scholarly journals Clinical applications for out-of-office blood pressure monitoring

2020 ◽  
Vol 11 ◽  
pp. 204062232090166 ◽  
Author(s):  
Hailan Zhu ◽  
Haoxiao Zheng ◽  
Xinyue Liu ◽  
Weiyi Mai ◽  
Yuli Huang
Keyword(s):  
Blood Pressure ◽  
Clinical Studies ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Epidemiological Data ◽  
Organ Damage ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring

Hypertension is one of the most common chronic diseases as well as the leading risk factor for cardiovascular disease (CVD). Efficient screening and accurate blood pressure (BP) monitoring are the basic methods of detection and management. However, with developments in electronic technology, BP measurement and monitoring are no longer limited to the physician’s office. Epidemiological and clinical studies have documented strong evidence for the efficacy of out-of-office BP monitoring in multiple fields for managing hypertension and CVD. This review discusses applications for out-of-office BP monitoring, including home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM), based on recent epidemiological data and clinical studies regarding the following factors: the detection of abnormal BP phenotypes, namely, white coat hypertension and masked hypertension; stronger ability to determine the prognosis for target organ damage and mortality; better BP control; screening for hypotension; and unique approaches to identifying circadian BP patterns and BP variability.

scholarly journals State-of-the-Art review: Home blood pressure monitoring: current status and new developments

2021 ◽  
Author(s):  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Home Blood Pressure ◽  
Target Organ ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Increased Risk

Abstract Home blood pressure monitoring (HBPM) is a reliable, convenient and less costly alternative to ambulatory blood pressure monitoring (ABPM) for the diagnosis and management of hypertension. Recognition and use of HBPM has dramatically increased over the last 20 years and current guidelines make strong recommendations for the use of both HBPM and ABPM in patients with hypertension. The accuracy and reliability of home BP measurements requires use of a validated device and standardized procedures, and good patient information and training. Key HBPM parameters include morning BP, evening BP and the morning-evening difference. In addition, newer semi-automatic HBPM devices can also measure nighttime BP at fixed intervals during sleep. Advances in technology mean that HBPM devices could provide additional relevant data (e.g. environmental conditions) or determine BP in response to a specific trigger (e.g. hypoxia, increased heart rate). The value of HBPM is highlighted by a growing body of evidence showing that home BP is an important predictor of target organ damage, and cardiovascular disease- and stroke-related morbidity and mortality, and provides better prognostic information than office BP. In addition, use of HBPM to monitor antihypertensive therapy can help to optimize reductions in BP, improve BP control, and reduce target organ damage and cardiovascular risk. Overall, HBPM should play a central role in the management of patients with hypertension, with the goal of identifying increased risk and predicting the onset of cardiovascular disease events, allowing proactive interventions to reduce risk and eliminate adverse outcomes.

scholarly journals Phenotyping of masked hypertension based on the clustering of 24-hour blood pressure monitoring data

2020 ◽  
Vol 25 (3) ◽  
pp. 3286
Author(s):  
B. I. Geltser ◽  
K. I. Shakhgeldyan ◽  
V. N. Kotelnikov ◽  
O. O. Vetrova ◽  
V. V. Orlova-Ilyinskaya ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
Balanced Distribution ◽  
R Programming ◽  
Glomerular Filtration Rate Estimation

Aim. Phenotyping of masked hypertension (MH) based on clustering of 24-hour ambulatory blood pressure monitoring (ABPM) results data and comparing it with indicators of target organ damage.Material and methods. We retrospectively analyzed medical records of 207 men with a median age of 34,6 years and normal office blood pressure (BP), who were systematically exposed to occupational stressors and were undergoing a routine in-patient examination. All patients underwent ABPM, echocardiography, carotid ultrasound, glomerular filtration rate estimation. The clustering of ABPM data was carried out using the Kohonen self-organizing neural networks and K-means algorithm. Data processing was performed in the R programming language using the RStudio environment.Results. MH was diagnosed in 142 (68,6%) patients which were divided into 3 clusters according to 4 criteria factors of ABPM: systolic-diastolic (SDMH) — 50,7%, isolated systolic (ISMH) — 27,5% and isolated diastolic (IDMH) — 21,8%. Majority (51,4%) of patients with SDMH were characterized by a relatively balanced distribution of episodes of increased systolic and diastolic BP during the day, and other ratios were much less common. In patients with ISMH, hypertension prevailed in the daylight, and in IDMР — nighttime. Individual clusters differed significantly in terms of the 24-hour BP profile and signs of target organ damage. Various types of cardiac remodeling were recorded in 24 (17%) patients with MH, 16 (66,7%) of which belonged to the SDMH phenotype. Intima-media thickening >0,9 mm occurred in 40% of patients with IDMH, in 30% — SDMH and only 9% — ISMH. At the same time, the majority of patients with glomerular hyperfiltration was recorded in patients with ISMH (20,5%), and with hypofiltration — IDMH (29%) and SDMH (23,6%).Conclusion. Modern technologies of clustering increase the effectiveness of risk stratification for patients with MH, and contribute to the personification of preventive and therapeutic programs.

