MO730THORACIC BIOIMPEDANCE AS AN INNOVATIVE TOOL TO DETECT CHANGES IN BLOOD PRESSURE DURING HEMODIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Melanie Schoutteten ◽  
Lucas Lindeboom ◽  
Christophe Smeets ◽  
Bart De Moor ◽  
Jacques Peeters ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pearson Correlation ◽  
Extracellular Volume ◽  
The Body ◽  
Whole Body ◽  
P Value ◽  
Predictive Tool ◽  
Low Frequencies ◽  
Dialysis Vintage ◽  
Innovative Tool

Abstract Background and Aims Blood pressure (BP) variability is an important cardiovascular risk factor that contributes to the high burden of cardiovascular mortality in hemodialysis (HD) patients. Ultrafiltration rate (UFR) and plasma refill rate modify the extracellular volume (ECV), which is a major determinant of the systolic BP. Segmental bioimpedance of the thoracic region addresses the central volume compartment of the body. We hypothesize that changes in bioimpedance reflect changes in BP and that thoracic measurements are more accurately in detecting intradialytic BP changes compared to whole body bioimpedance. Method During two consecutive short-term interval HD sessions, thoracic bioimpedance signal was registered continuously from predialysis until the end of the session. Corresponding BP, whole body bioimpedance and ultrafiltration volume (UFV) after the start and at the end of dialysis was registered. After outlier detection, valid raw bioimpedance data [Ohm] at 8 and 160 kHz for thoracic measurements, and 5 and 200 kHz for whole body measurements, were taken into further analysis. Dialysis sessions were divided into 3 groups according to the development of the systolic BP: a drop ≥ than 20 mmHg was defined as a hypotensive session, an increase ≥ 10 mmHg was considered as a hypertensive session. Pearson correlation analysis was applied (r, p-value) to the relative data, calculated as a percentage from the start value. Results From 2 dialysis centres, a total of 46 HD patients were enrolled in the study (65.2% male, mean age 71 ± 12.6 years, mean dialysis vintage 4 ± 3.9 years), which resulted in 89 dialysis sessions to analyse. Mean systolic BP after start of dialysis was 133.2 ± 20.7 mmHg and mean UF volume was 1817.5 ± 801.5 mL. 23 sessions showed a hypotensive gradient from the start till the end of dialysis, and 13 sessions progressed with an increase of more than 10 mmHg. When the 8 kHz curve was plotted according to the 3 BP groups, a more plane increase in thoracic bioimpedance signal was observed in the group with a normal tension course (Figure 1). There was a significant relationship between UFR and changes in relative bioimpedance data, as well as thoracic (r = .49 at 8 kHz, r = .46 at 160 kHz, all ps < .001), as whole body bioimpedance (r = .58 at 5 kHz, r = .52 at 200 kHz, all ps < .001). UFV correlated with changes in systolic BP (r = -.31, p < .01). Both bioimpedance techniques correlated with each other (r = .38, p = .001 for low frequencies; r = .29, p < .01 for high frequencies). Where the relative thoracic bioimpedance signal correlated with changes in systolic BP (r = -.35 at 8kHz, -.32 at 160 kHz, all ps < .01) (Figure 2), whole body did not. Conclusion Thoracic bioimpedance is associated with intradialytic BP changes, whereas whole body bioimpedance is not. Thoracic bioimpedance has the potential to function as an important diagnostic and predictive tool in BP variability during HD.

P1303ASSOCIATION BETWEEN PULSE PRESSURE AND EXTRACELLULAR TO INTRACELLULAR WATER RATIO IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Robert Ekart ◽  
Gasper Keber ◽  
Benjamin Dvorsak ◽  
Masa Knehtl ◽  
Radovan Hojs
Keyword(s):  
Blood Pressure ◽  
Body Composition ◽  
Diastolic Blood Pressure ◽  
Pulse Pressure ◽  
Significant Risk ◽  
The Body ◽  
Intracellular Water ◽  
Whole Body ◽  
Multifrequency Bioimpedance ◽  
Dialysis Vintage

