 1947 when subjects were 20 +/- 2 years old. Exercise, blood pressure and lipid tests were repeated in 1979. Tracking of blood pressure and pulse response to exercise over the period was demonstrated. Baseline exercise response correlated with future blood pressure, cholesterol, triglycerides, and high density lipoproteins. Change in exercise pulse rate over the period correlated with change in cholesterol. Cold pressor systolic blood pressure response correlated with future systolic blood pressure and triglycerides. Pulse and blood pressure response to CO2 breathing correlated with cholesterol, triglyceride and high density lipoprotein 32 years later. These correlations were independent of baseline values of the variables and body mass index. Individuals who were judged "fit" (exercise pulse rise less than median) at both baseline and follow-up had the best cardiovascular risk profile (blood pressure and lipids). Blood pressure and pulse response to exercise tracked between ages 20 and 50. Exercise, cold pressor, and CO2 responses in youth correlated with blood lipid levels in middle age. PMID:6810858
Treatment: Types of Blood Pressure Medications | NIH MedlinePlus the Magazine
... any of my medications affect my blood pressure? Alpha-blockers: Alpha-blockers reduce nerve impulses to blood vessels, which ... more easily, causing blood pressure to go down. Alpha-beta-blockers: Alpha-beta-blockers work the same ...
Fully automated detection of the counting area in blood smears for computer aided hematology.
Rupp, Stephan; Schlarb, Timo; Hasslmeyer, Erik; Zerfass, Thorsten
For medical diagnosis, blood is an indispensable indicator for a wide variety of diseases, i.e. hemic, parasitic and sexually transmitted diseases. A robust detection and exact segmentation of white blood cells (leukocytes) in stained blood smears of the peripheral blood provides the base for a fully automated, image based preparation of the so called differential blood cell count in the context of medical laboratory diagnostics. Especially for the localization of the blood cells and in particular for the segmentation of the cells it is necessary to detect the working area of the blood smear. In this contribution we present an approach for locating the so called counting area on stained blood smears that is the region where cells are predominantly separated and do not interfere with each other. For this multiple images of a blood smear are taken and analyzed in order to select the image corresponding to this area. The analysis involves the computation of an unimodal function from image content that serves as indicator for the corresponding image. This requires a prior segmentation of the cells that is carried out by a binarization in the HSV color space. Finally, the indicator function is derived from the number of cells and the cells' surface area. Its unimodality guarantees to find a maximum value that corresponds to the counting areas image index. By this, a fast lookup of the counting area is performed enabling a fully automated analysis of blood smears for medical diagnosis. For an evaluation the algorithm's performance on a number of blood smears was compared with the ground truth information that has been defined by an adept hematologist. PMID:22256137
Acute cocaine administration alters posttraumatic blood pressure and cerebral blood flow in rats.
Muir, J K; Ellis, E F
Cocaine abuse is widespread, and it is possible that its two main pharmacological actions, sympathomimetic and local anesthetic, could influence the blood pressure and cerebral blood flow response to brain injury, which occurs with increased frequency in drug abusers. We tested this hypothesis in ventilated barbiturate-anesthetized rats. Brain injury was induced using the fluid-percussion method, and cortical blood flow was measured using laser-Doppler flowmetry. Saline, cocaine, methamphetamine, or lidocaine was administered 10 min before injury. Upon injury, both cocaine- and saline-pretreated rats showed a similar acute hypertensive phase, which was followed by a period of more pronounced hypotension in the cocaine group (68 +/- 4 vs. 100 +/- 6 mmHg). Cortical blood flow increased dramatically 3-15 s following injury-induced hypertension in both the cocaine and saline groups (approximately 230-260%), but then fell below preinjury values within minutes. At 1 h postinjury, the blood flow in the saline group was 53 +/- 6% of the preinjury value, while in the cocaine group, flow was 74 +/- 7% of preinjury baseline. Similar to the cocaine-treated animals, methamphetamine also caused a more pronounced hypotensive event, but blood flow was not significantly different from saline controls. Lidocaine did not alter posttraumatic blood pressure but did significantly elevate blood flow throughout the 1-h postinjury period. At 60 min posttrauma, blood flow in the lidocaine group was 80 +/- 10% of the preinjury value. The mechanism by which cocaine alters blood pressure and blood flow after injury is not entirely certain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7840303
Blood Pressure Variability and Stress Management Training for Essential Hypertension
ERIC Educational Resources Information Center
Garcia-Vera, Maria Paz; Sanz, Jesus; Labrador, Francisco J.
The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The…
Study, Examinations, and Stress: Blood Pressure Assessments in College Students
ERIC Educational Resources Information Center
Hughes, Brian M.
The issue of stress associated with higher education and its impact on markers of student health is explored in three experiments looking at blood pressure levels in college students. All participants were full-time undergraduate students of psychology. In Experiment 1, academic fear of failure, assessed using psychometric testing, was found to be…
High Blood Pressure - Multiple Languages: MedlinePlus
Health Promotion to Reduce Blood Pressure Level among Older Blacks.
ERIC Educational Resources Information Center
Haber, David
Low-income Black elders completed a 10-week health promotion program for the purpose of lowering or stabilizing blood pressure levels. Comparisons were made between classes that met weekly versus three times a week, and between yoga and aerobics formats. A peer-led program was developed that continued for 10 months after the professionally-led…
Nursing student caring behaviors during blood pressure measurement.
Becker, Mary Kay; Blazovich, Linda; Schug, Vicki; Schulenberg, Cathy; Daniels, Jessie; Neal, Diana; Pearson, Gloria; Preston, Sara; Ridgeway, Sharon; Simones, Joyce; Swiggum, Paula; Wenkel, Linda; Smith, MaryJo O
The purpose of this multisite, nonexperimental study was to examine, using a repeated measures design, the effects of a teaching intervention designed to promote caring behaviors as students learn the psychomotor skill of blood pressure measurement. Watson's theory of human caring and a combination of cognitive and connectionist learning theories were used as the organizing construct. Baccalaureate nursing student participants were videotaped and evaluated at two points in time while performing the psychomotor skill of blood pressure measurement on a role-player. Role-players rated the students' caring behaviors using the Role Player Survey of Caring Behaviors During Blood Pressure Measurement instrument. Between these data collection points, students learned about caring behaviors through analysis of a videotaped role-play and required readings. An evaluator randomly selected 10 student videotapes from each of the 6 baccalaureate nursing program study sites and noted the presence or absence of caring behaviors on the Caring Behaviors During Blood Pressure Measurement instrument. Pretest and posttest scores on both subjective and objective research instruments were compared using descriptive statistics and repeated measures analysis of variance (ANOVA). Students demonstrated a significant improvement in objective and subjective caring behaviors between the two performance examinations. The findings support further investigation of teaching interventions to promote the development of caring behaviors during nursing psychomotor skill development. PMID:18380262
Rare genetic variant analysis on blood pressure in related samples
The genetic variants associated with blood pressure identified so far explain only a small proportion of the total heritability of this trait. With recent advances in sequencing technology and statistical methodology, it becomes feasible to study the association between blood pressure and rare genetic variants. Using real baseline phenotype data and imputed dosage data from Genetic Analysis Workshop 18, we performed a candidate gene association analysis. We focused on 8 genes shown to be associated with either systolic or diastolic blood pressure to identify the association with both common and rare genetic variants, and then did a genome-wide rare-variant analysis on blood pressure. We performed association analysis for rare coding and splicing variants within each gene region and all rare variants in each sliding window, using either burden tests or sequence kernel association tests accounting for familial correlation. With a sample size of only 747, we failed to find any novel associated genetic loci. Consequently, we performed analyses on simulated data, with knowledge of the underlying simulating model, to evaluate the type I error rate and power for the methods used in real data analysis. PMID:25519320
Time Spent on the Internet and Adolescent Blood Pressure
ERIC Educational Resources Information Center
Cassidy-Bushrow, Andrea E.; Johnson, Dayna A.; Peters, Rosalind M.; Burmeister, Charlotte; Joseph, Christine L. M.
Internet use is nearly ubiquitous among adolescents. Growing evidence suggests heavy Internet use negatively impacts health, yet the relationship between time spent on the Internet and adolescent blood pressure (BP) is unknown. We examined the association between Internet use and elevated BP in a racially diverse cross-sectional sample of 331…
Measuring Arterial Blood Pressure. A Self-Contained Instructional Module.
ERIC Educational Resources Information Center
Schultz, Chris Ellen
This self-contained instructional module is designed to help adult caregivers learn how to measure arterial blood pressure in the home. The module includes the following parts: objectives; pretest (with answers); four sections of instructional material covering (1) equipment, (2) cuff placement and locating the brachial artery, (3) measuring blood…
High Blood Pressure - Multiple Languages: MedlinePlus
... Khmer (Khmer) Korean (한국어) Nepali (नेपाली) Portuguese (português) Russian (Русский) Somali (af Soomaali) Spanish (español) Tagalog ( ... ली (Nepali) Bilingual PDF Health Information Translations Portuguese (português) High Blood Pressure Pressão arterial alta - português (Portuguese) ...
High Blood Pressure in Pregnancy - Multiple Languages: MedlinePlus
... Japanese (日本語) Korean (한국어) Marshallese (kajin Majöl) Portuguese (português) Russian (Русский) Somali (af Soomaali) Spanish (español) Ukrainian ( ... Majöl (Marshallese) Bilingual PDF Health Information Translations Portuguese (português) High Blood Pressure in Pregnancy Pressão arterial (PA) ...
Subcutaneous blood pressure monitoring with an implantable optical sensor.
Theodor, Michael; Ruh, Dominic; Fiala, Jens; Förster, Katharina; Heilmann, Claudia; Manoli, Yiannos; Beyersdorf, Friedhelm; Zappe, Hans; Seifert, Andreas
We introduce a minimally invasive, implantable system that uses pulse transit time to determine blood pressure. In contrast to previous approaches, the pulse wave is detected by a photoplethysmographic (PPG) signal, acquired with high quality directly on subcutaneous muscle tissue. Electrocardiograms (ECG) were measured with flexible, implantable electrodes on the same tissue. PPG detection is realized by a flat 20 mm x 6 mm optoelectronic pulse oximeter working in reflection mode. The optical sensor as well as the ECG electrodes can be implanted using minimally invasive techniques, with only a small incision into the skin, making long-term monitoring of blood pressure in day-to-day life for high-risk patients possible. The in vivo measurements presented here show that the deviation to intra-arterial reference measurements of the systolic blood pressure in a physiologically relevant range is only 5.5 mmHg, demonstrated for more than 12 000 pulses. This makes the presented sensor a grade B blood pressure monitor. PMID:23657895
National High Blood Pressure 12-Month Kit. May 1988.
ERIC Educational Resources Information Center
National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD. National High Blood Pressure Education Program.
Part I of this kit provides information for program planners and health professionals on ways to overcome barriers to health care among the medically underserved, promote high blood pressure control through the media and other community channels, and improve adherence to treatment among hypertensive patients. It lists additional resources for…
Cardiac risk factors: new cholesterol and blood pressure management guidelines.
Anthony, David; George, Paul; Eaton, Charles B
The 2013 American College of Cardiology/American Heart Association cholesterol guidelines depart from low-density lipoprotein (LDL) treatment targets and recommend treating four specific patient groups with statins. Statins are the only cholesterol-lowering drugs with randomized trial evidence of benefit for preventing atherosclerotic cardiovascular disease (ASCVD). The groups are patients with clinical ASCVD; patients ages 40 to 75 years with diabetes and LDL of 70 to 189 mg/dL but no clinical ASCVD; patients 21 years or older with LDL levels of 190 mg/dL or higher; and patients ages 40 to 75 years with LDL of 70 to 189 mg/dL without clinical ASCVD or diabetes but with 10-year ASCVD risk of 7.5% or higher. Ten-year ASCVD risk may be calculated using the Pooled Cohort Equations. The Eighth Joint National Committee (JNC 8) guidelines for blood pressure management recommend a blood pressure goal of less than 140/90 mm Hg for all adults except those 60 years or older. For the latter group, the JNC 8 recommends a systolic blood pressure goal of less than 150 mm Hg. In another notable change from prior guidelines, the JNC 8 recommends relaxing the systolic blood pressure goal for patients with diabetes and chronic kidney disease to less than 140 mm Hg from less than 130 mm Hg. PMID:24936717
A Nutrition Curriculum for Families with High Blood Pressure.
ERIC Educational Resources Information Center
Farris, Rosanne P.; And Others
A nutrition curriculum for elementary and secondary school students with high blood pressure was implemented as part of a Dietary/Exercise Alteration Program trial. Reduced sodium and energy intake and increased potassium intake were promoted. Materials and methods of the program are described. (Author/DF)
Health Instruction Packages: Consumer--Your Heart and Blood Pressure.
ERIC Educational Resources Information Center
Woods, James W.; And Others
Text, illustrations, and exercises are utilized in this set of learning modules to instruct the general public in the prevention and treatment of heart disease. The first module, by James W. Woods, presents a medical definition of high blood pressure, reviews its causes and effects, and discusses its treatment. A script to a slide version of this…
Measures of blood pressure and cognition in dialysis patients
Technology Transfer Automated Retrieval System (TEKTRAN)
There are few reports on the relationship of blood pressure with cognitive function in maintenance dialysis patients. The Cognition and Dialysis Study is an ongoing investigation of cognitive function and its risk factors in six Boston area hemodialysis units. In this analysis, we evaluated the rela...
Regional grey matter shrinks in hypertensive individuals despite successful lowering of blood pressure
Jennings, J. R.; Mendelson, D. N.; Muldoon, M. F.; Ryan, Christopher M.; Gianaros, P. J.; Raz, N.; Aizenstein, H.
Objective To determine whether reduction in brain grey matter volume associated with hypertension persisted or was remediated among hypertensive patients newly treated over the course of a year. Methods Forty-one hypertensive patients were assessed over the course of a one-year successful anti-hypertensive treatment. Brain areas identified previously in cross-sectional studies as differing in volume between hypertensive and normotensive individuals were examined with a semi-automated measurement technique (ALP, automated labeling pathway). Volumes of grey matter regions were computed at baseline and after a year of treatment and compared to archival data from normotensive individuals. Results Reductions in regional grey matter volume over the follow-up period were observed despite successful treatment of blood pressure. The comparison group of older, but normotensive individuals showed no significant changes over a year in the regions tested in the treated hypertensive group. Conclusions These novel results suggest that essential hypertension is associated with regional grey matter shrinkage and successful reduction of blood pressure may not completely counter that trend. PMID:21490622
The Conundrum of Arterial Stiffness, Elevated blood pressure, and Aging
AlGhatrif, Majd; Lakatta, Edward G.
