摘要:

ObjectiveTo determine the reproducibility and the cost of the Loaned Self‐measurement Equipment Model for blood pressure.SubjectsSeventy‐five subjects with non‐complicated essential hypertension, having an average age of 56.2 ± 11 years, were evaluated.MethodsThe Loaned Self‐measurement Equipment Model consists of a set of sphygmomanometers belonging to the clinic, loaned to patients for 3‐day periods for them to carry out 27 readings, and then returned. Using a mercury sphygmomanometer, a nurse carried out office blood pressure readings during two visits. A month later, the same procedure was repeated under the same clinical conditions. The agreement between studies was assessed by correlation coefficients, coefficients of variation and standard deviation of the differences (SDD).ResultsThe office blood pressure was 147 ± 17/89 ± 12 mmHg during visit A, and 145 ± 16/88 ± 11 mmHg during visit B. The self‐measurement blood pressure was 139 ± 16/84 ± 10 mmHg during the first visit, and 136 ± 15/84 ± 11 mmHg during the second visit. In neither of the cases were the differences statistically significant. The correlation coefficients for the office and self‐measurement systolic blood pressure were statistically significant (P = 0.018), while those for the diastolic blood pressure were not statistically significant. The SDD for self‐measurement systolic blood pressure was 10.7, compared to 15.0 for the office blood pressure (P < 0.01). The comparison in the case of diastolic blood pressure was not significant. The cost of each loan was $5.85 (US dollars).ConclusionsThe Loaned Self‐measurement Equipment Model has a good short‐term reproducibility, and the cost is reasonable.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe aim of this study was to determine arterial elasticity in normotensive and hypertensive individuals.BackgroundIn addition to blood pressure, other parameters serve as markers for vascular disease. Arterial elasticity is one parameter that can be determined by a modified Windkessel model of the circulation. This model estimates, from a computerized pulse contour analysis, the proximal (capacitive) elasticity of the large arteries and the distal (reflective) elasticity of the small arteries.MethodsA prospective, multi-center, controlled clinical study evaluated large-artery and small-artery elasticity indices in four groups: (1) normotensives without a family history of hypertension; (2) normotensives with a family history of hypertension; (3) treated and controlled hypertensives; and (4) untreated and uncontrolled hypertensives. Blood pressure, using a mercury manometer, and arterial elasticity, using a CVProfilor™ DO-2020 CardioVascular Profiling System (Hypertension Diagnostics, Inc., Eagan, MN, USA), were measured supine in triplicate 3 min apart in a randomized sequence.ResultsThere were 212 evaluable subjects of mean age 46 years; 57% were women, 51% Caucasian and 33% African-American. Comparing normotensives without a family history and untreated hypertensives, both large-artery and small-artery elasticity indices were significantly different (P < 0.0001). After controlling for age and body surface area, a significant linear trend (P = 0.0001) across the four groups was detected for both large- and small-artery elasticity indices.ConclusionAs the hypertension status worsened, large- and small-artery elasticity indices decreased, suggesting a potential for the diagnostic use of arterial elasticity determinations.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundSustained and white-coat hypertensives show hypertension in the office setting but different blood pressure values outside the clinical environment. So far, only a few incomplete data on heart rate are available inside and outside the clinical setting in these groups of patient. The aim of this study was to evaluate clinic and ambulatory heart in sustained hypertensives, white-coat hypertensives and normotensives.MethodsWe selected 236 sustained hypertensives, 236 white-coat hypertensives and 236 normotensives matched for age, gender and body mass index, and with a similar occupation. The subjects had been submitted to clinic evaluation and the non-invasive monitoring of blood pressure and heart rate. White-coat hypertension was defined as clinic hypertension and a daytime blood pressure of less than 135/85 mmHg.ResultsThe clinic heart rate was significantly higher in sustained hypertensives and white-coat hypertensives than in normotensives (76 ± 11 versus 75.5 ± 10 versus 70 ± 9 beats/min [bpm], respectively,P < 0.05). The daytime heart rate was significantly higher in sustained hypertensives than in white-coat hypertensives and normotensives (79.4 ± 10 versus 