scholarly journals Validation of the optical Aktiia bracelet in different body positions for the persistent monitoring of blood pressure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Josep Sola ◽  
Anna Vybornova ◽  
Sibylle Fallet ◽  
Erietta Polychronopoulou ◽  
Arlene Wurzner-Ghajarzadeh ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Real Life ◽  
Organ Damage ◽  
Standing Position ◽  
Health Interventions ◽  
Wearable Device ◽  
Cross Sectional ◽  
Candidate Solution ◽  
Diagnosis Of Hypertension

AbstractThe diagnosis of hypertension and the adjustment of antihypertensive drugs are evolving from isolated measurements performed at the physician offices to the full phenotyping of patients in real-life conditions. Indeed, the strongest predictor of cardiovascular risk comes from night measurements. The aim of this study was to demonstrate that a wearable device (the Aktiia Bracelet) can accurately estimate BP in the most common body positions of daily life and thus become a candidate solution for the BP phenotyping of patients. We recruited 91 patients with BP ranging from low to hypertensive levels and compared BP values from the Aktiia Bracelet against auscultatory reference values for 4 weeks according to an extended ISO 81060-2 protocol. After initializing on day one, the observed means and standard deviations of differences for systolic BP were of 0.46 ± 7.75 mmHg in the sitting position, − 2.44 ± 10.15 mmHg in the lying, − 3.02 ± 6.10 mmHg in the sitting with the device on the lap, and − 0.62 ± 12.51 mmHg in the standing position. Differences for diastolic BP readings were respectively of 0.39 ± 6.86 mmHg, − 1.93 ± 7.65 mmHg, − 4.22 ± 6.56 mmHg and − 4.85 ± 9.11 mmHg. This study demonstrates that a wearable device can accurately estimate BP in the most common body positions compared to auscultation, although precision varies across positions. While wearable persistent BP monitors have the potential to facilitate the identification of individual BP phenotypes at scale, their prognostic value for cardiovascular events and its association with target organ damage will need cross-sectional and longitudinal studies. Deploying this technology at a community level may be also useful to drive public health interventions against the epidemy of hypertension.

ASSESSMENT OF THE SITUATION OF USE OF BLOOD PRESSURED DRUGS IN THE TREATMENT OF HIGH BLOOD PRESSURE FOR OUTCOME PATIENTS AT NAM DINH PROVINCIAL HOSPITAL IN JANUARY 2021

2021 ◽  
Vol 62 (6) ◽  
Author(s):  
Nguyen Thi Khanh ◽  
Nguyen Thi Tuyet Duong
Keyword(s):  
Ace Inhibitors ◽  
Antihypertensive Effect ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Cross Sectional ◽  
Calcium Blockers ◽  
Common Combination ◽  
Selection Of

Hypertension is a disease that seriously affects the health and life expectancy of the community, playing a major etiological role in target organ damage. The selection of antihypertensive drugs to ensure reasonable safety and effectiveness is always a matter of concern of the medical industry. Applying the cross-sectional method on 2,640 patients being examined and treated for hypertension at Nam Dinh general hospital, it was found that 54.67% female patients accounted for the majority. The age of disease in both sexes is over 50 years old with a relatively high frequency of comorbidities. Most of them were prescribed drug combinations in treatment 77,9%. The group of ACE inhibitors + calcium blockers is the most common combination. ACE inhibitors are also the most commonly prescribed drugs in monotherapy. 11,4% of cases had adverse drug interactions, the most dangerous combination is UCMC + Potassium chloride and UCMC + Spironolactone causing hypokalemia. The most common interaction between beta-blockers and calcium blockers increases the antihypertensive effect.

Abstract 6: Comparison Between Ambulatory BP Percentile And Load As Predictors Of Target Organ Damage In Youth

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Gilad Hamdani ◽  
Michael A Ferguson ◽  
Marc B Lande ◽  
Kevin Meyers ◽  
Mark Mitsnefes ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ventricular Hypertrophy ◽  
Significant Contribution ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Cut Points ◽  
Lv Mass ◽  
Diagnosis Of Hypertension

