ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The present study determined the relationships between ambulatory blood pressure, left ventricular mass, body mass index, and other clinical and demographic variables to left atrial size in previously untreated hypertensive and normotensive subjects. Left atrial size was measured uni-dimensionally using M-mode echocardiography in 58 newly diagnosed never-treated hypertensive patients (office blood pressure 149/96 ± 15/7 mmHg) and 28 normotensive control subjects (office blood pressure, 122/78 ± 8/8 mmHg). Left ventricular mass, septal and posterior wall thickness were significantly increased in hypertensive compared to normotensive subjects (230 ± 63 g versus 181 ± 45 g, 1.1 ± 0.2 cm versus 0.94 ± 0.2 cm, and 1.04 ± 0.2 cm versus 0.92 ± 0.2 cm respectively; allp < 0.001). Left ventricular internal diameter (4.9 ± 0.6 versus 4.8 ± 0.4 cm,p = 0.54) and left atrial size (3.74 ± 0.48 versus 3.70 ± 0.34 cm,p = 0.86) were not different between the two groups respectively. Body mass index, weight, left ventricular mass, wall thickness, and 24-h pulse pressure were significant correlates of left atrial size in the entire group and in the hypertensive subgroup. In the normotensive subgroup, body weight, body mass index, 24-h systolic and pulse pressure, and left ventricular mass were significant correlates. Multiple regression analyses in the entire group and the hypertensive subgroup alone showed that body mass index and left ventricular mass were the two best predictors of left atrial dimension. These data demonstrate that body mass index and left ventricular mass were the main correlates of left atrial size in patients with previously untreated stage I–II hypertension.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThere is a close relationship between left ventricular hypertrophy and cardiovascular diseases that are observed in hypertension. In this study, the amount of coronary artery calcium, which is an indicator of atherosclerosis, has been measured and its relationship with left ventricular hypertrophy and geometry and other traditional risk factors has been investigated.DesignA total of 249 (104 females, 145 males) hypertensive asymptomatic patients, without diabetes with an average age of 55.09 ± 11.32 years were included in the study. Left ventricular mass of the patients was measured with M-mode echocardiography and coronary artery calcium with electron beam tomography. The average age of the patients who had calcium in their coronary arteries (CAC+) was 59.99 ± 9.85 years, and the average age of the ones without calcium (CAC−) was 49.29 ± 10.19 years.ResultsMean left ventricular mass index (LVMI) was measured as 130.18 ± 43.24 g/m2in CAC+ patients and as 108.47 ± 29.09 g/m2in CAC− patients. These two groups did not differ in terms of the parameters such as total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride and uric acid levels, the presence of early coronary disease in the family and smoking. Patients who had calcium in their coronary arteries (CAC+) were more obese (P < 0.004). In the logistic regression analysis, we demonstrated that body mass index and age were the factors affecting the presence and amount of calcification seen in coronary arteries in left ventricular hypertrophy. In the analysis performed by taking left ventricular hypertrophy into consideration, mean calcium scores of the patients with normal remodeling, concentric remodeling, eccentric hypertrophy and concentric hypertrophy were 50.9 ± 187.4, 68.6 ± 159.3, 92.2 ± 160.2 and 315.4 ± 760.6, respectively. In the patients with concentric left ventricular hypertrophy (LVH), the mean calcium scores of the coronary arteries and the rate of being CAC+ were significantly high, although these patients were also older. After linear regression, the relationship between concentric LVH and coronary artery calcium (CAC) was still significant.ConclusionIn conclusion, left ventricular hypertrophy that is observed in hypertension is an important risk factor for sub-clinical atherosclerosis. Concentric left ventricular hypertrophy is a more important risk factor than other geometric patterns.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

