AN EVALUATION OF THE FLUSH METHOD FOR DETERMINING BLOOD PRESSURES IN INFANTS

PEDIATRICS ◽  
1957 ◽  
Vol 20 (1) ◽  
pp. 53-62
Author(s):  
Arthur J. Moss ◽  
Wilbert Liebling ◽  
Wallace O. Austin ◽  
Forrest H. Adams
Keyword(s):  
Blood Pressure ◽  
Congenital Heart ◽  
Older Children ◽  
Blood Pressure Cuff ◽  
Pressure Cuff ◽  
Direct Measurements ◽  
Blood Pressures ◽  
Accurate Procedure ◽  
The Mean ◽  
Disease Analysis

Using the flush technique, determinations of blood pressure were made on 294 normal infants from 1 day to 1 year of age and on 23 additional infants and older children with congenital heart disease. Analysis of the data showed that: The method was found to be a practical and relatively accurate procedure in the office or clinic. The pressure at the ankle was usually significantly lower than that at the wrist. Comparative studies with auscultatory and direct measurements indicated that values obtained by the flush technique represent the mean rather than the systolic blood pressure. Readings obtained with a 5 cm blood pressure cuff did not differ significantly from those obtained with a 7.0 cm or 9.5 cm cuff.

Unmasking the borderline coarctation: the utility of isoproterenol in the paediatric cardiac catheterisation laboratory

2018 ◽  
Vol 28 (6) ◽  
pp. 804-810 ◽  
Author(s):  
Neil D. Patel ◽  
Patrick M. Sullivan ◽  
Cheryl M. Takao ◽  
Sarah Badran ◽  
Joseph Ahdoot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coarctation Of The Aorta ◽  
Cardiac Catheterisation ◽  
Blood Pressure Cuff ◽  
Post Intervention ◽  
Arterial Blood ◽  
Pressure Cuff ◽  
Blood Pressures ◽  
The Mean ◽  
The Impact

AbstractBackgroundOne indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state.ObjectivesWe aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients.MethodsA retrospective study was performed on two-ventricle patients who underwent cardiac catheterisation for coarctation with isoproterenol testing.Results25 patients received isoproterenol before and after intervention. With isoproterenol, the mean diastolic (p=0.0015) and mean arterial (p=0.0065) blood pressures proximal to the coarctation decreased significantly. The mean systolic, diastolic, and mean arterial blood pressures distal to the coarctation decreased significantly (p<0.0001). In patients with a baseline gradient ⩽20 mmHg (n=17) at catheterisation, the median gradient increased from 10 (0–20) to 30 (15–50) mmHg (p<0.0001) with isoproterenol. Of these, 15 patients developed a gradient >20 mmHg. Post intervention, the median gradient decreased to 2 (0–29) mmHg, versus baseline, p=0.005, and with isoproterenol it decreased to 8 (0–27) mmHg, versus pre-intervention isoproterenol, p<0.0001. There were significant improvements in the gradients by Doppler (<0.0001) and by blood pressure cuff (p=0.0313). The gradients on isoproterenol best correlated with gradients by blood pressure cuff in the awake state (R2=0.76, p<0.0001).ConclusionsIsoproterenol can be a useful tool to assess the significance of a coarctation and the effectiveness of an intervention. Percutaneous interventions can effectively reduce the gradients elicited by isoproterenol.

POSITIONING THE BLOOD PRESSURE CUFF

Nursing ◽  
1976 ◽  
Vol 6 (10) ◽  
pp. 18-29
Author(s):  
Rebecca Sills ◽  
Carolyn M. Jarvis
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Cuff ◽  
Pressure Cuff

Abstract P606: Hemodynamic Predictors of Multiple Recurrent Strokes in the Patients With Prior Lacunar Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Alexandra Kvernland ◽  
Alen Delic ◽  
Ka-ho Wong ◽  
Nazanin Sheibani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Failure Time ◽  
Recurrent Stroke ◽  
Cox Proportional Hazards Model ◽  
Lacunar Stroke ◽  
Blood Pressures ◽  
Recurrent Strokes ◽  
The Mean

