Comparing blood pressure measurements between a photoplethysmography-based and a standard cuff-based manometry device

Abstract Repeated blood pressure (BP) measurements allow better control of hypertension. Current measurements rely on cuff-based devices. The aim of the present study was to compare BP measurements using a novel cuff-less photoplethysmography-based device to a standard sphygmomanometer device. Males and females were recruited from within the general population who arrived at a public BP screening station. One to two measurements were taken from each using a sphygmomanometer-based and the photoplethysmography-based devices. Devices were considered equal if the mean difference between paired measurements was below 5 mmHg and the Standard Deviation (SD) was no greater than 8 mmHg. Agreement and reliability analyses were also performed. 1057 subjects were included in the study analysis. There were no adverse events during the study. The mean (± SD) difference between paired measurements for all subjects was -0.1 ± 3.6 mmHg for the systolic and 0.0 ± 3.5 mmHg for the diastolic readings. We found 96.31% agreement in identifying hypertension and an Interclass Correlation Coefficient of 0.99 and 0.97 for systolic and diastolic measurements, respectively. The photoplethysmography-based device was found similar to the gold-standard sphygmomanometer-based device with high agreement and reliability levels. The device might enable a reliable, more convenient method for repeated BP monitoring.

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Establishment of Normal Mechanical Tibial Joint Angles in Dachshunds

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0040-1722336 ◽

2021 ◽

Author(s):

Charlotte Banks ◽

Richard Meeson ◽

Elvin Kulendra ◽

Darren Carwardine ◽

Benjamin Mielke ◽

...

Keyword(s):

Standard Deviation ◽

Surgical Planning ◽

Sagittal Plane ◽

Frontal Plane ◽

Joint Angles ◽

Interclass Correlation Coefficient ◽

Observer Reliability ◽

Radiographic Measurements ◽

Interclass Correlation ◽

The Mean

Abstract Objective The aim of this study was to establish breed-standard mechanical tibial joint reference angles in the frontal plane in Dachshunds. Study Design Craniocaudal (n = 38) and mediolateral (n = 32) radiographs of normal tibiae from Dachshunds were retrospectively reviewed. The mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal tibial angles were measured on three occasions by two separate observers using previously established methodology. Interclass correlation coefficient was used to assess the reliability of radiographic measurements. Results The mean and standard deviation for mechanical medial proximal, mechanical medial distal, mechanical caudal proximal and mechanical cranial distal were 93.1 degrees ± 4.2, 97.5 degrees ± 3.9, 75.3 degrees ± 3.7 and 85.0 degrees ± 5.3 respectively. Intra-observer reliability was good to excellent for all measures, while inter-observer reliability was moderate to excellent in the frontal plane and poor to good in the sagittal plane. Dachshund-specific joint reference angles were similar to a range of previously reported non-chondrodystrophic breeds in the frontal plane but differed to most in the sagittal plane. Conclusion Dachshund tibial joint reference angles are reported which can be used in surgical planning for correction of bilateral pes varus.

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Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome

Neurocritical Care ◽

10.1007/s12028-021-01229-w ◽

2021 ◽

Author(s):

Min Chen ◽

Dorothea Kronsteiner ◽

Johannes Pfaff ◽

Simon Schieber ◽

Laura Jäger ◽

...

Keyword(s):

