scholarly journals Patient perceptions, opinions and satisfaction of telehealth with remote blood pressure monitoring postpartum

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicole A. Thomas ◽  
Anna Drewry ◽  
Susan Racine Passmore ◽  
Nadia Assad ◽  
Kara K. Hoppe
Keyword(s):  
Blood Pressure ◽  
Patient Monitoring ◽  
Blood Pressure Monitoring ◽  
Study Endpoint ◽  
Free Text ◽  
Remote Patient Monitoring ◽  
Pressure Monitoring ◽  
Link Type ◽  
Remote Patient

Abstract Background Our aim was to conduct a post participation survey of respondent experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension. We hypothesized that the in-home remote patient monitoring application will be implemented with strong fidelity and have positive patient acceptability. Methods This analysis was a planned secondary analysis of a non-randomized controlled trial of telehealth with remote blood pressure patient monitoring for postpartum hypertension compared to standard outpatient monitoring in women with a hypertension-related diagnosis during pregnancy. In collaboration with survey experts, we developed a 41-item web-based survey to assess 1) perception of quality of care received, 2) ease of use/ease to learn the telehealth program, 3) effective orientation of equipment, 4) level of perceived security/privacy utilizing telehealth and 5) problems encountered. The survey included multiple question formats including Likert scale responses, dichotomous Yes/No responses, and free text. We performed a descriptive analysis on all responses and then performed regression analysis on a subset of questions most relevant to the domains of interest. The qualitative data collected through open ended responses was analyzed to determine relevant categories. Intervention participants who completed the study received the survey at the 6-week study endpoint. Results Sixty six percent of respondents completed the survey. The majority of women found the technology fit easily into their lifestyle. Privacy concerns were minimal and factors that influenced this included age, BMI, marital status, and readmissions. 95% of women preferred remote care for postpartum follow-up, in which hypertensive type, medication use and ethnicity were found to be significant factors in influencing location of follow-up. Most women were satisfied with the devices, but rates varied by hypertensive type, infant discharge rates and BMI. Conclusions Postpartum women perceived the telehealth remote intervention was a safe, easy to use method that represented an acceptable burden of care and an overall satisfying method for postpartum blood pressure monitoring. Trial registration ClinicalTrials.gov identification number: NCT03111095 Date of registration: April 12, 2017.

scholarly journals Patient Perceptions, Opinions and Satisfaction of Telehealth With Remote Blood Pressure Monitoring Postpartum

2020 ◽  
Author(s):  
Nicole Thomas ◽  
Anna Drewry ◽  
Susan Passmore ◽  
Nadia Assad ◽  
Kara Hoppe
Keyword(s):  
Blood Pressure ◽  
Patient Monitoring ◽  
Blood Pressure Monitoring ◽  
Controlled Trial ◽  
Ease Of Use ◽  
Study Endpoint ◽  
Free Text ◽  
Pressure Monitoring ◽  
Discharge Rates

Abstract Background: We conducted a post participation process evaluation of participant experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension. In collaboration with expert opinion, we developed a self-administered questionnaire to investigate patient factors we hypothesized to be relevant influencing participant perceptions. Factors included type of hypertension, medication, maternal demographics, and infant discharge rates. Methods: This analysis was a planned secondary analysis of a non-randomized controlled trial of telehealth with remote blood pressure patient monitoring for postpartum hypertension compared to standard outpatient monitoring in women with a hypertension-related diagnosis during pregnancy. In collaboration with survey experts, we developed a 41-item web-based survey to assess 1) perception of quality of care received, 2) ease of use/ease to learn the telehealth program, 3) effective orientation of equipment, 4) level of perceived security/privacy utilizing telehealth and 5) problems encountered. The survey included multiple question formats including Likert scale responses, dichotomous Yes/No responses, and free text. We performed a descriptive analysis on all responses and then performed regression analysis on a subset of questions most relevant to the domains of interest. The qualitative data collected through open ended responses was analyzed to determine relevant categories. Study participants received the survey at the 6-week study endpoint. Results: 60% of participants completed the survey. The majority of women found the technology fit easily into their lifestyle. Privacy concerns were minimal and factors that influenced this included age, BMI, marital status, and readmissions. 95% of women preferred remote care for postpartum follow-up, in which hypertensive type, medication use and ethnicity were found to be significant factors in influencing location of follow-up. Most women were satisfied with the devices, but rates varied by hypertensive type, infant discharge rates and BMI. Conclusions: Postpartum women perceived the telehealth remote intervention was a safe, easy to use method that represented an acceptable burden of care and an overall satisfying method for postpartum blood pressure monitoring. Trial registration: ClinicalTrials.gov identification number: NCT03111095, Date of registration: April 12, 2017.