Isolated systolic hypertension is a major health burden that is expanding with the aging of our population. There is evidence that central arterial stiffness contributes to the rise in systolic blood pressure (SBP); at the same time central arterial stiffening is accelerated in patients with increased (SBP). This bidirectional relationship created a controversy in the field on whether arterial stiffness leads to hypertension or vice versa. Given the profound interdependency of arterial stiffness and blood pressure, this question seems intrinsically challenging, or probably naïve. The aorta's function of dampening the pulsatile flow generated by the heart is optimal a range of distending pressure that secures the required distal flow, keeps the aorta in an optimal mechanical conformation, and minimizes cardiac work. This homeostasis is disturbed by age-associated, minute alterations in aortic hemodynamic and mechanical properties that induce short- and long-term alterations in each other. Hence, it is impossible to detect an "initial insult" at an epidemiological level. Earlier manifestations of these alterations are observed in young adulthood with a sharp decline in aortic strain and distensibility accompanied by an increase in diastolic blood pressure. Subsequently aortic mechanical reserve is exhausted, and aortic remodeling with wall stiffening and dilatation ensue. These two phenomena affect pulse pressure in opposite directions and different magnitudes. With early remodeling there is an increase in pulse pressure, due to the dominance of arterial wall stiffness, which in turn accelerates aortic wall stiffness and dilation. With advanced remodeling, which appears to be greater in men, the effect of diameter becomes more pronounced and partially offsets the effect of wall stiffness leading to plateauing in pulse pressure in men, and slower increase in PP than that of wall stiffness in women. The complex nature of hemodynamic changes with aging makes the
Continuous non-invasive finger blood pressure monitoring in children.
Tanaka, H; Thulesius, O; Yamaguchi, H; Mino, M; Konishi, K
We evaluated the performance of continuous non-invasive finger arterial pressure measurement using the volume-clamp technique (Finapres). This study was designed to compare finger arterial pressure with brachial blood pressure estimated by the auscultatory method in 217 children (90 boys and 127 girls) aged 4-16 years and in 38 adults (aged 18-45 years). Finger and brachial artery pressure readings were obtained consecutively from the ipsilateral side in the supine position. Finger arterial pressure waveforms were recorded in all children except 4 with small and thin fingers. There was good agreement for systolic pressure with only a slight underestimation of 1.9 mmHg and 5.1 mmHg lower for diastolic pressure. This difference most probably reflects inaccuracy of the auscultatory cuff method rather than an error in the Finapres. There was large inter-individual variability in Finapres recordings which might be due to differences in vasomotor tone, as demonstrated by systolic amplification in 5 patients with anorexia. However, Finapres showed a small within-subject variability (3.8 mmHg for systolic and 4.1 mmHg for diastolic pressure) determined in 5 patients during phenylephrine infusion, and as good reproducibility as the auscultatory method. These results suggest that finger arterial pressure measurement in children older than 6 years of age has similar accuracy as that in adults, and that this method is useful for clinical applications in children, especially for the non-invasive evaluation of autonomic control and cardiovascular reflexes involving transient and rapid blood pressure changes. PMID:7919764
Synchronization patterns in cerebral blood flow and peripheral blood pressure under minor stroke
NASA Astrophysics Data System (ADS)
Chen, Zhi; Ivanov, Plamen C.; Hu, Kun; Stanley, H. Eugene; Novak, Vera
Stroke is a leading cause of death and disability in the United States. The autoregulation of cerebral blood flow that adapts to changes in systemic blood pressure is impaired after stroke. We investigate blood flow velocities (BFV) from right and left middle cerebral arteries (MCA) and beat-to-beat blood pressure (BP) simultaneously measured from the finger, in 13 stroke and 11 healthy subjects using the mean value statistics and phase synchronization method. We find an increase in the vascular resistance and a much stronger cross-correlation with a time lag up to 20 seconds with the instantaneous phase increment of the BFV and BP signals for the subjects with stroke compared to healthy subjects.
Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants
Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.
The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 (/sup 133/Xe) clearance technique, which uses an intravenous bolus of /sup 133/Xe, an external chest detector to estimate arterial /sup 133/Xe concentration, eight external cranial detectors to measure cephalic /sup 133/Xe clearance curves, and a two-compartmental analysis of the cephalic /sup 133/Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications.
[Oversized patient arms: a problem with blood pressure measurements].
Meyer, Fritz; Meyer, Thomas; Klein, Reinhold
The increase in the worldwide prevalence of obesity systematically leads to a higher number of individuals who may be wrongly diagnosed as hypertensive because their arms are too large for standard blood pressure cuffs, which are ordinarily appropriate in patients with normal sized arms. The aim was to gain real data of upper arm and wrist circumferences in 327 elected subjects with larger arms (upper arm circumference >32.5 cm) from two Bavarian general practices. We found that 93.9% of all patients had an upper arm circumference of a maximum of 41.0 cm and a wrist circumference of at most 20.5 cm. These data were then compared with the approved size ranges of six wrist blood pressure measurement devices, one special three-in-one cuff for different sizes and the two large adult cuffs recommended by the German Hypertension Society. Availability of one large cuff and one wrist blood measurement device (either used at the upper arm or at the wrist depending on patient dimensions) seems to be sufficient. This should allow for true blood pressure readings to be obtained in at least 96% of all patients with arms of more than normal circumference. PMID:16955625
The development of a blood pressure simulator in KRISS.
Song, Han Wook; Lee, SungJun; Park, Yon Kyu; Choi, In Mook; Woo, Sam Yong
Blood pressure is defined as the amount of force at unit area which the blood exerts on a wall of a blood vessel. The BP has a clinical importance as the basic index in the medical examination of patients. Especially, the percentage of the hypertensive is more than 15% in an adult population of Korea and hypertension is notorious as 'a silent killer' because it has no prior symptoms. The most important thing in the diagnosis, treatment and prognosis of hypertension is the accurate measurement of the BP. In this study, we developed the blood pressure simulator for the monitoring of oscillometric BP devices and compared this KRISS simulator with commercial simulators. Finally, we tested the commercial oscillometric BP devices (6 models from 5 manufacturers) using the KRISS simulator. The KRISS simulator has the repeatability error below 0.1% for the pressure generation and we expected to develop the BP simulator for Korean by the collection of clinical data from Koreans. PMID:19163409
Immune cells control skin lymphatic electrolyte homeostasis and blood pressure.
Wiig, Helge; Schröder, Agnes; Neuhofer, Wolfgang; Jantsch, Jonathan; Kopp, Christoph; Karlsen, Tine V; Boschmann, Michael; Goss, Jennifer; Bry, Maija; Rakova, Natalia; Dahlmann, Anke; Brenner, Sven; Tenstad, Olav; Nurmi, Harri; Mervaala, Eero; Wagner, Hubertus; Beck, Franz-Xaver; Müller, Dominik N; Kerjaschki, Dontscho; Luft, Friedrich C; Harrison, David G; Alitalo, Kari; Titze, Jens
The skin interstitium sequesters excess Na+ and Cl- in salt-sensitive hypertension. Mononuclear phagocyte system (MPS) cells are recruited to the skin, sense the hypertonic electrolyte accumulation in skin, and activate the tonicity-responsive enhancer-binding protein (TONEBP, also known as NFAT5) to initiate expression and secretion of VEGFC, which enhances electrolyte clearance via cutaneous lymph vessels and increases eNOS expression in blood vessels. It is unclear whether this local MPS response to osmotic stress is important to systemic blood pressure control. Herein, we show that deletion of TonEBP in mouse MPS cells prevents the VEGFC response to a high-salt diet (HSD) and increases blood pressure. Additionally, an antibody that blocks the lymph-endothelial VEGFC receptor, VEGFR3, selectively inhibited MPS-driven increases in cutaneous lymphatic capillary density, led to skin Cl- accumulation, and induced salt-sensitive hypertension. Mice overexpressing soluble VEGFR3 in epidermal keratinocytes exhibited hypoplastic cutaneous lymph capillaries and increased Na+, Cl-, and water retention in skin and salt-sensitive hypertension. Further, we found that HSD elevated skin osmolality above plasma levels. These results suggest that the skin contains a hypertonic interstitial fluid compartment in which MPS cells exert homeostatic and blood pressure-regulatory control by local organization of interstitial electrolyte clearance via TONEBP and VEGFC/VEGFR3-mediated modification of cutaneous lymphatic capillary function. PMID:23722907
Impact of baseline systolic blood pressure on visit-to-visit blood pressure variability: the Kailuan study
Wang, Anxin; Li, Zhifang; Yang, Yuling; Chen, Guojuan; Wang, Chunxue; Wu, Yuntao; Ruan, Chunyu; Liu, Yan; Wang, Yilong; Wu, Shouling
Background To investigate the relationship between baseline systolic blood pressure (SBP) and visit-to-visit blood pressure variability in a general population. Methods This is a prospective longitudinal cohort study on cardiovascular risk factors and cardiovascular or cerebrovascular events. Study participants attended a face-to-face interview every 2 years. Blood pressure variability was defined using the standard deviation and coefficient of variation of all SBP values at baseline and follow-up visits. The coefficient of variation is the ratio of the standard deviation to the mean SBP. We used multivariate linear regression models to test the relationships between SBP and standard deviation, and between SBP and coefficient of variation. Results Approximately 43,360 participants (mean age: 48.2±11.5 years) were selected. In multivariate analysis, after adjustment for potential confounders, baseline SBPs <120 mmHg were inversely related to standard deviation (P<0.001) and coefficient of variation (P<0.001). In contrast, baseline SBPs ≥140 mmHg were significantly positively associated with standard deviation (P<0.001) and coefficient of variation (P<0.001). Baseline SBPs of 120–140 mmHg were associated with the lowest standard deviation and coefficient of variation. The associations between baseline SBP and standard deviation, and between SBP and coefficient of variation during follow-ups showed a U curve. Conclusion Both lower and higher baseline SBPs were associated with increased blood pressure variability. To control blood pressure variability, a good target SBP range for a general population might be 120–139 mmHg. PMID:27536123
Blood pressure regulation IV: adaptive responses to weightlessness.
Norsk, Peter
During weightlessness, blood and fluids are immediately shifted from the lower to the upper body segments, and within the initial 2 weeks of spaceflight, brachial diastolic arterial pressure is reduced by 5 mmHg and even more so by some 10 mmHg from the first to the sixth month of flight. Blood pressure thus adapts in space to a level very similar to that of being supine on the ground. At the same time, stroke volume and cardiac output are increased and systemic vascular resistance decreased, whereas sympathetic nerve activity is kept surprisingly high and similar to when ground-based upright seated. This was not predicted from simulation models and indicates that dilatation of the arteriolar resistance vessels is caused by mechanisms other than a baroreflex-induced decrease in sympathetic nervous activity. Results of baroreflex studies in space indicate that compared to being ground-based supine, the carotid (vagal)-cardiac interaction is reduced and sympathetic nerve activity, heart rate and systemic vascular resistance response more pronounced during baroreflex inhibition by lower body negative pressure. The future challenge is to identify which spaceflight mechanism induces peripheral arteriolar dilatation, which could explain the decrease in blood pressure, the high sympathetic nerve activity and associated cardiovascular changes. It is also a challenge to determine the cardiovascular risk profile of astronauts during future long-duration deep space missions. PMID:24390686
Device and method for automated separation of a sample of whole blood into aliquots
Burtis, Carl A.; Johnson, Wayne F.
A device and a method for automated processing and separation of an unmeasured sample of whole blood into multiple aliquots of plasma. Capillaries are radially oriented on a rotor, with the rotor defining a sample chamber, transfer channels, overflow chamber, overflow channel, vent channel, cell chambers, and processing chambers. A sample of whole blood is placed in the sample chamber, and when the rotor is rotated, the blood moves outward through the transfer channels to the processing chambers where the blood is centrifugally separated into a solid cellular component and a liquid plasma component. When the rotor speed is decreased, the plasma component backfills the capillaries resulting in uniform aliquots of plasma which may be used for subsequent analytical procedures.
21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.
Code of Federal Regulations, 2014 CFR
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21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Indwelling blood oxygen partial pressure (PO2... Indwelling blood oxygen partial pressure (PO2) analyzer. (a) Identification. An indwelling blood oxygen... electrode) and that is used to measure, in vivo, the partial pressure of oxygen in blood to aid...
21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Indwelling blood oxygen partial pressure (PO2... Indwelling blood oxygen partial pressure (PO2) analyzer. (a) Identification. An indwelling blood oxygen... electrode) and that is used to measure, in vivo, the partial pressure of oxygen in blood to aid...
21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Indwelling blood oxygen partial pressure (PO2... Indwelling blood oxygen partial pressure (PO2) analyzer. (a) Identification. An indwelling blood oxygen... electrode) and that is used to measure, in vivo, the partial pressure of oxygen in blood to aid...
21 CFR 868.1200 - Indwelling blood oxygen partial pressure (PO2) analyzer.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Indwelling blood oxygen partial pressure (PO2... Indwelling blood oxygen partial pressure (PO2) analyzer. (a) Identification. An indwelling blood oxygen... electrode) and that is used to measure, in vivo, the partial pressure of oxygen in blood to aid...
Moyamoya disease in pregnancy: maintenance of maternal blood pressure
Barrett, Helen L; Lust, Karin; Fagermo, Narelle; Callaway, Leonie K; Minuzzo, Lee
Moyamoya disease is a rare cerebrovascular occlusive disorder characterized by stenosis in the circle of Willis with the development of a compensatory circulation. It has been associated with significant morbidity in pregnancy including intracranial haemorrhage, ischaemic stroke and epilepsy. We present the case of a 26-year-old woman with a previous diagnosis of moyamoya vasculopathy with bilateral superficial temporal to middle cerebral artery bypass grafting. During the second trimester, she developed significant neurological symptoms related to postural hypotension in the presence of a stenosis of the right-sided graft. The hypotension was treated with fludrocortisone therapy with improvement in blood pressure and symptoms. Moyamoya vasculopathy poses unique challenges to obstetric care. This is the first report of use of fludrocortisone for maintenance of blood pressure during pregnancy in this condition.
Estimating blood pressure using Windkessel model on Photoplethysmogram.
Choudhury, Anirban Dutta; Banerjee, Rohan; Sinha, Aniruddha; Kundu, Shaswati
Simple and non-invasive methods to estimate vital signs are very important for preventive healthcare. In this paper, we present a methodology to estimate Blood Pressure (BP) using Photoplethysmography (PPG). Instead of directly relating systolic and diastolic BP values with PPG features, our proposed methodology initially maps PPG features with some person specific intermediate latent parameters and later derives BP values from them. The 2-Element Windkessel model has been considered in the current context to estimate total peripheral resistance and arterial compliance of a person using PPG features, followed by linear regression for simulating arterial blood pressure. Experimental results, performed on a standard hospital dataset yielded absolute errors of 0.78±13.1 mmHg and 0.59 ± 10.23 mmHg for systolic and diastolic BP values respectively. Results also indicate that the methodology is more robust than the standard methodologies that directly estimate BP values from PPG signal. PMID:25571008
[Scientific production of Brazilian nurses on blood pressure measurement].
