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1.
JMIR Mhealth Uhealth ; 12: e53355, 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39166440

RESUMEN

Background: Hypertension is highly prevalent among patients undergoing hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underused. Objective: This study aimed to explore the efficacy of a web-based home BP monitoring (HBPM) program in improving predialysis BP control and enhancing knowledge, perception, and adherence to HBPM among patients with hypertension undergoing hemodialysis. Methods: A multicenter, open-label, randomized controlled trial was conducted at 2 hemodialysis units. Patients were randomly allocated in a 1:1 ratio to either the web-based HBPM program as the intervention group or to usual care as the control group over a 6-month period. The primary outcomes were the predialysis BP control rate, defined as less than 140/90 mm Hg, and the predialysis systolic and diastolic BP, assessed from baseline to the 6-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the HBPM Knowledge Questionnaire, HBPM Perception Scale, and HBPM Adherence Scale, respectively. A generalized estimating equations analysis was used to analyze the primary outcomes in the intention-to-treat analysis. Results: Of the 165 patients enrolled in the program (n=84, 50.9% in the web-based HBPM group and n=81, 49.1% in the control group), 145 (87.9%) completed the follow-up assessment. During the follow-up period, 11 instances of hypotension occurred in 9 patients in the web-based HBPM group, compared to 15 instances in 14 patients in the control group. The predialysis BP control rate increased from 30% (25/84) to 48% (40/84) in the web-based HBPM group after the 6-month intervention, whereas in the control group, it decreased from 37% (30/81) to 25% (20/81; χ22=16.82, P<.001; odds ratio 5.11, 95% CI 2.14-12.23, P<.001). The web-based HBPM group demonstrated a significant reduction after the 6-month intervention in the predialysis systolic BP (t163=2.46, P=.02; ß=-6.09, 95 % CI -10.94 to -1.24, P=.01) and the predialysis diastolic BP (t163=3.20, P=.002; ß=-4.93, 95% CI -7.93 to -1.93, P=.001). Scores on the HBPM Knowledge Questionnaire (t163=-9.18, P<.001), HBPM Perception Scale (t163=-10.65, P<.001), and HBPM Adherence Scale (t163=-8.04, P<.001) were significantly higher after 6 months of intervention. Conclusions: The implementation of a web-based HBPM program can enhance predialysis BP control and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This web-based HBPM program should be promoted in appropriate clinical settings.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Diálisis Renal , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Diálisis Renal/métodos , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Hipertensión/psicología , Hipertensión/terapia , Hipertensión/complicaciones , Internet , Encuestas y Cuestionarios , Adulto
2.
J Clin Hypertens (Greenwich) ; 26(7): 842-849, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38980252

RESUMEN

Adequate management of nocturnal hypertension is crucial to reduce the risk of organ damage and cardiovascular events. The EARLY-NH study was a prospective, open-label, multicenter study conducted in Japanese patients with nocturnal hypertension who received esaxerenone treatment for 12 weeks. This post hoc analysis aimed to assess (1) the relationship between changes in morning home systolic blood pressure (SBP), bedtime home SBP, and nighttime home SBP based on changes in SBP and achievement rates of target SBP levels; and (2) the correlation between nighttime home SBP measurements using brachial and wrist home BP monitoring (HBPM) devices. This analysis evaluated 82 patients who completed the 12-week treatment period. Among those who achieved target morning home SBP (<135 mmHg) and target bedtime home SBP (<135 mmHg), the brachial HBPM device showed achievement rates of 63.6% and 56.4%, respectively, for target nighttime home SBP (<120 mmHg). The wrist device showed achievement rates of 66.7% and 63.4%, respectively, for the same targets. Significant correlations were observed between both devices for nighttime home SBP measurements at baseline (r = 0.790), Week 12 (r = 0.641), and change from baseline to Week 12 (r = 0.533) (all, p < .001). In this patient population, approximately 60% of individuals who reached target morning or bedtime home SBP levels <135 mmHg exhibited well-controlled nighttime home SBP. Although nighttime home SBP measurements obtained using both brachial and wrist HBPM devices displayed a significant correlation, the wrist device needs to be examined in more detail for clinical use.


