Asociación entre el control de la hipertensión arterial en la población y la mortalidad por cardiopatía isquémica y accidente cerebrovascular en 36 países y territorios de la Región de las Américas, 1990-2019: un estudio ecológico / Association between population hypertension control and ischemic heart disease and stroke mortality in 36 countries of the Americas, 1990-2019: an ecological study / Associação entre controle populacional da hipertensão e mortalidade por doença cardíaca isquêmica e acidente vascular cerebral em 36 países das Américas, 1990-2019: um estudo ecológico

RESUMEN Objetivo. Cuantificar la asociación entre la prevalencia de control de la hipertensión arterial a nivel poblacional y la mortalidad por cardiopatía isquémica y accidente cerebrovascular en 36 países y territorios de la Región de las Américas entre 1990 y el 2019. Métodos. Este estudio ecológico emplea la prevalencia de la hipertensión, la concientización, el tratamiento y el control de la hipertensión arterial en la población producidos por la Colaboración sobre Factores de Riesgo de las Enfermedades No Transmisibles (NCD-RisC, por su sigla en inglés) y estimaciones de mortalidad por cardiopatía isquémica y accidente cerebrovascular del estudio sobre la carga mundial de enfermedad del 2019. Se realizó un análisis de regresión para evaluar las tendencias temporales y la asociación entre el control de la hipertensión arterial en la población y la mortalidad. Resultados. Entre 1990 y el 2019, las tasas de mortalidad estandarizadas por edad a causa de cardiopatía isquémica y accidente cerebrovascular disminuyeron en 2,2% (intervalos de confianza de 95%: -2,4 a -2,1) y 1,8% (-1,9 a -1,6) anual, respectivamente. La tasa de reducción anual de la mortalidad por cardiopatía isquémica y accidente cerebrovascular se redujo a -1% (-1,2 a -0,8) entre el 2000 y el 2019. Del 1990 al 2019, la prevalencia de hipertensión arterial controlada definida como presión arterial sistólica/diastólica ≤140/90 mmHg aumentó anualmente en 3,2% (3,1 a 3,2). Se observó una relación inversa entre el control poblacional de la hipertensión y la mortalidad por cardiopatía isquémica y por accidente cerebrovascular, respectivamente, en toda la Región y en los 36 países, a excepción de tres. En toda la Región, por cada aumento de 1% en el control de la hipertensión arterial en la población, nuestros datos predijeron una reducción de 2,9% (-2,94 a -2,85) en las muertes por cardiopatía isquémica por 100 000 habitantes, equivalente a 25 639 muertes evitables (2,5 muertes por 100 000 habitantes) y de 2,37% (-2,41 a -2,33) en las muertes por accidente cerebrovascular por 100 000 habitantes, equivalente a 9 650 muertes evitables (una muerte por 100 000 habitantes). Conclusiones. Existe una sólida asociación ecológica negativa entre la mortalidad por cardiopatía isquémica y accidente cerebrovascular y el control de la hipertensión arterial en la población. Los países con mejor resultado en el control de la hipertensión mostraron un mayor progreso en la reducción de la mortalidad por enfermedad cardiovascular. Los modelos de predicción tienen implicaciones en el manejo de la hipertensión en la mayoría de los grupos poblacionales de la Región de las Américas y otras partes del mundo.

ABSTRACT Objective. To quantify the association between the prevalence of population hypertension control and ischemic heart disease (IHD) and stroke mortality in 36 countries of the Americas from 1990 to 2019. Methods. This ecologic study uses the prevalence of hypertension, awareness, treatment, and control from the NCD-RisC and IHD and stroke mortality from the Global Burden of Disease Study 2019. Regression analysis was used to assess time trends and the association between population hypertension control and mortality. Results. Between 1990 and 2019, age-standardized death rates due to IHD and stroke declined annually by 2.2% (95% confidence intervals: -2.4 to -2.1) and 1.8% (-1.9 to -1.6), respectively. The annual reduction rate in IHD and stroke mortality deaccelerated to -1% (-1.2 to -0.8) during 2000-2019. From 1990 to 2019, the prevalence of hypertension controlled to a systolic/diastolic blood pressure ≤140/90 mmHg increased by 3.2% (3.1 to 3.2) annually. Population hypertension control showed an inverse association with IHD and stroke mortality, respectively, regionwide and in all but 3 out of 36 countries. Regionwide, for every 1% increase in population hypertension control, our data predicted a reduction of 2.9% (-2.94 to -2.85) in IHD deaths per 100 000 population, equivalent to an averted 25 639 deaths (2.5 deaths per 100 000 population) and 2.37% (-2.41 to -2.33) in stroke deaths per 100 000 population, equivalent to an averted 9 650 deaths (1 death per 100 000 population). Conclusion. There is a strong ecological negative association between IHD and stroke mortality and population hypertension control. Countries with the best performance in hypertension control showed better progress in reducing CVD mortality. Prediction models have implications for hypertension management in most populations in the Region of the Americas and other parts of the world.

RESUMO Objetivo. Quantificar a associação entre a prevalência de controle populacional da hipertensão e mortalidade por doença cardíaca isquêmica (DCI) e acidente vascular cerebral (AVC) em 36 países das Américas, de 1990 a 2019. Métodos. Este estudo ecológico utilizou os dados de prevalência da hipertensão e prevalência da detecção, tratamento e controle populacional da hipertensão do estudo NCD-RisC, e de mortalidade por DCI e AVC do Estudo de Carga Global de Doença de 2019. Análise de regressão foi utilizada para avaliar as tendências no tempo e a associação entre controle populacional da hipertensão e mortalidade. Resultados. Entre 1990 e 2019, as taxas de mortalidade padronizadas por idade devidas a DCI e AVC diminuíram anualmente 2,2% (intervalos de confiança de 95%: −2,4 a −2,1) e 1,8% (−1,9 a −1,6), respectivamente. A taxa anual de redução na mortalidade por DCI e AVC desacelerou para −1% (−1,2 a −0,8) durante o período de 2000-2019. De 1990 a 2019, a prevalência de hipertensão controlada com pressão arterial sistólica/diastólica ≤140/90 mmHg apresentou aumento anual de 3,2% (3,1 a 3,2). O controle populacional da hipertensão apresentou associação inversa com mortalidade por DCI e AVC, respectivamente, em toda a região, e em todos os 36 países, com a exceção de três. Em toda a região, para cada 1% de aumento no controle populacional da hipertensão, nossos dados previram uma redução de 2,9% (−2,94 a −2,85) nos óbitos por DCI por 100 000 habitantes, equivalente à prevenção de 25 639 óbitos (2,5 óbitos por 100 000 habitantes), e de 2,37% (−2,41 a −2,33) nos óbitos por AVC por 100 000 habitantes, equivalente à prevenção de 9 650 óbitos (1 óbito por 100 000 habitantes). Conclusão. Existe forte associação ecológica negativa entre mortalidade por DCI e AVC e controle populacional da hipertensão. Os países com o melhor desempenho no controle da hipertensão mostraram melhor progresso na redução da mortalidade por doenças cardiovasculares. Os modelos de previsão têm implicações no controle da hipertensão na maioria das populações da Região das Américas e em outras partes do mundo.

