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BP Measurements (bp + measurement)

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Medical Sciences	100%

Selected Abstracts

Characterizing blood pressure control in individuals with Type 2 diabetes: the relationship between clinic and self-monitored blood pressure

DIABETIC MEDICINE, Issue 9 2003
R. S. Mazze
Abstract Aims To determine the relationship between blood pressure (BP) measurement in the clinic and self-monitored blood pressure (SMBP); and to evaluate the accuracy of self-reported data in patients with Type 2 diabetes treated intensively for hypertension. Methods Seventy subjects had baseline and 1-week follow-up clinic BP measured using an Omron 907® automated device. During a contemporaneous 14-day period these subjects measured their BP at least four times each day using an Omron IC® semiautomatic portable monitor which, unknown to them, contained an onboard memory capable of storing BP with corresponding time and date. Results There was no significant difference between mean clinic and mean self-monitored BP. Correlations between clinic BP and SMBP were r = 0.61 (P < 0.0001) for systolic BP and r = 0.69 (P < 0.0001) for diastolic BP. Clinic BP classified 56 subjects as uncontrolled hypertension (BP , 130/80 mmHg, adjusted for diabetes) and 14 subjects as controlled hypertension. Using World Health Organization-International Society of Hypertension criteria for SMBP (, 125/75 mmHg), 55 cases of clinic classified uncontrolled hypertension were confirmed, resulting in 98% sensitivity. Clinic and SMBP agreed in one case of controlled hypertension, resulting in 7% specificity. For all subjects, the median percent of values exceeding SMBP criteria for controlled hypertension was systolic 92% and diastolic 70%. Self-reporting precision averaged 89 ± 10% (range 45,100%); under-reporting was 25 ± 16% (ranging from 0 to 56%) and over-reporting was 12 ± 15% (ranging from 0 to 46%). The overall logbook mean was not significantly different from the downloaded data from the Omron IC® monitors. Conclusions SMBP was able to identify 13 patients with uncontrolled hypertension who, by clinic BP measurement, had been classified as controlled. [source]

Assessment of blood pressure in patients with Type 2 diabetes: comparison between home blood pressure monitoring, clinic blood pressure measurement and 24-h ambulatory blood pressure monitoring

DIABETIC MEDICINE, Issue 6 2001
M. G. Masding
Abstract Aims To compare a home blood pressure (BP) monitoring device and clinic BP measurement with 24-h ambulatory BP monitoring in patients with Type 2 diabetes mellitus (DM). Methods Fifty-five patients with type 2 DM had BP measured at three consecutive visits to the DM clinic by nurses using a stethoscope and mercury sphygmomanometer (CBP). Twenty-four-hour ambulatory BP was measured using a Spacelabs 90207 automatic cuff-oscillometric device (ABPM). Subjects were then instructed in how to use a Boots HEM 732B semiautomatic cuff-oscillometric home BP monitoring device and measured BP at home on three specified occasions on each of 4 consecutive days at varying times (HBPM). Results Correlations between HBPM and ABPM were r = 0.88, P < 0.001 for systolic BP and r = 0.76, P < 0.001 for diastolic BP, with correlations between CBP and ABPM being systolic r = 0.59, P < 0.001, diastolic r = 0.47, P < 0.001. HBPM agreed with ABPM more closely compared with CBP (CBP +10.9/+3.8 (95% confidence intervals (CI) 6.9, 14.8/1.6, 6.1) vs. HBPM +8.2/+3.7 (95% CI 6.0, 10.3/2.0, 5.4)). The sensitivity, specificity and positive predictive value of HBPM in detecting hypertension were 100%, 79% and 90%, respectively, compared with CBP (85%, 46% and 58%, respectively). Conclusions In patients with Type 2 DM, home BP monitoring is superior to clinic BP measurement, when compared with 24-h ambulatory BP, and allows better detection of hypertension. It would be a rational addition to the annual review process. Diabet. Med. 18, 431,437 (2001) [source]

The effect of crossing legs on blood pressure in hypertensive patients

JOURNAL OF CLINICAL NURSING, Issue 9-10 2010
Rukiye Pinar
Aims., The aim of this study was to examine whether there is any difference between BP readings with patients crossing a leg at the knee level and uncrossing during BP measurement. Background., It is clear that numerous factors influence an individual's blood pressure (BP) measurement. However, guidelines for accurately measuring BP inconsistently specify that the patient should keep feet flat on the floor. Design., Repeated measures. Method., Using a mercury-filled column sphygmomanometer, BP was measured at uncrossed leg position, crossed leg position and again at uncrossed leg position in 283 unmedicated or medicated patients. Three experienced nurses specially trained for the study performed BP measurements. Results., The results indicated that BP increased significantly with the crossed leg position. Systolic and diastolic BP significantly increased approximately 10 and 8 mmHg, respectively. Conclusion., Crossing the leg at knee results in a significant increase in BP. Relevance to clinical practice., Leg position during measurement of BP should be standardised and mentioned in publications. [source]