Asunto(s)
Antihipertensivos , Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Ritmo Circadiano , Hipertensión , Muñeca , Humanos , Masculino , Femenino , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Persona de Mediana Edad , Estudios Prospectivos , Hipertensión/tratamiento farmacológico , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Anciano , Antihipertensivos/uso terapéutico , Ritmo Circadiano/fisiología , Presión Sanguínea/fisiología , Presión Sanguínea/efectos de los fármacos , Japón , Resultado del Tratamiento
4.
Vasc Health Risk Manag ; 20: 333-339, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39070216

RESUMEN

Purpose: The performance of Omron HEM-1026 (HCR-1901T2 / HCR-1902T2) for monitoring blood pressure (BP) in the upper arm was validated in accordance with the International Organization for Standardization (ISO) 81060-2:2018+amendment (Amd)1:2020 protocol. Methods: The device was assessed in 101 participants who fulfilled the inclusion criteria, including arm circumference range and systolic and diastolic BP provided by the protocol. Data validation and analysis were performed according to the manufacturer's instructions. Results: In the ISO 81060-2:2018+Amd 1:2020 validation procedure (criterion 1), the mean ± standard deviation (SD) of the differences between the test device and reference BP was -2.1 ± 7.24/-0.6 ± 5.63 mmHg (systolic/diastolic). These data fulfilled the ISO81060-2:2018+Amd1:2020 requirement of ≤5±≤8 mmHg. The mean differences between the two observers and Omron HEM-1026 were -2.1 ± 5.71 mmHg for systolic BP and -0.6 ± 4.81 mmHg for diastolic BP, fulfilling criterion 2 with an SD of ≤ 6.62 for systolic BP and ≤ 6.91 for diastolic BP. The two ISO criteria were fulfilled. Conclusion: The Omron HEM-1026 BP monitor fulfilled the requirements of the ISO 81060-2:2018+Amd 1:2020 validation standard and can be recommended for home BP measurements in the general population.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Diseño de Equipo , Valor Predictivo de las Pruebas , Humanos , Reproducibilidad de los Resultados , Masculino , Femenino , Persona de Mediana Edad , Anciano , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/normas , Adulto , Monitores de Presión Sanguínea/normas , Variaciones Dependientes del Observador , Extremidad Superior/irrigación sanguínea
5.
JMIR Mhealth Uhealth ; 12: e55617, 2024 Jul 12.
Artículo en Inglés | MEDLINE | ID: mdl-39012077

RESUMEN

Unlabelled: User engagement with remote blood pressure monitoring during pregnancy is critical to optimize the associated benefits of blood pressure control and early detection of hypertensive disorders of pregnancy. In our study population of pregnant individuals, we found that connected blood pressure cuffs, which automatically sync measures to a monitoring platform or health record, increase engagement (2.13 [95% CI 1.36-3.35] times more measures per day) with remote blood pressure monitoring compared to unconnected cuffs that require manual entry of measures.


Asunto(s)
Determinación de la Presión Sanguínea , Humanos , Embarazo , Femenino , Adulto , Determinación de la Presión Sanguínea/instrumentación , Determinación de la Presión Sanguínea/métodos , Determinación de la Presión Sanguínea/estadística & datos numéricos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/estadística & datos numéricos , Monitoreo Ambulatorio de la Presión Arterial/normas
6.
High Blood Press Cardiovasc Prev ; 31(4): 341-357, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38913296