Arcuri, Edna Apparecida Moura; de Araújo, Thelma Leite; Veiga, Eugênia Veludo; de Oliveira, Sonia Maria Junqueira Vasconcellos; Lamas, José Luiz Tatagiba; Santos, Jair Lício Ferreira
In the previous issue of this journal the authors celebrated in an article the discovery of the Korotkoff sounds, in 1905, and presented the historical facts that determined the important role of the University of São Paulo's Nursing School (EEUSP) in the development of the oldest blood pressure research line in Brazilian Nursing: "Cuff Width Influence in Blood Pressure Measurement." This new article presents the scientific production derived from the studies carried out by nurses with a PhD from EEUSP during and after their doctoral programs in the area. The path each researcher followed in his/her group and laboratory is emphasized. The data presented is aimed at offering a number of qualitative and quantitative indicators that make possible to evaluate the impact of the research that they have carried out, as well as the development of knowledge in the area. PMID:17722397
[The oral cavity condition in patients with high blood pressure].
Rosiak, Joanna; Kubić-Filiks, Beata; Szymańska, Jolanta
The incidence of high blood pressure in adults is estimated at ca. 30-40% of the general population. Both hypertension disease and hypertensive drugs affect the condition of the patients' oral cavity. A review of the current literature shows that disorders most frequently found in the masticatory organ of patients with hypertension include: xerostomia, changes in salivary glands, gum hypertrophy, lichenoid lesions, taste disorders, and paraesthesias. The authors emphasize that patients with high blood pressure, along with the treatment of the underlying disease, should receive prophylactic and therapeutic dental care. This would enable reduction and/or elimination of unpleasant complaints, and also help prevent the emergence of secondary disorders in the patients' oral cavity as a result of hypertension pharmacotherapy. PMID:26608497
Central regulation of blood pressure by the Mineralocorticoid Receptor
Gomez-Sanchez, Elise P.; Gomez-Sanchez, Celso E.
Addition of mineralocorticoid receptor (MR) antagonists to standard therapy for heart failure, kidney disease, metabolic syndrome, and diabetes is increasing steadily in response to clinical trials demonstrating clear benefits. In addition to blocking deleterious activity of MR within the heart, vessels and kidneys, MR antagonists target MR in hemodynamic regulatory centers in the brain, thereby decreasing excessive sympathetic nervous system drive, vasopressin release, abnormal baroreceptor function, and circulating and tissue pro-inflammatory cytokines. However, brain MR are also involved with cognition, memory, affect and functions yet to be determined. Understanding specific central mechanisms involved in blood pressure regulation by MR is necessary for the development of agents to target downstream events specific to central hemodynamic regulation, not only to avoid the hypokalemia caused by inhibition of renal tubular MR, but also to avoid untoward long term effects of inhibiting brain MR that are not involved in blood pressure control. PMID:21664417
[Synchonization of the blood flow rate in arterial with the changing rate of space of blood pressure with time].
Zhang, Shenghua; Qin, Renjia
In physiology-related books, there are many relationship curves about blood flow rate in arteries and blood pressure changes with time, but there are not much explanation about such relationship. This is the very the question that the present article tries to answer. We clarified the relations between blood flow rate and blood pressure gradient using the experimental curves as the basis, using Poiseuille Law and relative knowledge of phisics and mathematics, and using analysis and reasoning. Based on the study, it can be concluded that in every course of cardiac cycle, the blood flow rate of any section in artery blood vessel is roughly synchronized with changing rate of space and time of the blood pressure, but blood flow rate is not synchronized with blood pressure. PMID:23198422
Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure
Boltz, Agnes; Schmidl, Doreen; Werkmeister, René M; Lasta, Michael; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna J; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold
In the choroid, there is evidence that blood flow does not only depend on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). The present study included 40 healthy subjects to investigate whether such behavior is also found in the optic nerve head (ONH). The ONH blood flow (ONHBF) was studied using laser Doppler flowmetry during a separate increase in IOP and MAP as well as during a combined elevation. Mean arterial pressure was increased by isometric exercise and IOP by the suction method. During both, the change in ONHBF was less pronounced than the change in OPP indicating autoregulation. Correlation analysis was performed for the combined experiments after pooling all data according to IOP and MAP values. A correlation between ONHBF and MAP was found at IOPs ⩽25 mm Hg (P<0.001), but not at IOPs>25 mm Hg (P=0.79). Optic nerve head blood flow and IOP were significantly correlated (P<0.001), and ONHBF was only slightly dependent on MAP. The data of the present study indicate a complex regulation of ONHBF during combined changes in MAP and IOP. Our results may be compatible with myogenic mechanisms underlying autoregulation, and indicate better ONHBF regulation during an increase in MAP than during an increase in IOP. PMID:23921903
Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure.
Boltz, Agnes; Schmidl, Doreen; Werkmeister, René M; Lasta, Michael; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna J; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold
In the choroid, there is evidence that blood flow does not only depend on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). The present study included 40 healthy subjects to investigate whether such behavior is also found in the optic nerve head (ONH). The ONH blood flow (ONHBF) was studied using laser Doppler flowmetry during a separate increase in IOP and MAP as well as during a combined elevation. Mean arterial pressure was increased by isometric exercise and IOP by the suction method. During both, the change in ONHBF was less pronounced than the change in OPP indicating autoregulation. Correlation analysis was performed for the combined experiments after pooling all data according to IOP and MAP values. A correlation between ONHBF and MAP was found at IOPs 25 mm Hg (P<0.001), but not at IOPs>25 mm Hg (P=0.79). Optic nerve head blood flow and IOP were significantly correlated (P<0.001), and ONHBF was only slightly dependent on MAP. The data of the present study indicate a complex regulation of ONHBF during combined changes in MAP and IOP. Our results may be compatible with myogenic mechanisms underlying autoregulation, and indicate better ONHBF regulation during an increase in MAP than during an increase in IOP. PMID:23921903
Wavelet analysis of blood pressure waves in vasovagal syncope
NASA Astrophysics Data System (ADS)
Marrone, A.; Polosa, A. D.; Scioscia, G.; Stramaglia, S.; Zenzola, A.
We describe the multiresolution wavelet analysis of blood pressure waves in vasovagal syncope affected patients compared with healthy people. We argue that there exist discriminating criteria which allow us to isolate particular features, common to syncope-affected patients sample, indicating a tentative, alternative diagnosis methodology for this syndrome. We perform a throughout analysis both in the Haar basis and in a Gaussian one, with an attempt to grasp the underlying dynamics.
Self-Organization of Blood Pressure Regulation: Experimental Evidence
Fortrat, Jacques-Olivier; Levrard, Thibaud; Courcinous, Sandrine; Victor, Jacques
Blood pressure regulation is a prime example of homeostatic regulation. However, some characteristics of the cardiovascular system better match a non-linear self-organized system than a homeostatic one. To determine whether blood pressure regulation is self-organized, we repeated the seminal demonstration of self-organized control of movement, but applied it to the cardiovascular system. We looked for two distinctive features peculiar to self-organization: non-equilibrium phase transitions and hysteresis in their occurrence when the system is challenged. We challenged the cardiovascular system by means of slow, 20-min Tilt-Up and Tilt-Down tilt table tests in random order. We continuously determined the phase between oscillations at the breathing frequency of Total Peripheral Resistances and Heart Rate Variability by means of cross-spectral analysis. We looked for a significant phase drift during these procedures, which signed a non-equilibrium phase transition. We determined at which head-up tilt angle it occurred. We checked that this angle was significantly different between Tilt-Up and Tilt-Down to demonstrate hysteresis. We observed a significant non-equilibrium phase transition in nine healthy volunteers out of 11 with significant hysteresis (48.1 ± 7.5° and 21.8 ± 3.9° during Tilt-Up and Tilt-Down, respectively, p < 0.05). Our study shows experimental evidence of self-organized short-term blood pressure regulation. It provides new insights into blood pressure regulation and its related disorders. PMID:27065880
Wearable Beat-to-Beat Blood Pressure Monitor
NASA Technical Reports Server (NTRS)
Lee, Yong Jin
Linea Research Corporation has developed a wearable noninvasive monitor that provides continuous blood pressure and heart rate measurements in extreme environments. Designed to monitor the physiological effects of astronauts' prolonged exposure to reduced-gravity environments as well as the effectiveness of various countermeasures, the device offers wireless connectivity to allow transfer of both real-time and historical data. It can be modified to monitor the health status of astronaut crew members during extravehicular missions.
Longitudinal Impedance Tomography for Blood Pressure Characterization of Valve Deformation
Vahabi, Zahra; Amirfattahi, Rasool
Aorta is formed in a dynamic environment which gives rise to imbalances between many forces that tend to extend the diameter and length. Furthermore, internal forces tend to resist this extension. Impedance tomography can show this imbalance to stimulate the stenosis of aortic valve, growth of the elastic, collagen and to effectively reduce the stresses in the underlying tissue. In blood flow, auscultation noises occurred and in the echocardiography decrease in left ventricular ejection speed can be observed. In this paper, we have modeled an aorta based on anatomical studies to simulate natural, 20% and 30% stenosis as usual heart disease to early diagnosis. Valve deformation causes different impedance tomography in 3D mesh of aorta as blood pressure. Remodeling of aorta and its flow is found when a cylindrical slice of the fully retracted blood aorta is cut longitudinally through the wall. PMID:26120568
Validation of the Parama-Tech PS-501 device for office blood pressure measurement according to the international protocol.
Kikuya, Masahiro; Ohkubo, Takayoshi; Satoh, Michihiro; Hashimoto, Takanao; Hirose, Takuo; Metoki, Hirohito; Obara, Taku; Inoue, Ryusuke; Asayama, Kei; Totsune, Kazuhito; Imai, Yutaka
The PS-501 device (Parama-Tech, Fukuoka, Japan), an automated device for office blood pressure measurement based on the Korotkoff method and designed for professional use in clinical settings, was validated. Consecutive outpatients with hypertension and ≥30 years old at an outpatient hypertension clinic were recruited. According to the European Society of Hypertension protocol, 33 participants were included in the validation study (phase 1, n = 15; phase 2, n = 18). The cuff deflation rate can be selected manually from 2, 3, and 4 mm Hg/beat. The validation was performed with the device deflating at a rate of 2 mm Hg/beat. All blood pressure readings were measured on the left arm. The tested device passed all criteria for both systolic and diastolic blood pressure measurements. The mean (± standard deviation) differences in systolic and diastolic blood pressure between the tested device and the mean of observer readings were -1.9 ± 4.6 and -2.5 ± 2.9 mm Hg, respectively. The PS-501 device for office blood pressure measurement passed all the validation criteria of the European Society of Hypertension and can therefore be recommended for clinical use in an adult population. PMID:21967030
Effects of nattokinase on blood pressure: a randomized, controlled trial.
Kim, Ji Young; Gum, Si Nae; Paik, Jean Kyung; Lim, Hyo Hee; Kim, Kyong-Chol; Ogasawara, Kazuya; Inoue, Kenichi; Park, Sungha; Jang, Yangsoo; Lee, Jong Ho
The objective of this study was to examine the effects of nattokinase supplementation on blood pressure in subjects with pre-hypertension or stage 1 hypertension. In a randomized, double-blind, placebo-controlled trial, 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure (SBP) of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for 8 weeks. Seventy-three subjects completed the protocol. Compared with the control group, the net changes in SBP and diastolic blood pressure (DBP) were -5.55 mmHg (95% confidence interval [CI], -10.5 to -0.57 mmHg; p<0.05) and -2.84 mmHg (CI, -5.33 to -0.33 mmHg; p<0.05), respectively, after the 8-week intervention. The corresponding net change in renin activity was -1.17 ng/mL/h for the nattokinase group compared with the control group (p<0.05). In conclusion, nattokinase supplementation resulted in a reduction in SBP and DBP. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension. PMID:18971533
Dietary Protein and Blood Pressure: A Systematic Review
Altorf – van der Kuil, Wieke; Engberink, Mariëlle F.; Brink, Elizabeth J.; van Baak, Marleen A.; Bakker, Stephan J. L.; Navis, Gerjan; van 't Veer, Pieter; Geleijnse, Johanna M.
Background Elevated blood pressure (BP), which is a major risk factor for cardiovascular disease, is highly prevalent worldwide. Recently, interest has grown in the role of dietary protein in human BP. We performed a systematic review of all published scientific literature on dietary protein, including protein from various sources, in relation to human BP. Methodology/Principal Findings We performed a MEDLINE search and a manual search to identify English language studies on the association between protein and blood pressure, published before June 2010. A total of 46 papers met the inclusion criteria. Most observational studies showed no association or an inverse association between total dietary protein and BP or incident hypertension. Results of biomarker studies and randomized controlled trials indicated a beneficial effect of protein on BP. This beneficial effect may be mainly driven by plant protein, according to results in observational studies. Data on protein from specific sources (e.g. from fish, dairy, grain, soy, and nut) were scarce. There was some evidence that BP in people with elevated BP and/or older age could be more sensitive to dietary protein. Conclusions/Significance In conclusion, evidence suggests a small beneficial effect of protein on BP, especially for plant protein. A blood pressure lowering effect of protein may have important public health implications. However, this warrants further investigation in randomized controlled trials. Furthermore, more data are needed on protein from specific sources in relation to BP, and on the protein-BP relation in population subgroups. PMID:20711407
Central and Peripheral Irisin Differentially Regulate Blood Pressure
Zhang, Chao; Zhang, Ruthann; Li, Ziru; Chai, Biaoxin; Li, Jiyao; Chen, Eugene; Mulholland, Michael
Introduction Irisin is a newly identified 112 amino acid hormone, derived as a product of fibronectin type III domain containing 5 (FNDC5), which is highly related to metabolic activity in skeletal muscle and brown fat. The effects of irisin on cardiovascular functions are unknown. Purpose To explore the effects of central and peripheral irisin on cardiovascular functions. Methods Irisin was either administrated into 3rd ventricle of rats or intravenously, and its effects on blood pressure and cardiac contractibility measured. Results Administration of recombinant human irisin into the 3rd brain ventricle of rats activated neurons in the paraventricular nuclei of the hypothalamus. Central administration of irisin increased blood pressure and cardiac contractibility. Exogenous irisin reversed atenolol-induced inhibition of cardiac contractibility. In contrast, peripheral administration of irisin reduced blood pressure in both control and spontaneously hypertensive rats. Irisin dilated mesenteric artery rings through ATP-sensitive potassium channels. Conclusion Our studies indicate that central and peripheral irisin may differentially regulate cardiovascular activities. PMID:25820670
Methodology and technology for peripheral and central blood pressure and blood pressure variability measurement: current status and future directions - Position statement of the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability.