scholarly journals Role of Ambulatory Blood Pressure Monitoring in Predicting Adverse Maternofetal Events in Pregnancy

2021 ◽  
Author(s):  
Satish Kumar Rao Vavilala ◽  
Indrani Garre ◽  
Sumalatha Beeram
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Standard Deviation ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Statistical Significance ◽  
Binary Logistic Regression ◽  
Pressure Monitoring ◽  
In Pregnancy

Abstract Aims To correlate the relationship between the ambulatory blood pressure parameters and the occurrence of the antenatal and postnatal adverse maternofetal events in pregnancy. Methods Observational study designed for 50 pregnant patients who had an appointment to the obstetrics with abnormal blood pressure (BP) measurements and for whom ambulatory blood pressure monitoring (ABPM) was studied between January 2019 and June 2019. Data about age, personal history, obstetrics, family, body mass index (BMI), weight gain in pregnancy, values of blood pressure in the appointment, values recorded in ABPM, delivery and newborn, pregnancy and postpartum events, and follow-up of woman and child. Data were analyzed using descriptive and inferential statistics with Minitab 17.0 for Windows. Results Patients demographic data, clinical history, and laboratory results, including the ABPM parameters, were compiled. Antenatal complications occurred in 22 patients (44%), and postpartum complications were found in 41 patients (82%) whose ABPM values were deranged. Antenatal complications were studied using the binary logistic regression analysis for calculating the role each factor played in the development of hypertension. In the sample studied, mean age was 24.980 with a standard deviation of 4.876 (p = 0.003; minimum age of 19 years and maximum age of 38 years), mean weight of patient was 63.71 with a standard deviation of 63.71 (p = 0.001), mean gravida was 1.780 with a standard deviation of 0.910 (p = 0.034), mean gestation weeks at presentation was 33.000 weeks with a standard deviation of 4.086 (p = 0.041), mean birth weight was 2.226 with a standard deviation of 0.797 (p = 0.000), mean maximum diastole was 109.22 with a standard deviation of 16.53 (p = 0.002), mean day maximum systole was 187.2 with a standard deviation of 203.5 (p = 0.009), mean day minimum diastole was 63.50 with a standard deviation of 12.99 (p = 0.013), all of which had statistical significance. It is found that the nighttime diastolic blood pressure (DBP) and daytime maximum systolic blood pressure (SBP) were the best predictors of adverse events. Among antenatal complications (ANC), the most common complication is intrauterine growth restriction (IUGR), noted in (n = 19, 86.36%) preterm delivery (n = 17, 77.27%) among the 17 babies who were delivered preterm; 12 (70.5%) needed neonatal intensive care unit (NICU) care of which 4 (25%) babies died because of prematurity; intrauterine death (IUD) was noted in 7 (31.81%) patients and eclampsia was seen in 5 (22.72%). Nondippers proðle had a worse survival rate at follow-up until delivery compared with those with a dipper proðle. Postnatal complications were seen in 41 patients; among them, 13 patients (31.7%) had abnormal fundus examination, 15 patients (36.58%) required usage of antihypertensive beyond first postpartum, 9 patients (21.95%) required blood transfusion for severe bleeding in the form of postpartum hemorrhage. Binary logistic regression for systolic dippers versus nondippers shows statistical significance in age (p = 0.023), weight (p = 0.038), and para (p = 0.045) (Table 3). Binary logistic regression for diastolic dippers versus nondippers shows statistical significance in age (p = 0.039), weight (p = 0.020), birth weight (p = 0.010), maximum heart rate (p = 0.043), and ANC (p = 0.007) Adverse events occurred most commonly in nondippers. Systole nondippers is noted in (n = 41, 82%). Dippers is noted in (n = 9, 18%), Diastole nondippers is noted in (n = 39, 78%) Dippers is noted in (n = 11, 22%). Conclusion ABPM recorded blood pressure is very precise. ABPM is the advised method for both diagnostic and therapeutic monitoring of hypertensive pregnancy diseases, mainly in situations like whitecoat hypertension, masked hypertension, nocturnal hypertension, and nondipping profile. In patients with high-risk pregnancy, elderly primigravida, and precious pregnancy, who have a high-risk of developing pregnancy-induced hypertension (PIH) and related complications, early use of ABPM predicts adverse maternofetal events, which when intervened at an earlier date can prevent antenatal and postnatal complications.

