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Open Heart Dec 2023Blood pressure (BP) is a crucial factor in cardiovascular health and can affect cardiac imaging assessments. However, standard outpatient cardiovascular MR (CMR) imaging...
AIMS
Blood pressure (BP) is a crucial factor in cardiovascular health and can affect cardiac imaging assessments. However, standard outpatient cardiovascular MR (CMR) imaging procedures do not typically include BP measurements prior to image acquisition. This study proposes that brachial systolic BP (SBP) and diastolic BP (DBP) can be modelled using patient characteristics and CMR data.
METHODS
In this multicentre study, 57 patients from the PREFER-CMR registry and 163 patients from other registries were used as the derivation cohort. All subjects had their brachial SBP and DBP measured using a sphygmomanometer. Multivariate linear regression analysis was applied to predict brachial BP. The model was subsequently validated in a cohort of 169 healthy individuals.
RESULTS
Age and left ventricular ejection fraction were associated with SBP. Aortic forward flow, body surface area and left ventricular mass index were associated with DBP. When applied to the validation cohort, the correlation coefficient between CMR-derived SBP and brachial SBP was (r=0.16, 95% CI 0.011 to 0.305, p=0.03), and CMR-derived DBP and brachial DBP was (r=0.27, 95% CI 0.122 to 0.403, p=0.0004). The area under the curve (AUC) for CMR-derived SBP to predict SBP>120 mmHg was 0.59, p=0.038. Moreover, CMR-derived DBP to predict DBP>80 mmHg had an AUC of 0.64, p=0.002.
CONCLUSION
CMR-derived SBP and DBP models can estimate brachial SBP and DBP. Such models may allow efficient prospective collection, as well as retrospective estimation of BP, which should be incorporated into assessments due to its critical effect on load-dependent parameters.
Topics: Humans; Blood Pressure; Prospective Studies; Retrospective Studies; Stroke Volume; Ventricular Function, Left
PubMed: 38114194
DOI: 10.1136/openhrt-2023-002484 -
Vascular Health and Risk Management 2023Hypertension (HTN) poses a significant health risk for Indonesia's large population. Underlying factors contributing to this disease are not fully understood at a...
PURPOSE
Hypertension (HTN) poses a significant health risk for Indonesia's large population. Underlying factors contributing to this disease are not fully understood at a national level. Therefore, this study aimed to evaluate factors associated with HTN in Indonesia.
PATIENTS AND METHODS
This study used data from the Indonesian Family Life Survey-5, a 2014 national cross-sectional population-based survey of individuals aged 15 years and older. The mean arterial pressure (MAP) value was determined from three blood pressure measurements taken by trained nurses using Omron digital sphygmomanometers. The respondent was classified as hypertensive when the MAP value was at least 100. The study summarised the socio-demographic factors (age, gender, marital status, ethnicity and occupation status) and lifestyle habits (smoking, sleep quality, physical activity) with descriptive statistics. The potential associations between these factors and HTN were assessed using logistic regression analysis. The results were reported in terms of odds ratios (OR) with a 95% confidence interval (CI).
RESULTS
The study included 32,670 respondents; 31.2% of them had HTN. Factors that were more likely associated with HTN were being <65 years old, being married (OR 1.257, 95% CI 1.170-1.352) and being smoker (OR 1.297, 95% CI 1.198-1.404), while being male (OR 0.677, 95% CI: 0.625-0.733) and doing no physical activity (OR 0.870, 95% CI: 0.813-0.930) were less likely to be associated with HTN.
CONCLUSION
This study indicates that there are associations between certain socio-demographic factors and lifestyle habits with HTN in Indonesia. This information may help policymakers and healthcare providers to develop effective strategies in order to control HTN in Indonesia, thereby improving the overall health and well-being of the population.
Topics: Adult; Humans; Male; Aged; Female; Cross-Sectional Studies; Indonesia; Risk Factors; Hypertension; Family Characteristics; Prevalence
PubMed: 38108024
DOI: 10.2147/VHRM.S438180 -
The Lancet Regional Health. Western... Feb 2024This study aims to evaluate primary care providers' adherence to the standard of measuring blood pressure for people aged 35 or above during their initial visit, as per...
BACKGROUND
This study aims to evaluate primary care providers' adherence to the standard of measuring blood pressure for people aged 35 or above during their initial visit, as per Chinese guidelines, and to identify factors affecting their practices.
METHODS
We developed 11 standardized patients (SP) cases as tracer conditions to evaluate primary care, and deployed trained SPs for unannounced visits to randomly selected providers in seven provinces of China. The SPs used a checklist based on guidelines to record whether and how blood pressure was measured. Data were analyzed descriptively and regression analysis was performed to examine the association between outcomes and factors such as provider, patient, facility, and clinical case characteristics.