Patterns of QT Dispersion in Athletic and Hypertensive Left Ventricular Hypertrophy

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2004
Laura Maria Lonati M.D.
Objective:,The objective of this article is to assess whether left ventricular hypertrophy (LVH) due to physical training or of hypertensive patients shows similarities in QT length and QT dispersion. Methods:,A total of 51 subjects were studied: 17 essential hypertensive patients (27.7 ± 5.6 years), 17 athletes involved in agonistic activity (canoeing) (24.8 ± 6.1 years), and 17 normotensive healthy subjects as control group (24.8 ± 3.6 years). The testing protocol consisted of (1) clinic BP measurement, (2) echocardiography, (3) 12-lead electrocardiographic examination (QT max, QTc max, QT min, QTc min, ,QT, ,QTc). Results:,There were no significant differences between the body surface area, height, and age of the three groups. Clinic blood pressure was higher in hypertensives (146.5 ± 45.2/93.5 ± 4.9 mmHg) versus athletes (120.9 ± 10.8/77.1 ± 6.0 mmHg) and controls (123.5 ± 4.8/78.8 ± 2.9 mmHg) by definition. Indexed left ventricular mass (LVM/BSA) was significantly greater in both athletes (148.9 ± 21.1 g/m2) and hypertensives (117.1 ± 15.2 g/m2) versus controls (81.1 ± 14.5 g/m2; P < 0.01), there being no statistical difference among them. LVH (LVMI > 125 g/m2) was observed in all athletes, while the prevalence in hypertensives was 50%. In spite of this large difference in cardiac structure there were no significant differences in QT parameters between athletes and the control group, while hypertensive patients showed a significant increase in QT dispersion versus the two other groups (,QT 82 ± 2.1, 48 ± 1.3, 49 ± 2.3 ms; P < 0.01; ,QTc 88 ± 2.0, 47 ± 1.4, 54 ± 2.7; P < 0.01). Conclusions:,LVH induced by physical training activity is not associated with an increase in QT dispersion, whereas pathological increase in LVM secondary to hypertension is accompanied by an increased QT dispersion. [source]

Impact of Terminal Digit Preference by Family Physicians and Sphygmomanometer Calibration Errors on Blood Pressure Value: Implication for Hypertension Screening

JOURNAL OF CLINICAL HYPERTENSION, Issue 5 2008
Theophile Niyonsenga PhD
The accuracy of blood pressure (BP) measurement is important; systematic small errors can mislabel BP status in many persons. The objective of this study was to assess the impact of 2 types of measurement errors on the evaluation of BP in family medicine: errors associated with terminal digit preference and those associated with calibration errors of sphygmomanometers. Secondary data analyses from 2 different projects were used to derive empiric distributions of terminal digit and BP device errors. Taking into account both types of errors, the proportion of false positives (falsely high BP) and false negatives (falsely normal BP) varied between 0. 82% and 5.18% of the population of consulting family physicians. In the United States, false positives and false negatives in patients' BP evaluations might lead to overtreating or undertreating 1.15 million to 7.25 million patients. Results support the need for the development of systematic interventions for quality control of BP measurements and periodic retraining for health professionals. [source]

The effect of crossing legs on blood pressure in hypertensive patients

Association between bone lead concentration and blood pressure among young adults

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2002
Fredric Gerr MD
Abstract Background Occupational and environmental exposure to lead has been examined for its effect on blood pressure (BP) in adults with varying results. The present analyses assessed the association between bone lead concentration and BP in early adult life in persons exposed during childhood. Methods Study participants included young adult members of two cohorts with different past histories of lead exposure. Lead exposure was assessed using noninvasive K-X-ray fluorescence spectroscopy to quantify bone lead concentration, an index of long-term lead exposure superior to current blood lead concentration. Systolic and diastolic BP measurements were obtained using conventional clinical methods. Multiple linear regression models were constructed to allow for control of covariates of BP identified a priori. Results Analyses were performed on 508 participants. While controlling for potential confounders, systolic BP was 4.3 mm,Hg greater among members of the highest of four bone lead concentration groups (>,10 ,gPb/g bone) when compared with the lowest bone lead concentration group (<,1 ,gPb/g bone; P,=,0.004), and diastolic BP was 2.8 mm,Hg greater among members of the highest bone lead concentration group when compared with the lowest bone lead concentration group (P,=,0.03). Conclusions These results suggest that substantial lead exposure during childhood can increase BP during young adulthood. Am. J. Ind. Med. 42:98,106, 2002. © 2002 Wiley-Liss, Inc. [source]

Do maternal- or pregnancy-associated disease states affect blood pressure in the early neonatal period?

