Neue amerikanische Leitlinien zur Hypertonie: neue Konsequenzen für uns?

2018 ◽  
Vol 143 (12) ◽  
pp. 907-911
Author(s):  
Bastian Schrader ◽  
Stephan Lüders ◽  
Michael Koziolek ◽  
Hermann Haller ◽  
Joachim Schrader
Keyword(s):  
Blood Pressure ◽  
Opposite Effect ◽  
Blood Pressure Measurement ◽  
Individual Risk ◽  
The Us ◽  
The Individual ◽  
Diagnosis Of Hypertension ◽  
Selection Of Patients ◽  
Selection Of

AbstractFollowing the publication of the new US guidelines, especially the new classifications of hypertension and the general reduction in treatment targets were discussed worldwide. Applying the US guidelines to a recent German cohort study would in practice lead to a significant increase in the diagnosis of “hypertension” in untreated patients. The number of under-adjusted patients would also increase sharply, increasing more than those predicted in the US Guidelines. Affected by an intensified antihypertensive therapy would be particularly elderly patients, in which adverse drug reactions but also occur more frequently. It seems doubtful whether the massive increase in the diagnosis “hypertension” can improve the supply situation: the opposite effect of avoiding therapists and patients could occur. Determining the individual risk with suitable, evaluated instruments certainly makes sense to treat more targeted patients. More important than new blood pressure limits is a more accurate classification of blood pressure. Repeated self-measurements and ambulatory blood pressure measurement lead to a better selection of patients benefiting from a therapy.

Youtube as a source of information on "Manual Blood Pressure Measurement"

2021 ◽  
Author(s):  
Mehmet Fatih Yılmaz ◽  
Sedat Kalkan
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Health Workers ◽  
Blood Pressure Measurement ◽  
Average Score ◽  
Educational Value ◽  
Manual Blood Pressure ◽  
The Individual ◽  
Source Of Information

Objectives: The aim of the study is to evaluate the quality and reliability of videos on manual blood pressure measurement on Youtube. Patients and Methods: In January 2021, the first 100 videos found as a result of a search with the keywords 'manual blood pressure measurement' on Youtube were watched and evaluated. According to exclusion criteria, 75 videos were included in the study. Duplicate videos, irrelevant videos, and videos in languages other than English were excluded from the study. Each video was scored according to the questions prepared based on the guidelines. The GQS score and the 'Reliability' score were used to assess the quality of the videos. Results: According to the checklist prepared according to the hypertension consensus report, the mean score of the videos was 8.33 ± 2.1. When the videos were evaluated according to their sources, the average score of the videos of the health sites was 9±2.5, the average score of the videos of the individual health workers was 8.66±1.8, the average score of the videos of the unidentified people was 7.54±2.1. Conclusion: Manual blood pressure measurement videos on Youtube have little educational value. Videos of health websites should be preferred for education.

Validity and reliability of 1-h automated office blood pressure measurement for the diagnosis of hypertension

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Antoni Sisó-Almirall ◽  
Belchin Kostov ◽  
Esther Blat ◽  
Noemí García ◽  
Berta de Andres ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
Validity And Reliability ◽  
Automated Office Blood Pressure ◽  
Diagnosis Of Hypertension

Abstract 11530: Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
David Conen ◽  
Stefanie Aeschbacher ◽  
Lutgarde Thijs ◽  
Yan Li ◽  
José Boggia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Population Based ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Daytime Blood Pressure ◽  
Collaborative Analysis ◽  
The Individual ◽  
Age Range ◽  
Diagnosis Of Hypertension