Follow-Up of a Method of Twenty-Four-Hour Indirect Blood Pressure Monitoring: Evaluation of Carvedilol, a New Antihypertensive Agent

Nephron ◽  
1987 ◽  
Vol 47 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Wolfgang Meyer-Sabellek ◽  
Karl-Ludwig Schulte ◽  
Armin Distler ◽  
Reinhard Gotzen
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Agent ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Indirect Blood Pressure

Two-Year Follow-Up of 24-Hour Indirect Blood Pressure Monitoring: An Open Study

Drugs ◽  
1988 ◽  
Vol 36 (Supplement 6) ◽  
pp. 106-112 ◽  
Author(s):  
Wolfgang Meyer-Sabellek ◽  
Karl-Ludwig Schulte ◽  
Bernd Streitberg ◽  
Reinhard Gotzen
Keyword(s):  
Blood Pressure ◽  
Open Study ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Indirect Blood Pressure

scholarly journals Dynamics of blood pressure indicators in patients with diabetes mellitus after planned percutaneous coronary intervention

2021 ◽  
Vol 17 (1) ◽  
pp. 12-20
Author(s):  
A. M. Kochergina ◽  
O. L. Barbarash
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Effective Control ◽  
Pressure Monitoring ◽  
Night Time ◽  
Percutaneous Coronary ◽  
History Of ◽  
Pressure Indicators

Arterial hypertension (AH) is a common modifiable cardiovascular risk factor. Despite the wide choice of antihypertensive drugs, according to epidemiological studies, just over 20% of patients demonstrate effective control of hypertension. Failure to achieve the target values of blood pressure (BP) determines a high probability of developing cardiovascular events, which is also true for patients undergoing percutaneous coronary interventions (PCI). However, there is evidence that individuals who have undergone PCI show a higher percentage of achieving the target blood pressure levels. Aim of the study was to evaluate the dynamics of blood pressure indicators in patients with stable coronary artery disease (CAD) and diabetes mellitus, depending on the fact of performing PCI.Material and methods. The study was conducted at federal state budgetary scientific institution research institute of complex issues of cardiovascular diseases as a prospective, open, not comparative. The study included 75 patients with stable CAD and type 2 diabetes who regularly received therapy for at least 1 month prior to the start of participation in this study. The majority of patients 45 (60%) are represented by males. The median age was 52.64±6.96 years. 44 patients (58.81%) had a history of myocardial infarction, and 46 patients (61.33%) had previously undergone myocardial revascularization, history of stroke had 5 patients (6.66%). All patients according to the daily blood pressure monitoring at the 1st visit had average daily blood pressure values above 130/80 mmHg. Participants were divided into 2 groups: 43 patients had indications for routine PCI at the time of inclusion in the study, 32 patients had no indications for revascularization. The groups did not have significant differences in clinical and anamnestic characteristics, and regular significant differences were noted in relation to previously undergone revascularization (46.51 and 81.25%, respectively, p=0.0022) and the SYNTAX Score (14.39±9.20 and 6.13±8.28, respectively, p=0.0001). During 4 visits (1 visit, 1 month, 3 months, 6 months), ambulatory blood pressure monitoring (ABPM) was performed using the BiPiLAB system.Results. Initially according ABPM parameters group without the alleged PCI had greater variability in systolic blood pressure (SBP) in the daytime, higher values of mean diastolic blood pressure (DBP) at night, more time index of hypertension DBP at night. After 1 month of follow — up (for the group with PCI 1 month after the procedure), there were significant differences in the average daily SBP and DBP, the index of the time of hypertension DBP in the daytime, and the average daily SBP. Patients who underwent revascularization had lower ABPM values. The previously described differences in the night time DBP and the index of hypertension time at night were preserved. After 3 months of follow-up, significant differences were observed only in the indicators of night time SAD and DBP. At the end of the study (6 months of follow-up), the groups had differences only in the indicators of mean diastolic pressure at night.Conclusion. Patients who underwent PCI for 1 month after the procedure have a significant tendency to normalize (compared to the group without revascularization) blood pressure indicators. However, over time, the effect «escapes». Most likely, the short-term improvement in blood pressure is due to a temporary improvement in treatment adherence after an invasive procedure.