RESUMEN

INTRODUCTION: Widespread use of smartphone applications has opened new perspectives for home Blood Pressure monitoring based on mobile health (mHealth) technologies. Patient engagement has been dubbed 'the silver bullet of the century'. AIM: The aim was to identify the impact of engagement in patients with blood pressure using mHealth. METHODS: This scoping review was conducted in accordance with the Ark0sey and O'Malley framework. DATABASE: Pubmed, CINAHL, Scopus and PsycInfo. This review considered both qualitative and quantitative primary searches. We excluded articles belonging to grey literature, secondary literature and paediatric setting. Between September and November 2023, the review was carried out. RESULTS: A total of 569 documents were retrieved from the four databases. After the deduplication process, five articles were removed. The selection process based on titles and abstracts included 133 records. Ten studies were selected and analysed. The reviewers identified the following themes: device type and mobile applications, engagement, blood pressure control, health behaviours and hypertension knowledge. Self-management using digital technologies in the home is strongly linked to engagement, reduction and control of Blood Pressure, improved health practices and increased knowledge of hypertension. Healthcare interventions using IT platforms have had a significant impact on the health outcomes of patients diagnosed with hypertension. CONCLUSIONS: The review findings suggest the value of these technologies in improving patient engagement and, consequently, adherence to antihypertensive treatment and achieving blood pressure control rates, potentially reducing cardiovascular risk.


Asunto(s)
Presión Sanguínea , Conocimientos, Actitudes y Práctica en Salud , Hipertensión , Participación del Paciente , Telemedicina , Humanos , Hipertensión/fisiopatología , Hipertensión/diagnóstico , Hipertensión/terapia , Hipertensión/tratamiento farmacológico , Presión Sanguínea/efectos de los fármacos , Aplicaciones Móviles , Masculino , Femenino , Resultado del Tratamiento , Adulto , Persona de Mediana Edad , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Anciano , Antihipertensivos/uso terapéutico
7.
J Public Health Manag Pract ; 30: S89-S95, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38870365

RESUMEN

CONTEXT: Disparities in cardiovascular disease prevalence and death exist among South Carolina's rural residents. Blood pressure self-monitoring (BPSM), where individuals measure their own blood pressure outside of the clinical environment, coupled with additional support, is an evidence-based, cost-effective strategy that is underutilized at large. PROGRAM: The YMCA's BPSM program is an evidence-based, 4-month program that includes 2 individualized office hours with a Healthy Heart Ambassador and 4 nutrition education sessions per month. Participants are provided with a blood pressure cuff and notebook to track their blood pressure at home in between sessions. IMPLEMENTATION: The SC Department of Health and Environmental Control partnered with the SC Alliance of YMCAs to expand the YMCA's BPSM program virtually. The traditional program was adapted to allow for virtual participant encounters. To target rural communities, partnerships were leveraged or established with rural health centers, federally qualified health centers, free medical clinics, and other state health department regions for participant referrals into the program. EVALUATION: A developmental evaluation design was utilized to monitor the virtual adaptation of the YMCA's BPSM program from April 2021 to May 2023. At the end of the project, 10 referral sources were identified to refer participants to the program. In total, 253 participants were referred to the program, 126 participants enrolled into the program, and 52 participants completed the program. Completers of the virtual program were successful in improving their blood pressure. DISCUSSION: Successes of the virtual program were not without challenges. Lessons learned from the virtual expansion of this program included ensuring participants' readiness to engage in a 4-month program, assessing participants' digital literacy, and considering broadband access in rural areas. Improvements in blood pressure and the program's reach demonstrate merit in continuing to scale the virtual adaptation of this program; however, contextual and structural factors should be considered.