FINDINGS
The SPs conducted 1201 visits and found that less than one-third of USPs ≥35 had their blood pressure measured. Only 26.9% of migraine and 15.4% of diabetes cases received blood pressure measurements. Additionally, these measurements did not follow the proper guidelines and recommended steps. On average, 55.6% of the steps were followed with few providers considering influencing factors before measurement and only 6.0% of patients received both-arm measurements. The use of wrist sphygmomanometers was associated with poor blood pressure measurement.
INTERPRETATION
In China, primary care hypertension screening practices fall short of guidelines, with infrequent initiation of blood pressure measurements and inadequate adherence to proper measurement steps. To address this, priority should be placed on adopting, implementing, and upholding guidelines for hypertension screening and measurement.
FUNDING
National Natural Science Foundation of China, Swiss Agency for Development and Cooperation, Doctoral Fund Project of Inner Mongolia Medical University, China Postdoctoral Science Foundation.
PubMed: 38076324
DOI: 10.1016/j.lanwpc.2023.100973 -
The Lancet. Child & Adolescent Health Feb 2024Hypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate the prevalence of and risk factors for elevated...
BACKGROUND
Hypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate the prevalence of and risk factors for elevated blood pressure (hypertension ≥140 mm Hg systolic, ≥90 mm Hg diastolic, or both) and high-normal blood pressure (130-139 mm Hg systolic, 85-89 mm Hg diastolic, or both) among youth in Zimbabwe.
METHODS
A population-based, cross-sectional survey of randomly sampled youth aged 18-24 years from 24 urban and peri-urban communities in three provinces (Harare, Bulawayo, and Mashonaland East) in Zimbabwe was conducted between Oct 4, 2021, and June 2, 2022. Standardised questionnaires were used by research assistants to collect sociodemographic, behavioural, and clinical data. Height, bodyweight, and blood pressure were recorded. Three seated blood pressure measurements were taken at standardised timepoints during participant interview using a digital sphygmomanometer and cuffs sized on mid-upper arm circumference. The association of potential risk factors with elevated blood pressure was examined using multivariable logistic regression.
FINDINGS
17 682 (94·4%) of 18 729 eligible participants were recruited, 17 637 (99·7%) of whom had complete data, and 16 883 (95·7%) of whom were included in the final study sample after excluding 754 (4·3%) pregnant women. The median age was 20 years (IQR 19-22), 9973 (59·1%) participants were female, and 6910 (40·9%) were male. The prevalence of hypertension was 7·4% (95% CI 7·0-7·8) and high-normal blood pressure was 12·2% (11·7-12·7). Overall, prevalence of hypertension was higher in men (8·7% [95% CI 8·2-9·6]) than in women (6·6% [6·0-6·9]), but with age increased to similar levels (at age 18 years 7·3% [6·2-8·6] and 4·3% [3·5-5·2]; at age 23-24 years 10·9% [9·3-12·6] and 9·5% [8·4-10·7] in men and women, respectively). After adjusting for factors associated with hypertension in the crude analysis, hypertension was associated with male sex (adjusted odds ratio 1·53 [95% CI 1·36-1·74]), increasing age (age 19-20 years 1·20 [1·00-1·44]; age 21-22 years 1·45 [1·20-1·75]; age 23-24 years 1·90 [1·57-2·30], vs age 18 years), and BMI of 30·0 kg/m or more (1·94 [1·53-2·47] vs 18·5-24·9 kg/m). A BMI of 18·5 kg/m or less (0·79 [0·63-0·98] vs 18·5-24·9 kg/m) and living with HIV (0·71 [0·55-0·92]) were associated with lower odds of hypertension.
INTERPRETATION
Prevalence of elevated blood pressure is high among urban and peri-urban youth in Zimbabwe and increases rapidly with age. Further research is needed to understand drivers of blood pressure elevation and the extent of target organ damage in youth in Zimbabwe and similar sub-Saharan African settings, to guide implementation of prevention and management strategies.
FUNDING
Wellcome Trust.
Topics: Adolescent; Humans; Female; Male; Young Adult; Pregnancy; Adult; Blood Pressure; Cross-Sectional Studies; Prevalence; Zimbabwe; Hypertension
PubMed: 38070533
DOI: 10.1016/S2352-4642(23)00287-0 -
RSC Advances Nov 2023In recent times, the high demand for flexible and wearable pressure sensors to monitor human health, particularly for patients afflicted with hypertension or high blood...