74.6 ± 8.5 versus 74.5 ± 8.5 bpm, respectively,P < 0.05), as were the night-time heart rate (67 ± 8.5 versus 63 ± 8 versus 63 ± 8 bpm, respectively,P < 0.05) and 24 h heart rate (76.3 ± 9 versus 72 ± 7.8 versus 72 ± 8 bpm, respectively,P < 0.05). When men and women were analyzed separately, the same trend was observed.ConclusionsThe clinic heart rate is similar in sustained and white-coat hypertensives, but the ambulatory heart rate is lower in white-coat hypertensives. As ambulatory heart rate is more representative of 24 h heart rate load and may be a better indicator of the detrimental effect of heart rate, our findings suggest that white-coat hypertensives are at lower cardiovascular risk than sustained hypertensives.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundThe urinary albumin level has been found to be positively correlated with blood pressure in hypertensive patients. To our knowledge, this relationship has not been evaluated in normotensive subjects and compared with that in hypertensives using casual and ambulatory blood pressure measurements.MethodsIn this cross-sectional study, a cohort of 234 normotensive and hypertensive participants wore an ambulatory blood pressure monitor for 24 h, standardized casual blood pressure measurements being taken. The urinary albumin concentration was determined by the dipstick Micral Test. The bivariate and multivariate relationship between urinary albumin concentration and demographic and blood pressure measures was investigated using correlational and regression analyses.ResultsThe prevalence of microalbuminuria was significantly greater in the hypertensive than normotensive participants. The urinary albumin concentration was positively associated with both casual and ambulatory measures of blood pressure in both the normotensive and hypertensive subsamples, stronger correlations being found for systolic blood pressure. The relationship between systolic blood pressure and urinary albumin concentration was similar in the normotensive and hypertensive subsamples.ConclusionsThese findings confirm earlier reports of the greater prevalence of microalbuminuria in patients with hypertension than in normotensive participants, as well as those reporting a continuous relationship in hypertensive participants. This study extends prior research to a normotensive subsample, in whom a similar relationship of blood pressure to microalbuminuria, using both ambulatory and casual measures of blood pressure, was found. Future research should investigate the causal direction of this relationship.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo analyze whether the number of blood pressure registrations per hour and/or different ways of defining day and night have any influence on the result of ambulatory blood pressure monitoring.Design and methodsThe study used blood pressure data from 40 normotensive subjects (20 men) and 40 (20 men) treated hypertensive patients who had undergone 24 h non-invasive ambulatory blood pressure monitoring twice (on a work day and a non-work day), three recordings per hour being made. Calculations were made based on all recordings and with one and two recordings per hour randomly removed. The definition of night was the subject's own (from going to bed until getting up), and an arbitrary designation of 2200 h–0600 h.ResultsThe mean blood pressure (systolic/diastolic and standard deviation) over 24 h showed no significant difference between calculations based on three, two or one blood pressure registrations per hour in either hypertensives or normotensives, nor was there any significant difference when the same kind of calculation for day and night was made based on the subject's own statement or on arbitrary dividing lines. The between-patient standard deviation increased, albeit marginally, with fewer registrations. Individual comparisons revealed a difference over 24 h of 8.4/6.7 mm Hg between three and one registrations per hour in one hypertensive patient during a non-work day. All the others had lesser and very small differences.ConclusionAn analysis of our data revealed no major differences in mean blood pressure if one, two or three recordings per hour were used. Arbitrary dividing lines for day and night or according to the individual's own statement did not have any major effect on the result. This must be considered to be an advantage when data from different studies are compared or pooled. It may, however, be wise to perform recordings no less than every 30 min when evaluating individual patients.