scholarly journals Is 7-days home BP measurement comparable to 24-hours Ambulatory BP Measurement?

2021 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Chandan Karmakar ◽  
Syed Imran Ahmed ◽  
Ralph Maddison
Keyword(s):  
Blood Pressure ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Home Blood Pressure ◽  
Significant Difference ◽  
Hypertension Diagnosis ◽  
The Mean ◽  
Measurement Biases ◽  
Healthy Community ◽  
Absolute Reliability

High blood pressure (BP) or hypertension is a significant risk factor for the global burden of cardiovascular diseases. Home blood pressure measurements (HBPM) have been recommended for hypertension diagnosis, treatment initiation and medication titration, but guidelines for the number of measurements and duration are inconsistent. This study compared the accuracy of 3 home BP measurements per day for seven days with 24-hour ambulatory BP measurements. We examined 24-hour ambulatory BP measurements (ABPM) and HBPM during-morning, afternoon, and evening each day for seven days in healthy community living volunteers. Standardized Bland-Altman scatterplots and limits of agreement (LOA) were used to assess absolute reliability and the variability of measurement biases. We used nonparametric Mann-Whitney U-tests to compare the mean (SD) of the devices. Correlations between HBPM and 24-hour ABPM measurements were statistically significant at p<0.05. The high correlation coefficient (r=0.75) was observed between the systolic BP retrieved from two devices compared to moderate correlation (r=0.46) among diastolic BP. A significant difference was found for systolic BP (P<0.05) between the HBPM and ABPM but was non-significant for diastolic BP (P>0.05). In Bland-Altman plots, the LOA between HBPM and ABPM was 0.07-26.23 mmHg for SBP and 11.24 -16.20 mmHg for DBP. The overall mean difference (bias) in SBP and DBP was 13.08 and 2.48, respectively. Our results suggest that HBPM three times per day for seven days can potentially be used where ABPM is unavailable. Further studies in a diverse group of people with hypertension are needed.

scholarly journals The Role of Past Suicidal Behavior on Current Suicidality: A Retrospective Study in the Israeli Military

2021 ◽  
Vol 18 (2) ◽  
pp. 649
Author(s):  
Leah Shelef ◽  
Jessica M Rabbany ◽  
Peter M Gutierrez ◽  
Ron Kedem ◽  
Ariel Ben Yehuda ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Military Service ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Severity Rating ◽  
Significant Difference

Past suicide attempts are a significant risk factor for future suicidality. Therefore, the present military-based study examined the past suicidal behavior of soldiers who recently made a severe suicide attempt. Our sample consisted of 65 active-duty soldiers (61.5% males), between the ages of 18 and 28 years old (M = 20.4, SD ± 1.3). The inclusion criterion was a recent severe suicide attempt, requiring at least a 24 h hospitalization. This sample was divided into two groups, according to previous suicidal behavior, namely whether their first suicide attempt was before or after enlistment (n = 25; 38.5% and n = 40; 61.5%, respectively). We then examined the lethality and intent of the recent event in regard to this division. Four measures were used to assess the subjects’ suicidal characteristics: the Columbia Suicide Severity Rating Scale, the Self-Harm Behavior Questionnaire, the Suicidal Behaviors Questionnaire-Revised, and the Beck Scale for Suicide Ideation. No significant difference in the severity of the suicide attempts (either actual or potential severity) were found between those who had suicide attempts before enlistment and those who had their first attempt in the service. As a matter of fact, most of the suicide attempts that occurred for the first time during military service had used a violent method (58.3%, n = 21). Finally, using multivariate analyses, we found that current thoughts and behavior, rather than past suicidality, was the strongest predictor for the lethality of suicide attempts.

Late Neurological Deterioration after Acute Intracerebral Hemorrhage: A post hoc Analysis of the ATACH-2 Trial

2020 ◽  
Vol 49 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Shuhei Okazaki ◽  
Haruko Yamamoto ◽  
Lydia D. Foster ◽  
Mayumi Fukuda-Doi ◽  
Masatoshi Koga ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intracerebral Hemorrhage ◽  
Significant Risk ◽  
Blood Pressure Level ◽  
Neurological Deterioration ◽  
Major Influence ◽  
Case Report Form ◽  
Hematoma Volume ◽  
Systolic Blood Pressure Level ◽  
Significant Difference

