P3563The influence of circadian patterand obstructive sleep apnean of blood pressure in nocturnal arrhythmias in hypertensive patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Marinheiro ◽  
L Parreira ◽  
P Amador ◽  
D Mesquita ◽  
J Farinha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Holter Monitoring ◽  
Adverse Outcomes ◽  
Pressure Monitoring ◽  
Premature Ventricular Contractions ◽  
Hypertensive Patients ◽  
Nocturnal Dipping ◽  
Obstructive Sleep ◽  
Unit Increase

Abstract Introduction There is growing evidence suggesting hypertension is related to the occurrence of arrhythmias. When occurring predominantly during the night, two potential entities commonly present in hypertensive patients could be related with increased arrhythmogenesis: (1) the lack of normal nocturnal dipping of blood pressure (BP) (non-dipping pattern of hypertension) or (2) obstructive sleep apnea (OSA). Thus, nocturnal arrhythmias (NAs) can identify hypertensive patients with OSA and/or non-dipping pattern, both related with adverse outcomes. Aims To determine if NAs are related with non-dipping hypertension, OSA or both. Methods We studied hypertensive patients who performed ambulatory blood pressure monitoring (ABPM) and also polysomnography and 24-hour Holter monitoring. Non-dipping pattern was considered when nocturnal BP reduction was inferior to 10%. Based on Holter monitoring, NAs were present when atrial fibrillation, frequent premature atrial contractions (PACs) (>30 PACs/hour), runs of >4 consecutive PACs, frequent premature ventricular contractions (PVCs) (>30PVCs/hour) or runs of >4 consecutive PVCs were present predominantly during sleeping hours. During polyssonography, apnoea/hypopnoea index (AHI) and oxygen saturation (SaO2) were analysed. Moderate to severe OSA was considered when AHI >15. Results We studied 104 patients [median age 62 (54–70) years, 65% male): 42 (40%) had moderate to severe OSA (median AHI=11 (6–26), mean SaO2=94% (92–95)] and 64 (61%) were non-dippers. NAs occurred in 18 patients (17%) and they were independently associated with AHI (Odds Ratio (OR) for a one unit increase 1.04, 95% confidence interval (CI) 1.01–1.07, p=0.03) but not with SaO2 (OR 0.96, CI 0.78–1.19, p=0.73) nor non-dipping pattern (OR 1.23, CI 0.38–3.98, p=0.72). No interaction was found between OSA and non-dipping hypertension (p=0.35). In patients with dipping pattern (n=40), AHI was higher in NAs patients comparing with no NAs patients (median AHI 29 versus 10, p=0.04), while in those with non-dipping pattern (n=64), AHI was not statistically different between patients with and without NAs (21 versus 11, p=0.12) (figure). Figure 1 Conclusion In this population of hypertensive patients, the presence of NAs was associated with OSA severity (i.e AHI), but not with the non-dipping pattern of hypertension. The importance of obstructive events in arrhythmogenesis seemed to be more pronounced in dipping patients, suggesting the abnormal high blood pressure during the night may also have some impact on NAs in non-dipping patients. Overall, our results suggest that OSA screening should be considered when nocturnal arrhythmias are detected in hypertensive patients, but ABPM should not be forgotten since multiple mechanisms can be involved in nocturnal arrhythmogenesis.

scholarly journals Perbedaan Derajat Ansietas antara Penyandang Hipertensi Belum Terkontrol dengan yang Terkontrol

e-CliniC ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Cerelia E. C. Sugeng ◽  
Emma Sy. Moeis ◽  
Glady I. Rambert
Keyword(s):  
Blood Pressure ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Blood Pressure Monitoring ◽  
Office Blood Pressure ◽  
Generalized Anxiety ◽  
Pressure Monitoring ◽  
Hypertensive Patients ◽  
Significant Difference ◽  
The Difference

