No abstract available.
Blood Pressure Monitoring, Ambulatory*

No abstract available.
Blood Pressure Monitoring, Ambulatory*

Background: Blood pressure (BP) monitoring was identified to have a direct relationship with adherence and BP control. Measurement of blood pressure (BP) at home or out-of-clinic can accomplish several of the advantages of ambulatory BP monitoring. Furthermore, regular measurement of BP may increase awareness of the condition and may lead to behavioral changes needed in the management of hyepertension such as DASH diet, smoking cessation, limited alcohol intake and regular exercise. It may also increase compliance with antihypertensive therapy and reduce the number of visits required for the diagnosis and treatment of hypertension. Objective: To determine the effect of provision of BP monitoring card on improving patient's adherence to medication and control of BP among hypertensive patients of PGH-Family Medicine Clinic. Design, Setting, and Participants: An open, randomized controlled trial based on a Chronic Care Model. The trial was conducted at the Philippine General Hospital-Family Medicine Clinic enrolling 102 participants aged 30-70 years with uncontrolled essential hypertension based on JNC VII classification. Participants were recruited from December 2008 to March 2009 and were followed up for 6 months. Intervention participants were assigned and randomized to usual care (control group) and usual care plus BP card (intervention group). Patients were instructed to do BP measurements at least twice a week for the whole duration of study. Outcome Measures: The primary outcome measures were the percentage of patients with controlled BP (<140/ 90mmHg) and changes in systolic and diastolic BP at six months based on average blood pressure measurement taken during clinic visits. Secondary outcome is the proportion of patients with regular BP monitoring and proportion of adherent patients at six months. BP card or diary was collected and checked for completeness. Adherence was measured by empty blister count. Results: Of 102 patients, 85 (83%) completed the 6-month follow-up visit. Socio-demographic characteristics were comparable (P value> 0.05). Comparison of clinical profile, associated risk factors in hypertension, behaviors related to hypertension, and presence of co-morbid conditions and target-organ damage, factors affecting blood pressure monitoring and pharmacoadherence exhibited similar results (P value> 0.05). Mean SBP and DBP for study population was also similar 158.3 (18.46) and 159.76 (16.51) mmHg; and 93.86 (8.27) and 94.15 (7.74) mmHg for control and intervention groups, respectively. Compared with patients receiving usual care, the proportion of patients adherent to the prescribed regimen was higher in the group with usual care plus BP card in all clinic visits [29(70.7%) 30(73.2%) 32(78.0%)]. The difference was statistically significant on the 6th month of follow-up (P value =: 0.02). A greater proportion of patients had controlled BP in the intervention group [24(54.5%) vs 32(78.0%)] after six months. The intervention group had a lower systolic and diastolic SP than the control group [SBP 135.68 (11.74), 129.15 (9.02) DBP 82.73 (5.55), 78.90 (5.914)] and this was statistically significant with a P value of 0.01 for both measurements. Conclusions: A new model of patient-centered care that uses BP card can improve BP monitoring, and this may lead to behavioral change particularly adherence to medication and improve SP control in patients with hypertension. This very simple and cost-effective model proved to be effective and the same intervention could be used to improve the care of large numbers of patients with uncontrolled hypertension and the provision of SP monitoring cards to all hypertensive patients could be included in the standard care.
BLOOD PRESSURE MONITORING ; HYPERTENSION

Several shorter-term alternatives for whole-day ambulatory monitoring of BP using Pressureometer III or standard sphygmomanometer were evaluated in 12 male hypertensive patients. Averages of BP reading at 8 AM once, consecutive 3 readings either by Pressurometer or manual, serial readings during 2-hr intervals of 8-10 AM and 2/4 PM were compared with that of 24-hr ambulatory, non-invasive BP readings. Both systolic and diastolic 2-hr Bp averages in the morning were correlated more strongly with 24-hour averages(r=0.91 and 0.91), than were those of the 3 readings(r=0.88 and 0.66) or single reading(r=0.49 and -0.35) alternatives. In conclusion, the average of serial readings obtained during 2-hr monitoring period from 8 to 10AM is a reliable predictor of 24-hr ambulatory BP and represents it more closely than the conventional single or multiple BP readings.
Blood Pressure Monitoring, Ambulatory* ; Humans ; Male ; Monitoring, Ambulatory ; Reading ; Sphygmomanometers

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

A new method for continuous measurement of blood pressure (BP) via selecting characteristic parameters of pulse wave pertinent to BP is presented in this paper. In order to validate the precision of the measurement, we have developed a Tonometer. The results of the instrument based on this method are precise if the subjects are at rest. This instrument could be used for BP monitoring of critically ill patients and in common medical researches; it might be applied to BP monitoring during spaceflight and in daily life after movement artifact being restrained.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; instrumentation ; Humans ; Manometry ; Pulse

No abstract available.
Blood Pressure Monitoring, Ambulatory ; Blood Pressure ; Compliance ; Humans

No abstract available.
Blood Pressure ; *Blood Pressure Monitoring, Ambulatory ; Humans ; *Hypertension

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.
Blood Pressure Monitoring, Ambulatory* ; Blood Pressure* ; Humans ; Pheochromocytoma*

BACKGROUND: Ambulatory blood pressure monitoring is widely available in clinical practice. To evaluate the pattern of normal 24 hour variation of blood pressure and the problems in analysis of data which was obtained with use of automatic blood pressure recorder, 24 hour ambulatory blood pressure was measured. METHODS: Ambulatory blood pressure was recorded for 24 hours with automatic blood pressure monitor in 22 normotensive young adolescents. RESULTS: 1) Average 24-hour BP was 109mmHg in systolic(115+/-30 for male, 102+/-30 for female), 66mmHg in diastolic(69+/-18 for male, 63+/-19 for female) and pulse rate was 72 beats per minute(70+/-23 for male, 75+/-26 for female). 2) Data obtained from ambulatory blood pressure monitor should be analyzed after deletion of unacceptable data with use of conventional criteria. Blood pressure increase which is not accompanied by increase in pulse rate increase can be used as another criteria to rule out unacceptable blood pressure data. 3) Blood pressure was low from mid-night to 6 A.M. and began to rise slowly till mid-day and then maintained steadily through the remainder of the day. And 24 hour variation of blood pressure was more adequately assessed after application of Fourier analysis. CONCLUSIONS: These results suggest that certain deletion criteria was inevitable during analysis of the data which were obtained from ambulatory blood pressure recorder and Fourier analysis can be used as valuable smoothing technique to assess the 24-hour blood pressure profiles.
Adolescent* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Fourier Analysis ; Heart Rate ; Humans ; Male