Introduction: Mean daytime ambulatory blood pressure (ABP) values are considered to be lower than conventional BP (CBP) values, but data on this relation among younger individuals <50 years are scarce. To address this issue, we performed a collaborative analysis in a large group of participants representing a wide age range. Methods: CBP and 24-hour ABP were measured in 9550 individuals not taking BP lowering treatment from 13 population based cohorts. We compared the individual differences between daytime ABP and CBP according to 10-year age categories. Age-specific prevalences of white-coat hypertension and masked hypertension were calculated based on guideline-recommended thresholds. Results: Among individuals aged 18-30, 30-40 and 40-50 years, mean daytime systolic and diastolic ABP were significantly higher than the corresponding CBP (6.0, 5.2 and 4.7 mmHg for systolic BP; 2.5, 2.7 and 1.7 mmHg for diastolic BP, all p<0.0001) (Figure). Systolic and diastolic BP indices were similar in participants aged 50-60 years (p=0.20 and 0.11, respectively). In individuals aged 60-70 and ≥70 years, CBP was significantly higher than daytime ABP (5.0 and 13.0 mmHg for systolic BP; 2.0 and 4.2 mmHg for diastolic BP, all p<0.0001) (Figure). Accordingly, the prevalence of white coat hypertension exponentially increased from 2.2% to 19.5% from those aged 18-30 years to those aged ≥70 years, with some variation between men and women (prevalence 8.0% versus 6.1%, p=0.0003). Masked hypertension was more prevalent among men (21.1% versus 11.4%, p<0.0001). The age-specific prevalence of masked hypertension was 18.2%, 27.3%, 27.8%, 20.1% 13.6% and 10.2% in men, and 9.0%, 9.9%, 12.2%, 11.9%, 14.7% and 12.1% in women. Conclusions: In this large collaborative analysis we found that the relation between daytime ABP and CBP strongly varies by age. These findings may have important implications for the diagnosis of hypertension and its subtypes in clinical practice.

Hypertensive disorders

ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Medical Complications ◽  
Pharmacological Management ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Diagnosis Of Hypertension ◽  
In Pregnancy

Hypertensive disorders in pregnancy are the most common medical complications affecting 5–10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.

scholarly journals Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review

2020 ◽  
Vol 42 (10) ◽  
pp. 659-668
Author(s):  
Nádya Santos Moura ◽  
Maria Luziene Sousa Gomes ◽  
Ivana Rios Rodrigues ◽  
Daniel Lorber Rolnik ◽  
Fabrício Silva Costa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Data Extraction ◽  
Qualitative Synthesis ◽  
Manual Search ◽  
The Individual ◽  
Selection Of ◽  
Mcmaster University

Abstract Objective To identify the most effective procedures recommended for the prevention of preeclampsia. Data Sources A systematic review was performed in the following databases: Pubmed/MEDLINE, CINAHL, Web of Science, Cochrane and LILACS via the Virtual Health Library (VHL). A manual search was also performed to find additional references. The risk of bias, the quality of the evidence, and the classification of the strength of the recommendations were evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Selection of Studies In the initial search in the databases, the total number of articles retrieved was 351, and 2 were retrieved through the manual search; after duplicate articles were removed, 333 citations remained. After a thorough review of the titles and abstracts, 315 references were excluded. Accordingly, 18 articles were maintained for selection of the complete text (phase 2). This process led to the exclusion of 6 studies. In total, 12 articles were selected for data extraction and qualitative synthesis. Data Collection The articles selected for the study were analyzed, and we inserted the synthesis of the evidence in the online software GRADEpro Guideline Development Tool (GDT) (McMaster University and Evidence Prime Inc. All right reserved. McMaster University, Hamilton, Ontário, Canada); thus, it was possible to develop a table of evidence, with the quality of the evidence and the classification of the strength of the recommendations. Data Synthesis In total, seven studies recommended the individual use of aspirin, or aspirin combined with calcium, heparin or dipyridamole. The use of calcium alone or in combination with phytonutrients was also highlighted. All of the studies were with women at a high risk of developing preeclampsia. Conclusion According to the studies evaluated, the administration of aspirin is still the best procedure to be used in the clinical practice to prevent preeclampsia.