Ambulatory BP (ABP) is increasingly used to confirm the diagnosis of hypertension. Pediatric but not adult guidelines consider BP load (% readings above 95 th %ile) in risk-stratification of the ABP phenotype. We compared ABP sex- and height- specific percentile and BP load as predictors of left ventricular hypertrophy (LVH) in youth. We measured casual BP, ABP, anthropometrics, and calculated LV mass by echo as (g)/height (m) 2.7 (LVMI) in 357 adolescents (mean age 15.5 + 1.7 years, 63% white, 59% male). ABPM was performed with the Ontrak device (Spacelabs Inc., Snoqualmie, WA). ABP index was defined as mean ABP/sex- and height-specific 95 th %ile. LVH was defined as LVMI ≥38.6 (pediatric cut-point). Logistic regression was used to assess different ABP measures as predictors of LVH. Sensitivity and specificity of different ABP cut points as predictors of LVH were calculated. Seventy (19.6%) participants had LVH. Systolic 24-hour, wake and sleep ABP indices as well as 24-hour SBP load were all significantly associated with LVH, while wake and sleep SBP load were not. When adjusted for BMI percentile and sex, only the associations between ABP indices and LVH remained statistically significant (table). SBP percentiles also had better balanced sensitivities and specificities in predicting LVH (24-hour 65 th percentile: 63% and 59%; wake 70 th percentile: 54% and 62%; sleep 75 th percentile: 60% and 61%). There was no significant association between diastolic BP measures and LVH. We conclude that there is no significant contribution of BP load in predicting LVH in youth. Systolic ABP percentiles lower than the commonly used 95 th percentile are the best predictors of LVH in this population.

scholarly journals Pattern of use of biologics in psoriasis among Indian dermatologists – A cross sectional survey

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Shekhar Neema ◽  
Disha Dabbas ◽  
S. Radhakrishnan ◽  
Arun Kumar Yadav
Keyword(s):  
Small Sample Size ◽  
Target Organ Damage ◽  
Group Discussion ◽  
Organ Damage ◽  
Small Sample ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Factors ◽  
Prohibitive Cost ◽  
The Cost

Background and Aims: Biologics are a relatively new class of highly effective drugs in the management of psoriasis. They act on specific immune processes, achieve rapid and sustained clearance and do not cause target organ damage unlike conventional systemic therapy. It appears that their use in our country is not as widespread as in developed nations despite these benefits ; their prohibitive cost may be a major factor for the limited usage. This survey aimed to find out the extent of use and factors hindering usage of biologics for the management of psoriasis by Indian dermatologists. Methods: It was a cross-sectional questionnaire based study. The questionnaire was designed after a focussed group discussion, followed by validation. The survey was sent in the form of a link to Indian dermatologists. The responses were recorded in excel-sheet and the data was analyzed by SPSS ver 25. Results: Of the 310 participants who took part, 287 completed the survey. Two hundred (70%) were users of biologics, while 87 (30%) had never used them. Cost was the major factor which prevented biologic use. Majority of the respondents used biologics in less than 2 cases per month. Secukinumab was the most common biologic used followed by etanercept. The factors which determined choice of biologics were convenience, cost, previous experience, co-morbid conditions and recommendations by an expert. Limitations: A small sample size was the limitation of the study. Dermatologists who do not use biologics may be under-represented in the study. Conclusions: Biologics are not used optimally by Indian dermatologists for management of psoriasis. The cost, fear of adverse effects, lack of awareness and inadequate felt need are major factors which prevent their regular use.

scholarly journals Empagliflozin for Patients With Presumed Resistant Hypertension: A Post Hoc Analysis of the EMPA-REG OUTCOME Trial

2020 ◽  
Author(s):  
João Pedro Ferreira ◽  
David Fitchett ◽  
Anne Pernille Ofstad ◽  
Bettina Johanna Kraus ◽  
Christoph Wanner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Repeated Measures ◽  
Cox Regression ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Cardiac Events ◽  
Post Hoc Analysis ◽  
Post Hoc

Abstract BACKGROUND Type 2 diabetes (T2D) and resistant hypertension often coexist, greatly increasing risk of target-organ damage and death. We explored the effects of empagliflozin in patients with and without presumed resistant hypertension (prHT) in a post hoc analysis of EMPA-REG OUTCOME (NCT01131676). METHODS Overall, 7,020 patients received empagliflozin 10, 25 mg, or placebo with median follow-up of 3.1 years. We defined baseline prHT as ≥3 classes of antihypertensive drugs including a diuretic and uncontrolled blood pressure (BP; systolic blood pressure (SBP) ≥140 and/or diastolic blood pressure ≥90 mm Hg) or ≥4 classes of antihypertensive, including a diuretic, and controlled BP. We explored the effect of empagliflozin on cardiovascular (CV) death, heart failure (HF) hospitalization, 3-point major adverse cardiac events, all-cause death, and incident/worsening nephropathy by Cox regression and BP over time by a mixed-repeated-measures-model analysis. RESULTS 1,579 (22.5%) patients had prHT. The mean difference in change in SBP from baseline to week 12 vs. placebo was −4.5 (95% confidence interval, −5.9 to −3.1) mm Hg (P < 0.001) in prHT and −3.7 (−4.5, −2.9) mm Hg (P < 0.001) in patients without prHT. SBP was more frequently controlled (<130/80 mm Hg) with empagliflozin than with placebo. Patients with prHT had 1.5- to 2-fold greater risk of HF hospitalization, incident/worsening nephropathy, and CV death compared with those without prHT. Empagliflozin improved all outcomes in patients with and without prHT (interaction P > 0.1 for all outcomes). CONCLUSIONS Empagliflozin induced a clinically relevant reduction in SBP and consistently improved all outcomes regardless of prHT status. Due to these dual effects, empagliflozin should be considered for patients with hypertension and T2D.