In recent times, the high demand for flexible and wearable pressure sensors to monitor human health, particularly for patients afflicted with hypertension or high blood pressure (BP), has captured the keen interest of researchers. Capacitance-based flexible sensing devices offer real-time metrics regarding vital physiological parameters of the human body, such as BP and pulse rate (PR), thereby enabling the identification of cardiovascular complications. In this regard, we have developed a capacitive pressure sensor using polydimethylsiloxane (PDMS) and deionized water (DIW) and improved its key parameters by adding baking powder to PDMS-DIW. The sensor demonstrated excellent performance in static pressure measurements with a sensitivity of 0.021 Pa, detection limit of 1 Pa, and response time of 100 ms. We further investigated its application in human BP monitoring. The sensor successfully captured the oscillometric waveform (OMW) for all 160 participants and demonstrated excellent performance in accurately measuring BP, meeting all criteria outlined as the universal standard when compared with the reference devices: OMRON BP device and the gold-standard mercury-based sphygmomanometer. Furthermore, the sensor accurately provided the PR and agreed well with the reference BP device. Therefore, the developed BP sensor can be a viable alternative to replace the pressure sensors in existing BP devices.
PubMed: 38058557
DOI: 10.1039/d3ra06447f -
Medicine Dec 2023The number of studies investigating the role of physical activity and exercise in hypertension (HT) patients is insufficient in the literature, and reports evaluating...
The number of studies investigating the role of physical activity and exercise in hypertension (HT) patients is insufficient in the literature, and reports evaluating the relationship between HT, physical activity, and balance are lacking. This study aims to examine the relationship between physical activity levels and balance parameters, muscle strength, and fear of falling in patients with HT. 78 subjects with HT participated in this study. Demographic and clinical characteristics of all participants were recorded. Blood pressure was evaluated using a sphygmomanometer, physical activity level was assessed using a SenseWear Armband, fear of falling was assessed using the Fall Efficacy Scale, balance was assessed using the Fullerton Advanced Balance Scale, and muscle strength was evaluated using a digital handheld dynamometer. All 78 subjects completed the study as planned. The average age of participants was 57.75 ± 5.82, the mean systolic blood pressure was 133 ± 5.73, and the diastolic blood pressure was 84 ± 6.78. 34.2% of participants used angiotensin-converting enzyme inhibitors, 38% used beta blockers, and 26% used diuretic drugs. A positive correlation between physical activity and balance scores of individuals with HT was found (P < .005). It was also found that low muscle strength was associated with balance and risk of falling (P < .005). There is a positive correlation between decreased physical activity levels and balance in participants with HT. The results suggest that people with HT who have poor balance also have decreased muscle strength against gravity, such as in the quadriceps femoris and gluteus maximus. Overall, we recommend that patients with HT should improve their physical activity levels.
Topics: Humans; Fear; Postural Balance; Muscle Strength; Exercise; Hypertension
PubMed: 38050230
DOI: 10.1097/MD.0000000000036495 -
Jornal de Pediatria 2024To examine if the substitution of different screen time intervals with light physical activity (LPA), moderate to vigorous physical activity (MVPA) and sleep is...
OBJECTIVE
To examine if the substitution of different screen time intervals with light physical activity (LPA), moderate to vigorous physical activity (MVPA) and sleep is associated with cardiovascular indicators and inflammatory markers in children.
METHODS
This is a cross-sectional study developed with 186 children aged between six and 11 years old from public schools in southern Brazil. CRF was measured with the 6-minute running and walking test, following the Brazil Sports Project procedures. The percentage of fat was evaluated through DXA. LPA and MVPA were measured using accelerometers. Sleep and screen time were assessed by questionnaires answered by parents. Leptin and C-reactive protein were measured by fasting blood collection. Systolic and diastolic blood pressure were determined through a digital sphygmomanometer. Isotemporal substitution models were used for statistical analysis.
RESULTS
Replacing 1 h of screen time with MVPA was associated with lower BMI, systolic and diastolic blood pressure, fat percentage, leptin, and C-reactive protein. When screen time was substituted for sleep time, lower waist circumference was observed. Regarding the substitution of 1 h of screen time with LPA, significant values were found only for leptin.
CONCLUSION
The replacement of screen time with physical activities of different intensities and sleep time was associated with benefits in cardiovascular indicators and inflammatory markers in childhood.
Topics: Child; Humans; Leptin; Brazil; C-Reactive Protein; Cross-Sectional Studies; Screen Time; Exercise; Sleep; Accelerometry
PubMed: 38043583
DOI: 10.1016/j.jped.2023.10.007 -
The Pan African Medical Journal 2023the stress associated with hypertension treatment makes using coping strategies inevitable. However, most patients with hypertension apply inefficient coping strategies,... (Observational Study)
Observational Study
INTRODUCTION
the stress associated with hypertension treatment makes using coping strategies inevitable. However, most patients with hypertension apply inefficient coping strategies, leading to uncontrolled blood pressure (BP). The study analyzed coping strategies associated with hypertension treatment and determined how these coping strategies predicted the current BP of patients with hypertension.
