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Home blood pressure monitoring

Stefan Wagner
Blood pressure self-measurement has been used extensively as part of several clinical processes including in the home monitoring setting for mitigating white coat effect and gaining more detailed insights into the blood pressure variability of patients over time. Self-measurement of BP is also being used as part of telemonitoring and telemedicine processes, as well as in the waiting rooms and self-measurement rooms of general practice clinics, specialized hospital department's outpatient clinics, and in other types of care facilitates and institutions...
October 19, 2016: Advances in Experimental Medicine and Biology
Yuan-Yuan Kang, Yan Li, Qi-Fang Huang, Jie Song, Xiao-Li Shan, Ji-Guang Wang
OBJECTIVE: Cigarette smoking is associated with chronic and acute endothelial dysfunction, and hence probably also elevated out-of-clinic blood pressure. In the present study, we investigated the association between cigarette smoking and masked hypertension defined as elevated out-of-clinic pressure but normal clinic pressure. DESIGN AND METHOD: Our study included male participants of the China Ambulatory and Home BP Registry, who underwent clinic, 24-hour ambulatory and 7-day home BP monitoring...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
Hidenori Urata, Sankar Devarajan, Keisuke Okamura
OBJECTIVE: The aim of this study was to test chymase inhibitory traditional Japanese food (Japanese Water Pepper, JWP) intake in salt-induced hypertensive mouse model and in human. DESIGN AND METHOD: Salt-dependent hypertension model using 8 weeks age of wild type mice was established giving 2% NaCl drinking water. This model shows chronic moderate hypertension (AJP 2015). Our extensive food extract survey for inhibition of human chymase revealed that JWP possessed human chymase inhibitory effect in vitro...
September 2016: Journal of Hypertension
Hiromi Rakugi
European guidelines (ESH-ESC2013) for the elderly have discussed well about treatment blood pressure (BP) levels and targeting BP levels. In general, elderly patients with systolic BP (SBP) ≥160 mmHg including individuals older than 80 years in good physical and mental conditions are recommended reducing SBP to between 150 and 140 mmHg. Furthermore, fit elderly patients <80 years old are recommended to consider antihypertensive treatment at SBP values ≥140 mmHg with a target SBP <140 mmHg. On the other hand, frail elderly patients are recommended to leave decisions on antihypertensive therapy to the treating physician, and based on monitoring of the clinical effects of treatment...
September 2016: Journal of Hypertension
Kazuomi Kario, Satoshi Hoshide
OBJECTIVE: It has been long believed that there is a close association between hypertension and atrial fibrillation (AF). However, there have been few studies on the impact of antihypertensive medication in hypertensives with AF. To investigate whether the timing of the antihypertensive drug administration influences blood pressure (BP) level and biomarkers to hypertensives with AF. DESIGN AND METHOD: The present study was a multicentered, prospective, randomized, open-labelled clinical trial to investigate the difference in the effect of telmisartan/amlodipine combination tablets on BP levels and BP variability using ambulatory BP monitoring (ABPM) and home BP between the morning administration and the bedtime administration in hypertensives with paroxysmal AF...
September 2016: Journal of Hypertension
Qian-Hui Guo, Yuan-Yuan Kang, Jie Song, Qi Chen, Chang-Yuan Liu, Shao-Kun Xu, Yi-Bang Cheng, Yan Li, Ji-Guang Wang
OBJECTIVE: Prognosis of exaggerated morning surge (MS) of blood pressure (BP) remains controversial, possibly due to the ethnic difference in the size of MS. Compared to MS, evidence on morning hypertension (MH) is more consistent. With the use of a national BP registry database, we studied the size of MS and the prevalence and determinants of exaggerated MS and MH in Chinese. DESIGN AND METHOD: In the 3547 patients (mean age, 56.8 years; women, 49.1%; hypertension, 79...
September 2016: Journal of Hypertension
Annika Lindroos, Jouni Johansson, Pauli Puukka, Ilkka Kantola, Veikko Salomaa, Eeva Juhanoja, Sam Sivén, Pekka Jousilahti, Antti Jula, Teemu Niiranen
OBJECTIVE: The aim of this study was to test the agreement between nighttime home and nighttime ambulatory blood pressure (BP) and to compare their associations with hypertensive end-organ damage for the first time in the general population. DESIGN AND METHOD: A population sample of 248 participants underwent measurements for nighttime home BP (3 measurements on 2 nights with a timer-equipped home device), nighttime ambulatory BP, pulse wave velocity (PWV), carotid intima-media thickness (IMT) and echocardiographic left ventricular mass index (LVMI)...
September 2016: Journal of Hypertension
Ruixin Ma, Qiongying Wang, Ningyin Li, Yang Zhao, Xu Zhao, Heng Yu, Jing Yu
OBJECTIVE: Home blood pressure monitoring (HBPM) is more likely to reflect the patient's underlying blood pressure (BP), than measurements in the clinic. HBPM coupled with titration of medications under the guidance of doctors, is a viable intervention to control hypertension. The purpose of this study is to evaluate whether HBPM can increase the safety of the combination therapy of three or more different classes of antihypertensive drugs. DESIGN AND METHOD: We enrolled patients with severe (grade 3) hypertension, whose BP remain uncontrolled under combination treatment with standard doze of an angiotensin II receptor blocker and hydrochlorothiazide...