Stergiou, George S; Parati, Gianfranco; Vlachopoulos, Charalambos; Achimastos, Apostolos; Andreadis, Emanouel; Asmar, Roland; Avolio, Alberto; Benetos, Athanase; Bilo, Grzegorz; Boubouchairopoulou, Nadia; Boutouyrie, Pierre; Castiglioni, Paolo; de la Sierra, Alejandro; Dolan, Eamon; Head, Geoffrey; Imai, Yutaka; Kario, Kazuomi; Kollias, Anastasios; Kotsis, Vasilis; Manios, Efstathios; McManus, Richard; Mengden, Thomas; Mihailidou, Anastasia; Myers, Martin; Niiranen, Teemu; Ochoa, Juan Eugenio; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Papaioannou, Theodore; Protogerou, Athanasios; Redon, Josep; Verdecchia, Paolo; Wang, Jiguang; Zanchetti, Alberto; Mancia, Giuseppe; O'Brien, Eoin
Office blood pressure measurement has been the basis for hypertension evaluation for almost a century. However, the evaluation of blood pressure out of the office using ambulatory or self-home monitoring is now strongly recommended for the accurate diagnosis in many, if not all, cases with suspected hypertension. Moreover, there is evidence that the variability of blood pressure might offer prognostic information that is independent of the average blood pressure level. Recently, advancement in technology has provided noninvasive evaluation of central (aortic) blood pressure, which might have attributes that are additive to the conventional brachial blood pressure measurement. This position statement, developed by international experts, deals with key research and practical issues in regard to peripheral blood pressure measurement (office, home, and ambulatory), blood pressure variability, and central blood pressure measurement. The objective is to present current achievements, identify gaps in knowledge and issues concerning clinical application, and present relevant research questions and directions to investigators and manufacturers for future research and development (primary goal). PMID:27214089
Automated computational framework of blood vessel quantification in chick chorioallantoic membrane angiogenesis
NASA Astrophysics Data System (ADS)
Shi, Peng; Hong, Jinsheng; Huang, Yue; Zhang, Zhenhuan; Zhang, Mei; Zhang, Lurong
Chick chorioallantoic membrane (CAM) angiogenesis assay has been widely used for finding drugs targeting new blood vessel development in cancer research. In addition to the setup materials and protocols, laboratory findings depend on the quantification and analysis of microscopic blood vessel images. However, it is still a challenging problem because of the high complexity of blood vessel branching structures. We applied preprocessing on CAM microscopic images by keeping the integrity of minor branches in the vessel structure. We then proposed an efficient way to automatically extract blood vessel centerlines based on vector tracing starting from detected seed points. Finally, all branches were coded to construct an abstract model of the branching structure, which enabled more accurate modeling for in-depth analysis. The framework was applied in quantifying Icaritin (ICT) inhibition effects on angiogenesis in a CAM model. Experimental results showed the high accuracy in blood vessel quantification and modeling compared with semimanual measurements. Meanwhile, a set of blood vessel growth indicators were extracted to provide fully automated analysis for angiogenesis assays. Further analysis proved that ICT took effect in a dose-dependent manner which could be applied in suppressing tumor blood vessel growth.
Automated computational framework of blood vessel quantification in chick chorioallantoic membrane angiogenesis.
Shi, Peng; Hong, Jinsheng; Huang, Yue; Zhang, Zhenhuan; Zhang, Mei; Zhang, Lurong
Chick chorioallantoic membrane (CAM) angiogenesis assay has been widely used for finding drugs targeting new blood vessel development in cancer research. In addition to the setup materials and protocols, laboratory findings depend on the quantification and analysis of microscopic blood vessel images. However, it is still a challenging problem because of the high complexity of blood vessel branching structures. We applied preprocessing on CAM microscopic images by keeping the integrity of minor branches in the vessel structure. We then proposed an efficient way to automatically extract blood vessel centerlines based on vector tracing starting from detected seed points. Finally, all branches were coded to construct an abstract model of the branching structure, which enabled more accurate modeling for in-depth analysis. The framework was applied in quantifying Icaritin (ICT) inhibition effects on angiogenesis in a CAM model. Experimental results showed the high accuracy in blood vessel quantification and modeling compared with semimanual measurements. Meanwhile, a set of blood vessel growth indicators were extracted to provide fully automated analysis for angiogenesis assays. Further analysis proved that ICT took effect in a dose-dependent manner which could be applied in suppressing tumor blood vessel growth. PMID:25277148
Risk Associated with Pulse Pressure on Out-of-Office Blood Pressure Measurement
Gu, Yu-Mei; Aparicio, Lucas S.; Liu, Yan-Ping; Asayama, Kei; Hansen, Tine W.; Niiranen, Teemu J.; Boggia, José; Thijs, Lutgarde; Staessen, Jan A.
Background Longitudinal studies have demonstrated that the risk of cardiovascular disease increases with pulse pressure (PP). However, PP remains an elusive cardiovascular risk factor with findings being inconsistent between studies. The 2013 ESH/ESC guideline proposed that PP is useful in stratification and suggested a threshold of 60 mm Hg, which is 10 mm Hg higher compared to that in the 2007 guideline; however, no justification for this increase was provided. Methodology Published thresholds of PP are based on office blood pressure measurement and often on arbitrary categorical analyses. In the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) and the International Database on HOme blood pressure in relation to Cardiovascular Outcome (IDHOCO), we determined outcome-driven thresholds for PP based on ambulatory or home blood pressure measurement, respectively. Results The main findings were that for people aged <60 years, PP did not refine risk stratification, whereas in older people the thresholds were 64 and 76 mm Hg for the ambulatory and home PP, respectively. However, PP provided little added predictive value over and beyond classical risk factors. PMID:26587443
The diagnostic value of supine blood pressure in hypertension
Stańczyk, Adam; Gielerak, Grzegorz; Piotrowicz, Katarzyna; Banak, Małgorzata; Wójcik, Agnieszka
Introduction Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension. Material and methods This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring. Results The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p < 0.000001). The correlations between ABP and supBP/OBP were moderate and strong (correlation coefficients in range 0.55–0.76). The ROC analysis revealed that mean supBP ≥ 130/80 mm Hg was more precise than OBP ≥ 140/90 mm Hg in diagnosing hypertension (AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p < 0.0001) and the additive value derived mostly from its higher predictive power of identifying patients with increased night-time BP. Conclusions In young and middle-aged hypertensive patients the blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension. PMID:27186174
High blood pressure and syncope: orthostatic hypotension as a link.
Rafanelli, Martina; Ungar, Andrea
The prevalence of hypertension increases with the age. Diagnostic criteria are the same as for the young, but in older adults isolated systolic hypertension is more frequent, due to loss of vascular compliance. Blood pressure should be measured on both sides in the seated position, moreover in the supine and upright position to detect orthostatic hypotension. Ambulatory blood pressure monitoring is useful to detect white coat hypertension and masked hypertension, to tailor the treatment and search for diurnal and nocturnal blood pressure pattern abnormalities. Given that frailty can affect the relationship between blood pressure and mortality, the clinician should properly evaluate and monitor physical performance and cognitive status, throughout specific tools, as the Fried Frailty Phenotype, aiming at a systolic blood pressure target between 130 and 150 mmHg. Before starting hypotensive drugs, a careful risk and benefits' evaluation should be performed given the high risk of hypertension and hypotension consequences and the frequent coexistence of orthostatic hypotension, which predisposes to syncope and falls. RiassuntoLa prevalenza dell'ipertensione arteriosa aumenta con l'età. I criteri diagnostici sono gli stessi previsti nel giovane, nell'anziano tuttavia si osserva più frequentemente ipertensione sistolica isolata, dovuta a perdita dell'elasticità vascolare. Ai fini diagnostici, la misurazione della pressione arteriosa bilateralmente in posizione seduta, deve essere integrata con la ricerca di ipotensione ortostatica. Il monitoraggio della pressione arteriosa nelle 24h è indicato per la conferma diagnostica, per la ricerca di "white coat hypertension" e "masked hypertension", per monitorare la risposta terapeutica e ricercare alterazioni del ritmo circadiano. I benefici della terapia antiipertensiva sono noti, tuttavia un trattamento troppo aggressivo si è dimostrato dannoso, rendendo la gestione dell'ipertensione arteriosa nell'anziano ancora pi
Prediction of mean arterial blood pressure with linear stochastic models.
Genc, Sahika
A model-based approach that integrates known portion of the cardiovascular system and unknown portion through a parameter estimation to predict evolution of the mean arterial pressure is considered. The unknown portion corresponds to the neural portion that acts like a controller that takes corrective actions to regulate the arterial blood pressure at a constant level. The input to the neural part is the arterial pressure and output is the sympathetic nerve activity. In this model, heart rate is considered a proxy for sympathetic nerve activity. The neural portion is modeled as a linear discrete-time system with random coefficients. The performance of the model is tested on a case study of acute hypotensive episodes (AHEs) on PhysioNet data. TPRs and FPRs improve as more data becomes available during estimation period. PMID:22254409
External Counterpulsation Reduces Beat-to-Beat Blood Pressure Variability When Augmenting Blood Pressure and Cerebral Blood Flow in Ischemic Stroke
Tian, Ge; Xiong, Li; Lin, Wenhua; Han, Jinghao; Chen, Xiangyan; Leung, Thomas Wai Hong; Soo, Yannie Oi Yan
Background and Purpose External counterpulsation (ECP) is a noninvasive method used to enhance cerebral perfusion by elevating the blood pressure in ischemic stroke. However, the response of the beat-to-beat blood pressure variability (BPV) in ischemic stroke patients during ECP remains unknown. Methods We enrolled recent ischemic stroke patients and healthy controls. Changes in the blood flow velocities in bilateral middle cerebral arteries and the continuous beat-to-beat blood pressure before, during, and after ECP were monitored. Power spectral analysis revealed that the BPV included oscillations at very low frequency (VLF; <0.04 Hz), low frequency (LF; 0.04–0.15 Hz), and high frequency (HF; 0.15–0.40 Hz), and the total power spectral density (TP; <0.40 Hz) and LF/HF ratio were calculated. Results We found that ECP significantly increased the systolic and diastolic blood pressures in both stroke patients and controls. ECP decreased markedly the systolic and diastolic BPVs at VLF and LF and the TP, and the diastolic BPV at HF when compared with baseline. The decreases in diastolic and systolic BPV reached 37.56% and 23.20%, respectively, at VLF, 21.15% and 12.19% at LF, 8.76% and 16.59% at HF, and 31.92% and 23.62% for the total TP in stroke patients, which did not differ from those in healthy controls. The change in flow velocity on the contralateral side was positively correlated with the total TP systolic BPV change induced by ECP (r=0.312, p=0.035). Conclusions ECP reduces the beat-to-beat BPV when increasing the blood pressure and cerebral blood flow velocity in ischemic stroke patients. ECP might be able to improve the clinical outcome by decreasing the beat-to-beat BPV in stroke patients, and this should be explored further in future studies. PMID:27095525
Automated Triplex (HBV, HCV and HIV) NAT Assay Systems for Blood Screening in India
This review is confined to triplex nucleic acid testing (NAT) assays to be used on fully automated platform. Around the world, these assays are being used at various transfusion medicine centres or blood banks to screen blood units for HBV, HCV and HIV. These assay systems can screen up to 1000 blood units for HBV, HCV and HIV simultaneously in a day. This area has been dominated by mainly two manufacturers: M/s Gen-Probe-Novartis and M/s Roche Molecular Systems. The triplex NAT assay systems of both manufacturers are licensed by United States Food and Drug Administration. There is not much awareness about the technology and procedures used in these assays. The main objective of this review is to create awareness about the technology and procedure of these assays. PMID:27042485
Automated Triplex (HBV, HCV and HIV) NAT Assay Systems for Blood Screening in India.
Rajput, Manoj Kumar
This review is confined to triplex nucleic acid testing (NAT) assays to be used on fully automated platform. Around the world, these assays are being used at various transfusion medicine centres or blood banks to screen blood units for HBV, HCV and HIV. These assay systems can screen up to 1000 blood units for HBV, HCV and HIV simultaneously in a day. This area has been dominated by mainly two manufacturers: M/s Gen-Probe-Novartis and M/s Roche Molecular Systems. The triplex NAT assay systems of both manufacturers are licensed by United States Food and Drug Administration. There is not much awareness about the technology and procedures used in these assays. The main objective of this review is to create awareness about the technology and procedure of these assays. PMID:27042485
Intraocular Pressure, Blood Pressure, and Retinal Blood Flow Autoregulation: A Mathematical Model to Clarify Their Relationship and Clinical Relevance
Guidoboni, Giovanna; Harris, Alon; Cassani, Simone; Arciero, Julia; Siesky, Brent; Amireskandari, Annahita; Tobe, Leslie; Egan, Patrick; Januleviciene, Ingrida; Park, Joshua
Purpose. This study investigates the relationship between intraocular pressure (IOP) and retinal hemodynamics and predicts how arterial blood pressure (BP) and blood flow autoregulation (AR) influence this relationship. Methods. A mathematical model is developed to simulate blood flow in the central retinal vessels and retinal microvasculature as current flowing through a network of resistances and capacitances. Variable resistances describe active and passive diameter changes due to AR and IOP. The model is validated by using clinically measured values of retinal blood flow and velocity. The model simulations for six theoretical patients with high, normal, and low BP (HBP-, NBP-, LBP-) and functional or absent AR (-wAR, -woAR) are compared with clinical data. Results. The model predicts that NBPwAR and HBPwAR patients can regulate retinal blood flow (RBF) as IOP varies between 15 and 23 mm Hg and between 23 and 29 mm Hg, respectively, whereas LBPwAR patients do not adequately regulate blood flow if IOP is 15 mm Hg or higher. Hemodynamic alterations would be noticeable only if IOP changes occur outside of the regulating range, which, most importantly, depend on BP. The model predictions are consistent with clinical data for IOP reduction via surgery and medications and for cases of induced IOP elevation. Conclusions. The theoretical model results suggest that the ability of IOP to induce noticeable changes in retinal hemodynamics depends on the levels of BP and AR of the individual. These predictions might help to explain the inconsistencies found in the clinical literature concerning the relationship between IOP and retinal hemodynamics. PMID:24876284
Comparison of non-invasive and invasive blood pressure in aeromedical care.