Background: Neurological deterioration (ND) has a major influence on the prognosis of intracerebral hemorrhage (ICH); however, factors associated with ND occurring after 24 h of ICH onset are unknown. Methods: We performed exploratory analyses of data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 trial, which compared intensive and standard blood pressure lowering treatment in ICH. NDs were captured on the adverse event case report form. Logistic regression analysis was performed to examine the independent predictors of late ND. Results: Among 1,000 participants with acute ICH, 82 patients (8.2%) developed early ND (≤24 h), and 64 (6.4%) had late ND. Baseline hematoma volume (adjusted OR [aOR] per 1-cm3 increase 1.04, 95% CI 1.02–1.06, p < 0.0001), hematoma volume increase in 24 h (aOR 2.24, 95% CI 1.23–4.07, p = 0.008), and the presence of intraventricular hemorrhage (IVH; aOR 2.38, 95% CI 1.32–4.29, p = 0.004) were independent predictors of late ND (vs. no late ND). Late ND was a significant risk factor for poor 90-day outcome (OR 3.46, 95% CI 1.82–6.56). No statistically significant difference in the incidence of late ND was noted between the 2 treatment groups. Conclusions: Initial hematoma volume, early hematoma volume expansion, and IVH are independent predictors of late ND after ICH. Intensive reduction in the systolic blood pressure level does not prevent the development of late ND.

External Ventricular Drain Infection

2007 ◽  
Vol 107 (1) ◽  
pp. 248 ◽  
Author(s):  
George K. C. Wong ◽  
Wayne W. S. Poon
Keyword(s):  
Major Trauma ◽  
Independent Predictor ◽  
External Ventricular Drain ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
External Ventricular Drainage ◽  
Infection Rates ◽  
The Mean ◽  
The Relationship ◽  
Shed Light

Object The authors explored the relationship among the duration of external ventricular drainage, revision of external ventricular drains (EVDs), and cerebrospinal fluid (CSF) infection to shed light on the practice of electively revising these drains. Methods In a retrospective study of 199 patients with 269 EVDs in the intensive care unit at a major trauma center in Australasia, the authors found 21 CSF infections. Acinetobacter accounted for 10 (48%) of these infections. Whereas the duration of drainage was not an independent predictor of infection, multiple insertions of EVDs was a significant risk factor. Second and third EVDs in previously uninfected patients were more likely to become infected than first EVDs. An EVD infection was initially identified a mean of 5.5 ±0.7 days postinsertion (standard error of the mean); these data—that is, the number of days—were normally distributed. Conclusions This pattern of infection is best explained by EVD-associated CSF infections being acquired by the introduction of bacteria on insertion of the drain rather than by subsequent retrograde colonization. Elective EVD revision would be expected to increase infection rates in light of these results, and thus the practice has been abandoned by the authors' institution.

scholarly journals Effects of Aroma Massage on Home Blood Pressure, Ambulatory Blood Pressure, and Sleep Quality in Middle-Aged Women with Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Myeong-Sook Ju ◽  
Sahng Lee ◽  
Ikyul Bae ◽  
Myung-Haeng Hur ◽  
Kayeon Seong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Placebo Group ◽  
Sleep Quality ◽  
Nursing Intervention ◽  
Home Blood Pressure ◽  
Control Group ◽  
Middle Aged ◽  
Significant Difference ◽  
Before And After ◽  
Massage Group

The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n=28), the placebo group (n=28), and the no-treatment control group (n=27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F=6.71,P=0.002) between groups after intervention. There was also a significant difference in SBP (F=13.34,P=0.001) and diastolic blood pressure (DBP) (F=8.46,P=0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F=6.75,P=0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life.

Abstract 240: Hypertension Prevalence and Management Among Adult Congenital Heart Disease Patients

Hypertension ◽  
2014 ◽  
Vol 64 (suppl_1) ◽  
Author(s):  
Joshua R Thomas ◽  
Ricky T Munoz ◽  
Mark D Fox ◽  
Angela T Yetman
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Hypertension Prevalence ◽  
Significant Difference ◽  
Adult Congenital ◽  
The Mean

