Measurement of brachial artery endothelial function using a standard blood pressure cuff

Brief periods of ischaemia activate systemic mechanisms that induce whole-body tolerance to subsequent prolonged and injurious ischaemia. This phenomenon, remote ischaemic preconditioning (RIPC), is sufficiently acute to reduce ischaemia-reperfusion (IR) injury even when applied simultaneously with injurious ischaemia. This aspect of RIPC is termed remote postconditioning (RPostC). We have previously demonstrated a role for the autonomic nervous system in RIPC. Using an in vivo model of endothelial IR injury, we determined if RPostC is dependent on adrenergic autonomic mechanisms. Vascular ultrasound was used to assess endothelial function in healthy volunteers by measuring dilatation of the brachial artery in response to increased blood flow during reactive hyperaemia (flow-mediated dilatation; FMD). Endothelial IR injury was induced by 20 min of upper limb ischaemia (inflation of a blood pressure cuff to 200 mm Hg) followed by reperfusion. RPostC was induced by applying 2 cycles of 5 minutes ischaemia and 5 minutes reperfusion on the leg during arm ischaemia (via a second blood pressure cuff). In order to determine the dependence of RPostC on autonomic activation, we administered the alpha adrenoceptor blocker phentolamine (0.2– 0.7mg/min, intravenously) during the application of the RPostC stimulus. FMD was determined before ischaemia and at 20 minutes of reperfusion. FMD (percentage change from baseline diameter) was compared statistically by ANOVA. IR alone caused a significant reduction in FMD (5.9±0.7% pre- versus 2.2±0.4% post-IR, n=9, P<0.001). This reduction was prevented by RPostC (5.8±0.4% pre- versus 5.4±0.3% post-IR, n=8, P>0.05). Systemic phentolamine blocked the protective effects of RPostC (FMD 6.1±0.5% pre- versus 2.0±0.3% post-IR, n=7, P<0.001). These data indicate, for the first time in humans, that protection from RPostC depends on preservation of adrenergic signalling. Alpha blockade neutralises one of the endogenous mechanisms of ischemic protection in humans; the clinical consequences of this remain to be determined.

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Abstract P182: Quantifying Differences in Blood Pressure by Using Different Blood Pressure Cuff Sizes in Children

Hypertension ◽

10.1161/hyp.74.suppl_1.p182 ◽

2019 ◽

Vol 74 (Suppl_1) ◽

Author(s):

Ruchi Gupta Mahajan ◽

Kashif Iqubal ◽

Jeffrey Kern

Keyword(s):

Blood Pressure ◽

Blood Pressure Cuff ◽

Pressure Cuff

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Impact of blood pressure cuff inflation rates on flow-mediated dilatation and contralateral arm response

Journal of Human Hypertension ◽

10.1038/jhh.2010.128 ◽

2011 ◽

Vol 26 (1) ◽

pp. 35-40 ◽

Cited By ~ 2

Author(s):

H-F Lin ◽

M S Dhindsa ◽

T Tarumi ◽

S C Miles ◽

D Umpierre ◽

...

Keyword(s):

Blood Pressure ◽

Cuff Inflation ◽

Blood Pressure Cuff ◽

Pressure Cuff ◽

Inflation Rates ◽

Flow Mediated Dilatation

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520 EVALUATION OF BLOOD PRESSURE CUFF POSITIONING FOR THE ANEROID SPHYGMOMANOMETER.

Journal of Investigative Medicine ◽

10.1136/jim-52-suppl1-520 ◽

2004 ◽

Vol 52 (Suppl 1) ◽

pp. S170.2-S170

Author(s):

K. Tsai ◽

J. Chung ◽

R. Gerkin ◽

K. B. Desser ◽

M. K. Jasser

Keyword(s):

Blood Pressure ◽

Blood Pressure Cuff ◽

Pressure Cuff

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An Outbreak of Mupirocin-ResistantStaphylococcus aureuson a Dermatology Ward Associated with an Environmental Reservoir

Infection Control and Hospital Epidemiology ◽

10.1086/646764 ◽

1993 ◽

Vol 14 (7) ◽

pp. 369-375 ◽

Cited By ~ 39

Author(s):