Background: Recurrent stroke has higher morbidity and mortality than incident stroke. We evaluated hemodynamic risk factors for multiple recurrent strokes. Methods: We included patients in the SPS3 trial. The primary predictor was the top tertile, compared to the bottom tertile, of the mean systolic blood pressure (mSBP) and blood pressure variability represented as standard deviation (sdSBP) using blood pressures from day 30 of the trial to the end of follow-up. We excluded blood pressures from the first 30 days to reduce confounding from the trial’s intervention. We fit a logistic regression model to ≥2 recurrent strokes from day 30 to the end of follow-up and, to accurately analyze the multiple failure-time data, we ordered the multiple failure events to the Prentice, Williams and Peterson extension of the Cox proportional-hazards model. Results: We included 2,882 patients, of which 223 had a recurrent stroke and 41/223 had ≥2 recurrent strokes for a total of 272 strokes. The mean (SD) number of blood pressure readings was 78.0 (37.4). The etiology of the 272 strokes was 161 (59.2%) lacunar, 22 (8.1%) intracranial atherosclerosis, 10 (3.7%) extracranial atherosclerosis, 24 (8.8%) cardioembolic, and 55 (20.2%) cryptogenic or other. In both unadjusted and adjusted logistic regression models and PWP Cox models, the top tertile of sdSBP was consistently predictive of multiple recurrent strokes, while mSBP was not (Tables 1/2). Conclusions: We found that in patients with an index lacunar stroke, higher SBP variability, but not mean SBP, was predictive of multiple recurrent strokes of varying mechanisms.

scholarly journals Negative Air Pressure on Wet Cupping in Decreasing Blood Pressures in Hypertensive Patients

2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast
Keyword(s):  
Blood Pressure ◽  
Repeated Measures ◽  
Community Health Centers ◽  
Intervention Group ◽  
Air Pressure ◽  
Control Group ◽  
P Value ◽  
Decrease Blood Pressure ◽  
Blood Pressures ◽  
The Mean

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.

scholarly journals Fibroblast Growth Factor 23 and Blood Pressure in Older Adults

Hypertension ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 236-243
Author(s):  
David A. Drew ◽  
Ronit Katz ◽  
Stephen Kritchevsky ◽  
Joachim H. Ix ◽  
Michael G. Shlipak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Growth Factor ◽  
Fibroblast Growth Factor 23 ◽  
Fibroblast Growth ◽  
Antihypertensive Medications ◽  
Incident Hypertension ◽  
Blood Pressures ◽  
The Mean ◽  
Fgf 23

FGF-23 (fibroblast growth factor 23) regulates phosphorus and vitamin D. Elevated FGF-23 is associated with incident hypertension in young- and middle-aged adults, but there is limited data in older adults. Serum FGF-23 was measured using an intact ELISA assay in 2496 participants of the Healthy Aging and Body Composition Study. The association between FGF-23 and prevalent hypertension (self-reported and confirmed by use of antihypertensive medications) and number of antihypertensive medications was determined. The associations between FGF-23 and incident hypertension, and diastolic and systolic blood pressure trajectories were evaluated over 10 years. Models were adjusted for demographics, estimated glomerular filtration rate and albuminuria, cardiovascular disease risk factors, and measures of mineral metabolism. The mean (SD) age was 75 (3) years, with 51% women, and 40% black participants. The prevalence of hypertension at baseline was 75% and the mean systolic and diastolic blood pressures were 134 (21) mm Hg and 70 (12) mm Hg, respectively. The majority of participants without hypertension at baseline developed incident hypertension (576 of 1109 or 52%). In adjusted models, each 2-fold higher FGF-23 was associated with prevalent baseline hypertension (odds ratio=1.46 [1.24–1.73]) and greater number of blood pressure medications (IRR=1.14 [1.08–1.21]) but not with baseline diastolic or systolic blood pressure. In fully adjusted longitudinal analyses, a 2-fold higher FGF-23 was associated with incident hypertension (hazard ratio=1.18 [1.03–1.36]) and worsening systolic blood pressures (β=0.24 [0.08–0.40] mm Hg per year increase), but not with diastolic blood pressures (β=0.04 [−0.04 to 0.12] mm Hg per year increase). Higher FGF-23 concentrations are associated with prevalent and incident hypertension as well as rising systolic blood pressures in community-living older adults.