Asunto(s)
Población Rural , Telemedicina , Humanos , South Carolina , Población Rural/estadística & datos numéricos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/estadística & datos numéricos , Hipertensión/epidemiología , Hipertensión/diagnóstico , Hipertensión/prevención & control , Anciano , Presión Sanguínea/fisiología , Evaluación de Programas y Proyectos de Salud/métodos
8.
ACS Nano ; 18(27): 17407-17438, 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38923501

RESUMEN

Continuous blood pressure (BP) tracking provides valuable insights into the health condition and functionality of the heart, arteries, and overall circulatory system of humans. The rapid development in flexible and wearable electronics has significantly accelerated the advancement of wearable BP monitoring technologies. However, several persistent challenges, including limited sensing capabilities and stability of flexible sensors, poor interfacial stability between sensors and skin, and low accuracy in BP estimation, have hindered the progress in wearable BP monitoring. To address these challenges, comprehensive innovations in materials design, device development, system optimization, and modeling have been pursued to improve the overall performance of wearable BP monitoring systems. In this review, we highlight the latest advancements in flexible and wearable systems toward continuous noninvasive BP tracking with a primary focus on materials development, device design, system integration, and theoretical algorithms. Existing challenges, potential solutions, and further research directions are also discussed to provide theoretical and technical guidance for the development of future wearable systems in continuous ambulatory BP measurement with enhanced sensing capability, robustness, and long-term accuracy.


Asunto(s)
Algoritmos , Dispositivos Electrónicos Vestibles , Humanos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Presión Sanguínea , Diseño de Equipo
10.
J Am Board Fam Med ; 37(2): 187-195, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38740471

RESUMEN

INTRODUCTION: Effective management of hypertension (HTN) is a priority in primary care. With telehealth now considered a staple care delivery method, uninsured and low-income patients without home blood pressure (BP) monitors may need additional attention and resources to achieve successful HTN control. METHODS: This prospective study at an underserved community clinic assessed the impact of distributing free BP monitors on patients' HTN control and therapy adherence. Enrollees were randomized into 2 groups, both completing 4 primary care physician (PCP) visits over a 6-month study period. Intervention participants collected home BP readings to report to their PCP and comparison participants completed an equivalent number of visits without having home BP data available for their PCP to review. Both groups completed an initial and final Therapy Adherence Scale (TAS) questionnaire. RESULTS: 263 patients were invited and 200 participants (mean age 50, 60% female, 19% Black, 67% Hispanic) completed the study. Intervention and comparison subjects featured comparable initial BP levels and TAS scores. After adjusting for age, race, ethnicity, sex, presence of diabetes and therapy adherence, intervention participants experienced higher odds of controlled HTN (OR 4.0; 95% Confidence Interval 2.1 to 7.7). A greater proportion of participants achieved BP control in the intervention arm compared with the comparison arm (82% vs 54% of participants, P < .001). TAS scores were higher in the intervention group (Mean = 44.1 vs 41.1; P < .001). DISCUSSION: The provision of free home BP monitors to low-income patients may feasibly and effectively improve BP control and therapy adherence.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Pobreza , Humanos , Femenino , Masculino , Hipertensión/diagnóstico , Hipertensión/terapia , Persona de Mediana Edad , Estudios Prospectivos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/métodos , Adulto , Atención Primaria de Salud , Telemedicina/métodos , Telemedicina/instrumentación , Empoderamiento , Cooperación del Paciente/estadística & datos numéricos , Anciano , Cumplimiento de la Medicación/estadística & datos numéricos
11.
J Clin Hypertens (Greenwich) ; 26(6): 703-707, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38650108

RESUMEN

The aim of this study was to evaluate the accuracy of the single upper-arm cuff oscillometric blood pressure (BP) monitor RBP-9801 developed for office and home BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018). Subjects were recruited to fulfil the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. A total of 105 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 2.3 ± 6.4/3.1 ± 5.8 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.24/5.03 mmHg (systolic/diastolic). The conclusion is that the RBP-9801 oscillometric device for office and home BP measurement fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in the general population and can be recommended for clinic and self-use at home.