Background: Cardiovascular risk factors (CRFs) are poorly defined among the population of adults with congenital heart disease. In particular, the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) are currently unknown. Objective: To determine the prevalence of pre-HTN and HTN among adults with congenital heart disease; and to assess HTN control rates among different clinic types. Methods: A retrospective analysis of a cohort of adults with congenital heart disease (CHD) was conducted. Data regarding CHD patients' blood pressure (BP), medications, and provider specialty were analyzed. Results: The cohort consisted of 971 patients. The mean age was 30.4 years (SD = 10.4), with 51% male. Thirty-two percent had HTN (n = 304). There was no statistically significant difference in the prevalence of Pre-HTN and HTN by clinic type (i.e. specialty vs. non-specialty)( p = .225, p= .633 respectively). However, a statistically significant association exists between clinic type and HTN control rates χ 2 (1) = 3.185, p = .07 (Table 1). Those receiving care from a specialty clinic are 1.6 times more likely to have controlled HTN. Conclusions: Pre-HTN and HTN are common among adults with congenital heart disease. These CRFs are better managed in specialty clinics devoted to this population.

Significance of dynamic contour tonometry in evaluation of progression of glaucoma in patients with a history of laser refractive surgery

2019 ◽  
Vol 104 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Sang Yeop Lee ◽  
Eun Woo Kim ◽  
Wungrak Choi ◽  
Chan Keum Park ◽  
Sangah Kim ◽  
...  
Keyword(s):  
Refractive Surgery ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Significant Risk ◽  
Applanation Tonometry ◽  
Dynamic Contour Tonometry ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Laser Refractive Surgery

AimsIn this study, we tested the hypothesis that intraocular pressure (IOP) parameters measured by dynamic contour tonometry (DCT) would be more relevant in progression of glaucoma when there is a history of laser refractive surgery (LRS) than the IOP parameters measured by Goldmann applanation tonometry (GAT) or calculated by correction formulae.MethodsNinety-eight eyes in 54 patients with open-angle glaucoma and a history of LRS were included in this retrospective study. IOP was measured by both GAT and DCT during follow-up. Baseline, mean, and peak IOP, IOP fluctuation, and IOP reduction were measured by each tonometry method. Corrected IOP parameters using central corneal thickness and mean keratometry values were also analysed. Clustered logistic regression was used to identify variables correlated with progression of glaucoma. Areas under the curve (AUCs) for correlated variables were also compared.ResultsThe mean DCT value (OR 1.36, p=0.024), peak DCT value (OR 1.19, p=0.02) and pattern SD (OR 1.10, p=0.016) were significant risk factors for progression. There was a significant difference in the predictive ability of the mean DCT and GAT values (AUC 0.63 and 0.514, respectively; p=0.01) and of the peak DCT and GAT values (0.646 and 0.503, respectively, p=0.009). The AUCs for corrected IOP did not exceed those of DCT.ConclusionsIOP measurements were more associated with progression of glaucoma when measurements were obtained by DCT than by GAT or correction formulae in eyes with a history of LRS.

scholarly journals Venous Thromboprophylaxis in Gastrointestinal Bleeding

2015 ◽  
Vol 29 (3) ◽  
pp. 145-148 ◽  
Author(s):  
Neel Malhotra ◽  
Nilesh Chande
Keyword(s):  
Thrombotic Event ◽  
Antiplatelet Agent ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Primary Diagnosis ◽  
Gi Bleeding ◽  
Duration Of Treatment ◽  
Vte Prophylaxis ◽  
Significant Difference ◽  
Gi Bleed

OBJECTIVE: To study the use of venous thromboembolism (VTE) prophylaxis and the incidence of thrombotic events in patients with acute gastrointestinal (GI) bleeding.METHODS: Individuals admitted with a primary diagnosis of a GI bleed along with any endoscopically confirmed source (over a two-year period) were included. Patient comorbidity and data regarding anticoagulation or antiplatelet agent use before hospitalization were collected, in addition to type of VTE prophylaxis and duration of treatment. The primary end point was the development of VTE (deep vein thrombosis or pulmonary embolism) within one year of presentation.RESULTS: Data from 504 patients admitted with GI bleeding were eligible for review. The total number of VTE events was 20 (4%) while the mortality rate during hospitalization was 4.6%; 397 patients were not given VTE prophylaxis during their hospitalization. Of the patients who were given VTE prophylaxis, 68 received prophylactic heparin or heparin derivatives during their admission. One hundred sixty-five patients had at least one other significant risk factor for VTE including recent or subsequent surgery, past thrombotic event or malignancy. The incidence of thrombosis in those with significant risk factors for VTE was significantly higher than those without (8.5% versus 1.8%; P=0.0009). Overall, there was no significant difference in thrombotic events between individuals receiving pharmacological prophylaxis (1.2%) and those who did not (2.8%) (P=0.4).CONCLUSION: Overall, VTE prophylaxis did not significantly affect thrombotic events in patients admitted for an active GI bleed.