Abstract Background and Aims Optimal fluid management is a challenge in patients with end-stage kidney disease (ESRD) on maintenance hemodialysis (HD). Multifrequency bioimpedance spectroscopy (MBIS) is a non-invasive method to estimate body composition, including estimates of extracellular water (ECW) and intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Pulse pressure is a significant risk factor of cardiovascular disease and death in general and dialysis population. Our study aimed to analyse the correlation between systolic, diastolic and pulse pressure with body composition status in ESRD patients before HD. Method We performed a retrospective single-centre cohort study in 93 HD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany). Blood pressure was measured with OMRON monitors. Results The mean age of patients was 64 ± 13 years, mean dialysis vintage 63 (1-352) months, 61% were men, all patients had arteriovenous fistula as vascular access. Sixty-nine (74.2%) patients were fluid overload (FO) with > 1.1 L overhydration. Other data are presented in table 1. We found a statistically significant correlation between the pulse pressure and ECW/ICW ratio (r=0.258; P=0.033) in FO patients. In contrast, there was no significant correlation between systolic, diastolic blood pressure and ECW/ICW ratio in FO patients. Conclusion Only pulse pressure and not systolic or diastolic blood pressure values measured before HD are associated with ECW/ICW ratio in FO patients.

scholarly journals Pengaruh Aromaterapi Lavender secara Masase terhadap Tekanan Darah dan Tingkat Stres Mahasiswa Jurusan Keperawatan Poltekkes Palangka Raya

2020 ◽  
Vol 5 (2) ◽  
pp. 100-107
Author(s):  
Reny Sulistyowati ◽  
Syam�ani Syam�ani
Keyword(s):  
Blood Pressure ◽  
Univariate Analysis ◽  
T Test ◽  
The Body ◽  
Bivariate Analysis ◽  
Control Group ◽  
P Value ◽  
Stress Levels ◽  
Before And After ◽  
Distress Scale

Stress is an individual's adaptive response to various external pressures or demands and produces a variety of disorders including physical, emotional and behavioral disorders. Final year students often experience feelings of stress so that it can interfere with concentration to attend lectures and can even hamper completing education in a timely manner. There are several ways of managing stress, one of which is using aromatherapy. Aromatherapy is a non-pharmacological therapy, which is a type of therapy that applies direct body contact and has a therapeutic effect that combines physiological effects, caused by massage on the body, with psychological effects, which are derived from essential oils. The general purpose of the study is to analyze the effect of aromatherapy on blood pressure and stress levels by using the Kessler Psychological Distress Scale in final semester students. The research method used a quasi-experimental design with a pretest-posttest control group design approach, in 28 intervention groups, namely respondents who were given lavender aromatherapy massage and 28 respondents in the control group. The univariate analysis was conducted to show frequency distribution and bivariate analysis was conducted by independent sample T-test and dependent sample T-test. The results showed that there were significant differences in systolic blood pressure before and after the intervention in the intervention and the control group with a p-value of 0.01 < 0.05. Whereas the stress level variable found that there is no difference in stress levels in the intervention and the control group before and after the intervention with p-value 0.169> 0.05.

scholarly journals Correlation between Core Strength and Stability with Body Mass Index among Postmenopausal Women.

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
S Bhosale Komal ◽  
V Bhosale Siddhi ◽  
Anandh Dr. S
Keyword(s):  
Body Mass Index ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Pearson Correlation ◽  
The Body ◽  
P Value ◽  
Endurance Test ◽  
Core Strength ◽  
The Core ◽  
Flexion Test