scholarly journals Correlation Between Divided Doses of Chronic Antihypertensive Drugs and Pregnancy Outcomes

2017 ◽  
Vol 8 (3) ◽  
pp. 328-332
Author(s):  
Safura Hatamipour Dehno ◽  
Simin Taghavi ◽  
Nayyereh Ayati
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Pressure Monitoring ◽  
Fetal Complications

Objectives: Hypertension, as a common problem during pregnancy, is a major cause of maternal and fetal morbidity and mortality. Anti-hypertensive drugs are used to prolong the pregnancy or modify perinatal outcomes in pregnant women with hypertensive disorders. Severe monitoring of blood pressure is subsequently essential in these mothers. The aim of this study was to evaluate the correlation between divided doses of chronic hypertensive drugs and the end of pregnancy in mothers with gestational hypertension. Materials and Methods: In this prospective research, 99 pregnant women with chronic hypertension, who were treated with antihypertensive medicines, were studied during pregnancy. During routine follow-up of these mothers, the number of the drug and the divided doses were recorded. The incidence of maternal and fetal outcomes were evaluated according to the number of less or more than 5 divided doses. Results: Maternal and fetal-baby complications were observed in 5.50 and 5.53% cases, respectively. The incidence of maternal and fetal complications were significantly enhanced by increasing the number of up-taken anti-hypertensive drugs. The maternal and fetal-baby complications were higher in mothers who received more than five divided doses compared to those who received less than five doses. Conclusion: Based on our results, chronic hypertension was associated with maternal and fetal-baby complications in half of the cases. It is clarified that precise blood pressure monitoring and regularly taking of anti-hypertensive medicine may decrease the hypertension side effects. The awareness about this field in the pre-pregnancy consulting is considered as the patients’ rights and should be respected.

scholarly journals Radiofrequency renal denervation with mono-electrode and multi-electrode device for treatment in patient with uncontrolled hypertension: results of a 6-month follow-up

2020 ◽  
Vol 17 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Regina A. Agaeva ◽  
Nikolai M. Danilov ◽  
Galina V. Shchcelkova ◽  
Yuri G. Matchin ◽  
Irina E. Chazova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Renal Denervation ◽  
Blood Pressure Monitoring ◽  
Hypotensive Effect ◽  
Uncontrolled Hypertension ◽  
Pressure Monitoring ◽  
Group A ◽  
Group B

Aim. To study the efficacy and safety of radiofrequency renal denervation with mono-electrode and multi-electrode devices in patients with uncontrolled arterial hypertension during а 6-month follow-up period. Materials and methods. The study included 52 patients with uncontrolled arterial hypertension, while receiving multicomponent antihypertensive therapy, including diuretic. Patients underwent radiofrequency renal denervation with a mono-electrode (group A; n=27) and multi-electrode devices (group B; n=25). The effectiveness of the procedure was study according to office blood pressure (BP) and ambulatory blood pressure monitoring (ABPM). Results. In group A and B, according to office BP after 6 months, there decreased in SBP/DBP by 32/14 and 30/10 mmHg (р=0.00001/р=0.00001 and p=0.00001/0.0004) respectively. According to ABPM, in group A there was a decrease in the average daily SBP and DBP by 7 and 4 mmHg (р=0.01 and р=0.03) respectively. According to ABPM, after 6 months in group B, there was a decrease in the average daily SBP and DBP by 12 and 6 mmHg (р=0.0003 and р=0.0007) respectively. Conclusions. The results confirm the safety and effectiveness of radiofrequency renal denervation. RDN of the distal branches of the renal arteries leads to a greater hypotensive effect.

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