Asunto(s)
Determinación de la Presión Sanguínea , Hipertensión , Oscilometría , Humanos , Masculino , Femenino , Persona de Mediana Edad , Oscilometría/instrumentación , Oscilometría/normas , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Determinación de la Presión Sanguínea/instrumentación , Determinación de la Presión Sanguínea/métodos , Determinación de la Presión Sanguínea/normas , Adulto , Monitores de Presión Sanguínea/normas , Presión Sanguínea/fisiología , Anciano , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/normas , Monitoreo Ambulatorio de la Presión Arterial/métodos , Reproducibilidad de los Resultados
12.
Blood Press Monit ; 29(4): 198-202, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38465742

RESUMEN

OBJECTIVE: Ambulatory blood pressure monitoring (ABPM) devices play a crucial role in diagnosing hypertension, not only in adults but also in pediatric patients. ABPM-06, the latest oscillometric device from Meditech Ltd. (Budapest, Hungary), is the focus of this study. The objective was to validate the ABPM-06 device using the International Organization for Standardization (ISO) 81060-2 : 2018 standard. METHODS: A total of 86 healthy patients, consisting of 34 males and 52 females, aged between 3 and 17 years, were enrolled in this study. During the ambulatory phase, a total of 50 patients were enrolled, with 35 patients falling within the 3- to 12-year-old age range and 15 patients aged between 12 and 17 years. Additionally, for the dynamic test, 36 patients were selected, comprising of 10 individuals aged 3-12 years and 26 patients aged 12-17 years. These patients were recruited from the outpatient clinics of the Department of Pediatrics at Albert Szent-Györgyi University in Szeged, Hungary. The validation process involved utilizing the same-arm sequence protocol, both in resting positions and during stress testing. RESULTS: The ABPM-06 performed well in both clinical and ambulatory validations. In terms of validation criterion 1, the mean ± SD of the differences between the test device and reference blood pressure readings was -1.3 ±â€…3.5  mmHg for systolic and -0.1  ±â€…2.3 mmHg for diastolic, in children under the age of 12 years. For those over the age of 12 years, the mean ± SD of the differences was -2.8 ± 4.6 mmHg for systolic and -0.5 ± 2.7 mmHg for diastolic. Regarding the ambulatory validation, for children under 12 years old, the mean ± SD of the differences was -1.3  ±â€…3.5  mmHg for systolic and -0.1  ±â€…2.3  mmHg for diastolic. In the age group above 12 years, the mean ± SD of the differences was -2.8 ± 4.6 mmHg for systolic and -0.5 ± 2.7 mmHg for diastolic. Both tests successfully met the established criteria regarding the mean and SD values of the differences between the device readings and the observed SBP and DBP measurements. CONCLUSION: The ABPM-06 oscillometric device fully adheres to the ISO 81060-2 : 2018 standard requirements for ABPM determination in the pediatric population (ages 3-17 years). Consequently, this ABPM device proves to be suitable for effectively managing hypertension in children and adolescents.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Humanos , Niño , Masculino , Femenino , Adolescente , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/normas , Preescolar , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Presión Sanguínea
13.
MCN Am J Matern Child Nurs ; 49(4): 194-203, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38512155

RESUMEN

BACKGROUND: Hypertensive disorders of pregnancy affect approximately 15% of pregnancies in the United States and are a leading cause of postpartum readmissions. Morbidity due to hypertension may be higher in the first several weeks postpartum. The ability to monitor blood pressure and intervene in the postpartum period is critical to reducing morbidity and mortality. LOCAL PROBLEM: At WellSpan Health, hypertensive disorders were increasing and a leading cause of severe maternal morbidity and readmission. INTERVENTIONS: A remote blood pressure monitoring app called BabyScripts™ myBloodPressure was implemented in September 2020. Prior to discharge postpartum, all patients with a diagnosis of a hypertensive disorder of pregnancy were given an automatic blood pressure cuff and instructions on how to monitor and track their blood pressure daily in the app. RESULTS: A total of 1,260 patients were enrolled in the BabyScripts™ myBloodPressure module between September 2020 and July 2022 across five maternity hospitals. Of those enrolled 74% ( n = 938) entered seven or more blood pressures, and of those who entered at least one blood pressure 9% ( n = 107) entered at least one critical range blood pressure ( ≥ 150 mmHg systolic and or ≥ 100 mmHg diastolic). CONCLUSION: Most women enrolled in the app were highly engaged and entered seven or more readings. Patients with critical blood pressures were identified; thus, the program has the potential to identify those at risk of severe complications. Barriers should be removed, and remote patient monitoring considered as a solution to improve postpartum assessment in patients with hypertensive disorders of pregnancy.