The practicalities of blood pressure measurement in children

2020 ◽  
Vol 5 (1) ◽  
pp. 13-17
Author(s):  
Eileen Brennan
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Traditional Methods ◽  
Diagnosis And Management ◽  
Hypertension In Children ◽  
Diagnosis Of Hypertension ◽  
Methods Of Measurement

The accurate measurement of children's blood pressure is essential to guide the diagnosis and management of hypertension and other blood pressure-related risks. However, the traditional methods of measurement using a sphygmomanometer and stethoscope have largely been superseded by the use of electronic monitor; however, their use in the diagnosis of hypertension in children is not recommended for children

Accuracy of the London School of Hygiene and Remler M2000 sphygmomanometers

1981 ◽  
Vol 61 (s7) ◽  
pp. 399s-401s ◽  
Author(s):  
D. J. Fitzgerald ◽  
W. G. O'Callaghan ◽  
K. O'Malley ◽  
E. T. O'Brien
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Calibration Error ◽  
London School ◽  
Lower Blood ◽  
Significant Difference ◽  
Blood Pressures ◽  
The Mean ◽  
Selection Of

1. The accuracy of the Remler M2000, a semiautomatic portable blood pressure recorder, was assessed with the London School of Hygiene (LSH) and Hawkesley random-zero sphygmomanometers used as reference standards. 2. The Remler gave higher recordings than the LSH sphygmomanometer, the mean systolic and diastolic differences being 5.9 mmHg (P &lt; 0.001) and 4.7 mmHg (P &lt; 0.001) respectively. No significant difference was demonstrated between paired Remler and Hawkesley recordings. 3. When simultaneous paired LSH and Hawkesley sphygmomanometer recordings were compared, the LSH gave lower blood pressures: 7.1 mmHg (P &lt; 0.001) for systolic and 3.6 mmHg (P &lt; 0.001) for diastolic recordings. 4. The LSH sphygmomanometer underestimates blood pressure, partly due to a calibration error but also because the selection of end points for this device differs from other methods of blood pressure measurement.

The features and development prospects of programs of individual tours

2015 ◽  
Vol 9 (2) ◽  
pp. 57-65
Author(s):  
Екатерина Агамирова ◽  
Ekaterina Agamirova ◽  
Елизавета Агамирова ◽  
Elizaveta Agamirova
Keyword(s):  
Quality Level ◽  
Trip Planning ◽  
Advantages And Disadvantages ◽  
Individual Program ◽  
Formation Programs ◽  
The Moment ◽  
The Individual ◽  
Different Characteristics ◽  
Selection Of

The article deals with the formation programs of individual tours. Based on the selection of specific features of individual tourist programs the authors define individual tourism stating that the main specific features of the individual tour is that the product is developed based on the desires and preferences of a particular tourist. It is shown that the individual tourist product allows meeting the needs of the tourist. Topicality is determined by the characteristics of the tourism market at the moment. The crisis that characterize Russian tourism today force to seek new approaches and new content in tourist activity in order to suggest possible ways to diversify the tourist offer, one of which is the individualization of tourist programs. The article also examines the specifics of individual programs, tours, given comparative characteristics according to different characteristics of mass and individual tourism products. Identified are the main advantages and disadvantages of acquisitions and trip planning of the individual program for tourists. The authors cover the basic steps and principles of formation and promotion of individual tourism products. Revealed is a difference in the sequence of the process of its development over the standard tour. Based on the study of offers of tourist companies categories of the most popular destinations of individual tourism are identified on the basis of which a classification of individual programs is proposed. On the basis of the study in the article suggested are the main characteristics of the different categories of consumers of individual tourism products. The article shows the prospects for the development of individual tourism products in the Russian tourist market. Based on the analysis of the actual supply of tourist services identified are the advantages and disadvantages of individual tours. The necessity of developing specific standards of service is explained. Due to the fact that the individual trip of tourists have special expectations, it is necessary to ensure the highest quality level of service in accordance with the program of travel. Characterized are the features of the technology of individual tourism, which aims to create a unique product.

Special populations

2012 ◽  
Author(s):  
Raymond W. Lam
Keyword(s):  
Evidence Base ◽  
Special Populations ◽  
Individual Risk ◽  
Risk Benefit Assessment ◽  
Evidence Based Treatments ◽  
Women And Children ◽  
Resistant Depression ◽  
The Individual ◽  
Ongoing Monitoring ◽  
Selection Of

• The keys to optimal management of treatment-resistant depression and depression in special populations include careful assessment, selection of evidence-based treatments tailored to the individual, and ongoing monitoring of response and outcome.• Given the still limited evidence base, use and selection of antidepressants depends on an individual risk-benefit assessment in elderly patients, those with other medical illnesses, pregnant and breastfeeding women, and children and adolescents....

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