scholarly journals Early Detection of Undiagnosed Hypertension Based on Occupational Screening in the Hotel and Restaurant Industry

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Reingard Seibt ◽  
Bettina Hunger ◽  
Lisa Stieler ◽  
Regina Stoll ◽  
Steffi Kreuzfeld

Blood pressure is the most important, modifiable risk factor for cardiovascular diseases. Lifestyle factors and also workload are the main, potential risk factors for the development of hypertension. This study focused on the early detection of unknown hypertension by screening employees in the hotel and restaurant industry (HRI). 148 HRI employees without hypertension (mean age: 34 years, men: 45%) self-measured their blood pressure during rest and for 24 hours of a normal workday. Individuals with a resting blood pressure ≥ 135/85 mmHg were classified as hypertensive. A further analysis investigated whether the currently applicable thresholds for hypertension during work, leisure, and sleep were exceeded on a working day. At rest, 36% of the study participants suffered from hypertension, which increased to 70% under workload and 46% during leisure time and dropped to 8% during sleep. Normal nocturnal dipping (10–20%) occurred only in 18% of cases; 78% were extreme dippers (>20%). Occupational hypertension screening is a suitable component of preventive healthcare. Resting blood pressure measurement alone is insufficient for the early detection of risk individuals and should be supplemented by 24-hour ambulatory blood pressure monitoring under working conditions. The impact of workload on blood pressure needs to be given more attention in the guidelines.

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 700
Author(s):  
Beata Moczulska ◽  
Maciej Zechowicz ◽  
Sylwia Leśniewska ◽  
Karolina Osowiecka ◽  
Leszek Gromadziński

Background and objectives: It is commonly known that obesity not only increases arterial hypertension (HT) risk but also impacts on the response to antihypertensives. This study aimed to assess blood pressure (BP) parameters based on Ambulatory Blood Pressure Measurement (ABPM) in obese patients. Materials and Methods: The study group consisted of 128 patients with obesity (BMI ≥ 30 kg/m2), with an average age of 43.25 years (±12.42), including 55 males and 73 females. They were divided into 2 groups: 1-with BMI ≥ 30 kg/m2 and <40 kg/m2, 2-with BMI ≥ 40 kg/m2. Each patient underwent 24-h blood pressure monitoring. The average 24-h, daytime and nighttime systolic and diastolic pressure, as well as 24-h mean heart rate and % of nocturnal dip, were assessed. Results: Mean BMI in group 1 was 34.73 kg/m2 (±2.96), and in group 2 it was 47.6 kg/m2 (±6.3). Group 1 was significantly older than group 2 (46.5 vs. 39 years old). The analysis of ABPM revealed significantly higher BP values in all measurements in group 2 (i.e., systolic blood pressure (SBP) 24 h median = 132 mmHg; diastolic blood pressure (DBP) 24 h median = 84 mmHg). The nocturnal dip was greater in group 1 (8.95%). Mean 24-h heart rate was also higher in group 2 (median = 76 beats/min) than group 1 (median = 67.5 beats/min). More than half of patients in group 2 had been previously treated for HT, and based on ABPM, new HT was diagnosed in 6 patients from group 1 and 14 patients from group 2. Three groups of patients were identified based on nighttime dip: dipper, non-dipper, and reverse-dipper. No patient of the extreme dipper type was found. Group 2 comprised of significantly more patients of the reverse-dipper type. Conclusions: Patients with extreme morbid obesity frequently exhibit HT of the reverse-dipping pattern. This type is often linked with a higher risk of more advanced cardiovascular illness.


2019 ◽  
Vol 2 (3) ◽  
pp. 206-214
Author(s):  
Putri Indes Oktabriani ◽  
Fuad Ughi ◽  
Aulia Arif Iskandar

The continuous blood pressure measurement research is widely known for helpingthe development of ambulatory blood pressure monitoring where it measures blood pressureevery 15 to 30 minutes throughout the day. The cuff is a problem for the patient withAmbulatory Blood Pressure Monitor. It can make a person feel uncomfortable and must staystill when the cuff starts to inflate. It is limiting and disturbing their daily activity when thedevice is starting to measure the blood pressure. Blood pressure measurement without cuff isbeing proposed in this research, called cuff-less blood pressure measurement. It will be based onPhotoplethysmography (PPG) and Electrocardiography (ECG) signal analysis. ECG (Lead 1,Lead 2, and Lead 3) with PPG signal produced from index finger on the left hand are comparedand analyzed. Then the relation of PPG and ECG signal and the optimum location for daily usecan be obtained. The optimum location will be based on the electrode’s position that producedthe optimum ECG lead Signal to measure blood pressure. Based on the result, PPG and ECGsignal have a linear relation with Blood Pressure Measurement and Lead 1 is more stable inproducing the ECG signal. The equation from Lead 1 appeared as one of the optimum equationsfor measuring Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP).


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thenral Socrates ◽  
Philipp Krisai ◽  
Annina S. Vischer ◽  
Andrea Meienberg ◽  
Michael Mayr ◽  
...  

