1.Comparison of automated versus manual blood pressure measurement among hospitalized medical patients: A crossover trial
Keven Joy C. Batan ; Karla Rhea R. Posadas ; Annie Ormaza-olarte
Philippine Journal of Internal Medicine 2025;63(2):77-84
BACKGROUND
Blood pressure is an important vital sign measured not only in hypertension but also among hospitalized patients for clinical evaluation of the actual hemodynamic status. In the digital era, mercury and aneroid sphygmomanometers are being replaced by automated monitors despite lacking validation and recommendations for their use, especially in acute illness.
OBJECTIVETo compare automated and manual blood pressure measurement among hospitalized medical patients with acute illness.
METHODSA crossover design was used in a single tertiary hospital. Blood pressure was recorded from 216 participants, with 432 observations from an automated monitor (Omron HBP1120) and a mercury sphygmomanometer. Automated and manual BP recordings were done twice following the same arm sequential method. The average of the two recordings was used for comparison.
RESULTSMost participants were female, elderly, obese, and had cardiac complaints. Comparing automated and manual methods, the mean difference for systolic was 1.47 ± 12.12 (p = 0.08) and 1.82 ± 10.99 (p=0.02) for diastolic. Subgroup analysis revealed that males had higher manual systolic BP than females (pairwise p-value= 0.017). Overweight and obese participants had higher automated systolic and diastolic BP (p=0.04). Overweight and obese participants had significantly higher systolic and diastolic BP regardless of the method. Significantly higher diastolic BP for different age groups and areas of admission (p=0.02) were observed from the automated method.
CONCLUSIONAutomated BP monitoring showed a significant difference in diastolic BP recordings. Automated BP monitors should be used with caution, especially in interpreting diastolic BP among hospitalized patients.
Human ; Blood Pressure ; Sphygmomanometers
2.Comparison of acute heart rate variability (HRV) response between neuromuscular and metabolic training in collegiate high-intensity intermittent sport athletes: A pilot study protocol
Kris Anthony T. Agarao ; Edwin Dwight De mesa ; Ivan Neil Gomez ; Angelica Phoebe Rane Mendinueto ; Aaron Miguel Ng ; Beatrice Therese Agustin ; Michael Kaleb Kim ; Sophia Anne Baetiong ; Reiniel Christian Rafael ; Jayemarie Gene Taguibao
Philippine Journal of Allied Health Sciences 2025;9(1):43-50
BACKGROUND
Heart rate variability (HRV) is a common tool for assessing autonomic nervous system activity and monitoring training load in athletes. However, limited research has explored how HRV responds to different forms of resistance training, particularly in high-intensity intermittent sports like basketball and football.
OBJECTIVEThis study aims to compare the acute HRV responses between neuromuscular and metabolic training in collegiate athletes involved in high-intensity intermittent sports.
STUDY DESIGNA comparative cross-sectional study with a quasi-experimental crossover design will be employed.
METHODSCollegiate athletes will be randomly assigned to undergo both neuromuscular and metabolic training sessions with a one-week wash-out period in between. HRV data will be recorded using the Polar H10 chest strap during each session.
DATA ANALYSISDescriptive statistics will summarize salient participant characteristics and HRV measurements. Inferential analysis will use paired t-tests or Wilcoxon signed-rank tests based on normality, assessed via the Kolmogorov-Smirnov test. All statistical analyses will be conducted using the IBM SPSS (ver.25) with a confidence interval set. at 95% and a critical α equal to 0.05.
EXPECTED RESULTSNeuromuscular training is expected to elicit higher low-frequency (LF) power and an increased LF/HF ratio, reflecting greater sympathetic activation, while metabolic training is expected to show lower LF power and a decreased LF/HF ratio, indicating a more balanced autonomic response. These findings will offer insights into the differential autonomic impacts of these training modalities.
Human ; Heart Rate ; Nervous System ; Sympathetic Nervous System
6.2023 Philippine Working Group Consensus Statement on renal denervation therapy for the management of hypertension
Raymond Oliva ; Deborah Ignacia D. Ona ; Lourdes Ella G. Santos ; Felix Eduardo Punzalan ; John David Tan ; Gilbert Villela ; Benjamin Balmores ; Krizia Camille Yap-Uy ; Roberta Maria Cawed-Mende ; Jose Nicholas Cruz
Philippine Journal of Cardiology 2024;52(1):12-18
BACKGROUND
Hypertension is the most common risk factor for cardiovascular disease in the Philippines. Despite the availability of antihypertensive medications that are effective, safe, and tolerated by Filipino patients, the numbers of uncontrolled hypertensives are still increasing. Several factors play in the poor control of blood pressure, particularly resistant hypertension and hyperactive sympathetic nervous system. Renal denervation therapy is a novel device that has been shown to lower blood pressure in patients with resistant and difficult-to-treat hypertension and is deemed safe in clinical trials. A Philippine Working Group composed of specialists in cardiology, hypertension, vascular surgery, and clinical epidemiology has come up with consensus statements in identifying patients who will benefit from the procedure. Locally, there is a need to have hypertension centers treating uncontrolled and resistant hypertension and offer renal denervation therapy to appropriate Filipino patients.