After a little more than a century of use, the conventional Riva-Rocci/Korotkoff technique of measuring blood pressure with a mercury sphygmomanometer and stethoscope, is now being relegated to the museum shelves. Affectionately attached though we may be to this clinical measurement, we must acknowledge that the technique is fraught with inaccuracy and that the age of technology has brought more accurate alternative methodologies. However, we must ensure that the automated devices that are replacing the conventional technique are validated independently for accuracy. The Working Group on Blood Pressure Monitoring of the European Society of Hypertension has recently published an International Protocol to facilitate the validation of more automated devices than was possible with the earlier more complicated protocols.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Mercury sphygmomanometers are gradually being phased out, not because of any technological advances but because of environmental concerns. While mercury is still accepted as the ‘gold standard’ for routine clinical measurement, it suffers from two deficiencies: poor observer technique, and problems due to poor maintenance of the devices. At the same time, there is no generally accepted alternative; the most widely advocated candidates are aneroid or oscillometric devices. Oscillometric devices have the advantages of eliminating observer error and mechanical drift, but it is suggested that the inherent limitations of the oscillometric method mean that it cannot become the gold standard for clinical measurement in individual patients. Aneroid monitors have been found in practice to be frequently deficient, and are subject to the same deficiencies in observer technique as mercury devices. Two possible but so far untested techniques are a ‘hybrid’ sphygmomanometer, whereby the mercury column is replaced by an electronic transducer and display, and the wideband recording technique, which has the potential of using the same basic principle as the auscultatory technique, while eliminating the human observer.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectiveTo evaluate three methods aimed at the reconstruction of brachial pressure from non-invasive finger arterial pressure measurements as implemented in the Finometer™, (FMS, Finapres Measurement Systems, Arnhem, Netherlands), the successor to the Finapres™ (TNO Biomedical Instrumentation, Amsterdam, Netherlands).MethodsFinger arterial pressure (FinAP) may differ from intra-brachial pressure (BAP). Pulse shape differences are removed by applying a generalized waveform filter. Pressure level differences are corrected by a generalized level correction equation using filtered systolic and diastolic levels and by level calibration, which uses an additional return-to-flow (RTF) systolic pressure measurement on the ipsilateral upper arm for an individual calibration of the reconstructed brachial pressure.ValidationThese methods were validated in 37 subjects, aged 41 to 83 years after a cardiac catheterization procedure. Intra-brachial and Finometer pressures were recorded simultaneously. Finometer pressures were compared after application of waveform filtering and level correction (flcAP), and after an additional RTF calibration (reBAP).ResultsFinger arterial systolic, diastolic and mean pressures for the group differed from BAP by −9.7 ± 13.0, −11.6 ± 8.0 and −16.3 ± 7.9 mmHg (mean ± SD) respectively. Similarly flcAP differed by −1.1 ± 10.7, −0.2 ± 6.8 and −1.5 ± 6.6 mmHg and reBAP differed by 3.1 ± 7.6, 4.0 ± 5.6 and 2.7 ± 4.7 mmHg.ConclusionReconstruction of BAP from FinAP as implemented in the Finometer reduces the pressure differences, with an individual RTF calibration to well within AAMI requirements.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Continuous blood pressure monitoring is an essential prerequisite for any study on blood pressure variability. Invasive procedures are no longer acceptable for research projects in a clinical setting, and recently developed devices able to record blood pressure on a beat-by-beat basis in a non-invasive fashion may represent valuable alternative tools. This article will briefly review the available information on the most recent advances in this field. It will focus on further developments of the original technology for finger blood pressure monitoring introduced by Penázet al., as well as on newer devices that have been proposed over the last few years for non-invasive cardiovascular monitoring both in research and in clinical studies.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundGender, age, smoking, race, and body mass index have been reported to determine the ambulatory white-coat effect (WCE) and white-coat hypertension (WCH).MethodsBaseline conventional, day-time ambulatory and self-measured home blood pressure measurements from the THOP trial were used to study the effect of gender, age, body mass index, smoking habits and treatment status on the white-coat syndrome as assessed by ambulatory monitoring or self-measurement.ResultsThe mean systolic/diastolic WCE was 9.1/6.7 mmHg if based on ambulatory blood pressure and 12.2/8.7 mmHg if based on self-measured blood pressure. The ambulatory WCE was significantly higher in women, in older subjects (65+), in obese subjects, in non-smokers and in patients on antihypertensive drug treatment. The self-measured WCE was significantly higher in women and in non-smokers. Ambulatory WCH was present in 6.6% of the untreated patients and 14.2% had self-measured WCH. The proportion of ambulatory WCH was significantly higher in obese subjects; the proportion of self-measured WCH did not differ by gender, age, body mass index, or smoking habits.ConclusionsThe ambulatory white-coat syndrome was determined by gender, age, body mass index, smoking habits, and treatment status. The self-measured white-coat syndrome was greater than the ambulatory white-coat syndrome but depended less on the determinants under study.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Silent myocardial ischemia is defined as an ischemic episode without chest pain but with transient ST abnormalities during stress testing or Holter monitoring. With Holter monitoring the prevalence of silent myocardial ischemia in hypertensive patients without coronary artery disease is between 25% and 73%. Simultaneous recording of ambulatory 24-h ECG and 24-h ambulatory blood pressure measurements (ABPM) with the option of additional ST-triggered blood pressure measurement is useful to detect silent ischemia and triggers of silent ischaemia. It is surprising that only a few combined 24-h Holter/ABPM devices are on the market, and in turn only three devices allow additional triggered blood pressure measurements. The paper provides an overview of studies investigating hypertensive patients with Holter monitoring for the detection of ST segment depression indicating myocardial ischaemia. Furthermore, requirements for combined devices allowing simultaneous ambulatory 24-h ECG and ABPM are defined.

ISSN:1359-5237    

出版商:OVID    

年代:2003

数据来源: OVID