scholarly journals Hydroureteronephrosis in women with pelvic organ prolapse: a prospective cohort study

2018 ◽  
Vol 7 (9) ◽  
pp. 3664
Author(s):  
Pushplata Kumari ◽  
Emily Divya Ebenezer ◽  
Caroline Salomi ◽  
Vaibhav Londhe ◽  
Aruna Nitin Kekre
Keyword(s):  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Pelvic Organ Prolapse ◽  
Kidney Disease ◽  
Prospective Observational Study ◽  
Surgical Repair ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Pelvic Organ ◽  
The Mean

Background: Pelvic organ prolapses (POP) is a common problem in women. The prevalence of POP increase with age. The true prevalence and risk factor for developing hydroureteronephrosis (HUN) in women with pelvic organ prolapse is still unclear due to lack of prospective studies on sufficiently large cohorts. This prospective study was done to study the prevalence of HUN in women with POP and to identify the risk factors for developing HUN.Methods: In this prospective observational study 219 patients were recruited for surgical repair for pelvic organ prolapse for 2 years.  Preoperatively, all patients had transabdominal scan to assess the uterus, adnexa and to look for Hydroureteronephrosis (HUN). Women with presence of HUN were followed postoperatively look for the resolution of HUN.Results: The prevalence of bilateral HUN was 6.85%. The mean age of women with HUN ranged from 51-69 years. Diabetes and hypertension were significant risk factor for development of HUN (OR 4.70, 95% CI -1.59-13.88 and OR 3.72, 95% CI- 1.23-11.1 respectively). There was a statistically significant correlation between chronic kidney disease and HUN. (OR 1 with 95%: CI 9.49-30.42). The correlation between stage of pelvic organ prolapse and HUN was not statistically significant (p = 0.062). There was a statistically significant correlation between the duration (2years -15 years) of POP to HUN. (OR 0.233, 95%0.13-0.419). Patients were followed up post operatively for resolution of HUN. HUN resolved in 9 women (60%) and persisted in 6 (40%).Conclusions: The prevalence of bilateral HUN in women with pelvic organ prolapse was 6.8%. Presence of hypertension, diabetes and chronic kidney disease was a risk factor for HUN. HUN resolved in 60% of women after pelvic reconstructive surgery.

scholarly journals Investigation of the effect of the virtual reality application on experimental pain severity in healthy

2019 ◽  
Vol 65 (3) ◽  
pp. 446-451
Author(s):  
Dilek Karaman ◽  
Funda Erol ◽  
Dilek Yılmaz ◽  
Yurdanur Dikmen
Keyword(s):  
Blood Pressure ◽  
Virtual Reality ◽  
Control Group ◽  
Control Groups ◽  
Adult Type ◽  
Significant Difference ◽  
The Mean ◽  
And Control ◽  
Experimental Group ◽  
Virtual Reality Application

SUMMARY OBJECTIVE: This study aimed to investigate the effect of virtual reality application on experimental ischemic pain created with a blood pressure instrument in healthy volunteers. METHODS: The research sample consisted of 172 volunteer adult students who conformed to the inclusion criteria. These individuals were assigned into an experimental (n=86) and a control group (n=86) by a simple randomization method. All individuals in the experimental and control groups wereexperimentally subjected to pain for two minutes by applying 260 mmHg of pressure 3-4 cm above the antecubital region of the left arm with an aneroid adult-type blood pressure instrument. During the procedure, the volunteers in the experimental group watched virtual reality images, while those in the control group received no intervention. Immediately after the procedure, the pain levels of the individuals in both groups were assessed with a Visual Analog Scale (VAS). RESULTS: We found that the mean pain score of the individuals in the experimental group was 2.62±1.82, and that of individuals in the control group was 5.75±1.65. Results of the statistical analysis showed a statistically significant difference between the mean pain scores of the individuals in the experimental and control groups (p<0.001). CONCLUSION: This study found that the use of virtual reality was effective in reducing the level of pain in healthy individuals. This method used a smartphone with widespread availability and ease of transportation, which can be used by health professionals as a non-pharmacological method in the management of pain.

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.

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