McMahon, N; Hogg, L A; Corfield, A R; Exton, A D
Blood pressure measurement is an essential physiological measurement for all critically ill patients. Previous work has shown that non-invasive blood pressure is not an accurate reflection of invasive blood pressure measurement. In a transport environment, the effects of motion and vibration may make non-invasive blood pressure less accurate. Consecutive critically ill patients transported by a dedicated aeromedical retrieval and critical care transfer service with simultaneous invasive and non-invasive blood pressure measurements were analysed. Two sets of measurements were recorded, first in a hospital environment before departure (pre-flight) and a second during aeromedical transport (in-flight). A total of 56 complete sets of data were analysed. Bland-Altman plots showed limits of agreement (precision) for pre-flight systolic blood pressure were -37.3 mmHg to 30.0 mmHg, and for pre-flight mean arterial pressure -20.5 mmHg to 25.0 mmHg. The limits of agreement for in-flight systolic blood pressure were -40.6 mmHg to 33.1 mmHg, while those for in-flight mean blood pressure in-flight were -23.6 mmHg to 24.6 mmHg. The bias for the four conditions ranged from 0.5 to -3.8 mmHg. There were no significant differences in values between pre-flight and in-flight blood pressure measurements for all categories of blood pressure measurement. Thus, our data show that non-invasive blood pressure is not a precise reflection of invasive intra-arterial blood pressure. Mean blood pressure measured non-invasively may be a better marker of invasive blood pressure than systolic blood pressure. Our data show no evidence of non-invasive blood pressures being less accurate in an aeromedical transport environment. PMID:23033983
Effects of Parental Smoking on Exercise Systolic Blood Pressure in Adolescents
Hacke, Claudia; Weisser, Burkhard
Background In adults, exercise blood pressure seems to be more closely related to cardiovascular risk than resting blood pressure; however, few data are available on the effects of familial risk factors, including smoking habits, on exercise blood pressure in adolescents. Methods and Results Blood pressure at rest and during exercise, parental smoking, and other familial risk factors were investigated in 532 adolescents aged 12 to 17 years (14.6±1.5 years) in the Kiel EX.PRESS. (EXercise PRESSure) Study. Exercise blood pressure was determined at 1.5 W/kg body weight using a standardized submaximal cycle ergometer test. Mean resting blood pressure was 113.1±12.8/57.2±7.1 mm Hg, and exercise blood pressure was 149.9±19.8/54.2±8.6 mm Hg. Parental smoking increased exercise systolic blood pressure (+4.0 mm Hg, 3.1 to 4.9; P=0.03) but not resting blood pressure of the subjects (adjusted for age, sex, height, body mass index percentile, fitness). Parental overweight and familial hypertension were related to both higher resting and exercise systolic blood pressure values, whereas associations with an inactive lifestyle and a low educational level of the parents were found only with adolescents' blood pressure during exercise. The cumulative effect of familial risk factors on exercise systolic blood pressure was more pronounced than on blood pressure at rest. Conclusions Parental smoking might be a novel risk factor for higher blood pressure, especially during exercise. In addition, systolic blood pressure during a submaximal exercise test was more closely associated with familial risk factors than was resting blood pressure, even in adolescents. PMID:25964207
Women and Heart Disease | Healthy Blood Pressure | NIH MedlinePlus the Magazine
... please turn Javascript on. Special Section: Healthy Blood Pressure Women and Heart Disease Past Issues / Winter 2010 ... Truth Campaign" Urges Women To Take Good Blood Pressure Seriously February is American Heart Month, and the ...
Percentage of Adults with High Blood Pressure Whose Hypertension Is Adequately Controlled
... is Adequately Controlled Percentage of Adults with High Blood Pressure Whose Hypertension is Adequately Controlled Heart disease ... Survey. Age Group Percentage of People with High Blood Pressure that is Controlled by Age Group f94q- ...
After Pregnancy-Linked Diabetes, Healthy Diet May Ease Blood Pressure
... Pregnancy-Linked Diabetes, Healthy Diet May Ease Blood Pressure Eating nutritious foods seems to counter higher risk, ... to reduce their future risk of high blood pressure by eating a healthy diet, researchers report. Their ...
Spikes in Blood Pressure Don't Always Need ER Care
... medlineplus/news/fullstory_159343.html Spikes in Blood Pressure Don't Always Need ER Care Most cases ... June 13, 2016 (HealthDay News) -- If your blood pressure reading at a routine doctor's office visit is ...
Blood Pressure Numbers: What They Mean | NIH MedlinePlus the Magazine
... on. Special Section: Healthy Blood Pressure Blood Pressure Numbers: What They Mean Past Issues / Winter 2010 Table ... mmHg, or millimeters of mercury) Category Systolic (top number) Diastolic (bottom number) Normal Less than 120 And ...
Student Reactions During a Campus-Wide Blood Pressure Screening Program
ERIC Educational Resources Information Center
Stern, Carol; Hertz, Dorith
This blood pressure screening program met the goals of (1) detecting and treating asymptomatic hypertension among college students and (2) alerting the university community about high blood pressure. (MM)
Spikes in Blood Pressure Don't Always Need ER Care
... gov/news/fullstory_159343.html Spikes in Blood Pressure Don't Always Need ER Care Most cases ... June 13, 2016 (HealthDay News) -- If your blood pressure reading at a routine doctor's office visit is ...
Rarefaction and blood pressure in systemic and pulmonary arteries.
Olufsen, Mette S; Hill, N A; Vaughan, Gareth D A; Sainsbury, Christopher; Johnson, Martin
The effects of vascular rarefaction (the loss of small arteries) on the circulation of blood are studied using a multiscale mathematical model that can predict blood flow and pressure in the systemic and pulmonary arteries. We augmented a model originally developed for the systemic arteries (Olufsen et al. 1998, 1999, 2000, 2004) to (a) predict flow and pressure in the pulmonary arteries, and (b) predict pressure propagation along the small arteries in the vascular beds. The systemic and pulmonary arteries are modelled as separate, bifurcating trees of compliant and tapering vessels. Each tree is divided into two parts representing the `large' and `small' arteries. Blood flow and pressure in the large arteries are predicted using a nonlinear cross-sectional area-averaged model for a Newtonian fluid in an elastic tube with inflow obtained from magnetic resonance measurements. Each terminal vessel within the network of the large arteries is coupled to a vascular bed of small `resistance' arteries, which are modelled as asymmetric structured trees with specified area and asymmetry ratios between the parent and daughter arteries. For the systemic circulation, each structured tree represents a specific vascular bed corresponding to major organs and limbs. For the pulmonary circulation, there are four vascular beds supplied by the interlobar arteries. This manuscript presents the first theoretical calculations of the propagation of the pressure and flow waves along systemic and pulmonary large and small arteries. Results for all networks were in agreement with published observations. Two studies were done with this model. First, we showed how rarefaction can be modelled by pruning the tree of arteries in the microvascular system. This was done by modulating parameters used for designing the structured trees. Results showed that rarefaction leads to increased mean and decreased pulse pressure in the large arteries. Second, we investigated the impact of decreasing vessel
Association of Blood Lead level with Elevated Blood Pressure in Hypertensive Patients
Alghasham, Abdullah A.; Meki, Abdel-Raheim M.A.; Ismail, Hisham A.S.
Background: Lead is a metal with many important industrial uses. The relationship between lead exposure and the rise of blood pressure has received a great deal of attention as it was implicated that the mortality from cardiovascular diseases might be reduced by lowering lead levels in the environment. Objectives: The study was to investigate the correlation between the blood lead (B-Pb) levels and the values of blood pressure in hypertensive patients. Moreover, the plasma activities of angiotensin converting enzyme (ACE), plasma levels of nitric oxide (NO), total antioxidants (TAOX) and malondialdehyde (MDA) were estimated to investigate the correlations between the measured parameters and B-Pb levels in hypertensive patients. Methods: Fifty-five hypertensive patients were compared with fifty-three age and sex matched control group. The B-Pb levels were detected by flame atomic absorption spectrometry. The plasma levels of ACE activities, NO, TAOX and MDA were measured by colorimetric methods. Results: In the hypertensive patients, B-Pb levels were significantly higher than controls. Concomitantly, the plasma levels of ACE activities and MDA were significantly increased while the plasma levels of NO and TAOX were significantly reduced in the hypertensive patients in comparison with controls. There were significant positive correlations between B-Pb and each of MDA, and systolic as well as diastolic blood pressure. Conversely, a significant negative correlation was found between B-Pb and NO. Conclusions: Our study indicated that a positive relationship exists between blood pressure and B-Pb levels. The increased B-Pb levels were associated with oxidative stress. Moreover, The B-Pb level was negatively correlated with NO and this may clarify the implication of Pb as leading risk factor for the cardiovascular diseases and hypertension. These findings provide support for continued efforts to reduce lead concentration in the population at Qassim region. PMID:22489226
The Body Mass Index, Blood Pressure, and Fasting Blood Glucose in Patients With Methamphetamine Dependence.
Lv, Dezhao; Zhang, Meijuan; Jin, Xuru; Zhao, Jiyun; Han, Bin; Su, Hang; Zhang, Jie; Zhang, Xiangyang; Ren, Wenwei; He, Jincai
Methamphetamine (MA) is a prevalently abused psychostimulant in the world. Previously published studies and case reports indicated potential associations between MA and body mass index (BMI) and cardiovascular factors (eg, blood pressure and fasting blood glucose). However, these associations have not been studied clearly. This study aimed to investigate BMI and cardiovascular factors in the MA-dependent patients.A total of 1019 MA-dependent patients were recruited between February 2, 2008 and March 11, 2013. A case report was used to gather information on sociocharacteristics and drug-dependent history. Meanwhile, a number of 1019 age- and sex-matched controls' information were collected from the physical examination center. We measured BMI, blood pressure, and fasting blood glucose among the participants.MA-dependent patients had significantly lower BMI (20.4 ± 0.1 vs 23.9 ± 0.1 kg/m, P < 0.001), lower fasting blood glucose (5.0 ± 0.01 vs 5.2 ± 0.01 mmol/L, P < 0.001) and higher systolic blood pressure (122.1 ± 0.4 vs 114.8 ± 0.4 mmHg, P < 0.001) compared with the control group after adjustment of possible confounders. Additional, we only found the duration of MA use was independently associated with BMI (B = -0.08, P = 0.04).This study demonstrated that MA dependence was associated with BMI and cardiovascular factors. In addition, we found a negative association between duration of MA use and BMI. PMID:27015198
The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women
Cakmak, Huseyin Altug; Cakmak, Burcu Dincgez; Yumru, Ayse Ender; Aslan, Serkan; Enhos, Asim; Kalkan, Ali Kemal; Coskun, Ebru Inci; Acikgoz, Abdullah Serdar; Karatas, Suat
Background Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women. Methods In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups. Results Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=−0.382; P=0.001), lumbar vertebral z-scores (r=−0.290; P=0.001), and proximal femoral T-scores (r=−0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=−0.318; P=0.001), lumbar vertebral z-scores (r=−0.340; P=0.001), and proximal femoral T-scores (r=−0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46–3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254–3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007–1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters. Conclusion The present study is the first to evaluate the relationships between blood pressure, blood glucose
Characteristics of a nonocclusive pressure-regulated blood roller pump.
Durandy, Yves
For decades, extracorporeal life support (ECLS) systems have relied on pumps designed for short-term cardiopulmonary bypass. In the past, occlusive roller pumps were the standard. They are being progressively replaced by centrifugal pumps and devices developed specifically for ECLS. However, the ideal pump for long-term bypass is yet to be created. One interesting alternative is the Rhône-Poulenc 06 pump that is a nonocclusive pressure-regulated blood pump developed in France in the 1970s. This pump is composed of a double-stage rotor with three rollers at each level. The raceway tubing is stretched on the roller and pump occlusivity depends on the tension of the chamber on the rotor. The pump is able to deliver physiological blood flow values without generating dangerous negative or positive pressures. The specific design of the chamber allows the pump to generate a pulsatile flow, inducing minimal blood trauma, and to act as a bubble trap, making it inherently safe. This pump has been used for cardiopulmonary bypass, extracorporeal lung support, and more specifically single-lumen single-cannula venovenous membrane oxygenation for neonates, left-heart or right-heart assist, and venovenous bypass during liver transplant. In conclusion, this old-fashion pump is perfectly adapted for any kind of short- or long-term bypass. PMID:23305578
[A multichannel telemetry system for autonomic neural signals, blood flow velocity, blood pressure, and ECG measurements].
Yonezawa, Y; Takenoshita, M; Ninomiya, I
A radio multichannel telemetry system has been developed for use with chronically instrumented, unrestrained, small animals. The system can simultaneously record autonomic neural signals, blood flow velocity, blood pressure, and ECG. The system is time-multiplexed and pulse width modulation (PWM)/FM device, which employs two sampling frequencies. The system is designed with 10 standard low power integrated circuits, a 3 terminal voltage regulator, and a transistor. The size is 53 x 42 x 20 mm, and the weight, including two batteries is 40 grams. The system is powered by two lithium cells, which provide 60 hours of continuous operation. PMID:1494988
Artificial arterial blood pressure artifact models and an evaluation of a robust blood pressure and heart rate estimator
Li, Qiao; Mark, Roger G; Clifford, Gari D
Background Within the intensive care unit (ICU), arterial blood pressure (ABP) is typically recorded at different (and sometimes uneven) sampling frequencies, and from different sensors, and is often corrupted by different artifacts and noise which are often non-Gaussian, nonlinear and nonstationary. Extracting robust parameters from such signals, and providing confidences in the estimates is therefore difficult and requires an adaptive filtering approach which accounts for artifact types. Methods Using a large ICU database, and over 6000 hours of simultaneously acquired electrocardiogram (ECG) and ABP waveforms sampled at 125 Hz from a 437 patient subset, we documented six general types of ABP artifact. We describe a new ABP signal quality index (SQI), based upon the combination of two previously reported signal quality measures weighted together. One index measures morphological normality, and the other degradation due to noise. After extracting a 6084-hour subset of clean data using our SQI, we evaluated a new robust tracking algorithm for estimating blood pressure and heart rate (HR) based upon a Kalman Filter (KF) with an update sequence modified by the KF innovation sequence and the value of the SQI. In order to do this, we have created six novel models of different categories of artifacts that we have identified in our ABP waveform data. These artifact models were then injected into clean ABP waveforms in a controlled manner. Clinical blood pressure (systolic, mean and diastolic) estimates were then made from the ABP waveforms for both clean and corrupted data. The mean absolute error for systolic, mean and diastolic blood pressure was then calculated for different levels of artifact pollution to provide estimates of expected errors given a single value of the SQI. Results Our artifact models demonstrate that artifact types have differing effects on systolic, diastolic and mean ABP estimates. We show that, for most artifact types, diastolic ABP estimates are
Cross-cultural variation in blood pressure: a quantitative analysis of the relationships of blood pressure to cultural characteristics, salt consumption and body weight.
Waldron, I; Nowotarski, M; Freimer, M; Henry, J P; Post, N; Witten, C
This study has analyzed the relationships of cross-cultural variation in blood pressure to cultural characteristics, salt consumption and body weight. The data used were blood pressures for adults in 84 groups, ratings of cultural characteristics (based on anthropological data and made by raters who had no knowledge of the blood pressure data) and, where available, salt consumption and body mass index (weight/height2). Blood pressures were higher and the slopes of blood pressure with age were greater in groups which had greater involvement in a money economy, more economic competition, more contact with people of different culture or beliefs, and more unfulfilled aspirations for a return to traditional beliefs and values. Blood pressures were also higher in groups for which the predominant family type was a nuclear or father-absent family, as opposed to an extended family. For Negroes, groups who were descended from slaves had higher blood pressures than other groups. The correlations between blood pressures and involvement in a money economy were substantial and significant even after controlling for level of salt consumption and, for men, also after controlling for body mass index. For men there were also significant partial correlations between blood pressure and salt consumption, controlling for type of economy. For women there were significant partial correlations between blood pressure and body mass index, controlling for type of economy. In conclusion, cross-cultural variation in blood pressure appears to be due to multiple factors. One contributory factor appears to be psychosocial stress due to cultural disruption, including the disruption of cooperative relationships and traditional cultural patterns which frequently occurs during economic modernization. In addition, both the protective effects of very low salt consumption in some groups and differences in body weight appear to contribute to cross-cultural variation in blood pressure. PMID:7079796
Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise
NASA Technical Reports Server (NTRS)
Gallagher, K. M.; Fadel, P. J.; Smith, S. A.; Norton, K. H.; Querry, R. G.; Olivencia-Yurvati, A.; Raven, P. B.