Developments in Strategies for Treating High-risk Hypertension

2009 ◽  
Vol 5 (1) ◽  
pp. 56
Author(s):  
Cristina Sierra ◽  
Antonio Coca ◽  
◽  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Current Evidence ◽  
Global Risk ◽  
Raas Blockade

On the basis of current evidence provided by various studies, the most recent international guidelines recommend reducing blood pressure levels to below 140/90mmHg for all hypertensive patients over 18 years of age, including the elderly, when this is clinically tolerated, as a necessary measure to reduce the global cardiovascular risk, which is the fundamental objective of treatment. For high-risk hypertensives, such as patients with diabetes, patients with silent target organ damage or established clinical cardiovascular disease, levels below 130/80mmHg should be reached and maintained, with even lower levels for patients with established renal disease and proteinuria within the nephrotic range. Blood pressure control in high-risk patients should be achieved as rapidly as possible using initial strategies that include combinations of antihypertensive drugs, and also the best drugs and drug combinations with proven capacity to regress silent organ damage and to interrupt the progression of cardiovascular disease. This must be accompanied by the additional lifestyle measures and drugs necessary to control other associated cardiovascular risk factors. In clinical practice this means that, together with renin–angiotensin–aldosterone system (RAAS) blockade, often associated with calcium-channel blockade, statins and antiplatelet drugs should routinely be administered in most patients, particularly those over 55 years of age, as they provide the only possibility of global risk prevention leading to greater survival.

scholarly journals A case of primary aldosteronism with a negative aldosterone-to-renin ratio

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fengyi Liu ◽  
Liang Wang ◽  
Yanchun Ding
Keyword(s):  
Blood Pressure ◽  
Primary Aldosteronism ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Screening Method ◽  
Organ Damage ◽  
Secondary Hypertension ◽  
Cardiovascular Damage ◽  
Aldosterone To Renin Ratio ◽  
Clinical Conditions

Abstract Background Primary aldosteronism (PA), as a cause of secondary hypertension, can cause more serious cardiovascular damage than essential hypertension. The aldosterone-to-renin ratio (ARR) is recommended as the most reliable screening method for PA, but ARR screening is often influenced by many factors. PA cannot be easily excluded when negative ARR. Case presentation We report the case of a 45-year-old Chinese man with resistant hypertension. Three years ago, he underwent a comprehensive screening for secondary hypertension, including the ARR, and the result was negative. After that, the patient's blood pressure was still poorly controlled with four kinds of antihypertensive drugs, the target organ damage of hypertension progressed, and hypokalaemia was difficult to correct. When the patient was hospitalized again for comprehensive examination, we found that aldosterone levels had significantly increased, although the ARR was negative. An inhibitory test with saline was further carried out, and the results suggested that aldosterone was not inhibited; therefore, PA was diagnosed. We performed a unilateral adenoma resection for this patient, and spironolactone was continued to control blood pressure. After the operation, blood pressure is well controlled, and hypokalaemia is corrected. Conclusion When the ARR is negative, PA cannot be easily excluded. Comprehensive analysis and diagnosis should be based on the medication and clinical conditions of patients.

scholarly journals ANGIOTENSIN II RECEPTOR ANTAGONISTS IN THE TREATMENT OF HYPERTENSION: PERSPECTIVES FOR CLINICAL USE

2013 ◽  
Vol 19 (2) ◽  
pp. 117-124 ◽  
Author(s):  
N. G. Poteshkina ◽  
G. V. Selivanova ◽  
T. Zh. Zhalsaraev
Keyword(s):  
Angiotensin Ii ◽  
Antihypertensive Drugs ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Review Of Literature ◽  
Angiotensin Ii Receptor ◽  
Angiotensin Ii Receptor Antagonists ◽  
Receptor Antagonists ◽  
Treatment Of Hypertension ◽  
Antiarrhythmic Effects

The review of literature presents evidence of the relevance of the wider application of angiotensin II receptor antagonists in the treatment of cardiovascular diseases. The advantages of this class of antihypertensive drugs on the effect on blood pressure and regression of target organ damage in patients with hypertension. The data on nephroprotective, neuroprotective, antiarrhythmic effects of angiotensin II receptor antagonists, as well as the opportunity of effective correction of the metabolic abnormalities are presented.

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