Women in postmenopausal period of their life face various physical and physiological changes causing lack of estrogen and progesterone hormones, changes in the reproductive and genitals organs, vasomotor system in the body along with mood related symptoms such as anxiety, etc. Lifestyle, body fat distribution and anthropometric changes adds on to the bone strength in postmenopausal women. It may be a risk factor for osteoporotic fracture, cardiovascular, metabolic diseases, etc. Core strength and stability is greatly influenced by body composition and adiposity. The aim of the study was to correlate the core strength assessed with the Body Mass Index (BMI) among postmenopausal women. The objective of the study is to find the correlation between the core strength assessed with the Body Mass Index using 60° flexion test, Beiring Sorenson test and Unilateral Hip Bridge Endurance test among postmenopausal women with age ranging from 46-70 years. 96 healthy postmenopausal women in Karad city with a natural history of menopause were selected for the study. Based upon BMI values, the subjects were grouped as Underweight (<18.5 kg/m2), Normal weight (18.5-24.9 kg/m2), Overweight (25-29.9 kg/m2 and more). The outcome values for strength were correlated with the BMI of postmenopausal women. In the study, the Pearson correlation(r) was -0.361 and the P value was 0.0003 showing extremely significant correlation between the BMI and 60° Flexion test. For the Beiring Sorenson Test, the Pearson correlation value was -0.305 and the P value was 0.0025 showing very significant correlation between the BMI and Beiring Sorenson Test. Correlation of BMI and Unilateral Hip Bridge Endurance Test shows a Pearson Correlation value of -0.322 and the P value 0.0013 claiming very significant correlation between the BMI and Unilateral Hip Bridge Endurance Test. The study concludes that there is a significantly negative correlation between the core strength and stability with the Body Mass Index among postmenopausal women.

P1185LUNG COMETS AND EVALUATION OF HYDRATION STATUS IN PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Robert Ekart ◽  
Lucijan Lucic Srajer ◽  
Katharina Marko ◽  
Nina Hojs ◽  
Sebastjan Bevc ◽  
...  
Keyword(s):  
Body Composition ◽  
Peritoneal Dialysis ◽  
The Body ◽  
Whole Body ◽  
Fluid Distribution ◽  
Hydration Status ◽  
Non Invasive ◽  
Fluid Status ◽  
Multifrequency Bioimpedance ◽  
Dialysis Vintage

Abstract Background and Aims Assessment of optimal hydration status in patients with end-stage renal disease (ESRD) on peritoneal dialysis (PD) is a challenge. Multiple diagnostic options to determine hydration status in PD patients are available. Multifrequency bioimpedance spectroscopy (MBIS) is a cheap, simple and non-invasive method of estimating body composition, including estimates of total body water (TBW), extracellular water (ECW), intracellular water (ICW) and the ratio between both spaces (ECW/ICW). Lung ultrasonography (LUS) and lung B-lines (lung comets) can be used for the evaluation of extravascular lung water. Ultrasound evaluation of inferior vena cava (UIVC) provides rapid, non-invasive assessment of a patient's hemodynamic and volume status. N-terminal pro-brain natriuretic peptide (NT-proBNP) is related to fluid status and fluid distribution. The aim of our study was to assess fluid status in PD patients comparing four different methods: MBIS, LUS, UIVC and NT-proBNP. Method We performed a single-centre cohort study in 19 PD patients. The body composition was measured using the portable whole-body MBIS device, Body Composition Monitor-BCM(®) (Fresenius Medical Care, Bad Homburg, Germany), LUS with portable US device (VScan, General Electrics Corporate), UIVC index with SonoSite US device. NT-proBNP was measured in a one-step sandwich chemiluminescent immunoassay (Dimension Vista® System 1500, Siemens Healthcare Diagnostics Inc., Newark, NJ, USA). Results The mean age of patients was 54 ± 10 years, mean dialysis vintage 53 (10-194) months, 63% were men. Thirteen (68.4%) patients had fluid overload (FO) &gt; 1.1 L. Data of patients are presented in table 1. We found a statistically significant correlation between the number of lung comets and ECW/ICW ratio (r = 0.496, P = 0.031) and NT-proBNP (r = 0.759, P &lt; 0.0001). In contrast, there was no significant correlation between the number of lung comets and UIVC (r = 0.221, P &lt; 0.364). Conclusion According to our results, LUS with lung comets, MBIS with ECW/ICW ratio and NT-proBNP are useful and complementary methods for evaluation of fluid status in PD patients.

scholarly journals Efektivitas Terapi Hinosis Lima Jari Terhadap Ansietas Klien Hipertensi Di Puskesmas Rawasari Kota Jambi Tahun 2017