Marcelle C. Layton ◽

Maritza Perez ◽

Peter Heald ◽

Jan Evans Patterson

Keyword(s):

Blood Pressure ◽

Dna Typing ◽

Epidemiologic Study ◽

Pulsed Field Gel Electrophoresis ◽

University Hospital ◽

Blood Pressure Cuff ◽

Pressure Cuff ◽

Environmental Reservoir ◽

Communal Areas ◽

Present On Admission

AbstractObjective:To investigate a cluster of mupirocin-resistantStaphylococcus aureuson a dermatology ward.Design:An outbreak of mupirocin-resistantSaureus was noted on the dermatology ward during a prospective epidemiologic study of methicillin-resistantS aureus(MRSA) and borderline methicillin-susceptibleS aureus(BMSSA). Pulsed-field gel electrophoresis (PFGE) of whole-cell DNA digested with Sma I was used as a marker of strain identity.Setting and Patients:An 850-bed university hospital with a 12-bed inpatient dermatology ward. Most patients have severe, exfoliating dermatologic disorders.Results:MRSA or BMSSA were isolated from 13 patients on the dermatology ward over a 14-month period. Eleven of these isolates (84.6%) were mupirocin-resistant. Nine isolates were present on admission (81.8%); 8 of these patients had been hospitalized on the same ward within the last two months. Nasal and hand cultures from 36 personnel were negative for mupirocin-resistant MRSA or BMSSA. Extensive environmental culturing revealed that a blood pressure cuff and the patients' communal shower were positive for mupirocin-resistant BMSSA. PFGE of all mupirocin-resistant isolates demonstrated that the nine patients and both environmental sources had identical DNA typing patterns.Interventions:Changing of blood pressure cuffs between patients and more stringent cleaning of communal areas was initiated. Repeat environmental cultures were negative.Conclusions:S aureusis not usually associated with an environmental reservoir; however, these patients all had severe desquamation, which may have prolonged environmental contamination.

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The Feasibility and Accuracy of Automated Blood Pressure Cuff Ankle-Brachial Index Measurements in Outpatients’ Screening

Journal of Vascular Surgery ◽

10.1016/j.jvs.2018.06.181 ◽

2018 ◽

Vol 68 (3) ◽

pp. e89-e90

Author(s):

Musaad AlHamzah ◽

Bertha Hughes ◽

Konrad Salata ◽

Mohamad A. Hussain ◽

Mohammed Al-Omran

Keyword(s):

Blood Pressure ◽

Ankle Brachial Index ◽

Blood Pressure Cuff ◽

Pressure Cuff

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Usability of a Home-Use Blood Pressure Monitor System: An Evaluation of the Device and Instructional Materials

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care ◽

10.1177/2327857919081036 ◽

2019 ◽

Vol 8 (1) ◽

pp. 147-151

Author(s):

Isis Chong ◽

Jackie Cha ◽

Frank Peng ◽

Denny Yu

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Home Blood Pressure ◽

Instructional Materials ◽

Monitor System ◽

Blood Pressure Cuff ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Pressure Cuff ◽

Blood Pressure Monitors

Although advancements in home-use technologies have allowed users to take control over how they monitor their health, their likely inexperience with such technologies can lead to use errors. The study aimed to determine the usability of a home-use blood pressure monitor, which included the device and instructional materials. Nineteen participants completed a 45-minute study which included an out-of-the-box handling scenario without moderator facilitation. The primary goal of this scenario was to determine if participants would be able to classify their heart rate reading obtained from the heart rate monitor as either low, average, or high in accordance to the thresholds set by the device. Although a majority of users were able to complete the use scenario, users nonetheless experienced major use errors and had difficulty with correctly placing the blood pressure cuff on their arm or inadvertently inflated the cuff when simply trying to turn on the device. There were also differences in the instructional materials such as how users should place the cuff around their arm. These inconsistencies were exacerbated by ambiguous wording without any pictorial clarifications. Additionally, 10% of users were unable to locate information on how to interpret their blood pressure readings. These findings highlight the importance of studying the usability of at-home blood pressure monitors to ensure more accurate health monitoring of users.

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