Blood Pressure ◽

Standard Deviation ◽

Functional Outcome ◽

Scale Score ◽

Endovascular Therapy ◽

National Institutes Of Health ◽

Modified Rankin Scale ◽

Vessel Occlusion ◽

Stroke Treatment ◽

The Mean

Abstract Background Optimal blood pressure (BP) management during endovascular stroke treatment in patients with large-vessel occlusion is not well established. We aimed to investigate associations of BP during different phases of endovascular therapy with reperfusion and functional outcome. Methods We performed a post hoc analysis of a single-center prospective study that evaluated a new simplified procedural sedation standard during endovascular therapy (Keep Evaluating Protocol Simplification in Managing Periinterventional Light Sedation for Endovascular Stroke Treatment). BP during endovascular therapy in patients was managed according to protocol. Data from four different phases (baseline, pre-recanalization, post recanalization, and post intervention) were obtained, and mean BP values, as well as changes in BP between different phases and reductions in systolic BP (SBP) and mean arterial pressure (MAP) from baseline to pre-recanalization, were used as exposure variables. The main outcome was a modified Rankin Scale score of 0–2 three months after admission. Secondary outcomes were successful reperfusion and change in the National Institutes of Health Stroke Scale score after 24 h. Multivariable linear and logistic regression models were used for statistical analysis. Results Functional outcomes were analyzed in 139 patients with successful reperfusion (defined as thrombolysis in cerebral infarction grade 2b–3). The mean (standard deviation) age was 76 (10.9) years, the mean (standard deviation) National Institutes of Health Stroke Scale score was 14.3 (7.5), and 70 (43.5%) patients had a left-sided vessel occlusion. Favorable functional outcome (modified Rankin Scale score 0–2) was less likely with every 10-mm Hg increase in baseline (odds ratio [OR] 0.76, P = 0.04) and pre-recanalization (OR 0.65, P = 0.011) SBP. This was also found for baseline (OR 0.76, P = 0.05) and pre-recanalization MAP (OR 0.66, P = 0.03). The maximum Youden index in a receiver operating characteristics analysis revealed an SBP of 163 mm Hg and MAP of 117 mm Hg as discriminatory thresholds during the pre-recanalization phase to predict functional outcome. Conclusions In our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.

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Measuring Blood Pressure

Nursing OSCEs ◽

10.1093/oso/9780199693580.003.0014 ◽

2012 ◽

Author(s):

Kate Devis

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Pressure Measurement ◽

Gold Standard ◽

Blood Pressure Measurement ◽

Maximum Pressure ◽

Pressure Measurements ◽

Health Care Settings ◽

Pressure Cuff ◽

The Uk

Blood pressure measurements are one part of a circulatory assessment (Docherty and McCallum 2009). Treatments for raised or low blood pressure may be initiated or altered according to blood pressure readings; therefore correct measurement and interpretation of blood pressure is an important nursing skill. Blood pressure should be determined using a standardized technique in order to avoid discrepancies in measurement (Torrance and Serginson 1996). Both manual and automated sphygmomanometers may be used to monitor blood pressure. The manual auscultatory method of taking blood pressure is considered the gold standard (MRHA 2006), as automated monitoring can give false readings (Coe and Houghton 2002), and automated devices produced by different manufacturers may not give consistent figures (MRHA 2006). So, although automated sphygmomanometers are in common use within health care settings in the UK, the skill of taking blood pressure measurement manually is still required by nurses. As a fundamental nursing skill, blood pressure measurement, using manual and automated sphygmomanometers, and interpretation of findings are often assessed via an OSCE. Within this chapter revision of key areas will allow you to prepare thoroughly for your OSCE, in terms of practical skill and understanding of the procedure of taking blood pressure. Blood pressure is defined as the force exerted by blood against the walls of the vessels in which it is contained (Docherty and McCallum 2009). A blood pressure measurement uses two figures—the systolic and diastolic readings. The systolic reading is always the higher figure and represents the maximum pressure of blood against the artery wall during ventricular contraction. The diastolic reading represents the minimum pressure of the blood against the wall of the artery between ventricular contractions (Doughetry and Lister 2008). You will need to be able to accurately identify systolic and diastolic measurements during your OSCE. When a blood pressure cuff is applied to the upper arm and inflated above the level of systolic blood pressure no sounds will be detected when listening to the brachial artery with a stethoscope. The cuff clamps off blood supply. As the cuff is deflated a noise, which is usually a tapping sound, will be heard as the pressure equals the systolic blood pressure —this is the first Korotkoff ’s sound.

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Characteristics of Individuals with Disagreement between Home and Ambulatory Blood Pressure Measurements for the Diagnosis of Hypertension

Healthcare ◽

10.3390/healthcare8040457 ◽

2020 ◽

Vol 8 (4) ◽

pp. 457

Author(s):

Chee Hae Kim ◽

Je Sang Kim ◽

Moo-Yong Rhee

Keyword(s):