2019 ◽  
Vol 19 (2) ◽  
pp. 353
Author(s):  
Mohd Syukri
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Sampling Technique ◽  
Reduce Blood Pressure ◽  
The Body ◽  
P Value ◽  
Lower Heart Rate ◽  
Post Test ◽  
Quasi Experimental ◽  
Pleasant Experience

Five-finger hypnosis is a movement that tightens and relaxes the muscles in one part of the body at one time which can present a relaxed condition physically and psychologically, by thinking of a pleasant experience (Keliat, 2011). Useful for giving inner peace to individuals. reduce anxiety, worry and anxiety, reduce tension and reduce blood pressure, lower heart rate and sleep soundly. This study aims to determine the effectiveness of five-finger hypnosis therapy against anxiety hypertension clients at Putri Ayu Health Center, Jambi City. Quasi experimental design pre-post test with without control. The sample was 33 people with a total sampling technique. The results showed that there was an effect of five-finger hypnosis therapy on anxiety in hypertensive clients (p value <0.05). There was a decrease in anxiety after five finger hypnosis therapy was carried out. Five finger hypnosis therapy is recommended to be applied as nursing therapy in treating hypertensive clients with anxiety.

scholarly journals ANALISIS FAKTOR YANG MEMPENGARUHI TEKANAN DARAH DAN SATURASI OKSIGEN PERIFER (SPO2)

2020 ◽  
pp. 21-30
Author(s):  
Siti Fadlilah ◽  
Nazwar Hamdani Rahil ◽  
Fransiska Lanni
Keyword(s):  
Blood Pressure ◽  
Nursing Students ◽  
Oxygen Saturation ◽  
Significant Relationship ◽  
The Body ◽  
Bivariate Analysis ◽  
P Value ◽  
Cross Sectional ◽  
P Values ◽  
Age And Sex

Tekanan darah merupakan faktor yang sangat penting pada sistem sirkulasi. Tidak semua tekanan darah berada dalam batas normal sehingga menyebabkan munculnya gangguan pada tekanan darah yakni hipertensi dan hipotensi. Prevalensi hipertensi di Daerah Istimewa Yogyakarta masuk di urutan ke-14 yaitu sebesar 25,7%. Selain itu ada cara untuk mendeteksi adanya gangguan tekanan darah atau masalah sirkulasi pada tubuh dengan cara memeriksa tekanan darah dan mengetahui nilai saturasi oksigen. Gangguan tekanan darah yang bisa mempengaruhi nilai pada saturasi oksigen di tubuh. Penelitian bertujuan untuk menganalisis hubungan umur dan jenis kelamin dengan tekanan darah dan saturasi oksigen (SpO2) pada mahasiswa keperawatan salah satu universitas di Yogyakarta. Penelitian ini merupakan jenis penelitian korelasi dengan rancangan penelitian cross sectional. Populasi adalah seluruh mahasiswa salah satu kampus keperawatan salah satu universitas di Yogyakarta berjumlah 137 orang. Teknik sampling yang digunakan adalah total sampling dengan 120 responden yang sesuai kriteria inklusi dan eksklusi. Instrumen penelitian yang digunakan adalah sphygmomanometer digital, pulse oximetry, dan lembar observasi. Analisis data penelitian menggunakan uji Kruskal wallis. Mayoritas berjenis kelamin perempuan yaitu 108 responden (90%). Mayoritas kategori remaja akhir yaitu 117 responden (97,5%). Mayoritas tekanan darah pada mahasiswa kategori normal sebanyak 81 responden (67,5%). Nilai median saturasi oksigen (SpO2) yaitu 98 mmHg. Hasil analisis bivariat antara umur dan jenis kelamin dengan tekanan darah didapatkan p-value 0,641 dan 0,176. Hasil analisis bivariat antara usia dan jenis kelamin dengan saturasi oksigen (SpO2) didapatkan p-value 0,385 dan 0,964. Hasil analisis bivariat antara tekanan darah dan saturasi oksigen (SpO2)  didapatkani p value adalah 0,010. Tidak ada hubungan signifikan antara umur dan jenis kelamin dengan tekanan darah. Tidak ada hubungan signifikan antara umur dan jenis kelamin dengan saturasi oksigen (SpO2). Ada hubungan antara tekanan darah dengan saturasi oksigen (SpO2) pada Mahasiswa Keperawatan   Blood pressure is a very important factor in the circulatory system. Not all blood pressure is within normal limits, causing interference with blood pressure, namely hypertension and hypotension. The prevalence of hypertension in the Special Region of Yogyakarta is ranked 14th at 25.7%. In addition there are ways to detect blood pressure disorders or circulation problems in the body by checking blood pressure and knowing the value of oxygen saturation. Blood pressure disorders that can affect the value of oxygen saturation in the body. The study aims to analyze the relationship between age and sex with blood pressure and oxygen saturation (SpO2) in nursing students at a university in Yogyakarta. This research is a type of correlation study with a cross sectional study design. The population is all students of one nursing campus of a university in Yogyakarta totaling 137 people. The sampling technique used is total sampling with 120 respondents who fit the inclusion and exclusion criteria. The research instruments used were digital sphygmomanometer, pulse oximetry, and observation sheets. Analysis of research data using the Kruskal Wallis test. The majority of women are 108 respondents (90%). The majority of late adolescent categories are 117 respondents (97.5%). The majority of blood pressure in normal category students was 81 respondents (67.5%). The median value of oxygen saturation (SpO2) is 98 mmHg. The results of bivariate analysis between age and sex with blood pressure obtained p-values ​​of 0.641 and 0.176. The results of bivariate analysis between age and sex with oxygen saturation (SpO2) obtained p-values ​​of 0.385 and 0.964. The results of the bivariate analysis between blood pressure and oxygen saturation (SpO2) found that the p value was 0.010. There is no significant relationship between age and sex with blood pressure. There is no significant relationship between age and sex with oxygen saturation (SpO2). There is a relationship between blood pressure and oxygen saturation (SpO2) in nursing students.