This investigation was designed to determine the role of intramuscular pressure-sensitive mechanoreceptors and chemically sensitive metaboreceptors in affecting the blood pressure response to dynamic exercise in humans. Sixteen subjects performed incremental (20 W/min) cycle exercise to fatigue under four conditions: control, exercise with thigh cuff occlusion of 90 Torr (Cuff occlusion), exercise with lower body positive pressure (LBPP) of 45 Torr, and a combination of thigh cuff occlusion and LBPP (combination). Indexes of central command (heart rate, oxygen uptake, ratings of perceived exertion, and electromyographic activity), cardiac output, stroke volume, and total peripheral resistance were not significantly different between the four conditions. Mechanical stimulation during LBPP and combination conditions resulted in significant elevations in intramuscular pressure and mean arterial pressure from control at rest and throughout the incremental exercise protocol (P < 0.05). Conversely, there existed no significant changes in mean arterial pressure when the metaboreflex was stimulated by cuff occlusion. These findings suggest that under normal conditions the mechanoreflex is tonically active and is the primary mediator of exercise pressor reflex-induced alterations in arterial blood pressure during submaximal dynamic exercise in humans.
Cardiac morphology and blood pressure in the adult zebrafish.
Hu, N; Yost, H J; Clark, E B
Zebrafish has become a popular model for the study of cardiovascular development. We performed morphologic analysis on 3 months postfertilization zebrafish hearts (n > or = 20) with scanning electron microscopy, hematoxylin and eosin staining and Masson's trichrome staining, and morphometric analysis on cell organelles with transmission electron photomicrographs. We measured atrial, ventricular, ventral, and dorsal aortic blood pressures (n > or = 5) with a servonull system. The atrioventricular orifice was positioned on the dorsomedial side of the anterior ventricle, surmounted by the single-chambered atrium. The atrioventricular valve was free of tension apparati but supported by papillary bands to prevent retrograde flow. The ventricle was spanned with fine trabeculae perpendicular to the compact layer and perforated with a subepicardial network of coronary arteries, which originated from the efferent branchial arteries by means of the main coronary vessel. Ventricular myocytes were larger than those in the atrium (P < 0.05) with abundant mitochondria close to the sarcolemmal. Sarcoplasmic reticulum was sparse in zebrafish ventricle. Bulbus arteriosus was located anterior to the ventricle, and functioned as an elastic reservoir to absorb the rapid rise of pressure during ventricular contraction. The dense matrix of collagen interspersed across the entire bulbus arteriosus exemplified the characteristics of vasculature smooth muscle. There were pressure gradients from atrium to ventricle, and from ventral to dorsal aorta, indicating that the valves and the branchial arteries, respectively, were points of resistance to blood flow. These data serve as a framework for structure-function investigations of the zebrafish cardiovascular system. PMID:11505366
77 FR 17060 - Announcement of Requirements and Registration for Beat Down Blood Pressure Challenge
Federal Register 2010, 2011, 2012, 2013, 2014
... HUMAN SERVICES Announcement of Requirements and Registration for Beat Down Blood Pressure Challenge... years, announces the launch of the Beat Down Blood Pressure Video Challenge. This challenge is an open... consumer e-health tools to manage high blood pressure. Health care providers are also encouraged to...
Subjective Stress and Coping Resources Interact To Predict Blood Pressure Reactivity in Black College Students.
ERIC Educational Resources Information Center
Clark, Rodney
Examined the effects of subjective stress and coping resources on blood pressure reactivity among black college students. The interactive effects of subjective stress and coping resources predicted diastolic blood pressure reactivity. Higher levels of problem-focused coping related to more marked diastolic blood pressure changes under conditions…
21 CFR 868.1150 - Indwelling blood carbon dioxide partial pressure (PCO2) analyzer.
Code of Federal Regulations, 2011 CFR
... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Indwelling blood carbon dioxide partial pressure....1150 Indwelling blood carbon dioxide partial pressure (PCO2) analyzer. (a) Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a...
21 CFR 868.1150 - Indwelling blood carbon dioxide partial pressure (PCO2) analyzer.
Code of Federal Regulations, 2014 CFR
... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Indwelling blood carbon dioxide partial pressure....1150 Indwelling blood carbon dioxide partial pressure (PCO2) analyzer. (a) Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a...
21 CFR 868.1150 - Indwelling blood carbon dioxide partial pressure (PCO2) analyzer.
Code of Federal Regulations, 2012 CFR
... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Indwelling blood carbon dioxide partial pressure....1150 Indwelling blood carbon dioxide partial pressure (PCO2) analyzer. (a) Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a...
21 CFR 868.1150 - Indwelling blood carbon dioxide partial pressure (PCO2) analyzer.
Code of Federal Regulations, 2013 CFR
... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Indwelling blood carbon dioxide partial pressure....1150 Indwelling blood carbon dioxide partial pressure (PCO2) analyzer. (a) Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a...
21 CFR 868.1150 - Indwelling blood carbon dioxide partial pressure (PCO2) analyzer.
Code of Federal Regulations, 2010 CFR
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Indwelling blood carbon dioxide partial pressure....1150 Indwelling blood carbon dioxide partial pressure (PCO2) analyzer. (a) Identification. An indwelling blood carbon dioxide partial pressure PCO2 analyzer is a device that consists of a...
Real-life Stories About High Blood Pressure | NIH MedlinePlus the Magazine
... turn Javascript on. Feature: High Blood Pressure Real-life Stories About High Blood Pressure Past Issues / Fall ... who's getting back in control!" For more real-life stories about high blood pressure, visit www.nhlbi. ...
Reliability of Oscillometric Blood Pressure Monitoring in Atrial Fibrillation Patients Admitted for Electric Cardioversion.
Maselli, Monica; Giantin, Valter; Corrado, Domenico; Franchin, Alessandro; Attanasio, Francesca; Pengo, Valentina; Tramontano, Alessandra; De Toni, Pietro; Perissinotto, Egle; Manzato, Enzo
The reliability of automated oscillometric blood pressure (BP) monitors in atrial fibrillation (AF) has been poorly investigated, only comparing different patients with AF and sinus rhythm (SR), and is a method influenced by individual characteristics. This study compared the reliability of the oscillometric device A&D TM-2430 (A&D Company, Tokyo, Japan) with that of a mercury sphygmomanometer in AF patients whose SR was restored after electric cardioversion (ECV). Three consecutive BP measurements were obtained on the day before and about 30 days after ECV in stable treatment conditions. Of the 100 patients studied, 63 reported an SR at follow-up, with a significant increase in systolic BP and a significant decrease in diastolic BP according to both devices. There were no significant differences between the systolic and diastolic biases before and after ECV using Bland Altman analysis (P > .05 each). The oscillometric device analyzed, using three repeated measurements, is reliable in measuring BP in AF patients. PMID:25855463
Blood pressure measurement: lessons learned from our ancestors.
Karamanou, Marianna; Papaioannou, Theodore G; Tsoucalas, Gregory; Tousoulis, Dimitris; Stefanadis, Christodoulos; Androutsos, George
The profound observations of William Harvey (1578-1657), in blood circulation and the progress of physical science laid the foundation for the development of the Iatrophysical School that contributed to the evolution of clinical sphygmomanometry. The pioneer work of Reverend Stephen Hales (1677-1761) demonstrated the dynamics of the vascular system. One century later the French physician Jean-Léonard-Marie Poiseuille (1797-1867) invented a U-tube mercury manometer and in 1860 the physiologist Etienne- Jules Marey (1830-1904) devised the first portable sphygmograph for recording the pulse wave. The non-invasive techniques of blood pressure measurement were completed by Scipione Riva-Rocci (1896-1937) sphygmomanometer and the description of "Korotkov sounds" by the Russian surgeon Nikolai- Sergeyevich Korotkov (1874-1920). PMID:25341864
Intraspecific scaling of arterial blood pressure in the Burmese python.
Enok, Sanne; Slay, Christopher; Abe, Augusto S; Hicks, James W; Wang, Tobias
Interspecific allometric analyses indicate that mean arterial blood pressure (MAP) increases with body mass of snakes and mammals. In snakes, MAP increases in proportion to the increased distance between the heart and the head, when the heart-head vertical distance is expressed as ρgh (where ρ is the density of blood, G: is acceleration due to gravity and h is the vertical distance above the heart), and the rise in MAP is associated with a larger heart to normalize wall stress in the ventricular wall. Based on measurements of MAP in Burmese pythons ranging from 0.9 to 3.7 m in length (0.20-27 kg), we demonstrate that although MAP increases with body mass, the rise in MAP is merely half of that predicted by heart-head distance. Scaling relationships within individual species, therefore, may not be accurately predicted by existing interspecific analyses. PMID:24737752
Blood pressure change in Africa: case study from Nigeria.
Kaufman, J S; Owoaje, E E; Rotimi, C N; Cooper, R S
Studies of migrants and comparisons of rural versus urban communities are potentially informative study designs because they allow examination of genetically similar population subgroups exposed to diverse environmental conditions. These designs have been underused in Africa, where recent urbanization has created many situations in which nearby communities of common ethnicity and culture live under different social and economic circumstances. The International Study of Hypertension in Blacks (ICSHIB) conducted several overlapping surveys in Nigeria starting in 1993. These surveys were based primarily in the rural village of Idere and the urban community of Idikan, both inhabited by people defined ethnically as Oyo Yoruba and sharing a common language and culture. Survey teams collected standardized blood pressure and anthropometric measurements, and some study participants provided 24-hr urine samples and questionnaire data on psychosocial stress and social integration. Rural and urban groups differed substantially in blood pressure and related characteristics. Age-adjusted prevalence of hypertension (blood pressure > or = 140/90 mm Hg) for participants aged 25 years and older was 7-8% in Idere and 24-27% in Idikan. The distributions of overweight, sodium/potassium ratio, perceived stress, and social integration scores all contributed to lower hypertension risk in Idere. The effects and interactions of these identified risk factors remain poorly understood, even among people who share a common genetic background, similar diet, and many other lifestyle features. Nonetheless, the rural-urban distinction is sufficiently salient to engender a nearly threefold difference in hypertension prevalence. This disparity in disease prevalence demonstrates the sensitivity of human beings to the environmental determinants of disease and provides a sobering example of the difficulty in identifying subtle genetic effects, which can be easily overwhelmed by small differences in
Identification of Normal Blood Pressure in Different Age Group
Lin, Jiunn-Diann; Chen, Yen-Lin; Wu, Chung-Ze; Hsieh, Chang-Hsun; Pei, Dee; Liang, Yao-Jen; Chang, Jin-Biou
Abstract The concept of using single criterion of normal blood pressure with systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg for all ages is still disputable. The aim of the study is to identify the cutoff value of normotension in different age and sex groups. Totally, 127,922 (63,724 men and 64,198 women) were enrolled for the analysis. Finally, four fifths of them were randomly selected as the study group and the other one fifths as the validation group. Due the tight relationship with comorbidities from cardiovascular disease (CVD), metabolic syndrome (MetS) was used as a surrogate to replace the actual cardiovascular outcomes in the younger subjects. For SBP, MetS predicted by our equation had a sensitivity of 55% and specificity of 67% in males and 65%, 83% in females, respectively. At the same time, they are 61%, 73% in males and 73%, 86% in females for DBP, respectively. These sensitivity, specificity, odds ratio, and area under the receiver operating characteristic curve from our equations are all better than those derived from the criteria of 140/90 or 130/85 mmHg in both genders. By using the presence of MetS as the surrogate of CVD, the regression equations between SBP, DBP, and age were built in both genders. These new criteria are proved to have better sensitivity and specificity for MetS than either 140/90 or 130/85 mmHg. These simple equations should be used in clinical settings for early prevention of CVD. PMID:27057846
Azilsartan/chlorthalidone combination therapy for blood pressure control
Cheng, Judy WM
Background Edarbyclor® is a combined angiotensin receptor blocker (ARB) and thiazide-like diuretic (azilsartan and chlorthalidone), and was approved on December 20, 2011 by the US Food and Drug Administration (FDA) for hypertension management. Objective To review the pharmacology, pharmacokinetics, efficacy, safety, tolerability, and role of azilsartan plus chlorthalidone for hypertension management. Methods Peer-reviewed clinical trials, review articles, and relevant treatment guidelines, were identified from the databases MEDLINE and Current Contents (both 1966 to February 15, 2013, inclusive) using search terms "azilsartan", "chlorthalidone", "pharmacology", "pharmacokinetics", "pharmacodynamics", "pharmacoeconomics", and "cost-effectiveness". The FDA website, as well as manufacturer prescribing information, was also reviewed to identify other relevant information. Results Azilsartan is a new ARB with high affinity for the angiotensin 1 receptor, approved by the FDA for hypertension management. Unlike other ARBs, azilsartan has no clinical data supporting improvement in cardiovascular outcomes, and is not approved for indications other than hypertension, which a select few other ARBs may be used for (eg, diabetic nephropathy and heart failure). Chlorthalidone is a longer acting thiazide-like diuretic that has been demonstrated to improve cardiovascular outcomes. Combination treatment with azilsartan/chlorthalidone is effective for reducing blood pressure. Compared to olmesartan/hydrochlorothiazide and azilsartan/hydrochlorothiazide combinations, azilsartan/chlorthalidone appears to be more efficacious for reducing blood pressure. Conclusions Azilsartan/chlorthalidone can be considered an antihypertensive therapy option in patients for whom combination therapy is required (blood pressure >20 mmHg systolic or >10 mmHg diastolic above goal). Cost to patients and insurance coverage will probably determine whether azilsartan
The evolution of blood pressure and the rise of mankind.