AbstractA cuffless blood pressure (BP) device (TestBP) using pulse transit time is in clinical use, but leads to higher BP values compared to a cuff-based 24 h-BP reference device (RefBP). We evaluated the impact of a recent software update on BP results and TestBP’s ability to differentiate between normo- and hypertension. 71 individuals had TestBP (Somnotouch-NIBP) and RefBP measurements simultaneously performed on either arm. TestBP results with software version V1.5 were compared to V1.4 and RefBP. Mean 24 h (± SD) BP for the RefBP, TestBP-V1.4 and TestBP-V1.5 were systolic 134.0 (± 17.3), 140.8 (± 20) and 139.1 (± 20) mmHg, and diastolic 79.3 (± 11.7), 85.8 (± 14.1) and 83.5 (± 13.0) mmHg, respectively (p-values < 0.001). TestBP-V1.5 area under the curve (95% confidence interval) versus RefBP for hypertension detection was 0.92 (0.86; 0.99), 0.94 (0.88; 0.99) and 0.77 (0.66; 0.88) for systolic and 0.92 (0.86; 0.99), 0.92 (0.85; 0.99) and 0.84 (0.74; 0.94) for diastolic 24 h, awake and asleep BP respectively. TestBP-V1.5 detected elevated systolic/diastolic mean 24 h-BP with a 95%/90% sensitivity and 65%/70% specificity. Highest Youden’s Index was systolic 133 (sensitivity 95%/specificity 80%) and diastolic 87 mmHg (sensitivity 81%/specificity 98%). The update improved the agreement to RefBP. TestBP was excellent for detecting 24 h and awake hypertensive BP values but not for asleep BP values.


2011 ◽  
Vol 27 (6) ◽  
pp. 266-268 ◽  
Author(s):  
Tony Joseph Eid ◽  
Amanda A Morris ◽  
Sachin A Shah

Objective: To report a case of hypertension secondary to ingestion of licorice root tea. Case Summary: A 46-year-old African American female with newly diagnosed stage 1 hypertension presented with a blood pressure measurement of 144/81 mm Hg and a reduced plasma potassium level of 3.2 mEq/L. The patient attempted lifestyle modifications prior to initiating an antihypertensive agent, but at a follow-up appointment, her blood pressure remained elevated. A current laboratory panel revealed a depressed morning plasma aldosterone concentration (PAC) of 5 ng/dL and low morning plasma renin activity (PRA) of 0.13 ng/mL/h. Later it was revealed that the patient regularly (1–2 cups/day) consumed “Yogi Calming” tea, a blend of herbs, including licorice root. The patient was advised to discontinue consumption of the herbal tea, and at a subsequent appointment, her blood pressure was 128/73 mm Hg and her laboratory panel had improved, including serum potassium concentration of 4.1 mEq/L, PAC of 6 ng/dL, and PRA of 0.19 ng/mL/h. Discussion: Excessive consumption of licorice has been well documented to cause pseudohyperaldosteronism, characterized by hypertension, hypokalemia, and suppressed plasma renin and aldosterone levels. Glycyrrhizin, the active ingredient in licorice, inhibits 11β-hydroxysteroid dehydrogenase type 2, an oxidase responsible for the conversion and inactivation of cortisol to cortisone. Chronic ingestion of licorice-containing foods has been demonstrated to cause pseudohyperaldosteronism. These include soft candies, lozenges, and dietary supplements, but licorice-containing teas have been infrequently described. Based on the Naranjo probability score, our patient's hypertension appears to have been a probable licorice-induced reaction secondary to a licorice-containing tea. Conclusions: Herbal and dietary supplements are frequently consumed by patients without full knowledge of the contents of the products or the impact on their health. In clinical practice, when hypertension is accompanied by hypokalemia and reduced PRA and PAC, licorice consumption should be investigated and causal hypertension ruled out.


2020 ◽  
Vol 3 (2) ◽  
pp. 48
Author(s):  
Isnaeni Rofiqoch

Non-Communicable Diseases (NCD) is one of the causes of death in the world. Indonesia is a developing country that is facing a double burden of diseases, namely infectious diseases and non-communicable diseases. NCD can appear without symptoms and show no clinical signs, so many people are not aware of the dangers of NCD disease. The purpose of this comunity service is to provide counseling about NCD and measure blood pressure in an effort to detect NCD Early.This community service uses counseling as a method to increases partner knowledge in early detection of NCD. The average of partners knowledge increase by 42.6%. This is calculated by comparing the pre test average value of 5.70 and the post test average value of 8.20. Implementation of community service can increase the knowledge of the elderly posyandu group of Sokaraja Kulon Village so that the participants have the desire to prevent NCD and find out blood pressure from blood pressure measurement results in order to reduce the causes of non-communicable diseases (NCD) and have the intention to inform knowledge about Non-Communicable Diseases (NCD) to Family, Relatives and Communities.Keywords :Early Detection,Non-Communicable Diseases