September 2016: Journal of Hypertension
Sarah-Jo Sinnott, Adrian Root, Rohini Mathur, Kathryn Mansfield, Laurie Tomlinson, Ian Douglas
OBJECTIVE: Recent evidence points to the effectiveness of spironolactone vs placebo in the treatment of resistant hypertension (RH). However, placebo is rarely a realistic treatment choice in uncontrolled hypertension. Using meta-analysis, we assessed the effectiveness of alternative 4 line anti-hypertensive agents in comparison to 4 line spironolactone/eplenerone in RH. DESIGN AND METHOD: Pubmed, EMBASE and the Cochrane library were systematically searched for randomised and non-randomised studies that compared any 4 line anti-hypertensive agent to spironolactone/eplenerone in RH...
September 2016: Journal of Hypertension
Jeong Bae Park
Blood pressure fluctuates beat to beat, minute to minute, day and night, day by day and even over longer period. However, changes in blood pressure (BP) itself reflect body's ability to adapt. These fluctuation or variability makes it difficult to diagnose and treat hypertension. And therefore, even though the clinic BP was the standard of BP for more than 100 years, there were many attempts to find other BP effects which influence on prognosis independent from clinical BP since there was the breakout of white coat effect and masked effect in clinic BP...
September 2016: Journal of Hypertension
Yan Li
Blood pressure in the morning or at night are both significant cardiovascular risk predictors. Morning blood pressure either recorded with 24-h ambulatory blood pressure monitoring (ABPM) or self-measured at home predicted stroke and cardiovascular mortality in Asian populations. In 757 Chinese hypertensive patients, only morning blood pressure was independently associated with asymptomatic intracranial arterial stenosis. While in the IDACO (International Database on Ambulatory blood pressure in relation to Cardiovascular Outcome) study, nocturnal blood pressure was superior to daytime blood pressure in predicting mortality risk, but as similarly predictive as daytime for combined fatal and nonfatal cardiovascular events...
September 2016: Journal of Hypertension
Kazuomi Kario
The essential benefit of the management of hypertension is derived from the blood pressure (BP) lowering per se, indicating the importance of BP throughout 24 hours. Recent guidelines stressed the importance of home BP for the diagnosis and management of hypertension. It is well-known that cardiovascular events occur more frequently in the morning BP levels have been shown to increase during the period from night to early morning. Clinical research using ambulatory BP monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than office BP (Kario et al...
September 2016: Journal of Hypertension
Seung Woo Park
Rapid progress of mobile information technologies such as wearable sensors, wireless communication, and world-wide use of smartphone cause digital health innovations. In the field of hypertension, wearable blood pressure (BP) monitoring and its wireless transfer to anywhere through smartphone, mobile smartphone apps, and cuffless blood pressure monitoring system are expected to change the way of diagnosis and management of hypertension. Home BP monitoring would be easier and wireless data transfer to health care providers would be common...
September 2016: Journal of Hypertension
Kazuomi Kario
Out-of-office blood pressure (BP) measured by home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM) was demonstrated to be superior to office BP for the prediction of cardiovascular events. The ABPM is superior to HBPM for detecting the all the BP-related risks throughout 24-hr, and the self-measured HBPM underestimates the risk of daytime stress hypertension and nocturnal hypertension. However, ABPM cannot always be provided in clinical practice, and home BP monitoring can be superior to ABPM as part of a home BP-guided antihypertension strategy in clinical practice...
September 2016: Journal of Hypertension
Chan Joo Lee, Sungha Park
Despite improvements in hypertension awareness and treatment, the blood pressure (BP) control rate still remains at around 50%. One of the major determinants of low BP control results from therapeutic inertia of the physician and suboptimal compliance of the patients. Home BP self-measurement and monitoring improves patients' awareness and helps the management of hypertension. Recent technological advances are allowing for accurate measurement and telemonitoring of home BP, with a number of randomized clinical trials demonstrating the efficacy of telemonitoring for BP control...
September 2016: Pulse (Basel, Switzerland)
J A Divisón Garrote
It is clear that clinical measurements of blood pressure can lead to errors in the diagnostic process and follow-up of patients with hypertension. Scientific societies recommend other measurement methods, such as home measurements and outpatient monitoring. Outpatient monitoring might be the golden standard but, nowadays has an important limitation-its availability. Home measurements solve 80-90% of the doubts of the diagnostic process and follow-up of patients with hypertension, and its higher availability and acceptance by the patient are clear...
October 10, 2016: Hipertensión y Riesgo Vascular
Michał Starosta, Justyna Redlicka, Michał Brzeziański, Marta Niwald, Elżbieta Miller
Diseases of the central nervous system are the most common cause of mobility and cognitive impairment. Stroke is the leading cause of hospitalization in the Neurological Rehabilitation Departments. Age increases the risk of stroke, therefore monitoring basic medical parameters, including blood pressure especially under age of 65, is a very important part of preventive healthcare. According to data from the National Association of Stroke, in 10% of patients after brain stroke, recovery of motor functions and mental state is almost complete, in 25% impairment is minimal, in 40% the functional and cognitive disability is moderated or significant therefore requires rehabilitation, in 10% in view of impossibility of active rehabilitation patients requires comprehensive nursing care service at home or in special long term care centers...
July 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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