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Blood Pressure Recordings (blood + pressure_recording)
Selected AbstractsPay (Adequately) For What Works: The Economic Undervaluation of Office and Ambulatory Blood Pressure RecordingsJOURNAL OF CLINICAL HYPERTENSION, Issue 4 2008Thomas D. Giles MD When they tell you it's not about the money,it's about the money.,H.L. Mencken (not verified) [source] Use of intravenous sedation in the management of patients with high blood pressureORAL SURGERY, Issue 3 2009S. Woolcombe Abstract Aim:, We aim to determine the prevalence of undiagnosed/poorly controlled hypertension and study the population demographics. We also aim to study the effects of intravenous midazolam on peri-operative blood pressure and pulse. Finally, we aim to assess the value of screening for hypertension and determine the degree of white coat hypertension. Material and methods:, A cohort of 83 patients with a pre-assessment blood pressure recording ,160/100 mmHg was studied. Oral surgery treatment was performed under intravenous sedation with midazolam or local anaesthesia alone where sedation was contraindicated. Blood pressure and pulse were monitored throughout surgery. Following treatment, patients were advised to attend their General Practitioner (GP) for assessment of their blood pressure and information regarding the outcome of this visit was requested. Results:, Seventy-three percent of the cohort had no previous diagnosis of hypertension. The use of intravenous midazolam significantly reduced peri-operative blood pressure compared with local anaesthesia alone [reduction in systolic blood pressure (BP) of 40 mmHg and diastolic BP of 21 mmHg]. Fifty percent of those who attended their GP received active treatment for hypertension at the first visit. A further 25% were kept under review. Blood pressure measurements at hospital pre-assessment were substantially higher than those recorded by GPs. Conclusion:, A clear indication exists for the use of intravenous sedation with midazolam for oral surgery procedures in patients with high blood pressure. There is a significant prevalence of undiagnosed and poorly controlled hypertension. Blood pressure screening in the dental setting is a valuable tool for identifying hypertensive patients. White coat hypertension is significantly greater in the oral surgery department than at the GP surgery. [source] Cardiac dysfunction during exercise in patients with primary hyperparathyroidismBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 9 2000I.-L. Nilsson Background ,Non-traditional' manifestations of primary hyperparathyroidism (HPT) are controversial, and include morbidity, mortality and risk factors for cardiovascular diseases with some prospects of normalization by parathyroidectomy (PTX). This study evaluated previously unexplored data on cardiac function during exercise in HPT. Methods Thirty patients with HPT (mean(s.d.) serum calcium 2·96(0·24) mmol l,1) and 30 normocalcaemic controls (selected randomly from the background population, and matched for age and sex) underwent exercise testing, echocardiography and 24-h ambulatory blood pressure recordings before and a mean of 13 months after PTX. Results HPT was associated with higher systolic blood pressure during exercise (mean(s.d.) 223(28) versus 203(33) mmHg; P = 0·02), which correlated to the left ventricular (LV) mass and serum PTH (P = 0·014, P = 0·004); higher LV mass in men (mean(s.d.) 142(20) versus 113(28) g m,2), which might relate to the hypertrophic effect of PTH; and increased LV isovolumic relaxation times (mean(s.d.) 102(19) versus 91(15) ms; P = 0·018), indicating LV diastolic dysfunction. ST depression during exercise decreased significantly (mean(s.d.) , 1·0(0·9) versus 0·7(0·5) mm; P = 0·028) and LV mass declined in proportion with the time after PTX (P = 0·04 in men). PTX also affected systolic functions, as fractional shortening, atrioventricular plane displacement and systolic index decreased in men (P = 0·05, P = 0·04, P = 0·04). Twenty-four-hour blood pressures were higher in HPT (P = 0·008), when subjects on ,-blockers (seven patients, five controls) were excluded, and were unaltered by PTX. Conclusion LV systolic and diastolic dysfunction occurs in HPT. The diastolic dysfunction seems to diminish with time after PTX, while the positive inotropic effect of calcium in itself may alleviate the systolic dysfunction. © 2000 British Journal of Surgery Society Ltd [source] Role of proteinuria in defining pre-eclampsia: Clinical outcomes for women and babiesCLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 4 2010Charlene E Thornton Summary 1.,The presence of proteinuria is not essential to the diagnosis of pre-eclampsia under many diagnostic consensus statements. The aim of the present study was to assess maternal and perinatal outcomes after proteinuric pre-eclampsia compared with other non-proteinuric disease presentations. 2.,An individual patient data review (n = 670) was undertaken for 2003,2006 at a tertiary referral centre in Sydney (NSW, Australia). Women were diagnosed in accordance with the Australasian Society for the Study of Hypertension in Pregnancy Consensus Statement. Data were analysed with the Chi-squared test, t -tests and non-parametric tests. Statistical significance was set at P < 0.05. 3.,The proteinuric cohort had higher systolic and diastolic blood pressure recordings than the non-proteinuric cohort (160/102 and 149/94 mmHg, respectively; P < 0.001), and were also administered magnesium sulphate more frequently (44 vs 22%, respectively; P < 0.001), delivered at earlier gestation (37 vs 38 weeks, respectively; P < 0.001), required operative delivery more frequently (63 vs 48%, respectively; P < 0.001) and received more antihypertensive medications during the antenatal period (72 vs 57%, respectively; P < 0.001). Acute renal failure and acute pulmonary oedema were rare. Four cases of eclampsia all occurred in non-proteinuric women. The perinatal mortality rate was lower for the offspring of women with proteinuric pre-eclampsia compared with offspring of non-proteinuric women (13/1000 and 31/1000, respectively; P = 0.006). 4.,The results of the present study indicate that the presence of proteinuria denotes a group of women who have higher antenatal blood pressure, who deliver at earlier gestation and require operative delivery more commonly, although it is not an indicator of other markers of maternal morbidity or perinatal mortality. [source] Respiratory effects on the reproducibility of cardiovascular autonomic parametersCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2007Éva Zöllei Summary The aim of this study was to assess the influence of breathing pattern on the reproducibility of the most commonly used heart rate and blood pressure variability parameters and baroreflex indices. 5,5 min ECG and blood pressure recordings were made and repeated for 10 healthy volunteers in supine rest on 10 consecutive days during spontaneous and 6 min,1 patterned breathing. We investigated the following parameters: mean RR interval (RRI); the standard deviation of RR intervals (SDRR); the root mean square of successive differences in RRI (RMSSD); the percentage of RRIs which differed by 50% from the proceeding RRI (PNN50); mean systolic arterial pressure (SAP); the standard deviation of SAP (SAP SD); mean mean arterial pressure (MAP); mean diastolic blood pressure (DAP) and baroreflex indices from spontaneous sequence method (upBRS and downBRS) and from cross spectral analysis (LF alpha, HF alpha). To assess reproducibility for each parameter within- and between-subject variability values were calculated and the ratio of within- and between-subject variability was assessed. In addition, we calculated intraclass correlation coefficient (ICC). Compared to spontaneous respiration during 6 min,1 patterned breathing the heart rate and blood pressure variability increased; upBRS, LF alpha and HF alpha increased, downBRS did not change. However, ICC showed good reproducibility for most parameters, which did not improve further with controlled breathing. In conclusion, respiration had a strong influence on the most widely used cardiovascular autonomic parameters. The controlling of breathing did not result in consistent improvement in their reproducibility. [source] | ||||||||||