scholarly journals Hubungan Intensitas Kebisingan Dan Lama Kerja Dengan Kejadian Hipertensi Pada Tenaga Kerja Bagian Produksi PT. Japfa Comfeed Indonesia Tbk.

2019 ◽  
Vol 15 (1) ◽  
pp. 591
Author(s):  
Andry Setiawan ◽  
Yohanes Joko Supriyadi ◽  
Maharso Maharso
Keyword(s):  
Blood Pressure ◽  
Noise Pollution ◽  
The United States ◽  
The Body ◽  
P Value ◽  
Emotional Instability ◽  
Cross Sectional ◽  
Health Checks ◽  
Moderate Relationship

The Relations Of The Intensity Of Noise And Work Term With The Hypertension Case Of The Production Parts Employees In PT. Japfa Comfeed Indonesia Tbk.. Some research results prove that one of the risk factor of stroke is high blood pressure (hypertension). Noise pollution may be associated with the occurrence of hypertention, this is supported by an epidemiological study in the United States. The results of that study mentioned that people exposed to noise tend to have unstable emotions. Emotional instability will lead to a stress. If the stress happened long enough, it will cause the narrowing of blood vessels, so it will make the heart to work harder to pump blood throughout the body. In a long term, blood pressure will rise, and this is called Hypertension. The purpose of this study is to determine the relations between the intensity of noise pollution and work term with the case of hypertension in the production parts employee of PT. Japfa Comfeed Indonesia Tbk. Tanah Laut regency in 2017. The research method used is an analytical survey with cross sectional approach. The population in this study is amounted to 57 people and the sample amounted to 57 people. The results of this study indicates that there is a moderate relationship between the intensity of noise pollution with the incidence of hypertension (p-value = 0,002 < α = 0,05 r = 0,407), and there is a low relationship between work term with the incidence of hypertension (p-value = 0,014 < α = 0,05 r = 0,323). Suggestions given to the company is to provide guidance on the use of PPE, perform routine health checks on employees and rotate the position of work on the employee of production.

scholarly journals Efektifitas Spiritual Emotional Freedom Technique (SEFT) dan menyanyi terhadap tekanan darah lansia di rumpelsos pucang gading semarang