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009
Alison L. KENT
Background: Placental vascular changes associated with maternal disease states may affect fetal vascular development. There is evidence suggesting that being born prematurely is associated with a higher blood pressure (BP) in later life. Aim: To determine whether maternal disease state affects BP in the early neonatal period. Methods: Cohort study of neonates admitted to neonatal intensive care unit with exposure to maternal hypertension and diabetes. Inclusion criteria were neonates greater than 27 weeks gestation not ventilated or requiring inotropes for more than 24 h, materna l hypertension (pregnancy induced or essential) or diabetes of any kind requiring treatment, and spontaneous delivery. Exclusion criteria included chromosomal or congenital anomaly and illicit maternal drug use. Oscillometric BP measurements taken until discharge on days 1, 2, 3, 4, 7, 14, 21 and 28. Placental histopathology was performed. Results: One hundred and ninety infants enrolled, 104 in the control and 86 in the study group. Sixty-five infants were born between 28,31 weeks and 125 infants between 32,41 weeks gestation. Those born between 28,31 weeks with a history of diabetes had a statistically higher systolic, mean and diastolic BP throughout the first 28 days of life (P = 0.001; P = 0.007; P = 0.02). Those born between 32,41 weeks gestation with placental pathology associated with altered uteroplacental perfusion had a higher systolic BP (P = 0.005). Conclusions: Maternal- or pregnancy-associated disease states appear to influence BP in the early neonatal period. Diabetes and altered placental perfusion were associated with higher BP readings. Clinical significance of these statistically elevated BPs in the early neonatal period is unknown. [source]

Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials

ACTA PAEDIATRICA, Issue 1 2010
AM Toschke
Abstract Aim:, Blood pressure (BP) is related with cardiovascular disease. BP tracking in childhood and its implication for intervention trials are unknown. Methods:, A systematic review and meta-analysis were conducted to estimate BP tracking. Results:, In 29 independent studies on 27 820 subjects, follow-up length and baseline age were associated with systolic BP tracking (both p < 0.05), while gender, BP measurement method and study place were not (p = 0.215, p = 0.185 and p = 0.391). The overall adjusted systolic BP correlation coefficient was 0.44 between 10 and 11 years and decreased to 0.37 between 10 and 20 years. Comparison of BP changes before and after intervention need a 26% increased sample size for a 10-year follow-up of 10 year olds, while trials comparing BP values at study end only require smaller sample sizes. Conclusion:, Blood pressure tracking from childhood to adulthood affects trials assessing long-term effects on BP and was low-to-moderate. Therefore, regular BP controls are also needed in children with normal BP measurements possibly identifying hypertensive children earlier. A slight short-term intervention effect on BP may not have any long-term effects because of low BP tracking and its decrease by age. [source]

Circadian systemic haemodynamics in borderline and mild hypertension

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 6 2000
R. Takalo
Circadian variations in blood pressure (BP), stroke volume (SV), heart rate (HR), cardiac output (CO) and total peripheral resistance (TPR) were determined by a pulse contour method from the intra-arterial pulse wave in 32 normotensive (NT), 32 borderline hypertensive (BHT) and 31 hypertensive (HT) middle-aged men. Daytime averages were used as the reference levels. The nocturnal decrease in BP and HR were similar in the three groups. In the night, SV did not change in the NT group, but was increased in the BHT and HT groups. The nocturnal increase in SV may reflect reduced venous capacity causing increased cardiac filling. As a consequence of the difference in SV, the nocturnal CO fall was diminished in the HT group as compared with the NT group. Moreover, TPR had a tendency to decrease in the HT group, which may be considered as a baroreflex response to buffer the expected rise in BP. Five years later, 25 NT, 24 BHT and 19 HT subjects were reassessed using casual BP measurements. In the NT and BHT groups, six and 17 subjects, respectively, had progressed to hypertension. In a logistic regression model for those who became HT, the nocturnal increase in SV was a significant predictor for future hypertension. In conclusion, the results suggest that circadian systemic haemodynamics may be altered before BP is markedly elevated, and that haemodynamic studies might be useful in predicting the development of sustained hypertension. [source]