Blood Pressure
7.Effect of tomato and cucumber juice on blood pressure in hypertensive patients: A quasi-experimental study
Agung Sutriyawan ; Ernie Halimatushadyah ; Fibrianti Fibrianti ; Ilham Kamaruddin ; Kurniawan Kurniawan ; Vina Vitniawati ; Ayuda Nia Agustina
Acta Medica Philippina 2024;58(Early Access 2024):1-8
Background:
Hypertension is associated with the improvement of cardiovascular disease and all-cause mortality. A healthy diet based on consuming natural foods can prevent and control hypertension.
Objective:
The aim of this study was to analyze the effectiveness of tomato and cucumber juice in reducing the blood pressure of hypertensive patients.
Methods:
The study used a quasi-experiment pretest-posttest control group design. The target population are people with hypertension Stage 1, people living in urban area - Cibiru Health Centre Work Area. Purposive sampling was used and the sample size was calculated using the average comparison formula with effect size=0.9, α=0.05, β =0.2. Forty-five subjects involved in the study were divided into three groups (15 subjects were given tomato juice, 15 subjects were given cucumber juice, and 15 subjects were given treatment with mineral water (control group)., This research used 100 grams of ripe red tomatoes, 100 grams of fresh cucumber, and 200 ml of water. The data collected were patient characteristics and blood pressure. The ANOVA analysis test and the Bonferroni Post Hoc test were used to analyze the data.
Results:
The results of the study showed a difference in blood pressure reduction in each group. The decrease in systolic blood pressure in the tomato juice group was 7.3+3.1, the cucumber juice group was 4.2+3.3, and the control group was -0.0+2.5 (p=0.0001). The decrease in diastolic blood pressure in the group given tomato juice was 9.2+3.1, the group given cucumber juice was 7.6+3.4, and the control group was 0.4+2.1 (p=0.0001).
Conclusion
There is a difference in blood pressure reduction between the group given tomato juice and the control group, and there is a difference in blood pressure between the group given cucumber juice and the control group.
Blood Pressure
8.Wearable sensing, big data technology for cardiovascular healthcare: current status and future prospective.
Fen MIAO ; Dan WU ; Zengding LIU ; Ruojun ZHANG ; Min TANG ; Ye LI
Chinese Medical Journal 2023;136(9):1015-1025
Wearable technology, which can continuously and remotely monitor physiological and behavioral parameters by incorporated into clothing or worn as an accessory, introduces a new era for ubiquitous health care. With big data technology, wearable data can be analyzed to help long-term cardiovascular care. This review summarizes the recent developments of wearable technology related to cardiovascular care, highlighting the most common wearable devices and their accuracy. We also examined the application of these devices in cardiovascular healthcare, such as the early detection of arrhythmias, measuring blood pressure, and detecting prevalent diabetes. We provide an overview of the challenges that hinder the widespread application of wearable devices, such as inadequate device accuracy, data redundancy, concerns associated with data security, and lack of meaningful criteria, and offer potential solutions. Finally, the future research direction for cardiovascular care using wearable devices is discussed.
Big Data
;
Delivery of Health Care
;
Wearable Electronic Devices
;
Technology
;
Blood Pressure
9.Right ventricular-arterial uncoupling as an independent prognostic factor in acute heart failure with preserved ejection fraction accompanied with coronary artery disease.
Hongdan JIA ; Li LIU ; Xile BI ; Ximing LI ; Hongliang CONG
Chinese Medical Journal 2023;136(10):1198-1206
BACKGROUND:
Right ventricular (RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction (HFpEF). Coronary artery disease (CAD) can contribute to the pathophysiological characteristics of HFpEF. This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD.
METHODS:
This prospective study included 250 consecutive acute HFpEF patients with CAD. Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value, based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was a composite of all-cause death, recurrent ischemic events, and HF hospitalizations.