Abstract: Hypertension and anxiety are among the group of the most common chronic disease worldwide, and according to numerous studies they are oftentimes associated each other. Patients suffered from chronic illnesses, such as hypertension, may have negative emotion that increases the risk of mental disorders, most commonly anxiety disorder. This study was aimed to assess the difference of anxiety degree between uncontrolled and controlled hypertensive patients. This was an observational analytical study with a cross-sectional design. Subjects were divided into two groups: controlled and uncontrolled hypertensive patients. Measurement of blood pressure parameter was performed by using office blood pressure monitoring. Anxiety parameter was classified based on the scoring of the Generalized Anxiety Disorder Scale (GAD-7). Data were analyzed by using the Mann-Whitney test. Subjects consisted of 60 hypertensive patients (35 males and 25 females), aged 30-70 years (mean 56.48 years). There were 35 controlled hypertension patients and 22 uncontrolled hypertensive patients. The results showed that the difference in anxiety degree based on GAD-7 between controlled hypertensive and uncontrolled hypertensive groups obtained a p-value of 0.000. In conclusion, there was a significant difference in anxiety degree between uncontrolled and controlled hypertensive patients. Screening for anxiety among hypertensive patients is a simple and cost-effective tool that may improve outcomes.Keywords: anxiety, uncontrolled hypertension, controlled hypertension Abstrak: Hipertensi dan ansietas merupakan kelompok penyakit kronik yang paling umum di seluruh dunia. Berdasarkan banyak penelitian kedua penyakit ini saling berhubungan satu sama lain. Penyandang hipertensi mungkin memiliki emosi negatif yang meningkatkan risiko terjadinya gangguan mental berupa ansietas. Ansietas dan dukungan sosial rendah akan menghambat proses penyembuhan terutama dalam mengontrol tekanan darah. Penelitian ini bertujuan untuk menge-tahui apakah terdapat perbedaan derajat ansietas antara penyandang hipertensi belum terkontrol dengan hipertensi terkontrol. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok penyandang hipertensi belum terkontrol dan hipertensi terkontrol. Pengukuran parameter tekanan darah dilakukan dengan menggunakan alat Oscillometric digital dengan cara Office Blood Pressure Monitoring (OBPM). Parameter ansietas diklasifikasikan berdasarkan skala Generalized Anxiety Disorder Scale (GAD-7). Adanya perbedaan derajat ansietas antara kedua kelompok dinilai dengan uji Mann-Whitney. Subyek penelitian terdiri dari 60 penyandang hipertensi (35 laki-laki dan 25 perempuan) berusia 30-70 tahun (rerata 56,48 tahun). Terdapat 25 penyandang hipertensi yang belum terkontrol dan 35 penyandang hipertensi terkontrol. Hasil penelitian menunjukkan bahwa terdapat perbedaan derajat ansietas berdasarkan GAD-7 antara kedua kelompok (p=0,000). Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam derajat ansietas antara penyandang hipertensi yang belum terkontrol dengan yang terkontrol. Skrining ansietas pada penyandang hipertensi merupakan modalitas penting dalam penatalaksanaan penyandang hipertensi.Kata kunci: ansietas, hipertensi belum terkontrol, hipertensi terkontrol

scholarly journals Ambulatory blood pressure monitoring changes in hypertensive patients

2019 ◽  
Vol 2 (8) ◽  
pp. 53-57
Author(s):  
V.S. Pasko
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Middle Aged ◽  
Hypertensive Patients

The aim of the study was to determine the peculiarities of ABPM indices in middle-aged and elderly hypertensive patients depending on the daily BP profile. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.

Invasive and Concomitant Noninvasive Intraoperative Blood Pressure Monitoring

2011 ◽  
Vol 115 (5) ◽  
pp. 973-978 ◽  
Author(s):  
David B. Wax ◽  
Hung-Mo Lin ◽  
Andrew B. Leibowitz
Keyword(s):  
Blood Pressure ◽  
Odds Ratio ◽  
Blood Pressure Monitoring ◽  
Antihypertensive Agents ◽  
Blood Transfusions ◽  
Blood Products ◽  
Pressure Monitoring ◽  
Antihypertensive Medications ◽  
Hypertensive Patients ◽  
Simultaneous Measurements

Background Noninvasive (NIBP) and intraarterial (ABP) blood pressure monitoring are used under different circumstances and may yield different values. The authors endeavored to characterize these differences and hypothesized that there could be differences in interventions associated with the use of ABP alone ([ABP]) versus ABP in combination with NIBP ([ABP+NIBP]). Methods Simultaneous measurements of ABP and NIBP made during noncardiac cases were extracted from electronic anesthesia records; the differences were subjected to regression analysis. Records of blood products, vasopressors, and antihypertensives administered were also extracted, and associations between the use of these therapies and monitoring strategy ([ABP] vs. [ABP+NIBP]) were tested using univariate, multivariate, and propensity score matched analyses. Results Among 24,225 cases, 63% and 37% used [ABP+NIBP] and [ABP], respectively. Systolic NIBP was likely to be higher than ABP when ABP was less than 111 mmHg and lower than ABP otherwise. Among patients with hypotension, transfusion occurred in 27% versus 43% of patients in the [ABP+NIBP] versus [ABP] group, respectively (odds ratio = 0.4; 95% CI 0.35-0.46), and 7% versus 18% of patients in the [ABP+NIBP] versus [ABP] group received vasopressor infusions, respectively (P < 0.01). Among hypertensive patients, 12% versus 44% of those in the [ABP+NIBP] versus [ABP] group received antihypertensive agents, respectively (P < 0.01). Conclusions NIBP was generally higher than ABP during periods of hypotension and lower than ABP during periods of hypertension. The use of NIBP measurements to supplement ABP measurements was associated with decreased use of blood transfusions, vasopressor infusions, and antihypertensive medications compared with the use of ABP alone.

Samples of standard operating procedures performed by mid-level workers in departments and rooms of functional diagnostics

2021 ◽  
pp. 53-62
Author(s):  
M. V. Pugachev ◽  
O. V. Ibatova ◽  
E. V. Korotina ◽  
V. M. Sinkin
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Holter Monitoring ◽  
Standard Operating Procedures ◽  
Pressure Monitoring ◽  
Functional Diagnostics ◽  
Standard Operating

As an example standard operating procedures performed by nurses in functional diagnostics departments are given. Methods of registration of electrocardiogram, electroencephalogram, spirogram, setting of recorders for Holter monitoring and blood pressure monitoring are considered.

Sign in / Sign up

Export Citation Format

Share Document