Schulte, Kevin; Kunter, Uta; Moeller, Marcus J
Why is it that only human beings continuously perform acts of heroism? Looking back at our evolutionary history can offer us some potentially useful insight. This review highlights some of the major steps in our evolution-more specifically, the evolution of high blood pressure. When we were fish, the first kidney was developed to create a standardized internal 'milieu' preserving the primordial sea within us. When we conquered land as amphibians, the evolution of the lung required a low systemic blood pressure, which explains why early land vertebrates (amphibians, reptiles) are such low performers. Gaining independence from water required the evolution of an impermeable skin and a water-retaining kidney. The latter was accomplished twice with two different solutions in the two major branches of vertebrate evolution: mammals excrete nitrogenous waste products as urea, which can be utilized by the kidney as an osmotic agent to produce more concentrated urine. Dinosaurs and birds have a distinct nitrogen metabolism and excrete nitrogen as water-insoluble uric acid-therefore, their kidneys cannot use urea to concentrate as well. Instead, some birds have developed the capability to reabsorb water from their cloacae. The convergent development of a separate small circulation of the lung in mammals and birds allowed for the evolution of 'high blood-pressure animals' with better capillarization of the peripheral tissues allowing high endurance performance. Finally, we investigate why mankind outperforms any other mammal on earth and why, to this day, we continue to perform acts of heroism on our eternal quest for personal bliss. PMID:25140012
Automated robotic equipment for ultrasonic inspection of pressurizer heater wells
Nachbar, Henry D.; DeRossi, Raymond S.; Mullins, Lawrence E.
A robotic device for remotely inspecting pressurizer heater wells is provided which has the advantages of quickly, precisely, and reliably acquiring data at reasonable cost while also reducing radiation exposure of an operator. The device comprises a prober assembly including a probe which enters a heater well, gathers data regarding the condition of the heater well and transmits a signal carrying that data; a mounting device for mounting the probe assembly at the opening of the heater well so that the probe can enter the heater well; a first motor mounted on the mounting device for providing movement of the probe assembly in an axial direction; and a second motor mounted on the mounting device for providing rotation of the probe assembly. This arrangement enables full inspection of the heater well to be carried out.
Automated assessment of noninvasive filling pressure using color Doppler M-mode echocardiography
NASA Technical Reports Server (NTRS)
Greenberg, N. L.; Firstenberg, M. S.; Cardon, L. A.; Zuckerman, J.; Levine, B. D.; Garcia, M. J.; Thomas, J. D.
Assessment of left ventricular filling pressure usually requires invasive hemodynamic monitoring to follow the progression of disease or the response to therapy. Previous investigations have shown accurate estimation of wedge pressure using noninvasive Doppler information obtained from the ratio of the wave propagation slope from color M-mode (CMM) images and the peak early diastolic filling velocity from transmitral Doppler images. This study reports an automated algorithm that derives an estimate of wedge pressure based on the spatiotemporal velocity distribution available from digital CMM Doppler images of LV filling.
Superiority of home blood pressure measurements over office measurements for testing antihypertensive drugs.
Vaur; Dubroca; Dutrey-Dupagne; Genès; Chatellier; Bouvier-d'Yvoire; Elkik; Ménard
OBJECTIVE: To compare the effects on office blood pressure and home blood pressure of placebo and active drug administration. DESIGN: After a 2-week wash-out period, patients with mild-to-moderate hypertension entered a 2-week single-blind placebo period and then a 4-week double-blind period. Patients were randomly assigned to be administered either 2 mg trandolapril once daily or its placebo in a 2:1 proportion. Office blood pressure was measured by a physician at the end of each period, using a mercury sphygmomanometer (mean of three consecutive measurements). Home blood pressure was measured during the last week of each period according to standard procedure carefully taught to each patient by the physician. Compliance was checked by using electronic pill boxes. RESULTS: Data for 34 of the 44 patients who entered the study were eligible for analysis. Baseline systolic blood pressure/diastolic blood pressure were significantly (P = 0.0001/P = 0.0001) higher for office blood pressure (161/101 mmHg) than they were for home blood pressure (145/93 mmHg). There was no statistically significant difference between the placebo and active-treatment groups at baseline. During the single-blind period, blood pressures measured at the office and at home did not change significantly. Office blood pressure decreased by 2.7 +/- 10 mmHg for systolic blood pressure and by 0.5 +/- 4 mmHg for diastolic blood pressure whereas home blood pressure increased by 0.8 +/- 6 mmHg for systolic blood pressure and by 0.7 +/- 4 mmHg for diastolic blood pressure. During the double-blind period, office blood pressure fell significantly with trandolapril treatment (systolic by 10.2 +/- 12 mmHg, diastolic by 8.3 +/- 6 mmHg; P = 0.0005/0.0001, versus single-blind placebo period) but this decrease was not significantly different (P = 0.45/0.92) from the fall in members of the placebo group (systolic by 6.9 +/- 9 mmHg, diastolic by 8.0 +/-6 mmHg; P = 0.04/0.002, versus single-blind placebo period
Stephen Hales and the measurement of blood pressure.
Lewis, O
Natural philosopher and inventor, Stephen Hales (1677-1761), undertook a lengthy series of experiments on animals described in Haemastaticks (1733) which led to the first direct measurement of blood pressure. Hales retained his interest in health and disease throughout his life, and this prompted what he regarded as his most important work: the invention of ventilation systems for use in ships or prisons. Hales was the 'perpetual curate' of Teddington, Middlesex, and he combined a mechanistic, quantitative approach to his experimental work with a need and, as he saw it, a duty to discover and wonder at the wisdom and goodness of God by studying His creation. PMID:7884783
Engineering studies of vectorcardiographs in blood pressure measuring systems
NASA Technical Reports Server (NTRS)
Mark, R. G.
The following projects involving cardiovascular instrumentation were conducted: (1) the development and fabrication of a three-dimensional display measurement system for vectorcardiograms, (2) the development and fabrication of a cardiovascular monitoring system to noninvasively monitor beat-by-beat the blood pressure and heart rate using aortic pulse wave velocity, (3) the development of software for an interactive system to analyze systolic time interval data, and (4) the development of microprocessor-based physiologic instrumentation, focussing initially on EKG rhythm analysis. Brief descriptions of these projects were given.
Table salt and blood pressure in Greek children.
Adamopoulos, P N; Chaniotis, F; Kodoyianis, S; Boutsicakis, J; Madalos, P; Kassos, D; Gatos, A; Moulopoulos, S
The habit of adding table salt was studied in a random sample of 2209 children 6-18 years old. Of these 10% routinely added table salt to prepared food before tasting it (group A), 29% after tasting it (group B) and 61% ate their food as it was prepared, without additional use of table salt (group C). Group A had higher blood pressure (BP), prevalence of systolic BP greater than or equal to 130 mmHG and body mass index (BMI) than groups B and C (P less than 0.0001). These differences were also observed in group B versus C (P less than 0.0001). PMID:3509835
Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion
NASA Astrophysics Data System (ADS)
Kyriacou, P. A.; Shafqat, K.; Pal, S. K.
Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse
Engineering studies of vectorcardiographs in blood pressure measuring systems, appendix 2
NASA Technical Reports Server (NTRS)
Mark, R. G.
The development of a cardiovascular monitoring system to noninvasively monitor the blood pressure and heart rate using pulse wave velocity was described. The following topics were covered: (1) pulse wave velocity as a measure of arterial blood pressure, (2) diastolic blood pressure and pulse wave velocity in humans, (3) transducer development for blood pressure measuring device, and (4) cardiovascular monitoring system. It was found, in experiments on dogs, that the pulse wave velocity is linearly related to diastolic blood pressure over a wide range of blood pressure and in the presence of many physiological perturbations. A similar relationship was observed in normal, young human males over a moderate range of pressures. Past methods for monitoring blood pressure and a new method based on pulse wave velocity determination were described. Two systems were tested: a Doppler ultrasonic transducer and a photoelectric plethysmograph. A cardiovascular monitoring system was described, including operating instructions.
Effects of nitrendipine on blood pressure and blood ciclosporin A level in patients with posttransplant hypertension.
Copur, M S; Tasdemir, I; Turgan, C; Yasavul, U; Caglar, S
In order to evaluate the antihypertensive effectiveness and interaction with ciclosporin A (CS-A) nitrendipine, a dihydropyridine derivative calcium entry blocking agent, was used in 16 (13 men, 3 women) hypertensive renal posttransplant patients followed by the Nephrology Department of Hacettepe University Hospital. The patients did not receive any antihypertensive drug for a 7-day period. They were then given 20 mg/day nitrendipine for 3 weeks. At the end of this period, mean (+/- SE) supine blood pressure fell from 163/108 +/- 3.6/1.87 to 141/87 +/- 3.8/2.2 mm Hg (p less than 0.01), while the heart rate was unchanged. 14 of 16 patients achieved full control of blood pressure levels with 20 mg/day nitrendipine, and only 2 patients needed a higher dosage of 30 mg/day (20 + 10 mg). After 3 weeks of treatment no significant variations in blood chemistry or renal functional parameters were noticed. There was also no difference between blood CS-A levels before and after treatment with nitrendipine (218.06 +/- 33 vs. 222.68 +/- 26 ng/ml, p greater than 0.05). We conclude that short-term therapy with nitrendipine in renal post-transplant patients does not appear to be harmful and longer term studies are needed to fully evaluate safety and efficacy of this drug. Because it influences neither blood chemistry nor renal functional parameters and blood CS-A level, it may be preferable to other calcium channel blocking agents in this group of patients. PMID:2662047
Gender differences in blood pressure regulation following artificial gravity exposure
NASA Astrophysics Data System (ADS)
Evans, Joyce; Goswami, Nandu; Kostas, Vladimir; Zhang, Qingguang; Ferguson, Connor; Moore, Fritz; Stenger, Michael, , Dr; Serrador, Jorge; W, Siqi
Introduction. Before countermeasures to space flight cardiovascular deconditioning are established, gender differences in cardiovascular responses to orthostatic stress, in general, and to orthostatic stress following exposure to artificial gravity (AG), in particular, need to be determined. Our recent determination that a short exposure to AG improved the orthostatic tolerance limit (OTL) of cardiovascularly deconditioned subjects drives the current effort to determine mechanisms of that improvement in men and in women. Methods. We determined the OTL of 9 men and 8 women following a 90 min exposure to AG compared to that following 90 min of head down bed rest (HDBR). On both days (21 days apart), subjects were made hypovolemic (low salt diet plus 20 mg intravenous furosemide) and orthostatic tolerance was determined from a combination of head up tilt and increasing lower body negative pressure until presyncope. Mean values and correlations with OTL were determined for heart rate, blood pressure, stroke volume, cardiac output, total peripheral resistance (Finometer), middle cerebral artery flow velocity (DWL), partial pressure of carbon dioxide (Novametrics) and body segmental impedance (UFI THRIM) at supine baseline, during orthostatic stress to presyncope and at supine recovery. Results. Orthostatic tolerance of these hypovolemic subjects was significantly greater following AG than following HDBR. Exposure to AG increased cardiac output in both men and women and increased stroke volume in women. In addition, AG decreased systolic blood pressure in men, but not women, and increased cerebral flow in women, but not men. In both men and women, AG exposure decreased peripheral resistance and decreased cerebrovascular resistance in women. Men's heart rate rose more at the end of OTL on their AG, compared to their HDBR, day but women's fell. Presyncopal stroke volume reached the same level on each day of study for both men and women. Conclusions. In the present
Exaggerated Response of Systolic Blood Pressure to Cycle Ergometer
Kim, Young Joo; Chun, Heaja
Objective The aim of this study is to exam the effects of exercise modes on the systolic blood pressure and rate-pressure product during a gradually increasing exercise load from low to high intensity. Methods Fifteen apparently healthy men aged 19 to 23 performed the graded exercise tests on cycle ergometer (CE) and treadmill (TM). During the low-to-maximal exercises, oxygen uptake (VO2), heart rate (HR), systolic blood pressure (SBP) and rate-pressure product were measured. Results CE had a significantly lower maximum VO2 than TM (CE vs. TM: 48.51±1.30 vs. 55.4±1.19 mL/kg/min; p<0.001). However, CE showed a higher maximum SBP (SBPmax) at the all-out exercise load than TM (CE vs. TM: 170±2.4 vs. 154±1.7 mmHg; p<0.001). During the low-to-maximal intensity increment, the slope of the HR with VO2 was the same as VO2 increased in times of the graded exercise test of CE and TM (CE vs. TM: 2.542±0.100 vs. 2.506±0.087; p=0.26). The slope of increase on SBP accompanied by VO2 increase was significantly higher in CE than in TM (CE vs. TM: 1.669±0.117 vs. 1.179±0.063; p<0.001). Conclusion The SBP response is stronger in CE than in TM during the graded exercise test. Therefore, there is a possibility that CE could induce a greater burden on workloads to cardiovascular system in humans than TM. PMID:23869334
2014 CRL Blood Pressure Study of Life Insurance Applicants.
Fulks, Michael; Dolan, Vera F; Stout, Robert L
Objective .- Define the relative mortality risk by systolic (SBP) and diastolic blood pressure (DBP) in a relatively healthy cohort split by age and sex with adjustment for smoking status, other findings and admitted heart disease history. Method .- Blood pressure (BP in mm Hg), build, laboratory studies and limited medical history are collected when people apply for individual life insurance. Information on 2,472,706 applicants tested by Clinical Reference Laboratory from 1993 to 2007 was utilized with follow-up for vital status using the September 2011 Social Security Death Master File identifying 31,033 deaths. Data was analyzed by SBP and DBP split by age and sex accounting for smoking and for BMI, urine protein/creatinine ratio and history of heart disease in a Cox multivariate survival analysis. Separate analysis by admitted hypertension history was also conducted. Results are presented by SBP and DBP for 4 age-sex groups with and without added covariates beyond age and smoking status. Results .- Relative mortality progressively increased by SBP level from the 90 to 119 band (down to 80 in younger women) upward with little additional impact by DBP. Addition of covariates beyond age and smoking resulted in a 5% to 10% reduction in relative risk. Although high DBP had limited impact, a pulse pressure/SBP ratio >½ identified 1% of applicants at high mortality risk, with little difference in risk for ratios ≤½. Hypertension history with current BP control was associated with a 10% to 25% increase in relative mortality risk as compared to those with similar BP but no such history. Conclusion .- Increasing SBP is closely associated with increasing relative mortality, starting from the lowest SBP. Increasing DBP has little additional impact, but a pulse pressure/SBP ratio >½ is a potent marker of increased risk as well. Accounting for build and other laboratory findings reduces risk modestly. A history of hypertension with current control increases risk. PMID
Flow-mediated dilation and exercise blood pressure in healthy adolescents
Lambiase, Maya J.; Dorn, Joan; Thurston, Rebecca C.; Roemmich, James N.