Blood Pressure ◽

Serum Creatinine ◽

Ambulatory Blood Pressure ◽

Outpatient Clinic ◽

Clinical Characteristics ◽

Pressure Measurements ◽

Cardiovascular Risks ◽

The Mean ◽

Ambulatory Blood Pressure Measurements ◽

Diagnosis Of Hypertension

Home and ambulatory blood pressure (BP) measurements are recommended for the diagnosis of hypertension. However, the clinical characteristics of individuals showing a diagnostic disagreement between their home and ambulatory BP measurements are unclear. Of the 470 individuals who were not on antihypertensive drug treatment with a BP ≥140/90 mmHg at an outpatient clinic, 399 who had valid office, home, and ambulatory BP results were included. Hypertension was diagnosed based on an average home BP ≥135/85 mmHg and/or an average daytime ambulatory BP ≥135/85 mmHg. The participants were divided into three groups: Agree-NT (home and ambulatory BP normotension), Disagree (home BP normotension and ambulatory BP hypertension, or home BP normotension and ambulatory BP hypertension), and Agree-HT (home and ambulatory BP hypertension). Eighty-four individuals (21.1%) were classified as the Disagree group. The mean serum creatinine, triglycerides, and electrocardiogram voltage in the Disagree group were intermediate between those observed in the Agree-NT and the Agree-HT group. In the Disagree group, the mean levels of office and home diastolic BP, all of the components of ambulatory BP, the aortic systolic BP, and the BP variabilities were found to be intermediate between those of the Agree-NT and the Agree-HT groups. These results indicate that individuals showing a diagnostic disagreement between their home and ambulatory BP may have cardiovascular risks that are intermediate between those with sustained home and ambulatory normotension and hypertension.

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Gender Disparity between Donor Sites of the Trochlea Used for Autologous Osteoarticular Transfer: An MRI Analysis

The Journal of Knee Surgery ◽

10.1055/s-0039-1677813 ◽

2019 ◽

Vol 33 (04) ◽

pp. 357-364

Author(s):

Kelly M. Rogers ◽

Daniel C. Berman ◽

Justin W. Griffin ◽

Kevin F. Bonner

Keyword(s):

Standard Deviation ◽

Trochlear Dysplasia ◽

Donor Site ◽

Donor Site Morbidity ◽

Gender Disparity ◽

Measurement Tool ◽

Level Of Evidence ◽

Osteochondral Autograft Transfer ◽

Males And Females ◽

The Mean

AbstractThe purpose of this study was to assess potential gender differences in size of the lateral and medial trochlea of the male and female knee as well as the variation within gender of potential osteochondral autograft transfer (OAT) donor site area. Two hundred and twelve skeletally mature patients, 106 males and 106 females, who underwent a 3T magnetic resonance imaging of the knee for a variety of indications were utilized for analysis. Exclusion criteria included degenerative arthritis, trochlear dysplasia, and poor image quality. Medial and lateral femoral trochlear cartilage width was obtained using a linear radiologic measurement tool. Widths were measured from a reproducible anatomic location representing the maximal trochlear dimension in a region where donor plugs are commonly harvested. Trochlear width was also plotted as a function of patient height. Statistical analysis was performed using a two-sample t-test. The mean and standard deviation of the lateral trochlear cartilage width (mm) for males and females were 23.38 +/− 2.14 and 20.44 +/− 2.16, respectively (p < 0.00001). The mean and standard deviation of the medial trochlear cartilage width (mm) for males and females were 14.16 +/− 2.17 and 11.78 +/− 2.03, respectively (p < 0.00001). The overall range in trochlear width for both the lateral and medial sides was 22.22 and 19.73 mm for males and females, respectively. A graft measuring 10 mm could represent as little as 34% of the lateral trochlea in males versus as much as 65% in females. Our results indicate that donor OAT plug diameter relative to available trochlear cartilage width will vary significantly both between genders and individual patients. Trochlear width variability and its potential implications on donor site morbidity may be an important consideration when contemplating osteochondral plug harvest for OAT or other indications. The level of evidence is IV.

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Isradipine Therapy in Hypertensive Pediatric Patients

Annals of Pharmacotherapy ◽

10.1177/106002809703100606 ◽

1997 ◽

Vol 31 (6) ◽

pp. 704-707 ◽

Cited By ~ 23

Author(s):

Cary E Johnson ◽

Pamala A Jacobson ◽

Min H Song

Keyword(s):