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundBlood pressure is the most ubiquitous diagnostic recording made in the doctor's office, but the measurement is subject to a number of sources of bias, which may lead to over- or underestimation. The current study examined the systematic influence of the way in which the measurements were taken – by the physician, by a nurse, or with the patient sitting alone, using an automated device.Subjects and methodsBlood pressure was measured in 17 essential hypertensive and 10 white-coat hypertensive individuals. On separate clinic visits, measurements were taken by the attending physician, by a nurse and using an automated device (Arteriosonde 1216).ResultsA repeated-measures ANOVA revealed that, for systolic pressure, there was a significant effect of measurement modality on blood pressure. Physician systolic pressures were on average approximately 10 mmHg higher than those taken by a nurse, nurse pressures being approxiamtely 7 mmHg higher than those recorded using Arteriosonde. The effect on diastolic pressure was similar but smaller, and no nurse–Arteriosonde difference was observed.ConclusionsWe conclude that the routine clinical assessment of blood pressure would be more representative of daily ambulatory pressure if an automated device, without doctor or nurse present, were used.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundIn experimental animals, a reduction in renal mass leads to glomerulosclerosis of the residual parenchyma and eventual renal failure. In humans, however, data on the influence of nephrectomy or agenesis on future functional parameters and hypertension are as yet controversial.ObjectiveTo evaluate blood-pressure patterns in children with a solitary kidney as a result of either unilateral renal agenesis (URA) or uninephrectomy (UNX) and correlate them to the increase in size of the remaining kidney.MethodsTwenty-eight children with a solitary kidney were divided into two groups: the URA group, with 18 subjects (13 male and five female, with a mean age of 9.6 ± 3.9 years), and the UNX group, which contained 10 subjects (four male and six female, with a mean age of 14.0 ± 2.7 years). The mean time since nephrectomy was 8.7 years. Each study group was assigned an age-, weight- and height-matched control group. In all subjects, ambulatory blood pressure monitoring was performed using the SpaceLabs model no. 90207. Daytime and night-time were defined as 0800–2200 h and 2200–0800 h, respectively. Urinalysis, serum creatinine and urea results were recorded for all the study group participants. The size of the remaining kidney was determined by ultrasound examination. The percentage increase in kidney size, as calculated from standard kidney-length-against-age nomograms was correlated to the percentage deviation from normal blood pressure values.ResultsThe mean 24 h, daytime and night-time systolic blood pressure (SBP) readings were significantly higher in children in the URA group than in those in the corresponding control group (111.4 ± 7.5 mmHg versus 106.9 ± 6.7 mmHg,P < 0.004; 115.2 ± 3.1 mmHg versus 110.7 ± 3.4 mmHg,P < 0.004; and 105.2 ± 2.6 mmHg versus 101.2 ± 1.8 mmHg,P < 0.002, respectively). Daytime heart rate was found to be significantly reduced (84.4 ± 5.2 versus 87.8 ± 8.2 beats/min,P < 0.04). In the UNX group, 24 h mean, systolic and diastolic blood pressure (DBP), as well as heart rate, did not differ from control values. Daytime systolic and diastolic blood pressures were higher than those of the controls (119.8 ± 4.0 mmHg versus 115.5 ± 3.8 mmHg,P < 0.02; and 72.7 ± 4.0 mmHg versus 70.0 ± 11.0 mmHg,P < 0.02, respectively). Nocturnal dipping was present in all groups and was of equal magnitude in the corresponding control groups. The mean 24 h diastolic blood pressure load was significantly greater in URA patients than in controls (19.6 versus 10.8%, respectively,P < 0.01). In the UNX group, the blood pressure loads were similar to those of controls. The percentage increase in length of the remaining kidney was found to correlate positively with the percentage delta increase in both systolic and diastolic blood pressure.ConclusionsCompared with the age-, height- and weight-matched controls, the children with a solitary kidney caused by URA had an elevated mean 24 h SBP. In contrast, those with UNX had mean 24 h blood pressure values similar to those of their controls. A rise in SBP was, however, seen in both groups during the daytime hours. Thus, the presence of a solitary kidney, for whatever reason, may be pathogenetically linked to a raised blood pressure, and this linkage may be more pronounced in URA. The delta increase in size of the remaining kidney may serve as a prognostic indicator of blood pressure elevation.

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1359-5237    

出版商:OVID    

年代:2001

数据来源: OVID