Objectives Exercise blood pressure is a robust predictor of cardiovascular disease risk. Endothelial dysfunction occurs early in development of cardiovascular disease and is associated with greater exercise blood pressure in adults. However, it is not yet clear whether endothelial function is associated with exercise blood pressure in youth. The purpose of this study was to examine the relationship between endothelial function, indexed by brachial artery flow-mediated dilation, and submaximal exercise blood pressure in healthy adolescents. Design Cross-sectional study. Method Adolescents (N = 45) completed a graded submaximal treadmill test. Blood pressure was measured during rest and each exercise stage. Ultrasound measurement of brachial artery flow-mediated dilation was completed on a separate visit. Pearson correlations and multiple regression were used to assess the unadjusted and multivariate adjusted associations between flow-mediated dilation and exercise blood pressure, respectively. Results Lower flow-mediated dilation was associated with lower diastolic blood pressure (r = 0.37, p = 0.01) and greater pulse pressure (r = −0.38, p = 0.01) during exercise. The significance did not change when adjusting for age, gender, fitness, or resting blood pressure. Exploratory analyses suggest that flow-mediated dilation was associated with exercise diastolic blood pressure primarily among adolescents with low resting diastolic blood pressure. Conclusions Studies in youth are important to understand the early pathogenesis of cardiovascular disease. Findings from this study suggest that endothelial function may play a role in regulating blood pressure responses during submaximal exercise in healthy adolescents. PMID:23809838
Need for Better Blood Pressure Measurement in Developing Countries to Improve Prevention of Cardiovascular Disease
Modesti, Pietro Amedeo; Perruolo, Eleonora; Parati, Gianfranco
Hypertension is now the foremost cause of disability and is responsible for the highest percentage of attributable death among risk factors. These global changes are mainly due to the increase in the prevalence of hypertension in most low- and middle-income countries (LMICs) as a consequence of relevant socioeconomic changes occurring during the last decades. Implementation of global prevention efforts urgently needs to be accelerated because of the increasing incidence of haemorrhagic stroke, renal failure, and hypertensive heart disease in developing countries. Blood pressure (BP) measurement has different implications in epidemiological studies performed in low-resource settings. First, the frequency of blood pressure measurement is a simple but reliable indicator of access to healthcare in epidemiological studies, which may disclose the favourable effects of urbanization; the opportunity to have BP measured increases hypertension awareness, facilitates drug treatment, and leads to better achievement of BP control. Second, BP measurement is a key element in cardiovascular risk stratification, focusing solely on the preferred strategy in low-resource settings where costs of biochemical tests might be less sustainable. Third, the issue of obtaining reliable estimation of BP values is crucial to achieve sound data on the burden of hypertension in LMICs, and some aspects of BP measurement, such as the use of reliable automated devices, the number of measurements/visits to achieve a consistent diagnosis of hypertension, and the possible confounding effect of environmental factors, must be closely considered. PMID:25420484
Transmitted ultrasound pressure variation in micro blood vessel phantoms.
Qin, Shengping; Kruse, Dustin E; Ferrara, Katherine W
Silica, cellulose and polymethylmethacrylate tubes with inner diameters of ten to a few hundred microns are commonly used as blood vessel phantoms in in vitro studies of microbubble or nanodroplet behavior during insonation. However, a detailed investigation of the ultrasonic fields within these micro-tubes has not yet been performed. This work provides a theoretical analysis of the ultrasonic fields within micro-tubes. Numerical results show that for the same tube material, the interaction between the micro-tube and megaHertz-frequency ultrasound may vary drastically with incident frequency, tube diameter and wall thickness. For 10 MHz ultrasonic insonation of a polymethylmethacrylate (PMMA) tube with an inner diameter of 195 microm and an outer diameter of 260 microm, the peak pressure within the tube can be up to 300% of incident pressure amplitude. However, using 1 MHz ultrasound and a silica tube with an inner diameter of 12 microm and an outer diameter of 50 microm, the peak pressure within the tube is only 12% of the incident pressure amplitude and correspondingly, the spatial-average-time-average intensity within the tube is only 1% of the incident intensity. PMID:18395962
Transmitted Ultrasound Pressure Variation in Micro Blood Vessel Phantoms
Qin, Shengping; Kruse, Dustin E.; Ferrara, Katherine W.
Silica, cellulose, and polymethylmethacrylate tubes with inner diameters of ten to a few hundred microns are commonly used as blood vessel phantoms in in vitro studies of microbubble or nanodroplet behavior during insonation. However, a detailed investigation of the ultrasonic fields within these micro-tubes has not yet been performed. This technical note provides a theoretical analysis of the ultrasonic fields within micro-tubes. Numerical results show that for the same tube material, the interaction between the micro-tube and megaHertz-frequency ultrasound may vary drastically with incident frequency, tube diameter, and wall thickness. For 10 MHz ultrasonic insonation of a polymethylmethacrylate (PMMA) tube with an inner diameter of 195 μm and an outer diameter of 260 μm, the peak pressure within the tube can be up to 300% of incident pressure amplitude. However, using 1 MHz ultrasound and a silica tube with an inner diameter of 12 μm and an outer diameter of 50 μm, the peak pressure within the tube is only 12% of the incident pressure amplitude, and correspondingly the spatial-average-time-average intensity within the tube is only 1% of the incident intensity. PMID:18395962
Sensitivity, specificity, and predictive values of a forearm blood pressure measurement method in severe obesity.
Leblanc, Marie-Ève; Cloutier, Lyne; Poirier, Paul
For blood pressure assessment, it has been reported that forearm blood pressure measurement appears to be as valid as an upper-arm blood pressure measurement method in individuals with severe obesity when correlated to the intra-arterial method, considered as the gold standard. Sensitivity, specificity, and predictive values for the presence of systemic hypertension in 25 severely obese patients from 352 blood pressure measurements were calculated. The sensitivity (0.98) and the positive predictive value (0.93) for hypertension on forearm blood pressure measurements are excellent, indicating that the forearm approach is a promising alternative to systemic hypertension diagnosis in severe obesity. PMID:25757220
Does Measurement of Central Blood Pressure have Treatment Consequences in the Clinical Praxis?
Mitchell, Gary F
Interest in relations between central aortic pressure and cardiovascular disease risk has increased markedly over the past two decades. Numerous studies have shown that higher pulse pressure is associated with increased risk. Further, pulse pressure differs variably and sometimes dramatically between the central aorta and the brachial artery, where blood pressure is generally measured. In light of the potential for variable misclassification of central systolic and pulse pressure by brachial measurements, central blood pressure has emerged as a potentially superior blood pressure measure. This brief review will examine the evidence supporting the use of central pressure to stratify risk and guide therapy in patients with hypertension. PMID:26142539
A Semi-automated Approach to Preparing Antibody Cocktails for Immunophenotypic Analysis of Human Peripheral Blood
Koguchi, Yoshinobu; Gonzalez, Iliana L.; Meeuwsen, Tanisha L.; Miller, William L.; Haley, Daniel P.; Tanibata-Branham, Alice N.; Bahjat, Keith S.
Immunophenotyping of peripheral blood by flow cytometry determines changes in the frequency and activation status of peripheral leukocytes during disease and treatment. It has the potential to predict therapeutic efficacy and identify novel therapeutic targets. Whole blood staining utilizes unmanipulated blood, which minimizes artifacts that can occur during sample preparation. However, whole blood staining must also be done on freshly collected blood to ensure the integrity of the sample. Additionally, it is best to prepare antibody cocktails on the same day to avoid potential instability of tandem-dyes and prevent reagent interaction between brilliant violet dyes. Therefore, whole blood staining requires careful standardization to control for intra and inter-experimental variability. Here, we report deployment of an automated liquid handler equipped with a two-dimensional (2D) barcode reader into a standard process of making antibody cocktails for flow cytometry. Antibodies were transferred into 2D barcoded tubes arranged in a 96 well format and their contents compiled in a database. The liquid handler could then locate the source antibody vials by referencing antibody names within the database. Our method eliminated tedious coordination for positioning of source antibody tubes. It provided versatility allowing the user to easily change any number of details in the antibody dispensing process such as specific antibody to use, volume, and destination by modifying the database without rewriting the scripting in the software method for each assay. A proof of concept experiment achieved outstanding inter and intra- assay precision, demonstrated by replicate preparation of an 11-color, 17-antibody flow cytometry assay. These methodologies increased overall throughput for flow cytometry assays and facilitated daily preparation of the complex antibody cocktails required for the detailed phenotypic characterization of freshly collected anticoagulated peripheral blood
Blood pressure variability in controlled and uncontrolled blood pressure and its association with left ventricular hypertrophy and diastolic function.
Wittke, E I; Fuchs, S C; Moreira, L B; Foppa, M; Fuchs, F D; Gus, M
High systolic blood pressure (SBP) variability has been associated with higher risk for target-organ damage. In a cross-sectional study done in a tertiary outpatient hypertension clinic, we compared short-term SBP variability among controlled and uncontrolled hypertensive patients and evaluated the association between higher levels of SBP variability and diastolic function and left ventricular hypertrophy (LVH). Patients were evaluated by 24-h ambulatory blood pressure monitoring and transthoracic Doppler echocardiogram. Blood pressure (BP) variability was evaluated by the time-rate index and high variability corresponded to index values in the top quartile of distribution. Echocardiographic parameters were compared in patients with and without higher BP variability within controlled and uncontrolled office BP (⩽140/90 mm Hg). The analyses included 447 patients with 58±12 years of age, 67% were women, 68% white, 43% current or previous smokers and 32% with diabetes mellitus. Among the whole sample, 137 patients had controlled and 310 uncontrolled BP. The 75th percentile cutoff points for the time-rate index were 0.502 mm Hg min(-1) and 0.576 mm Hg min(-1) for participants with controlled and uncontrolled BP, respectively. After adjustment for confounders, the time-rate index did not differ between controlled and uncontrolled patients. BP variability was not associated with LVH or diastolic function in controlled and uncontrolled BP after adjustment for 24-h SBP and age. Patients with controlled and uncontrolled BP had similar SBP variability assessed by time-rate index, which was not associated with LVH or diastolic function. These findings should be confirmed in studies with larger sample size. PMID:26467817
Ambulatory blood pressure monitoring in solid organ transplantation.
Ramesh Prasad, G V
Solid organ transplant recipients are at an increased risk for hypertension and cardiovascular disease. To assist in their management, 24-h ambulatory blood pressure monitoring (ABPM) has become increasingly used in both clinical research settings and practice. ABPM has been used to better define post-transplant hypertension incidence and prevalence in different solid organ transplantation populations. ABPM provides additional information on cardiovascular risk beyond that obtained by clinic-based readings, based on its ability to assess 24-h blood pressure (BP) load, detect nocturnal non-dipping, and predict target organ damage. It has provided some assurance about the safety of living kidney donation. Information from ABPM can be used to guide living kidney donor selection, and because ABPM-related data has been correlated with clinically important kidney and heart transplant recipient outcomes, it may be a valuable adjunct in their management. Despite these advantages, barriers to wider use of ABPM include expense, clinical inertia in hypertension management, lack of prospective clinical trial data, and clinical problems that compete with hypertension for attention such as acute or chronic allograft dysfunction. The increasing amount of research and clinical use for ABPM may allow for closer assessment and intervention to help address the increased cardiovascular risk faced by many solid organ transplant recipients. PMID:22220828
Regulation of Blood Pressure and Salt Homeostasis by Endothelin
Endothelin (ET) peptides and their receptors are intimately involved in the physiological control of systemic blood pressure and body Na homeostasis, exerting these effects through alterations in a host of circulating and local factors. Hormonal systems affected by ET include natriuretic peptides, aldosterone, catecholamines, and angiotensin. ET also directly regulates cardiac output, central and peripheral nervous system activity, renal Na and water excretion, systemic vascular resistance, and venous capacitance. ET regulation of these systems is often complex, sometimes involving opposing actions depending on which receptor isoform is activated, which cells are affected, and what other prevailing factors exist. A detailed understanding of this system is important; disordered regulation of the ET system is strongly associated with hypertension and dysregulated extracellular fluid volume homeostasis. In addition, ET receptor antagonists are being increasingly used for the treatment of a variety of diseases; while demonstrating benefit, these agents also have adverse effects on fluid retention that may substantially limit their clinical utility. This review provides a detailed analysis of how the ET system is involved in the control of blood pressure and Na homeostasis, focusing primarily on physiological regulation with some discussion of the role of the ET system in hypertension. PMID:21248162
Challenges in Treating Low Blood Pressure in Preterm Infants
Dempsey, Eugene M.
Whilst the prevalence of low blood pressure in preterm infants seems to have fallen over the last number of years, the problem is still frequently encountered in the neonatal intensive care unit and many babies continue to receive intervention. Great variability in practice persists, with a significant number of extremely low gestational age newborns in some institutions receiving some form of intervention, and in other units substantially less. A great degree of this variability relates to the actual criteria used to define hypotension, with some using blood pressure values alone to direct therapy and others using a combination of clinical, biochemical and echocardiography findings. The choice of intervention remains unresolved with the majority of centres continuing to administer volume followed by dopamine as a first line inotrope/vasopressor agent. Despite over 40 years of use there is little evidence that dopamine is of benefit both in the short term and long-term. Long-term follow up is available in only two randomised trials, which included a total of 99 babies. An under recognized problem relates to the administration of inotrope infusions in very preterm infants. There are no pediatric specific inotrope formulations available and so risks of errors in preparation and administration remain. This manuscript outlines these challenges and proposes some potential solutions. PMID:27417363
The Role of Metabolic Surgery on Blood Pressure Control.
Schiavon, Carlos Aurelio; Drager, Luciano F; Bortolotto, Luiz A; Amodeo, Celso; Ikeoka, Dimas; Berwanger, Otávio; Cohen, Ricardo Vitor
Obesity and hypertension are growing epidemics in the modern world. Lifestyle changes and medical treatment for obesity have disappointing long-term results and albeit drugs for hypertension are usually very effective, the necessity of multiple pills and frequent side effects make the adherence to treatment a huge challenge for healthcare systems. Bariatric/metabolic surgery is a very effective treatment and an exponential number of studies have been showing its positive impact beyond weight loss, mainly on type 2 diabetes. There is also growing evidence suggesting that bariatric/metabolic surgery is associated with reduced incidence of cardiovascular events, but the impact on hypertension and other components of metabolic syndrome usually derive from trials' secondary end points. Taking this limitation in mind, bariatric/metabolic surgery action on blood pressure is reaching a significant proportion of hypertension resolution or improvement. In this review, we discussed the current evidence on the impact of bariatric/metabolic surgery on blood pressure control and pointed out perspectives in this research area. PMID:27324638
Blood Pressure Mobile Monitoring for Pregnant Woman Based Android System
NASA Astrophysics Data System (ADS)
Supriyanti, Retno; Erfayanto, Uji; Ramadani, Yogi; Murdyantoro, Eko; Widodo, Haris B.
Currently, at least 18,000 women die every year in Indonesia due to pregnancy or childbirth. It means that every half hour a woman dies due to pregnancy or childbirth. As a result, every year 36,000 children became orphans. The high maternal mortality rate was put Indonesia on top in ASEAN. The main causes of maternal mortality are high-risk pregnancy. Mothers who have diseases like high blood pressure, pre-eclampsia, diabetes, hyperthyroidism, and already over 40 years old and infectious diseases such as rubella, hepatitis and HIV can be factors that lead to high-risk pregnancy. This paper will discuss the development of a blood pressure monitoring device that is suitable for pregnant women. It is based on convenience for pregnant women to get the equipment that is flexible with her presence. Results indicate that the equipment is in use daily support for pregnant women therefore, one of the causes of maternal mortality can be detected earlier.