Blood Pressure ◽

Pediatric Patients ◽

Diastolic Pressure ◽

University Teaching ◽

Chronic Hypertension ◽

Pressure Measurements ◽

Disease States ◽

The Mean ◽

Record Review ◽

Retrospective Medical Record Review

OBJECTIVE: To evaluate the dosage and effectiveness of isradipine to control acute or chronic hypertension in pediatric patients. DESIGN: Retrospective medical record review. SETTING: University teaching hospital. PARTICIPANTS: Hospitalized pediatric patients aged 1 day to 16 years with hypertension treated with isradipine between January 1994 and March 1996. MEASURES: Patient age, gender, weight, disease states, current medications, isradipine dosage and formulation, pre- and postsystolic, and pre- and postdiastolic blood pressure measurements with each dose of isradipine. RESULTS: Fifty-three patients with a mean age of 5.8 ± 4.0 years were evaluated. A mean change in the blood pressure measurements taken before the first dose of isradipine compared with the values recorded after the last dose or at discharge for all patients was −11.8% ± 12.5% and −17.4% ± 19.6%, respectively, for systolic and diastolic pressure. The mean dosage of isradipine in 46 patients who received regularly scheduled doses was 0.38 ± 0.22 mg/kg/d. Patients who demonstrated a response received a mean dosage of 0.40 ± 0.20 mg/kg/d. The total daily dosage was administered in one dose for 1 patient, two doses for 15 patients, three doses for 27 patients, and four doses for 3 patients. CONCLUSIONS: Isradipine was an effective antihypertensive agent to reduce the systolic and/or diastolic blood pressure 10% or more compared with pretreatment measurements in 43 (81 %) of 53 pediatric patients. The mean dosage was 0.38 ± 0.22 mg/kg/d, most frequently administered in two or three equally divided doses, which is higher than the normal recommended dosage for adults.

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The Influence of Heating on Toe pressure in Patients with Peripheral Arterial Disease

Scandinavian Journal of Surgery ◽

10.1177/1457496917705994 ◽

2017 ◽

Vol 107 (1) ◽

pp. 62-67 ◽

Cited By ~ 5

Author(s):

N. Settembre ◽

T. Kagayama ◽

P. Kauhanen ◽

P. Vikatmaa ◽

Y. Inoue ◽

...

Keyword(s):

Standard Deviation ◽

Skin Temperature ◽

Arterial Disease ◽

Pressure Measurements ◽

Baseline Measurement ◽

The Third ◽

The Mean ◽

Peripheral Arterial ◽

Different Response ◽

Toe Pressure

Background and Aim: The toe skin temperature in vascular patients can be low, making reliable toe pressure measurements difficult to obtain. The aim of this study was to evaluate the effect of heating on the toe pressure measurements. Materials and Methods: A total of 86 legs were examined. Brachial pressure and toe pressure were measured at rest in a supine position using a laser Doppler device that also measured skin temperature. After heating the toes for 5 min with a heating pad, we re-measured the toe pressure. Furthermore, after heating the skin to 40° with the probe, toe pressures were measured a third time. Results: The mean toe skin temperature at the baseline measurement was 24.0 °C (standard deviation: 2.8). After heating the toes for 5 min with a warm heating pad, the skin temperature rose to a mean 27.8 °C (standard deviation: 2.8; p = 0.000). The mean toe pressure rose from 58.5 (standard deviation: 32) to 62 (standard deviation: 32) mmHg (p = 0.029). Furthermore, after the skin was heated up to 40 °C with the probe, the mean toe pressure in the third measurement was 71 (standard deviation: 34) mmHg (p = 0.000). The response to the heating varied greatly between the patients after the first heating—from −34 mmHg (toe pressure decreased from 74 to 40 mmHg) to +91 mmHg. When the toes were heated to 40 °C, the change in to toe pressure from the baseline varied between −28 and +103 mmHg. Conclusion: Our data indicate that there is a different response to the heating in different clinical situations and in patients with a different comorbidity.

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The time of detection of sex-linked recessives in small populations

Genetics Research ◽

10.1017/s0016672300019248 ◽

1979 ◽

Vol 34 (1) ◽

pp. 11-17 ◽

Cited By ~ 3

Author(s):

J. W. James

Keyword(s):

Standard Deviation ◽

Recessive Gene ◽

Selection Line ◽

Single Pair ◽

Small Populations ◽

Single Female ◽

Visible Effect ◽

Males And Females ◽

The Mean ◽

Time To Detection

SUMMARYA sex-linked recessive gene with visible effect will first be detected in the hemizygous sex (male). In lines with equal numbers of males and females, when the gene is initially present in a single female the probabifity of detection falls from 2/3 in single pair lines to 0·54 in large lines. The mean and standard deviation of time to detection are almost independent of population size, being about 4/3 and 2/3 respectively. About 98% of all detections occur within three generations, so a gene detected much later than this after the foundation of a selection line is likely to be a new mutant. Higher initial frequencies and selection favouring heterozygotes increase the chance of detection. The time taken is decreased with higher initial frequencies and increased slightly by selection favouring heterozygotes.