Comparison of invasive and non-invasive blood pressure in perioperative elderly hypertensive patients with atherosclerosis of the extremities / 中华老年医学杂志

Objective:To compare the correlation and differences between invasive blood pressure(IBP)and noninvasive blood pressure(NBP)monitoring at three different levels of systolic blood pressure(SBP), diastolic blood pressure(DBP)and mean arterial pressure(MAP)in elderly hypertensive patients with atherosclerosis of the extremities during perioperative anesthesia.Methods:156 elderly patients were prospectively admitted to the Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, for peripheral vascular stenosis interventions between December 2018 and December 2021.Their IBP and NBP were measured simultaneously during the perioperative anesthesia period.Then the correlation and consistency between IBP and NBP were analyzed via the Pearson correlation coefficient, Bland-Altman plots, and the receiver operating characteristic curve(ROC curve).Results:A total of 156 elderly patients were enrolled, including 108 men(69.2%)and 48 women(30.8%), with a mean age of 72.2±7.6.Pearson correlation analysis revealed that there was a significant positive correlation between IBP and NBP.The correlation coefficient was 0.993 for invasive systolic blood pressure(ISBP)and non-invasive systolic blood pressure(NSBP), 0.808 for invasive diastolic blood pressure(IDBP)and non-invasive diastolic blood pressure(NDBP), and 0.853 for invasive mean arterial pressure(IMAP)and non-invasive mean arterial pressure(NMAP)( P<0.001 for all). Bland-Altman analysis showed that the mean deviation of ISBP and NSBP was(20.3±6.5)mmHg(95% CI: 19.18-21.38)(1 mmHg=0.133 kPa), the mean deviation of IDBP and NDBP was(3.8±9.7)mmHg(95% CI: 2.13-5.41), and the mean deviation of IMAP and NMAP was(12.7±11.0)mmHg(95% CI: 10.83-14.55). The correlation coefficient of ISBP-NSBP deviation with ISBP was 0.856, the correlation coefficient of IDBP-NDBP deviation with IDBP was 0.206, and the correlation coefficient of IMAP-NMAP deviation with IMAP was 0.583( P<0.05 for all). When ISBP≥137 mmHg, the sensitivity of an ISBP-NSBP deviation ≥20 mmHg was 96.3%, the specificity was 96.4%, and the area under the ROC curve was 0.970(95% CI: 0.934-1.000). When ISBP≥158 mmHg, the sensitivity and specificity of a predicted ISBP-NSBP deviation≥25 mmHg were 97.4% and 78.8%, respectively, and the area under the ROC curve was 0.876(95% CI: 0.820-0.933); When ISBP≥208 mmHg, the sensitivity and specificity of a predicted ISBP-NSBP deviation≥30 mmHg were 100% and 98.5%, respectively, and the area under the ROC curve was 0.985(95% CI: 0.964-1.000). Conclusions:There is a good agreement between IBP and NBP in elderly hypertensive patients with peripheral atherosclerosis during perioperative anesthesia.The magnitude of the deviation between the two is significantly and positively correlated with the level of blood pressure, suggesting that we should appropriately choose the method of blood pressure measurement in the perioperative period to correctly evaluate the blood pressure of these elderly patients.

Melhorando o controle da pressão arterial com a adoção da automedição da pressão arterial­ AMPA / Improving blood pressure control with blood pressur self-measurement ­ BPSM

A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contribuir para o diagnóstico e seguimento da hipertensão arterial. Em nosso meio, devido a dificuldades de realização da Monitorização Residencial da Pressão Arterial (MRPA) e da indisponibilidade da Monitorização Ambulatorial da Pressão Arterial (MAPA) na maioria dos serviços, a AMPA, que difere dos métodos supracitados, tem uso disseminado em nosso país. Assim, nos parece importante discorrer sobre esse método, tão utilizado e tão pouco estudado. Neste trabalho vamos descrever os métodos de medida de pressão arterial, auscultatório e oscilométrico, além de listar vantagens e desvantagens da medida da pressão arterial no consultório, comparando-as com AMPA. Vamos também fazer um alerta sobre a necessidade de que o paciente receba orientações para a medida da pressão e, por fim, citar as Diretrizes Brasileiras e Europeias no que tange à menção que elas fazem a esse método.

Blood Pressure Self-Measurement (BPSM) has gained interest lately and its practice can contribute to the diagnosis and follow-up of arterial hypertension. In Brazil, due to difficulties in carrying out Home Blood Pressure Monitoring (HBPM) and the unavailability of Ambulatory Blood Pressure Monitoring (ABPM) in most facilities, AMPA, which differs from the aforementioned methods, has widespread use in our country. Therefore, it seems important to discuss this method, which is largely used and poorly studied. In this paper, we will describe the methods for measuring blood pressure, auscultatory and oscillometric, in addition to listing the advantages and disadvantages of measuring blood pressure in the office, comparing them with AMPA. We will also make an alert about the need for the patient to receive guidance on blood pressure measurement and, finally, we will cite the Brazilian and European Guidelines regarding the mention they make about this method.

Melhorando o controle da pressão arterial com a adoção da automedição da pressão arterial ­ AMPA / Improving blood pressure control with blood pressur self-measurement ­ BPSM

A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contribuir para o diagnóstico e seguimento da hipertensão arterial. Em nosso meio, devido a dificuldades de realização da Monitorização Residencial da Pressão Arterial (MRPA) e da indisponibilidade da Monitorização Ambulatorial da Pressão Arterial (MAPA) na maioria dos serviços, a AMPA, que difere dos métodos supracitados, tem uso disseminado em nosso país. Assim, nos parece importante discorrer sobre esse método, tão utilizado e tão pouco estudado. Neste trabalho vamos descrever os métodos de medida de pressão arterial, auscultatório e oscilométrico, além de listar vantagens e desvantagens da medida da pressão arterial no consultório, comparando-as com AMPA. Vamos também fazer um alerta sobre a necessidade de que o paciente receba orientações para a medida da pressão e, por fim, citar as Diretrizes Brasileiras e Europeias no que tange à menção que elas fazem a esse método (AU).