Asunto(s)
Hipertensión Inducida en el Embarazo , Aplicaciones Móviles , Periodo Posparto , Humanos , Femenino , Aplicaciones Móviles/normas , Aplicaciones Móviles/estadística & datos numéricos , Embarazo , Adulto , Periodo Posparto/fisiología , Hipertensión Inducida en el Embarazo/fisiopatología , Hipertensión Inducida en el Embarazo/diagnóstico , Determinación de la Presión Sanguínea/métodos , Determinación de la Presión Sanguínea/normas , Determinación de la Presión Sanguínea/estadística & datos numéricos , Determinación de la Presión Sanguínea/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/estadística & datos numéricos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/normas
14.
Hypertens Res ; 47(6): 1576-1587, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38548911

RESUMEN

The nocturnal blood pressure (BP) surge in seconds (sec-surge) is defined as a brief, acute transient BP elevation over several tens of seconds, triggered by obstructive sleep apnea (OSA) and sympathetic hyperactivity. Sec-surge imposes a significant strain on the cardiovascular system, potentially triggering cardiovascular events. Quantitative evaluation of sec-surge level could be valuable in assessing cardiovascular risks. To accurately measure the detailed sec-surge, including its shape as BP rises and falls, we developed a beat-by-beat (BbB) BP monitoring device using tonometry. In addition, we developed an automatic sec-surge detection algorithm to help identify sec-surge cases in the overnight BbB BP data. The device and algorithm successfully detected sec-surges in patients with OSA. Our results demonstrated that sec-surge was associated with left ventricular hypertrophy and arterial stiffness independently of nocturnal BP level or variability. Sec-surge would be worth monitoring for assessing cardiovascular risks, in addition to nocturnal BP level. Nocturnal blood pressure (BP) surge in seconds (sec-surge) places heavy load on the cardiovascular system and can trigger cardiovascular events. To identify sec-surges, we developed a beat-by-beat BP monitoring device and a sec-surge detection algorithm. Furthermore, sec-surge was more related to cardiovascular risks than conventional nocturnal BP parameters.


Asunto(s)
Algoritmos , Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Humanos , Presión Sanguínea/fisiología , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/métodos , Ritmo Circadiano/fisiología , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/diagnóstico , Hipertensión/fisiopatología , Hipertensión/diagnóstico , Determinación de la Presión Sanguínea/instrumentación , Determinación de la Presión Sanguínea/métodos
15.
Blood Press Monit ; 29(3): 161-165, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38390625

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the accuracy of the Raycome model M2 oscillometric upper-arm blood pressure (BP) monitor developed for ambulatory BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) at rest and during dynamic exercise. METHOD: Subjects were recruited to fulfill the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in the general population using the same arm sequential BP measurement method. Three cuffs of the test device were used for arm circumference 18-22 cm (small), 22-32 cm (medium) and 32-42 cm (large). RESULTS: For the general validation study, 106 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ±â€…SD of the differences between the test device and reference BP readings was 0.5 ±â€…6.2/-0.2 ±â€…5.1 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.23/4.50 mmHg (systolic/diastolic). In the ambulatory validation study ( N  = 35), the mean difference was 0.4 ±â€…5.9/-1.1 ±â€…5.8 mmHg. The Raycome model M2 performed well against the standard in both the general and ambulatory validations and the Bland-Altman plots did not show any systematic variation in the error. CONCLUSION: These data show that the Raycome model M2 monitor meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and in the ambulatory setting, indicating its suitability for measuring BP in the general population.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Humanos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Monitoreo Ambulatorio de la Presión Arterial/normas , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Monitores de Presión Sanguínea/normas , Hipertensión/fisiopatología , Hipertensión/diagnóstico , Presión Sanguínea
19.
BMC Cardiovasc Disord ; 22(1): 19, 2022 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-35090399