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Gender comparisons of adolescents’ anthropometry and blood pressure in Osun State, South-Western Nigeria

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2014-0018 ◽

2015 ◽

Vol 27 (3) ◽

pp. 247-251 ◽

Cited By ~ 5

Author(s):

Bridget Omisore ◽

Akinlolu G. Omisore ◽

Emmanuel Akintunde Abioye-Kuteyi

Keyword(s):

Blood Pressure ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Female Adolescents ◽

Anthropometric Indices ◽

Cross Sectional ◽

Multi Stage ◽

Blood Pressures ◽

Males And Females ◽

The Mean

Abstract Background: Adolescents are in their formative years, and they experience several changes including anthropometric changes. Significant weight gain occurs in adolescence, and increasingly, obesity and consequent increase in blood pressure (BP) are found in adolescents. Objective: This study compared anthropometric and BP measurements in male and female adolescents. Methods: A cross-sectional study of 1000 adolescents (510 males and 490 females) were selected by multi-stage sampling from eight secondary schools. Pertinent information was collected with the aid of a structured questionnaire, anthropometric and blood pressure measurements. Data were analyzed using SPSS 16.0 version, and the means of anthropometric indices and blood pressures in males and females were compared using independent t-test. Results: The mean age for male respondents was 13.83 years (SD 2.12) and for females 13.62 (SD 1.96). Generally, anthropometric indices gradually increased from the lower ages to the higher ages in both males and females. The mean height was the same for both males and females (1.54 m), while the mean weight, body mass index (BMI), and waist circumference were significantly higher in females than in males (p<0.05). A significantly higher proportion of females compared with males were overweight (10.2%, 5.3%) and obese (3.9%, 2.0%), respectively. The overall prevalence of “hypertension,” was 4.1% and more females (70.7%) had “hypertension” than males (29.3%). Conclusion: Females were heavier and constituted the greater proportion of those who had elevated BP. Adequate attention needs to be given to the challenging problems of overweight and obesity to forestall development of hypertension in adolescents, especially female adolescents.

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Accuracy of abbreviated protocols for unattended automated office blood pressure measurements, a retrospective study

PLoS ONE ◽

10.1371/journal.pone.0248586 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248586

Author(s):

Annina S. Vischer ◽

Rebecca Hug ◽

Thenral Socrates ◽

Andrea Meienberg ◽

Michael Mayr ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Measurement ◽

Pressure Measurements ◽

Single Measurement ◽

Single Centre ◽

Limits Of Agreement ◽

Mean Values ◽

Single Centre Study ◽

The Mean ◽

Automated Office Blood Pressure

Background Blood pressure measurement (BPM) is one of the most often performed procedures in clinical practice, but especially office BPM is prone to errors. Unattended automated office BPM (AOBPM) is somewhat standardised and observer-independent, but time and space consuming. We aimed to assess whether an AOBPM protocol can be abbreviated without losing accuracy. Design In our retrospective single centre study, we used all AOBPM (AOBPM protocol of the SPRINT study), collected over 14 months. Three sequential BPM (after 5 minutes of rest, spaced 2 minutes) were automatically recorded with the patient alone in a quiet room resulting in three systolic and diastolic values. We compared the mean of all three (RefProt) with the mean of the first two (ShortProtA) and the single first BPM (ShortProtB). Results We analysed 413 AOBPM sets from 210 patients. Mean age was 52±16 years. Mean values for RefProt were 128.3/81.3 mmHg, for ShortProtA 128.4/81.4 mmHg, for ShortProtB 128.8/81.4 mmHg. Mean difference and limits of agreement for RefProt vs. ShortProtA and ShortProtB were -0.1±4.2/-0.1±2.8 mmHg and -0.5±8.1/-0.1±5.3 mmHg, respectively. With ShortProtA, 83% of systolic and 92% of diastolic measurements were within 2 mmHg from RefProt (67/82% for ShortProtB). ShortProtA or ShortProtB led to no significant hypertensive reclassifications in comparison to RefProt (p-values 0.774/1.000/1.000/0.556). Conclusion Based on our results differences between the RefProt and ShortProtA are minimal and within acceptable limits of agreement. Therefore, the automated procedure may be shorted from 3 to 2 measurements, but a single measurement is insufficient.

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