Blood Pressure Self-Measurement (BPSM) has gained interest lately and its practice can contribute to the diagnosis and follow-up of arterial hypertension. In Brazil, due to difficulties in carrying out Home Blood Pressure Monitoring (HBPM) and the unavailability of Ambulatory Blood Pressure Monitoring (ABPM) in most facilities, AMPA, which differs from the aforementioned methods, has widespread use in our country. Therefore, it seems important to discuss this method, which is largely used and poorly studied. In this paper, we will describe the methods for measuring blood pressure, auscultatory and oscillometric, in addition to listing the advantages and disadvantages of measuring blood pressure in the office, comparing them with AMPA. We will also make an alert about the need for the patient to receive guidance on blood pressure measurement and, finally, we will cite the Brazilian and European Guidelines regarding the mention they make about this method (AU).

Evaluation of oscillometric blood pressure measurement devices available for online sale / Evaluación de los aparatos oscilométricos de medición de la presión sanguínea disponibles para comercialización en línea / Avaliação dos dispositivos oscilométricos de medida de pressão arterial disponíveis para comercialização on-line

ABSTRACT Objectives: to characterize oscillometric blood pressure measurement devices for sale in the virtual market and identify which ones have undergone a validation study. Methods: this was a cross sectional study. The search for devices for sale was conducted on websites, and the sample was composed of 137 devices obtained from 644 ads. We conducted a bibliographic survey in five databases and web pages enlisting devices submitted for validation. The Kolmogorov-Smirnov test was used to check data distribution, followed by Mann-Whitney and Kruskal-Wallis tests for comparisons, using the SAS 9.4 program. Results: only 16.7% of the devices were validated. The home devices ranged from USD 10.57 to USD 275.67. Only 102 ads informed the cuff size, with different nomenclatures. Conclusions: most ads contained non-validated devices, which were cheaper. We identified some ads falsely informing validation.

RESUMEN Objetivos: caracterizar aparatos oscilométricos de medición de la presión sanguínea a la venta en el mercado virtual e identificar cuales pasaron por estudio de validación. Métodos: discorre de un estudio transversal. La búsqueda de equipos a la venta fue realizada en páginas de internet, y la muestra fue composta por 137 equipos, obtenidos en 644 anuncios. Realizado levantamiento bibliográfico en cinco bases de datos y consultadas páginas de internet que registran equipos sometidos a validación. Utilizadas las pruebas Kolmogorov-Smirnov para verificación de la distribución de los datos, seguidos de Mann-Whitney y Kruskal-Wallis para comparaciones, mediante el programa SAS 9.4. Resultados: solamente 16,7% de los aparatos eran validados. Equipos domiciliares presentaron variancia de R$ 58,70 a R$ 1.531. Solo 102 anuncios informaron las dimensiones del brazalete, con nomenclaturas diferentes. Conclusiones: la mayoría de los anuncios contenía equipos no validados, que eran más baratos. Fueron identificados anuncios con informaciones falsas sobre validación.

RESUMO Objetivos: caracterizar os dispositivos oscilométricos de medida da pressão arterial à venda no mercado virtual e identificar quais passaram por estudo de validação. Métodos: trata-se de um estudo transversal. A busca dos aparelhos à venda foi realizada em páginas da internet, e a amostra foi composta por 137 aparelhos, obtidos em 644 anúncios. Foi realizado levantamento bibliográfico em cinco bases de dados e consultadas páginas da internet que registram aparelhos submetidos à validação. Utilizaram-se os testes Kolmogorov-Smirnov para verificação da distribuição dos dados, seguidos de Mann-Whitney e Kruskal-Wallis para comparações, por meio do programa SAS 9.4. Resultados: somente 16,7% dos dispositivos eram validados. Os aparelhos domiciliares apresentaram variação de R$ 58,70 a R$ 1.531. Apenas 102 anúncios informaram as dimensões da braçadeira, com nomenclaturas diferentes. Conclusões: a maioria dos anúncios continha aparelhos não validados, que eram mais baratos. Foram identificados anúncios com informações falsas sobre validação.

Blood pressure variability in individuals with diabetes mellitus: a scoping review / Variabilidad de la presión arterial en individuos con diabetes mellitus: revisión del área / Variabilidade da pressão arterial em indivíduos com diabetes mellitus: revisão de escopo

ABSTRACT Objectives: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. Methods: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. Results: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). Conclusions: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

RESUMEN Objetivos: mapear métodos y dispositivos utilizados para evaluación de la variabilidad presórica de cortísimo, corto, mediano y largo plazo en adultos con diabetes mellitus tipo 1 o 2. Métodos: revisión del área realizada en enero y febrero de 2021 en las bases de datos MEDLINE, Web of Science, CINAHL, LILACS, PubMed y Embase. Incluidos estudios, realizados en los últimos diez años, que analizaron la variabilidad presórica en pacientes adultos y ancianos con diabetes mellitus tipo 1 o 2. Excluidos estudios que utilizaron dispositivos descontinuados. Resultados: la muestra fue compuesta por 25 artículos, publicados desde 2017, con mayoría desarrollada en Japón (n=11); predominancia del método oscilométrico (n=22); los dispositivos más utilizados fueron de la marca Omron® (n=14); el tipo de variabilidad más detectada fue la de largo plazo (n=10). Conclusiones: observado el creciente uso del método oscilométrico para análisis de la variabilidad presórica, presentando variedad de marcas y modelos de dispositivos automáticos.