METHODS
the study was a prospective observational cohort conducted between January and December, 2020. Consecutive sampling technique was used to enumerate 508 patients who consistently sought treatment at the healthcare facilities. A sphygmomanometer was used to measure BP to determine controlled and uncontrolled BP based on Ghana Health Service standards. A questionnaire was adapted from Coping Inventory for Stressful Situations-2 to measure patients' coping strategies. Descriptive statistics, cut off percentage and multiple linear regression were applied in analyzing the data at a 0.05 level of significance.
RESULTS
females were two-thirds (74%) of the study population and the mean age was 58.40 ± 11.72. All patients with hypertension used the three coping strategies: emotion-oriented coping (EOC), task-oriented coping (TOC) and avoidance coping (AC). However, EOC was highly used (61.2%), followed by TOC (58.5%) and AC (46.2%). Also, the study found coping with treatment regimens to be relatively poor since it was only physical exercise (79.5%) that they effectively observed. The multiple linear regression results revealed that the three coping strategies were significant predictors of current BP levels [F (3, 117) = 12.390 at p < 0.001]. Thus, AC, TOC, and EOC explained 37.4% of the variability of current BP status (R2 adj=0.374). Specifically, patients who use TOC (66.3%) were more likely to have a controlled BP than those using EOC (53.7%) and AC (35.8%).
CONCLUSION
patients' coping strategies were inadequate for hypertension treatment since treatment regimens were poorly observed. Meanwhile, EOC is most likely to negatively affect a patient's treatment, leading to uncontrolled BP. Our study recommends the need to encourage patients to combine their EOC with TOC to enable them control their BP better.
Topics: Female; Humans; Middle Aged; Aged; Ghana; Prospective Studies; Hypertension; Adaptation, Psychological; Blood Pressure; Hospitals; Antihypertensive Agents
PubMed: 38020354
DOI: 10.11604/pamj.2023.45.185.39994 -
Physiological Research Nov 2023The development of methods for measuring blood pressure (BP) in newborns and small children has a rich history. Methods for BP measuring in adults had to be adapted to... (Review)
Review
The development of methods for measuring blood pressure (BP) in newborns and small children has a rich history. Methods for BP measuring in adults had to be adapted to this age group. For measuring BP in direct invasive way, a suitable approach had to be found to access the arterial circulation through the umbilical and later radialis artery. Currently, results obtained from direct invasive BP measurement are considered the "gold standard". The development of non-invasive methods for BP measuring in newborns and children began with the use of von Basch's sphygmomanometer (1880). In 1899, Gustav Gärtner constructed the device, which was the basis for the flush method. After the discovery of the palpation and auscultation methods, these methods were also used for BP measurement in newborns and children, however, the BP values obtained in these ways were typically underestimated using excessively wide cuffs. From the auscultation method, methods utilizing ultrasound and infrasound to detect arterial wall movement and blood flow were later developed. The oscillometric method for BP measurement was introduced by E. J. Marey so early as in 1876. In 1912, P. Balard used the oscillometric technique to measure blood pressure in a large group of newborns. Through different types of oscillometers using various methods for detecting vascular oscillations (such as xylol method, impedance and volume plethysmography, etc.), the development has continued to assessment of vascular oscillations by modern sensor technology and software. For continuous non-invasive blood pressure measurement, the volume-clamp method, first described by Jan Peňáz in 1968, was developed. After modification for use in newborns, application of the cuff to the wrist instead of the finger, it is primarily used in clinical physiological studies to evaluate beat-to-beat BP and heart rate pressure variability, such as in the determination of the baroreflex sensitivity.
Topics: Adult; Child; Humans; Infant, Newborn; Infant; Blood Pressure; Blood Pressure Determination; Arterial Pressure; Arteries; Fingers
PubMed: 38015754
DOI: 10.33549/physiolres.935173 -
Journal of the American Heart... Dec 2023Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood...
BACKGROUND
Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents.
METHODS AND RESULTS
The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years.
CONCLUSIONS
Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.
Topics: Pregnancy; Adolescent; Humans; Male; Infant, Newborn; Female; Cohort Studies; Prevalence; Hypertension; Risk Factors; Blood Pressure; Body Mass Index; Weight Gain
PubMed: 38014655
DOI: 10.1161/JAHA.123.029627