No abstract available.
Blood Pressure Monitoring, Ambulatory*

No abstract available.
Blood Pressure Monitoring, Ambulatory*

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

This paper introduces several novel HPC-based monitoring devices for community medicine. They support net transmission and have superiorities of portability, small size, good mobility, easy use and strong adaptivity.
Blood Pressure Monitoring, Ambulatory ; instrumentation ; Community Health Services ; Computers, Handheld ; Electrocardiography, Ambulatory ; instrumentation ; Equipment Design ; Humans ; Monitoring, Physiologic ; instrumentation ; Telemedicine ; instrumentation

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

OBJECTIVETo investigate the relationship among circadian blood pressure rhythm, autonomic nervous system and myocardial energy expenditure (MEE) level in patients with primary hypertension.

METHODSA total of 102 hypertensive and 45 normotensive subjects were recruited. According to blood pressure reduction rate at night, the hypertensive patients were divided into non-dipper group (NDH group, n=54) with a reduction rate of <10% and dipper group (DH group, n=48) with a reduction rate of ≥10%. The circadian blood pressure rhythm and heart rate variability were measured with ambulatory blood pressure monitoring and 24-hour electrocardiograph monitoring, respectively, and MEE was measured by Doppler echocardiography to analyze their correlations.

RESULTSSDNN, SDANN, SDNNindex, RMSSD, PNN50, and HF were significantly lower in the hypertensive patients than in the control group (P<0.05); these parameters, except for PNN50, were all significantly lower in NDH group than in DH group (P<0.05). The hypertensive patients had significantly higher MEE than the control group (P<0.05), and MEE was significantly higher in NDH group than in DH group (P<0.05). Bivariate correlation analysis showed significant correlations of MEE with SDANN in the hypertensive patients (P<0.01).

CONCLUSIONPatients with primary hypertension, especially those in NDH group, have impaired autonomic nervous system function. The hypertensive patients in NDH group show a more prominent increase in MEE in relation to sympathetic activation, suggesting the importance of restoring circadian blood pressure rhythm in the treatment of hypertension.

Autonomic Nervous System ; physiology ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Case-Control Studies ; Circadian Rhythm ; Electrocardiography, Ambulatory ; Energy Metabolism ; Essential Hypertension ; Heart ; physiology ; Heart Rate ; Humans ; Hypertension ; physiopathology

OBJECTIVE: Appropriate evaluation of hypertension is important in the patients with a stroke because hypertension is a major cause of a stroke. Blood pressure may be falsely elevated or depressed immediately after a stroke, depending on the severity of neurological deficit, mobility, and physical activity, and the level of consciousness. To overcome this problem, ambulatory blood pressure monitoring (ABPM) has been proposed as a method of obtaining a more accurate clinical assessment. SUBJECTS AND METHODS: The present study was performed in an acute stage of stroke patients to assess the manifestation of 24 hour ambulatory blood pressure, to observe the nocturnal blood pressure fall and to evaluate the relationship of blood pressure degree on admission and nocturnal blood pressure dip. Thirty four patients admitted within 24 hours after onset of acute stroke were involved in this study. 24 Hour blood pressure monitoring device was installed on an independent arm by oscillometric method as soon as brain imaging study was performed. ABPM readings were obtained each 30 minutes during daytime and each 1 hour during nighttime with electrocardiography. Each patients were classified as the presence or absence of hypertension. We examined nocturnal blood pressure dip and mean pressure of 24 hour ambulatory blood pressure. RESULTS: 1)This study demonstrated that comparing daytime with nighttime 24 hour ambulatory blood pressure, 20 of 24 patients (83%) with acute stroke with hypertension, did not show nocturnal blood pressure dip, and there was sustained high nocturnal blood pressure in patients with acute stroke with hypertension. 2)There were significant differences between 24 hour ambulatory mean daytime blood pressure and mean nighttime blood pressure in patients with acute stroke without hypertension, so was lower in nighttime (p<0.05). 3)It is likely that in acute stroke patients with hypertension, patients with higher blood pressure on admission had more abnormality of nocturnal blood pressure dip. CONCLUSION: These results suggest that in patients with acute stroke, 24 hour ABPM is useful method to assess diurnal variation and evaluate hypertension in acute stage of stroke patients, and suggest that patients with acute stroke with hypertension trend to loss of nocturnal blood pressure dip.
Arm ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Blood Pressure Monitors ; Consciousness ; Electrocardiography ; Humans ; Hypertension ; Motor Activity ; Neuroimaging ; Reading ; Stroke*