RESUMO Objetivos: mapear métodos e dispositivos utilizados para avaliação da variabilidade pressórica de curtíssimo, curto, médio e longo prazo em adultos com diabetes mellitus tipo 1 ou 2. Métodos: revisão de escopo realizada nos meses de janeiro e fevereiro de 2021 nas bases de dados MEDLINE, Web of Science, CINAHL, LILACS, PubMed e Embase. Incluíram-se estudos, realizados nos últimos dez anos, que analisaram a variabilidade pressórica em pacientes adultos e idosos com diabetes mellitus tipo 1 ou 2. Excluíram-se estudos que utilizaram dispositivos descontinuados. Resultados: a amostra foi composta por 25 artigos, publicados a partir de 2017, com maioria desenvolvida no Japão (n=11); predominância do método oscilométrico (n=22); os dispositivos mais utilizados foram da marca Omron® (n=14); o tipo de variabilidade mais detectada foi a de longo prazo (n=10). Conclusões: observou-se o crescente uso do método oscilométrico para análise da variabilidade pressórica, apresentando variedade de marcas e modelos de dispositivos automáticos.

Errores de registro en las mediciones de presión arterial realizadas en dos centros de atención primaria de la salud de la ciudad de Salta, Argentina / Innacuracy in records of blood pressure measurements in two primary health centers of Salta City, Argentine

RESUMEN Introducción: El diagnóstico de hipertensión arterial (HTA) se realiza por la toma de la presión arterial (PA) en el consultorio médico (C) o en enfermería (E). Es frecuente aproximar los valores obtenidos a múltiplos de 10. Esto puede causar imprecisiones en el diagnóstico y el control de la HTA. Objetivo: Determinar cuántos registros de PA terminaban en cero en las mediciones realizadas en E y en C en dos centros de atención primaria de la salud de la ciudad de Salta. Material y métodos: Se efectuó un estudio descriptivo, transversal, de febrero a diciembre de 2018. Se utilizó un tensiómetro digital. A cada paciente se le midió la PA dos veces, primero en E y luego en C. Se utilizaron las pruebas de Chi2 y de Wilcoxon. Resultados: Se estudiaron 311 individuos, 60,77% mujeres. Edad media: 56,15 ± 13,8 años. Los registros terminados en cero tuvieron las siguientes frecuencias: PA sistólica en E: 36%; PA diastólica en E: 40,51%; PA sistólica en C: 11,58%; PA diastólica en C: 7,72% (p <0,0001). La PA sistólica y diastólica terminaron simultáneamente en cero en el 30,87% de los casos cuando se midieron en E y en el 0,64% de los casos cuando se midieron en C (p <0,0001). Conclusiones: La PA sistólica y la PA diastólica terminaron en cero con una frecuencia 3 y 5 veces mayor en E que en C, respectivamente, y la frecuencia de registros de PA sistólica y diastólica coincidentemente terminados en cero fue 48 veces mayor en E que en C. Estos resultados refuerzan la necesidad de una capacitación permanente para mejorar el registro en la medición de la PA.

ABSTRACT Background: The diagnosis of hypertension is established by blood pressure (BP) measurements in doctor (DO) or nursing offices (NO). Frecuently BP measurements are recorded as multiples of ten. This can lead to inaccuracy in diagnosis and control of hypertension. Objetive: To determine the percentage of BP measurements ending in zero in DO and NO, in the records of two health primary centers of Salta city. Methods: Observational study from february to december of 2018. Digital blood pressure monitor was used. Each patient BP was measured twice, first in NO and then in DO. Data were analyzed using the Chi2 and Wilcoxon tests. Results: 311 indivuals were enrolled, 60,77% were female. The average age was 56,15 ± 13,8 years. In NO the systolic BP and diastolic BP ending in zero were 36 and 40,51% respectively, while in DO were 11,58 and 7,72% (p <0,0001). The systolic BP and diastolic BP ending in zero simultaneously in NO was 30,87%, while in DO was 0,64% (p <0,0001). Conclusions: The systolic BP and the diastolic BP records ending in zero were three and five times more frequent in NO than in DO. The systolic BP and diastolic BP ending in zero simultaneously in NO were forty-eight times more frequent than in DO. These results reinforce the need of health personnel permanent training to improve precision for measuring and recording BP in medical centers.

Study on the therapeutic effects of individualized exercise prescriptions on hypertension in the elderly / 中华老年医学杂志

Objective:To examine the effects of individualized exercise rehabilitation prescriptions based on cardiopulmonary exercise tests on ambulatory blood pressure and cardiopulmonary function in elderly hypertension patients.Methods:This was a prospective randomized controlled study.Sixty essential hypertension patients hospitalized in our hospital from January 2020 to November 2020 and on regular antihypertensive medication were selected and divided using a random number table into the control group(30 cases)and the study group(30 cases). The control group received only conventional medication and the study group conducted individualized exercise rehabilitation in addition to medication, with no adjustment in anti-hypertensive medication for patients in either group.All enrolled patients underwent cardiopulmonary exercise testing and ambulatory blood pressure monitoring before treatment and 12 weeks after treatment.Changes in blood pressure and cardiopulmonary function in the two groups were compared.Results:Compared with the control group, the study group recorded reductions in the 24-hour average systolic blood pressure(135.6±8.7 mmHg vs.141.8±6.3 mmHg), 24-hour average diastolic blood pressure(79.3±9.4 mmHg vs.85.1±6.7 mmHg), daytime average systolic blood pressure(136.4±7.8 mmHg vs.140.2±6.6 mmHg), daytime average diastolic blood pressure(78.2±7.6 mmHg vs.84.4±7.2 mmHg), night-time average systolic blood pressure(125.0±9.6 mmHg vs.129.7±7.9 mmHg), and night-time average diastolic blood pressure(76.6±7.6 mmHg vs.84.5±6.7 mmHg)after 12 weeks of exercise( P<0.05 for all). Compared with pre-exercise levels, the study group achieved decreases in body mass index, resting heart rate, resting systolic blood pressure, resting diastolic blood pressure, peak systolic blood pressure, peak diastolic blood pressure( P<0.05 for all), and increases in maximum metabolic equivalent, peak oxygen uptake, maximum power and peak heart rate( P<0.05 for all), while the control group saw decreases in resting heart rate and resting diastolic blood pressure( P<0.05). After 12 weeks, the study group had lower levels than the control group in body mass index(24.5±2.0 kg/m 2vs.26.7±2.2 kg/m 2), resting systolic blood pressure(133.8±10.8 mmHg vs.139.3±9.0 mmHg)and resting diastolic blood pressure(79.4±8.0 mmHg vs.84.9±9.3 mmHg)( P<0.05)and higher levels in maximum metabolic equivalent(6.0±0.6 vs.5.2±1.1), peak oxygen uptake(22.0±2.7 ml·min -1·kg -1vs.20.3±3.7 ml·min -1·kg -1), maximum power(124.3±19.9 W vs.112.4±25.1 W)and peak heart rate(130.1±15.5 times/min vs.122.9±11.7 times/min)( P<0.05). Conclusions:Compared with antihypertensive drugs alone, the addition of individualized exercise prescriptions for rehabilitation based on cardiopulmonary exercise tests can effectively reduce blood pressure, improve cardiopulmonary function, and enhance exercise endurance and quality of life for elderly hypertension patients.