2019 ◽  
Vol 3 (1) ◽  
pp. 14
Author(s):  
Sonhaji Sonhaji ◽  
Roland Lekatompessy
Keyword(s):  
Blood Pressure ◽  
Social Service ◽  
The Elderly ◽  
The Body ◽  
P Value ◽  
Test Results ◽  
Body System ◽  
Left Group ◽  
Average Blood Pressure ◽  
Before And After

The result of statistical analysis obtained data on the average blood pressure inthe left group before being given the intervention of 173,76/96,41 while after being given the intervention of 170,29/93,82. On the singing group before being given intervention, the average of blood pressure of 153,06/87,41 and after being given intervention tobe 168/87. Camparative test results in both groups between before and after ihe invention were obtained p – value = 0,00 (p- value p < 0,05). Conclusion was spiritual emotional freedom techneque (SEFT) is more effective than singing to reduce the blood pressurenof the elderly with hypertension in social service home, Pucang Gading, Semarang. One of the body system disorders that is often experienced by the elderly. Namely the cardiovascular system such as hypertension. Hypertension of elderly can caused bad condition such as heartdiscase, stroke and kidney failure, there fore, intervention is needed to maintain blood pressure within normal himits.

scholarly journals Penurunanan Tekanan Darah pada Lansia Hipertensi dengan Senam Ergonomik

2020 ◽  
Vol 5 (1) ◽  
pp. 71
Author(s):  
Sri Muharni ◽  
Utari Christya Wardhani
Keyword(s):  
Blood Pressure ◽  
Time Series ◽  
Pharmacological Therapy ◽  
T Test ◽  
The Body ◽  
Control Group ◽  
P Value ◽  
Purposive Sampling ◽  
Group Time ◽  
Paired T Test

<div class="Section1"><p><em><em>Hypertension is one of the most common cardiovascular problem in elderly.  Prolonged high blood pressure canlead to destructionof the blood vessels throughout the body. However it can be controlled with pharmacology and non-pharmacology technique, one of the non-pharmacological therapy is ergonomic exercise. Ergonomic exercise is the gymnastic motion which is combined with breathing techniques. This study aimed was to know about the effect of ergonomic exercise to decreasing blood pressure in elderly with hypertensions in Community Health Center Sei Pancur region. The design was One Group Time Series, intervention given to one group only, without control group. Ergonomic exercise efectivity rated by comparing blood pressure pre and post exercise, during first, second, and third week. Sampling technique was used purposive sampling with 50 respondents. The respondents were given interventions four times. The data analysis used Paired T-Test and Annova Test. The results were shown that the blood pressure significantly decreased during fourth week, with p value: 0.00 for both systolic and diastolic blood pressure. As conclusions, ergonomic exercise had effect to decreasing blood pressure in elderly with hypertensions</em></em></p><p><em><br /></em></p><p><em>Hipertensi adalah salah satu masalah kardiovaskular yang sering terjadi pada lansia. Tekanan darah yang tinggi akan mengakibatkan kerusakan pembuluh darah di seluruh tubuh, kerusakan  tersebut dapat kita  kendalikan dengan terapi farmakologi maupun non farmakologi, salah satunya adalah senam ergonomik. Senam ergonomik adalah  suatu gerakan senam yang dikombinasikan dengan teknik pernapasan. Penelitian ini bertujuan untuk mengetahui pengaruh senam ergonomik terhadap penurunan tekanan darah  pada lansia  hipertensi di wilayah kerja Puskemas Sei Pancur. Desain dalam penelitian ini adalah One Group Time Series Design dengan mengintervensi satu kelompok saja tanpa kelompok pembanding. Efektifitas perlakukan senam ergonomik dinilai dengan cara membandingkan tekanan darah sebelum diberikan senam ergonomik dengan hasil tekanan darah setelah senam ergonomik minggu pertama,kedua dan ketiga. Dimana Teknik sampling yang digunakan adalah Purposive Sampling dengan jumlah sampel 50 responden. Pemberian sebanyak 4  kali intervensi. Analisa data menggunakan uji Paired T-Test dan Annova Test. Hasil penelitian menunjukkan bahwa tekanan darah mulai turun signifikan pada minggu ke-4, dengan nilai p = 0,00 untuk tekanan darah sistole dan 0,00 untuk tekanan darah diastol. Kesimpulan dalam penelitian ini adalah senam ergonomik berpengaruh terhadap penurunan tekanan darah pada lansia dengan hipertensi</em></p></div>