Author(s):  
Yuki Iwashita ◽  
Kent Nagumo ◽  
Kosuke Oiwa ◽  
Akio Nozawa

AbstractThe increasing number of people with hypertension worldwide has become a matter of grave concern. Blood pressure monitoring using a non-contact measurement technique is expected to detect and control this medical condition. Previous studies have estimated blood pressure variations following an acute stress response based on facial thermal images obtained from infrared thermography devices. However, a non-contact resting blood pressure estimation method is required because blood pressure is generally measured in the resting state without inducing acute stress. Day-long blood pressure variations include short-term variations due to acute stress and long-term variations in circadian rhythms. The aim of this study is to estimate resting blood pressure from facial thermal images by separating and excluding short-term variations related to acute stress. To achieve this, short-term blood pressure variations components related to acute stress on facial thermal images were separated using independent component analysis. Resting blood pressure was estimated with the extracted independent components excluding the short-term components using multiple regression analysis. The results show that the proposed approach can accurately estimate resting blood pressure from facial thermal images, with a 9.90 mmHg root mean square error. In addition, features related to resting blood pressure were represented in the nose, lip, and cheek regions.


Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Jennifer L Cluett ◽  
Anthony Ishak ◽  
Kenneth J Mukamal ◽  
Stephen P Juraschek

Background: Prescription stimulant medications are an important cause of secondary hypertension (HTN) and use is increasing in US adults. Although stimulants are known to increase blood pressure (BP), a systematic approach to assess impact in individual patients is lacking. Further, treating HTN secondary to stimulant use may differ from treatment of essential HTN. Objective: To develop a protocol using ambulatory blood pressure monitoring (ABPM) to differentiate HTN secondary to stimulant use from essential HTN. Methods: We used ABPM to evaluate pre- and post-stimulant systolic blood pressure (SBP) and diastolic blood pressure (DBP) for patients referred to the BIDMC Hypertension Center. Patient charts were reviewed by a clinical pharmacist to ensure the safety of holding the stimulant medication and to determine the duration of action. Average daytime BP on day 1 (off stimulant) was compared to day 2 (on stimulant) to assess the impact of stimulant on BP. We defined normotension as BP <135/<85 on both days, sustained HTN as BP ≥135/≥85 on both days and stimulant-induced HTN as BP <135/<85 on Day 1 and ≥135/≥85 on Day 2. We also defined an increase of SBP≥10 and/or DBP≥ 5 while taking the stimulant as a clinically significant effect on BP. Results: Eleven patients were assessed (see Table). Four had sustained normotension, six had sustained HTN, and one had stimulant-induced HTN. In addition, four of the patients had a clinically significant increase in their BP while on a stimulant. Overall, average increase in SBP was 6.7 mmHg and average increase in DBP was 3.2 mmHg. Conclusion: This novel ABPM protocol was useful for differentiating secondary HTN from stimulant use from essential HTN.


2012 ◽  
Vol 160 (3) ◽  
pp. 434-440.e1 ◽  
Author(s):  
Joseph T. Flynn ◽  
Christopher B. Pierce ◽  
Edgar R. Miller ◽  
Jeanne Charleston ◽  
Joshua A. Samuels ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032342 ◽  
Author(s):  
Ravina Barrett ◽  
James Hodgkinson

ObjectivesThe primary objective was to assess the accuracy (calibration and validation status) of digital blood pressure (BP) monitors used within community pharmacy in England and the secondary objectives were to assess the overall quality of the BP service by assessing service prevalence, service utilisation and other in-service considerations.DesignA cross-sectional survey.SettingPrimary-care retail-pharmacies.Participants500 pharmacies that contribute to government dispensing-data were invited by post to complete the survey. Private contractors were excluded.InterventionsWe conducted a questionnaire survey with a follow-up (September 2018 to December 2018).Results109 responses were received. 61% (n=66) of responding pharmacies provided a free BP check to their patients. 40 (61%) pharmacies used recommended validated clinical metres, 6 (9%) had failed validation and 20 (30%) provided too little information to enable us to determine their monitor’s status.ConclusionsResponding pharmacies were able to provide useful BP monitoring services to their patients, though quality enhancements need to be implemented. Majority of pharmacies use validated BP monitors, however, there was a lack of range of cuff sizes, variation in replacement and calibration of monitors and apparent absence of such practice in a minority of pharmacies alongside variation in training standards. We noted higher frequency of BP screening in the most deprived postcodes.We recommend in-service redesign and delivery improvements, and suggest professional bodies and researchers work together to create clearer frameworks for front-line practitioners, creating appropriate incentives to facilitate this service redesign.Funders and policy setters should consider the value added to the National Health Service and other healthcare agencies of such screening by pharmacy providers both nationally and internationally. It has the potential to reduce complications of undiagnosed hypertension and the medicines burden that it creates. Future work should examine the impact of pharmacist-led BP screening on patients.


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