Programas de rastreamento da pressão arterial: relato de experiência / Blood pressure screening programs: a case report / Programas de detección de la presión arterial: un informe de experiencia

Objetivo: relatar a experiência da construção e implementação de Programas de Rastreamento da Pressão Arterial realizados no Brasil entre os anos de 2015 e 2018. Método: relato de experiência conduzido em cinco municípios brasileiros, por meio das etapas: elaboração, cooperação, recrutamento, desenvolvimento, planejamento, treinamento, divulgação, execução e análise. Resultados: para a implementação do rastreamento foram estabelecidas parcerias com instituições públicas e privadas. Estudantes e profissionais de saúde receberam capacitação para realizar a medida da pressão arterial, preencher o instrumento de coleta de dados e orientar os participantes. Um cronograma foi elaborado para atender aos locais, datas, horários, recursos humanos e insumos necessários para a realização das atividades. Os indicadores prevalência, conhecimento, tratamento e controle da hipertensão arterial compuseram a análise descritiva dos dados coletados. Conclusão: os procedimentos metodológicos apresentados neste estudo são capazes de sustentar a construção e a implementação de programas sistematizados de rastreamento da pressão arterial no Brasil.

Objective: To report on the experience of developing and implementing Blood Pressure Screening Programs carried out in Brazil from 2015 to 2018. Method: A case report conducted in five Brazilian cities, covering the following stages: Elaboration, cooperation, recruitment, development, planning, training, dissemination, execution, and analysis. Results: Partnerships with public and private institutions were established for the implementation of the screening. Students and healthcare providers were trained to measure blood pressure, fill out the data collection instrument, and orient the participants. A schedule was prepared to address the locations, dates, times, human resources, and supplies needed to carry out the activities. The indicators prevalence, knowledge, treatment, and hypertension management comprised the descriptive analysis of the collected data. Conclusion: The methodological procedures presented in this study are capable of supporting the development and implementation of systematized blood pressure screening programs in Brazil.

Objetivo: reportar la experiencia de construcción e implementación de Programas de Detección de la Presión Arterial realizada en Brasil entre 2015 y 2018. Método: informe de experiencia realizado en cinco municipios brasileños, a través de los pasos: elaboración, cooperación, reclutamiento, desarrollo, planificación, capacitación, difusión, ejecución y análisis. Resultados: para la implementación del seguimiento se establecieron alianzas con instituciones públicas y privadas. Se capacitó a estudiantes y profesionales de la salud para medir la presión arterial, completar el instrumento de recolección de datos y orientar a los participantes. Se elaboró ​​un cronograma para conocer los lugares, fechas, horarios, recursos humanos e insumos necesarios para realizar las actividades. Los indicadores de prevalencia, conocimiento, tratamiento y control de la hipertensión arterial comprendieron el análisis descriptivo de los datos recolectados. Conclusión: los procedimientos metodológicos presentados en este estudio pueden apoyar la construcción e implementación de programas de detección sistemático de la presión arterial en Brasil.

Effect of blood pressure management on prognosis of cerebral infarction after intravenous thrombolytic therapy / 中国基层医药

Objective:To investigate the effects of blood pressure management on the prognosis of acute cerebral infarction after intravenous thrombolytic therapy.Methods:The clinical data of 60 patients with acute cerebral infarction who received intravenous thrombolytic therapy in The First People's Hospital of Fuyang District, Hangzhou, China between September 2017 and June 2019 were retrospectively analyzed. These 60 patients were divided into groups A and B according to different treatment methods ( n = 30/group). Patients in the group A received intravenous thrombolytic therapy with recombinant tissue plasminogen activator and those in the group B received intravenous thrombolysis with recombinant tissue plasminogen activator in combination with antihypertensive treatment. All patients were treated for 2 courses of treatment (14 days) and followed up for 3 months. Blood pressure, cerebral blood flow and prognosis were compared between groups A and B. Results:After 24 hours of treatment, there were no significant differences in blood pressure and cerebral blood flow between groups A and B (both P < 0.05). In the group B, modified Rankin Scale score ≥ 2 points was found in 1 (3.3%) patient and intracranial hemorrhage in 0 (0.0%) patient, which were significantly lower than 12 (40.0%) and 6 (20.0%) patients, respectively in the group A ( χ2 = 29.897, 19.573, both P < 0.05). Total effective rate in the group B was significantly higher than that in the group A [96.7% (29/30) vs. 86.67% (26/30), χ2 = 21.302, P < 0.05]. Conclusion:Blood pressure management highly affects the prognosis of cerebral infarction after intravenous thrombolytic therapy. The first 24 hours of intravenous thrombolytic therapy is the optimal time for blood pressure management.

Association between Therapeutic Adherence and the Profile of Patients with Resistant Hypertension

Abstract Background: Resistant hypertension (RH) consists of increased blood pressure (BP) despite the use of 3 or more antihypertensives or BP control only when is use of 4 or more antihypertensives. It is fundamental to exclude pseudoresistance, which can be attributed to poor therapeutic adherence. Adherence evaluation, generally by the Morisky-Grenn test, is important because, when appropriate, it is associated with fewer cardiovascular complications and better BP control. Objectives: To evaluate the adherence of patients with RH and to investigate its relation with epidemiological, anthropometric and clinical characteristics, as well as to estimate the prevalence of pseudoresistance and to outline strategies to improve adherence. Methods: Retrospective observational cohort from an interview with patients followed at an outpatient clinic for RH. Therapeutic adherence, demographic, anthropometric data, cardiovascular risk factors, comorbidities, complementary exams and BP level were collected. One-way ANOVA and Student's t-tests were used for normal variables, and the Kruskal-Wallis and Mann-Whitney tests were used for non-normal tests. Categorical variables were compared using the Chi-Square test. We considered a 5% significance level in all tests. Results: 217 individuals were included. Of these, 17% had poor adherence. Epidemiological and clinical characteristics, complications, comorbidities, BP level or drugs used were statistically insignificant between groups. The poor adherence group used significantly more drugs (p = 0.0313) and 28% of pseudoresistance was estimated. Conclusions: Most of the individuals presented good therapeutic adherence by the Morisky test. Only the number of antihypertensive drugs had a statistically significant influence on adherence, while the epidemiological, anthropometric and clinical characteristics were statistically insignificant.