RESULTS:
TAPSE/PASP ≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling (area under the curve, 0.731; sensitivity, 61.4%; and specificity, 76.6%). Of the 250 patients, 150 and 100 patients could be grouped into the RV-arterial coupling (TAPSE/PASP >0.43) and uncoupling (TAPSE/PASP ≤0.43) groups, respectively. Revascularization strategies were slightly different between groups; the RV-arterial uncoupling group had a lower rate of complete revascularization (37.0% [37/100] vs . 52.7% [79/150], P <0.001) and a higher rate of no revascularization (18.0% [18/100] vs . 4.7% [7/150], P <0.001) compared to the RV-arterial coupling group. The cohort with TAPSE/PASP ≤0.43 had a significantly worse prognosis than the cohort with TAPSE/PASP >0.43. Multivariate Cox analysis showed TAPSE/PASP ≤0.43 as an independent associated factor for the primary endpoint, all-cause death, and recurrent HF hospitalization (hazard ratios [HR]: 2.21, 95% confidence interval [CI]: 1.44-3.39, P <0.001; HR: 3.32, 95% CI: 1.30-8.47, P = 0.012; and HR: 1.93, 95% CI: 1.10-3.37, P = 0.021, respectively), but not for recurrent ischemic events (HR: 1.48, 95% CI: 0.75-2.90, P = 0.257).
CONCLUSION
RV-arterial uncoupling, based on TAPSE/PASP, is independently associated with adverse outcomes in acute HFpEF patients with CAD.
Humans
;
Prognosis
;
Prospective Studies
;
Stroke Volume/physiology*
;
Echocardiography, Doppler/adverse effects*
;
Coronary Artery Disease/complications*
;
Heart Failure
;
Pulmonary Artery/diagnostic imaging*
;
Ventricular Function, Right/physiology*
;
Ventricular Dysfunction, Right
10.Low diastolic blood pressure and adverse outcomes in inpatients with acute exacerbation of chronic obstructive pulmonary disease: A multicenter cohort study.
Chen ZHOU ; Qun YI ; Yuanming LUO ; Hailong WEI ; Huiqing GE ; Huiguo LIU ; Xianhua LI ; Jianchu ZHANG ; Pinhua PAN ; Mengqiu YI ; Lina CHENG ; Liang LIU ; Jiarui ZHANG ; Lige PENG ; Adila AILI ; Yu LIU ; Jiaqi PU ; Haixia ZHOU
Chinese Medical Journal 2023;136(8):941-950
BACKGROUND:
Although intensively studied in patients with cardiovascular diseases (CVDs), the prognostic value of diastolic blood pressure (DBP) has little been elucidated in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This study aimed to reveal the prognostic value of DBP in AECOPD patients.
METHODS:
Inpatients with AECOPD were prospectively enrolled from 10 medical centers in China between September 2017 and July 2021. DBP was measured on admission. The primary outcome was all-cause in-hospital mortality; invasive mechanical ventilation and intensive care unit (ICU) admission were secondary outcomes. Least absolute shrinkage and selection operator (LASSO) and multivariable Cox regressions were used to identify independent prognostic factors and calculate the hazard ratio (HR) and 95% confidence interval (CI) for adverse outcomes.
RESULTS:
Among 13,633 included patients with AECOPD, 197 (1.45%) died during their hospital stay. Multivariable Cox regression analysis showed that low DBP on admission (<70 mmHg) was associated with increased risk of in-hospital mortality (HR = 2.16, 95% CI: 1.53-3.05, Z = 4.37, P <0.01), invasive mechanical ventilation (HR = 1.65, 95% CI: 1.32-2.05, Z = 19.67, P <0.01), and ICU admission (HR = 1.45, 95% CI: 1.24-1.69, Z = 22.08, P <0.01) in the overall cohort. Similar findings were observed in subgroups with or without CVDs, except for invasive mechanical ventilation in the subgroup with CVDs. When DBP was further categorized in 5-mmHg increments from <50 mmHg to ≥100 mmHg, and 75 to <80 mmHg was taken as reference, HRs for in-hospital mortality increased almost linearly with decreased DBP in the overall cohort and subgroups of patients with CVDs; higher DBP was not associated with the risk of in-hospital mortality.
CONCLUSION:
Low on-admission DBP, particularly <70 mmHg, was associated with an increased risk of adverse outcomes among inpatients with AECOPD, with or without CVDs, which may serve as a convenient predictor of poor prognosis in these patients.
CLINICAL TRIAL REGISTRATION
Chinese Clinical Trail Registry, No. ChiCTR2100044625.
Humans
;
Blood Pressure
;
Pulmonary Disease, Chronic Obstructive/therapy*
;
Cohort Studies
;
Respiration, Artificial
;
Inpatients
;
Hospital Mortality


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