BACKGROUND: This study compared the results of 24 hour ambulatory blood pressure monitoring with the clinical blood pressure measurements, and we investigated the relationship of the blood pressure measurement and left ventricular hypertrophy, as determined by routine 12 lead electrocardiography. METHODS: We studied 204 healthy adults with no prior history of heart disease or antihypertensive medication. The clinic blood pressure was measured 3 times and the average was taken. We compared the clinic blood pressure with the daytime blood pressure of the 24 hour ambulatory blood pressure monitoring, and we compared the blood pressure with the sum of the voltage of the S wave on V1 and the R wave on V5. RESULTS: The average of the daytime ambulatory blood pressure of all the patients was 135.33+/-13.73 mmHg for the systolic pressure and 86.55+/-10.14 mmHg for the diastolic pressure. The average of the clinic blood pressure measurement was 140.10+/-17.41 mmHg for the systolic pressure and 88.84+/-10.14 mmHg for the diastolic pressure. The clinic blood pressure averaged higher than the daytime ambulatory blood pressure by 5 mmHg on the systolic pressure and 2 mmHg on the diastolic pressure (p<0.001). The normal ambulatory blood pressure limits were estimated as those that best correlated with 140/90 mmHg at the clinic. The estimated value was 135/87 mmHg for the daytime ambulatory blood pressure (p+/-0.001). The incidence of white coat hypertension was 10.8%. The sum of the voltage on electrocardiography showed a positive linear relationship with all the blood pressure measurements. The daytime systolic blood pressure showed the strongest correlation with the 24 hour ambulatory blood pressure monitoring (r=0.283, p+/-0.001). CONCLUSIONS: We found a linear relation and we analyzed the differences between the clinical and 24 hour ambulatory blood pressure. A daytime ambulatory blood pressure value of 135/87 mmHg was a suitable upper normal limit for the corresponding cutoff value of the clinic blood pressure. Left ventricular hypertrophy showed the strongest relationship with the daytime systolic blood pressure among the results of the 24 hour ambulatory blood pressure monitoring.
Adult ; Blood Pressure Monitoring, Ambulatory ; Blood Pressure* ; Electrocardiography* ; Heart Diseases ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Incidence ; White Coat Hypertension

In order to improve the accuracy of blood pressure measurement in wearable devices, this paper presents a method for detecting blood pressure based on multiple parameters of pulse wave. Based on regression analysis between blood pressure and the characteristic parameters of pulse wave, such as the pulse wave transit time (PWTT), cardiac output, coefficient of pulse wave, the average slope of the ascending branch, heart rate, etc. we established a model to calculate blood pressure. For overcoming the application deficiencies caused by measuring ECG in wearable device, such as replacing electrodes and ECG lead sets which are not convenient, we calculated the PWTT with heart sound as reference (PWTT(PCG)). We experimentally verified the detection of blood pressure based on PWTT(PCG) and based on multiple parameters of pulse wave. The experiment results showed that it was feasible to calculate the PWTT from PWTT(PCG). The mean measurement error of the systolic and diastolic blood pressure calculated by the model based on multiple parameters of pulse wave is 1.62 mm Hg and 1.12 mm Hg, increased by 57% and 53% compared to those of the model based on simple parameter. This method has more measurement accuracy.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Cardiac Output ; Electrocardiography ; Heart Rate ; Heart Sounds ; Humans ; Pulse Wave Analysis ; Regression Analysis

The present paper presents the design of a remote monitoring system based on smartphone and mobile internet. The system can realize functions such as multi-physiological parameter collection, micromation of collecting equipment, real-time monitoring, remote data transmission, automatic alarm, physiological parameter analyze and Global Position System (GPS) location of patient's position. Besides acting as a receiver and transmission platform, smartphone can also process and analyze the physiological parameters, such as detection of the apnea from electrocardiogram (ECG). The system contains technologies of MCU, Bluetooth transmission, Android and Wed development, wavelet transform, mobile communication as a whole. It propels further developments of the remote mobile medical based on smartphone.
Cell Phone ; Electrocardiography ; Geographic Information Systems ; Humans ; Internet ; Monitoring, Ambulatory