Conhecimento teórico e prático de estudantes de fisioterapia na medida indireta da pressão arterial: avaliação e desenvolvimento de um objeto virtual de aprendizagem / Theoretical and practical knowledge of the physiotherapy students on indirect blood pressure measurement: Evaluation and development of a virtual learning object

Dadas as modificações que as tecnologias de informação e comunicação promoveram na educação e, vislumbrando-se o potencial das estratégias de ensino digitais na formação dos estudantes de fisioterapia, realizou-se o presente estudo com o objetivo de desenvolver e avaliar um Objeto Virtual de Aprendizagem (OVA) orientado pelo processo de design instrucional (DI), sobre a temática "Medida indireta da pressão arterial". Trata-se de uma pesquisa metodológica de abordagem quantitativa, realizada no período de agosto de 2019 a abril de 2020, em duas etapas: 1) Avaliação diagnóstica do conhecimento teórico e prático de estudantes de graduação em fisioterapia, utilizando-se instrumento com 42 questões para caracterização sócio demográfica da amostra e avaliação de conhecimento teórico-prático sobre medida indireta da pressão arterial; 2) Desenvolvimento e avaliação do OVA, cuja qualidade foi avaliada por peritos fisioterapeutas e enfermeiros com experiência didática, utilizando-se o Learning Object Review Instrument 2.0. Participaram do estudo 126 graduandos em fisioterapia, cursando desde o segundo ao oitavo semestre do curso. A avaliação diagnóstica identificou lacunas no conhecimento teórico-prático sobre a medida indireta da pressão arterial e a necessidade de fortalecerem seus conhecimentos. Uma WebQuest curta sobre a temática foi desenvolvida, ambientada e avaliada no ambiente virtual de aprendizagem Moodle, via USP Extensão. A avaliação do OVA "WebQuest - Medida Indireta da Pressão Arterial" por oito peritos em fisioterapia e enfermagem indicou que os itens foram classificados como muito bom e excelente em relação à Qualidade do conteúdo, Alinhamento dos objetivos de aprendizagem, Feedback e adaptação, Motivação, Design de apresentação, Utilização de interação, Acessibilidade e Conformidade padrão. Os peritos fizeram sugestões pertinentes que permitiram a realização de ajustes para implementação futura junto a graduandos em fisioterapia. Os resultados evidenciam a relevância dos componentes da WebQuest, contemplando atividades que desenvolvem o pensamento crítico, a solução de problemas vivenciados e despertam o interesse dos graduandos para o aprender. A WebQuest demonstra-se compatível com a necessidade de ampliação do uso de estratégias de ensino digitais na formação profissional em fisioterapia.

Due to the changes that information and communication technologies have promoted in education and, considering the potential of digital teaching strategies in the training of physiotherapy students, this study was carried out with the objective of developing and evaluating a Virtual Learning Object (VLO) guided by the Instructional Design (ID) process, on the theme "Indirect blood pressure measurement". This is a methodological research with a quantitative approach, carried out from August 2019 to April 2020, in two stages: 1) Diagnostic evaluation of theoretical and practical knowledge of undergraduate physiotherapy students, using an instrument with 42 questions for socio-demographic characterization of the sample and evaluation of theoretical and practical knowledge about indirect blood pressure measurement; 2) Development and evaluation of a VLO, which quality was assessed by physiotherapists and nurses experts and with teaching experience, using the Learning Object Review Instrument 2.0. 126 undergraduate physiotherapy students participated in the study, taking courses from the second to the eighth semester of the course. The diagnostic evaluation identified gaps in theoretical and practical knowledge about the indirect blood pressure measurement and the need to strengthen their knowledge. A short WebQuest on the theme was developed, set and evaluated in the virtual learning environment Moodle, via USP Extension. The VLO "WebQuest - Indirect Blood Pressure Measurement" was evaluated by eight experts in physiotherapy and nursing whose indicated that the items were classified as very good and excellent in relation to Content quality, Learning goal alignment, Feedback and adaptation, Motivation, Presentation design, Interaction usability, Accessibility and Standard compliance. The experts made pertinent suggestions that allowed adjustments to be made for future implementation with undergraduate physiotherapy students. The results show the relevance of WebQuest's components, including activities that develop critical thinking, the solution of experienced problems and arouse the interest of students to learn it. WebQuest is compatible with the need to expand the use of digital teaching strategies in professional training in physiotherapy.

Relationship of inter-arm systolic blood pressure difference with subclavian artery stenosis and vertebral artery stenosis in patients undergoing carotid endarterectomy

Abstract Introduction: The aim of this study was to examine the association of inter-arm systolic blood pressure difference (IASBPD) with carotid artery stenosis, subclavian artery stenosis and vertebral artery stenosis in patients who underwent carotid endarterectomy. Methods: A total of 141 patients (29 females, 112 males; mean age 71.2±10.4 years; range 47 to 92 years) who underwent carotid endarterectomy between September 2010 and December 2017 were retrospectively evaluated. We classified patients into four groups according to the IASBPD ˂ 10 mmHg, ≥ 10 mm Hg, ≥ 20 mmHg and ≥ 30 mmHg. The stenosis of both subclavian and vertebral arteries was considered as ≥ 50%. Results: Of the 141 patients, 44 (31.2%) had ≥ 10 mmHg, 29 (20.5%) had ≥ 20 mmHg and 4 (2.8%) had ≥ 30 mmHg of IASBPD. 26 patients (18.4%) were diagnosed with significant subclavian artery stenosis and 18 (69.2%) of them had more than 20 mmHg of IASBPD. Of the 29 patients with IASBPD ≥ 20 mmHg, 19 patients (65.5%) had a significant subclavian artery stenosis. We found a significant correlation between preoperative symptoms and subclavian artery stenosis (P=0.018) and overall perioperative stroke was seen more frequently in patients with subclavian artery stenosis (P=0.041). A significant positive correlation was observed between vertebral artery stenosis and subclavian artery stenosis (P=0.01). Conclusion: Patients who were diagnosed with both subclavian artery stenosis and IASBPD (≥ 20 mmHg) had a higher risk of postoperative stroke and death, had higher total cholesterol, LDL-C, blood creatinine level, and were more symptomatic.