RESUMEN

BACKGROUND: Home blood pressure monitoring (HBPM) is an effective tool in treatment and long-term management of hypertension. HBPM incorporates more data points to help patients and providers with diagnosis and management. The characteristics of HBPM devices matter to patients, but the relative importance of the characteristics in choosing a device remains unclear. METHODS: We used data from a randomized cross-over pilot study with 100 Alaska Native and American Indian (ANAI) people with hypertension to assess the choice of a wrist or arm HBPM device. We use a random utility framework to evaluate the relationship between stated likely use, perceived accuracy, ease of use, comfort, and participant characteristics with choice of device. Additional analyses examined willingness to change to a more accurate device. RESULTS: Participants ranked the wrist device higher compared to the arm on a 5-point Likert scale for likely use, ease of use, and comfort (0.3, 0.5, 0.8 percentage points, respectively). Most participants (66%) choose the wrist device. Likely use (wrist and arm devices) was related to the probability of choosing the wrist (0.7 and - 1.4 percentage points, respectively). Independent of characteristics, 75% of participants would be willing to use the more accurate device. Ease of use (wrist device) and comfort (arm device) were associated with the probability of changing to a more accurate device (- 1.1 and 0.5 percentage points, respectively). CONCLUSION: Usability, including comfort, ease, and likely use, appeared to discount the relative importance of perceived accuracy in the device choice. Our results contribute evidence that ANAI populations value accurate HBPM, but that the devices should also be easy to use and comfortable to facilitate long-term management.


Asunto(s)
Algoritmos , Indio Americano o Nativo de Alaska , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Presión Sanguínea/fisiología , Hipertensión/diagnóstico , Estudios Cruzados , Femenino , Humanos , Hipertensión/etnología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Proyectos Piloto , Reproducibilidad de los Resultados , Estados Unidos/epidemiología
20.
BMC Cardiovasc Disord ; 21(1): 539, 2021 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-34772348

RESUMEN

BACKGROUND: The accurate and independent measurement of blood pressure (BP) by patients is essential for home BP monitoring (HBPM) and determining the quality of hypertension (HTN) control. This study aimed to evaluate the BP self-measurement techniques of hypertensive patients and their accuracy in accordance with established guidelines. We sought to identify the common errors that patients make and suggest improvements that can be implemented in the primary healthcare setting to increase the reliability of HBPM conducted by hypertensive patients. METHODS: One hundred patients diagnosed with HTN completed a questionnaire inquiring about their health and demographic data and BP monitoring practices. Patients were then observed and filmed while measuring their BP on their own devices in five primary healthcare centres in Kraków, Poland. The correctness of their techniques was assessed in accordance with the European Society of Hypertension guidelines on HBPM. RESULTS: Only 3% of patients measured their BP without error; 60% made three or more errors. The most frequent error, made by 76% of subjects, was incorrect sphygmomanometer cuff placement (above or below heart level, or/and the indicator mark was not aligned with the brachial artery). Regarding patients' previous instruction for the correct use of their devices, 36% of patients referred to their monitor's user manual, 22% did not receive any prior assistance, and only 29% were adequately counselled by physicians on how to measure their BP correctly. CONCLUSIONS: Our findings suggest that primary healthcare physicians and their personnel often do not adequately instruct patients on how to measure their BP correctly. Therefore, healthcare systems must provide patients with more adequate training and reference materials on the best practices of BP monitoring.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/diagnóstico , Autocuidado , Adulto , Anciano , Anciano de 80 o más Años , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Estudios Transversales , Errores Diagnósticos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Esfigmomanometros , Encuestas y Cuestionarios
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