P275 Uncontrolled post-clinic blood pressure readings can identify nocturnal non-dipping blood pressure pattern

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
H Shahab ◽  
H Khan ◽  
M Tufail ◽  
A Artani ◽  
A Almas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pearson Correlation ◽  
P Value ◽  
Clinic Blood Pressure ◽  
Nocturnal Dipping ◽  
Cardiovascular Morbidity And Mortality ◽  
Minute Post ◽  
The Difference

Abstract Funding Acknowledgements Aga Khan University Faculty of Health Sciences Research Committee (#80096) On Behalf PC BP (Post Clinic Blood Pressure) Study Group Background Nocturnal non-dipping increases cardiovascular morbidity and mortality in both hypertensive and normotensive subjects. Ambulatory blood pressure monitoring(ABPM) can identify nocturnal blood pressure(BP) dipping patterns but clinic BP cannot. We previously showed that 15-minute post-clinic BP correlates well with 24- hour ABPM. Purpose We aimed to determine if 15-minute post-clinic BP reading helped to identify patients with nocturnal non-dipping pattern. Methods A cross-sectional study involving 150 participants, as part of the Post Clinic-Ambulatory Blood Pressure(PC-ABP) study, was conducted in cardiology clinics. Participants aged ≥18 years, with hypertension or those referred for its assessment, were included. Pregnant females were excluded. Post-clinic BP was taken 15 minutes after the patient-physician encounter in the clinic using an automated, validated BP device by a research assistant. All the participants were then referred for 24-hour ABPM. Patterns of nocturnal dipping were studied amongst groups of controlled(&lt;140 mmHg) and uncontrolled(≥140mmHg) post-clinic systolic BP(SBP). Fischer exact test was used to determine the difference in dipping patterns amongst the two groups. Results The mean age of participants was 60.3 ± 11.9 years. Of 150 participants, 49% were male and of all, 76% were hypertensive. Mean nighttime SBP(±SD) was 121.9(±18) mmHg(p-value &lt;0.001). Mean nighttime DBP(±SD) was 68.7(± 8.7) mmHg(p &lt; 0.001). Patterns of nocturnal dipping amongst patients with mean post-clinic SBP &lt;140mmHg versus ≥140mmHg has been shown in Table 1. The difference in nocturnal dipping patterns between the two groups was statistically insignificant(p-value 0.071). Pearson correlation coefficient between post-clinic SBP and nighttime SBP for patients with loss of dip was higher (0.64; p &lt; 0.001) whereas it was 0.56(p-value &lt;0.001) for those with preserved dip.  Conclusion Uncontrolled post-clinic BP can help in identifying patients with nocturnal non-dipping. Larger studies can help determine the prognostic value of post-clinic BP amongst patients with nocturnal non-dipping. Nocturnal Dipping Amongst The Two Groups Controlled PC SBP &lt;140mmHg (n = 80) Uncontrolled PC SBP ≥140mmHg (n = 70) Preserved Nocturnal Dipping (10 to 20% nocturnal drop in SBP) 61.2% (n = 49) 47.1% (n = 33) Loss of Dip (&gt;0% to &lt;10% of nocturnal drop in SBP) 33.8% (n = 27) 48.6% (n = 34) Reversed Dip (≤0% drop in SBP) 5% (n = 4) 1.4%(n = 1) Excessive Dip (&gt;20% drop in SBP) 0 2.9% (n = 2) Table 1 shows the patterns of nocturnal dipping amongst patients with controlled (&lt;140mmHg) and uncontrolled (≥140mmHg) 15-minute post-clinic systolic blood pressure (PC SBP).

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