Effectiveness and accuracy of a domestic continuous non-invasive blood pressure device in monitoring intraoperative blood pressure / 中华麻醉学杂志

Objective To evaluate the effectiveness and accuracy of a domestic continuous non-invasive blood pressure (NIBP) device in monitoring intraoperative blood pressure.Methods Sixty patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in the study.The invasive blood pressure (IBP) and NIBP were simultaneously measured in the radial artery.Systolic and diastolic blood pressure (SBP,DBP) was continuously recorded,and the paired data and data of waveform were collected.For paired data,the agreement was evaluated using Bland-Altman analyses between the two monitoring methods.For waveform data,Pearson linear correlate analysis was performed between the two monitoring methods.Results For paired data,the bias of NIBP value from IBP value were (-2.1±5.4) mmHg (95％ CI-3.5-0.7 mmHg) and (2.6±6.4) mmHg (95％ CI 1.0-4.3 mmHg) for SBP and DBP,respectively.The 95％ limit of agreement of bias between the two methods was-12.6-8.5 mmHg for SBP and-10.0-15.3 mmHg for DBP.For waveform data,the bias of NIBP value from IBP value were (-2.1±6.5) mmHg (95％ CI-3.7-0.4 mmHg) and (3.1±6.8) mmHg (95％ CI 1.3-4.8 mmHg) for SBP and DBP,respectively.The correlation coefficient between the two methods was O.82 for SBP and 0.88 for DBP,P＜0.01.Conclusion The effectiveness and accuracy of this domestic continuous NIBP monitoring device in monitoring intraoperative blood pressure is clinically acceptable.

Classification , monitoring , influencing factors and treatment of blood pressure variability / 心血管康复医学杂志

Researches have proved that no matter with or without hypertension ,increased systolic blood pressure var-iability (BPV) is related with all-cause mortality ,increased risk of advanced kidney disease ,coronary heart disease and stroke .BPV can be classified as ultra-short term BPV ,short term BPV ,medium BPV ,long term BPV and ul-tra-long term BPV ,and there exist difference in influencing factors and medication among BPVs of different types . The present article discussed it from classification ,monitoring ,influencing factors and treatment .

Efeito de um programa educativo no conhecimento e na qualidade dos registros da pressão arterial / Effect of an educational program for the knowledge and quality of blood pressure recording / Efecto de un programa educativo en el conocimiento y en la calidad de los registros de la presión arterial

Objetivo avaliar o efeito de um programa educativo sobre o registro da pressão arterial para profissionais de enfermagem em relação ao conhecimento teórico e à qualidade desses registros. Método estudo quase-experimental conduzido em um serviço hospitalar localizado no município de São Paulo. O conhecimento teórico de 101 profissionais foi mensurado por meio de questionário validado antes e após a intervenção educativa. A qualidade dos registros da pressão arterial foi avaliada utilizando-se formulário validado e aplicado a 354 prontuários no período pré-intervenção e 288 no período pós-intervenção. O programa educativo foi fundamentado em metodologias ativas de ensino-aprendizagem e constituído por duas estratégias: aula expositiva-dialogada e um jogo de tabuleiro. Os testes de Wilcoxon, Mann-Whitney, Fisher e Qui-Quadrado foram utilizados para comparações, adotando-se um nível de significância de α=0,05. Resultados a mediana de acertos dos profissionais passou de 19 para 22 pontos no período pós-intervenção (p<0,001). Houve melhora na qualidade dos registros de pressão arterial quanto às variáveis tamanho do manguito (p<0,001), membro utilizado no procedimento (p<0,001) e posição do paciente (p<0,001). Conclusão o programa educativo mostrou resultados positivos na promoção do conhecimento dos profissionais de enfermagem e na melhora da qualidade dos registros da pressão arterial.

Objective to evaluate the effect of an educational program on blood pressure recording for nursing professionals in relation to theoretical knowledge and the quality of these records. Method quasi-experimental study conducted in a hospital service located in the city of São Paulo. The theoretical knowledge of 101 professionals was measured using a validated questionnaire before and after the educational intervention; the quality of blood pressure records was evaluated using a validated form which was applied to 354 records in the pre-intervention period and 288 in the post-intervention period. The educational program was based on active teaching-learning methodologies and consisted of two strategies: expository/dialogue class and a board game. The Wilcoxon, Mann-Whitney, Fisher and Chi-Square tests were used for comparisons, adopting a level of significance of α=0.05. Results the median of the professionals' scores increased from 19 to 22 points in the post-intervention period (p<0.001). There was an improvement in the quality of the blood pressure recordings regarding the variables: cuff size (p<0.001), arm used in the procedure (p<0.001) and patient position (p<0.001). Conclusion the educational program showed positive results in the promotion of knowledge among nursing professionals and in the improvement of the quality of blood pressure recording.

Objetivo evaluar el efecto de un programa educativo sobre el registro de la presión arterial para profesionales de enfermería en relación al conocimiento teórico y a la calidad de esos registros. Método estudio cuasi-experimental conducido en un servicio hospitalario ubicado en la ciudad de São Paulo. El conocimiento teórico de 101 profesionales fue medido a través de un cuestionario validado antes y después de la intervención educativa; la calidad de los registros de la presión arterial fue evaluada utilizando formulario validado y aplicado a 354 prontuarios en el período pre-intervención y 288 en el período post-intervención. El programa educativo fue fundamentado en metodologías activas de enseñanza-aprendizaje y constituido por dos estrategias: clase expositiva-dialogada y un juego de tablero. Las pruebas de Wilcoxon, Mann-Whitney, Fisher y Qui-cuadrado se utilizaron para comparaciones, adoptando un nivel de significancia de α=0,05. Resultados la mediana de aciertos de los profesionales pasó de 19 a 22 puntos en el período post-intervención (p<0,001). Se observó una mejoría en la calidad de los registros de presión arterial en cuanto a las variables: tamaño del manguito (p<0,001), miembro utilizado en el procedimiento (p<0,001) y posición del paciente (p<0,001). Conclusión el programa educativo mostró resultados positivos en la promoción del conocimiento de los profesionales de enfermería y en la mejora de la calidad de los registros de la presión arterial.