Prevalence and risk factors of white-coat hypertension and masked hypertension in Shunde District,Southern China:Observational Study (Preprint)

2021 ◽  
Author(s):  
Yuli Huang ◽  
Haoxiao Zheng ◽  
Xiaoyan Liang ◽  
Chunyi Huang ◽  
Lichang Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Family History ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
History Of

BACKGROUND White-coat hypertension (WCH) and masked hypertension (MH) can increase the risk of target organ damage. Home blood pressure monitoring is an important method for detecting WCH and MH. However, the prevalence and risk factors of WCH and MH in China has been rarely reported. OBJECTIVE To explore the prevalence and risk factors associated with white coat hypertension (WCH) and masked hypertension (MH) in Shunde District, Southern China. METHODS This study recruited subjects from the Physical Examination Center in Shunde Hospital, Southern Medical University. Office blood pressure and home blood pressure values were collected. The prevalence of WCH and MH was calculated by combining the office blood pressure and home blood pressure values. Multivariate logistic regression was used to explore the related risk factors for WCH and MH. RESULTS Four-hundred and sixty-one participants (61% male), with an average age of 49 years, were included. The incidence of WCH and MH was 5.1% and 15.2%, respectively. Multivariate logistic regression analysis showed that smoking (OR=4.71, 95%CI=1.05-21.15) and family history of coronary heart disease (OR=4.51, 95%CI=1.08-18.93) were associated with higher odds of WCH. The associated factors for higher odds of MH were smoking (OR=2.83, 95%CI=1.11-7.23), family history of hypertension (OR=2.17, 95%CI=1.11-4.26) and family history of coronary heart disease (OR=2.82, 95%CI=1.07-7.45). CONCLUSIONS WCH and MH are highly prevalent in the health check-up population in Southern China. Out-of-office blood pressure monitoring, especially home blood pressure monitoring with a telemedicine device should be recommended to identity abnormal BP phenotype. CLINICALTRIAL It has been registered in the Chinese Clinical Trial Registry(ChiCTR1800018515)

scholarly journals Assessment of the diagnostic accuracy of home blood pressure monitoring by patients

2020 ◽  
Vol 10 (4) ◽  
pp. e31-e31
Author(s):  
Sepideh Hajian ◽  
Nafiseh Rastgoo ◽  
Sanaz Jamshidi
Keyword(s):  
Blood Pressure ◽  
Diagnostic Accuracy ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
High Level

Introduction: According to available guidelines, home blood pressure monitoring (HBPM) can be used to diagnose hypertension and monitor its treatment; however, its effectiveness has rarely been studied in developing countries, including Iran. Objectives: This study aimed to evaluate the diagnostic accuracy of HBPM, as compared with that of 24-hour ambulatory blood pressure monitoring (ABPM) and office blood pressure measurement (OBPM). Patients and Methods: This study was conducted on 28 patients suspected of having primary hypertension. The blood pressure of the patients was measured by four methods. Initially, blood pressure was measured by a non-physician using a digital sphygmomanometer in a clinic (OBPM-Digital). After about 1 hour, blood pressure was measured by a physician at the clinic using a mercury sphygmomanometer (OBPM-Mercury). In the third stage, the patient’s blood pressure was monitored for 24 hours by the ABPM method. In the fourth stage, each subject used a digital sphygmomanometer to measure HBPM for seven consecutive days. Results: The blood pressure values measured through the ABPM method were significantly lower than those measured by other methods (P<0.05). The prevalence of hypertension diagnosed by OBPM-Mercury, OBPM-Digital, HBPM, and ABPM method was 82%, 54%, 50%, and 21%, respectively. As compared with ABPM as the gold standard, the diagnostic accuracy of HBPM, OBPM-Digital, and OBPM-Mercury was 64%, 61%, and 32%, respectively. The frequency of white coat hypertension (WCH) diagnosed by HBPM and ABPM methods was 39% and 64%, respectively, and the frequency of masked hypertension (MH) diagnosed was 7% and 4%, respectively. The sensitivity, specificity, and diagnostic accuracy of HBPM, as compared with ABPM, in detecting MH were 100%, 96%, and 97%, respectively; in addition, as compared with WCH, they were 56%, 90%, and 68%, respectively. Conclusion: The findings of the present study showed that HBPM had higher diagnostic accuracy than OBPM in diagnosing hypertension. Also, HBPM was able to detect MH with a high level of diagnostic accuracy, and in more than two-thirds of cases, it was also able to detect WCH and diagnose patients with sustained hypertension.

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