Confiabilidad de un monitor automatizado para la medición de la presión arterial / Reliability of an automatic monitor for blood pressure measurement

Background A correct blood pressure (BP) measurement is essential for the diagnosis and control of high BP. Aim: To evaluate the agreement and repeatability of BP measurements with the OMRON HEM-7320-LA device compared to a mercury sphygmomanometer. Material and Methods: A cross-sectional study comparing BP measurements made by two randomly selected trained nurses and an automatic oscillometric device. The mercurial sphygmomanometer was connected to the automated device via a "T" type connector and a dual-head stethoscope was used, allowing simultaneous measurements. The results were analyzed with one-factor analysis of variance, Bland-Altman's test, repeatability coefficient (RC), and intra-class correlation coefficient (ICC). Results: Forty-nine participants aged 56 ± 19 years were included. Nineteen had hypertension (38%). We did not observe a significant difference in either systolic (SBP) or diastolic blood pressure (DBP) pressure measurements between the observers and the device. The mean difference was −0.09 mmHg (95% confidence intervals (CI)-0.9 to 0.7) for SBP and −0.9 mmHg (95% CI −1.7 to −0.13) for DBP. The RC for SBP (6.2, 5.2 and 5.8 mmHg) and DBP (4.7, 4.2 y 5.2 mmHg) was similar between the observers and the device. The ICC for SBP was 0.990 (95% CI 0.983 to 0.995, p < 0.01) and 0.986 (95% CI 0.977 to 0.991, p < 0.01) for DBP. Conclusions: There was a high level of agreement and similar measurement repeatability in the measurements performed by the automatic device and the mercurial sphygmomanometer. No differences in BP measurements were observed.

Correlation among ambulatory blood pressure indexes and P wave dispersion in patients with hyperten-sion / 心血管康复医学杂志

Objective :To explore P wave dispersion (Pd) change in patients with hypertension ,and study correlation among ambulatory blood pressure indexes and Pd .Methods : A total of 100 patients with hypertension treated in our hospital from Jul 2015 to Jul 2017 were selected as hypertension group .Another 76 healthy subjects without cardio-vascular diseases undergoing physical examination during the same period were selected as normal control group .Ac-cording to circadian rhythm of blood pressure ,hypertension group was further divided into dipper group (n＝36 ) and non-dipper group (n＝64).All subjects received 24h ambulatory blood pressure monitoring and 12-lead ECG .P wave maximum time limit (Pmax) ,P wave minimum time limit (Pmin) and Pd were compared among all groups ,and correlation among ambulatory blood pressure indexes and Pd were analyzed .Results : Compared with normal con-trol group ,there were significant rise in Pmax [ (103.13 ± 9.19) ms vs.(118.04 ± 11.14) ms] and Pd [ (24.62 ± 5.96) ms vs.(38.05 ± 7.76) ms] in hypertension group , P＝0.001 both .Compared with dipper group ,there were significant rise in Pmax[ (116.04 ± 10.17) ms vs.(121.13 ± 12.06) ms] and Pd [ (35.05 ± 8.01) ms vs.(40.05 ± 7.16) ms] in non-dipper group , P＝ 0.035 ,0.002. Pearson correlation analysis indicated that Pd was significant positively correlated with 24h mean systolic blood pressure (SBP) ,24h SBP standard deviation (SD) ,24h diastolic blood pressure SD ,SBP load ,daytime mean SBP and nighttime mean SBP (r＝0.291～0.455 ,P＜0.05 or ＜0.01). Conclusion : SBP ,SBP load and blood pressure SD are significant positively correlated with Pd in patients with hy-pertension ,suggesting that these indexes possess higher value in assessing atrial injury in these patients .

Remote BP monitoring and online health guidance for predicting cardiovascular risk in morning hypertension patients / 中华老年心脑血管病杂志

Objective To study the clinical application of remote BP monitoring and online health guidance in predicting the risk of cardiovascular disease in morning hypertensive patients.Methods A total of 1200 morning hypertensive patients admitted to our hospital were randomly divided into observation group (n=600) and control group (n =600).The patients in observation group re ceived remote BP monitoring and online health guidance while those in control group received routine guidance.Their awareness rate of hypertension,control rate of BP,cardiac function index and incidence of cardiovascular events were recorded and compared before and after treatment.Results The awareness rate of hypertension and control rate of BP were significantly higher in observation group after treatment than before treatment (P＜0.05).The serum FPG,TG,AST levels and SBP,DBP,BMI were significantly lower while the serum ALT level was significantly higher in observation group after treatment than before treatment (P＜0.05).The LVEDD and LVESD were significantly shorter and the LVEF was significantly higher in observation group than in control group after treatment (53.16±8.25 mm vs 59.33±9.14 mm,37.16±2.13 mm vs 42.83± 1.35 mm,54.73％±2.63％ vs 51.95％ ± 1.96％,P＜0.05).The incidence of cardiovascular events was significantly lower in observation group than in control group (1.17％ vs 3.83％,P＜ 0.05).Conclusion Remote BP monitoring and online health guidance can effectively manage the risk factors for cardiovascular disease,improve the awareness rate of hypertension and control rate of BP,and reduce the incidence of cardiovascular events in morning hypertensive patients.

Effect of empty-nest on variability of self-measured blood pressure at home in elderly hypertensive patients / 中华老年心脑血管病杂志

Objective To study the effect of empty-nest (EN) on the variability of HBPV in elderly hypertensive patients.Methods 457 elderly essential hypertensive patients admitted to our hospi tal were divided into non EN group (A group,n =183),EN couple group (B group,n =150),and EN single group (C group,n=124).They underwent 7-day HBPV,their BPV was detected,their loneliness and depressive symptoms were assessed according to the UCLA-LS and GDS.Results The variability of self-measured DPB and SBP,UCLA-LS and GDS score were significantly higher in B and C groups than in A group (P＜0.05).The variability of SBP,UCLA-LS and GDS score were significantly higher in C group than in B group (46.06±7.98 vs 38.95±8.11;7.67±2.58 vs 6.48±2.60,P＜0.05).Partial correlation analysis showed that the variability of SBP and DBP was positively related with the UCLA-LS and GDS score (P＜0.05).The variability of SBP was significantly higher in B and C groups than in A group after adjustment of confounding factors (P=0.000).Conclusion EN,an independent influencing factor for the variability of blood pressure in elderly hypertensive patients,is related with their loneliness and depression.