Maintenance of Goal Blood Pressure following Conversion from Lisinopril to Fosinopril

2003 ◽  
Vol 19 (5) ◽  
pp. 266-270
Author(s):  
Maqual R Graham ◽  
Nicole M Allcock ◽  
Cameron C Lindsey
Keyword(s):  
Blood Pressure ◽  
Goal Attainment ◽  
Prospective Observational Study ◽  
Goal Blood Pressure ◽  
Assessment Visit ◽  
Blood Pressures ◽  
Blood Pressure Goals ◽  
The Mean ◽  
Medical Histories ◽  
Prescribing Information

Objective: To determine whether blood pressure could be maintained for patients on lisinopril following conversion to a theorized, therapeutic dose of fosinopril. The tolerability of fosinopril was also assessed. Methods: Subjects receiving lisinopril were considered candidates for this prospective, observational study. Prescribing information for both lisinopril and fosinopril suggested a milligram-to-milligram equivalency. Patients taking lisinopril 10 mg/d were switched to fosinopril 10 mg/d. Blood pressures were compared at baseline and 2, 6, and 18 weeks after conversion. A goal blood pressure of <140/90 mm Hg was assigned to all patients at enrollment and used to determine goal attainment at baseline and 18 weeks. More aggressive blood pressure goals are currently recommended; thus, medical histories were reevaluated at the end of the study and new goals were assigned and assessed. Adverse effect occurrence was also compared between visits. Results: One hundred thirty-three subjects were enrolled. The mean dose of lisinopril prior to conversion was 15 ± 11 mg/d compared with the mean final fosinopril dose of 20 ± 14 mg/d. Both the mean systolic and diastolic blood pressures increased significantly at the 18-week visit when compared with baseline (p = 0.00007 and p = 0.015, respectively). Using a goal blood pressure of <140/90 mm Hg, there was no difference detected between the baseline and the final assessment visit (p = 0.851). A greater number of subjects were unable to achieve goal status at 18 weeks when compared with baseline after applying the newly defined goals (p = 0.003). Sixteen of the original 133 subjects discontinued fosinopril due to adverse events. Conclusions: When converting subjects from lisinopril to fosinopril, equivalent blood pressure may be difficult to achieve without increasing the dose of fosinopril.

Incidence of Fractures From Perioperative Blood Pressure Cuff Use, Tourniquet Use, and Patient Positioning in Osteogenesis Imperfecta

2019 ◽  
Vol 39 (1) ◽  
pp. e68-e70 ◽  
Author(s):  
Brian T. Sullivan ◽  
Adam Margalit ◽  
Vaibhav S. Garg ◽  
Dolores B. Njoku ◽  
Paul D. Sponseller
Keyword(s):  
Blood Pressure ◽  
Osteogenesis Imperfecta ◽  
Patient Positioning ◽  
Blood Pressure Cuff ◽  
Pressure Cuff

scholarly journals Relationship between severity of hypertension and renal impairment in preeclampsia

2018 ◽  
Vol 11 (3) ◽  
pp. 213
Author(s):  
Khairun Nahar ◽  
Ferdousi Islam ◽  
Naila Atik Khan
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Uric Acid ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Preeclamptic Patient ◽  
Blood Pressures ◽  
Mild Preeclampsia ◽  
The Mean ◽  
The Relationship

<p class="Abstract">The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient.</p>

Abstract P129: Role of the Autonomic Nervous System in Remote Postconditioning in Humans

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Rupert P Williams ◽  
Michael I Okorie ◽  
Harminder Gill ◽  
John E Deanfield ◽  
Raymond J MacAllister ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Whole Body ◽  
Limb Ischaemia ◽  
Protective Effects ◽  
Blood Pressure Cuff ◽  
Autonomic Nervous ◽  
Pressure Cuff ◽  
Remote Postconditioning

Brief periods of ischaemia activate systemic mechanisms that induce whole-body tolerance to subsequent prolonged and injurious ischaemia. This phenomenon, remote ischaemic preconditioning (RIPC), is sufficiently acute to reduce ischaemia-reperfusion (IR) injury even when applied simultaneously with injurious ischaemia. This aspect of RIPC is termed remote postconditioning (RPostC). We have previously demonstrated a role for the autonomic nervous system in RIPC. Using an in vivo model of endothelial IR injury, we determined if RPostC is dependent on adrenergic autonomic mechanisms. Vascular ultrasound was used to assess endothelial function in healthy volunteers by measuring dilatation of the brachial artery in response to increased blood flow during reactive hyperaemia (flow-mediated dilatation; FMD). Endothelial IR injury was induced by 20 min of upper limb ischaemia (inflation of a blood pressure cuff to 200 mm Hg) followed by reperfusion. RPostC was induced by applying 2 cycles of 5 minutes ischaemia and 5 minutes reperfusion on the leg during arm ischaemia (via a second blood pressure cuff). In order to determine the dependence of RPostC on autonomic activation, we administered the alpha adrenoceptor blocker phentolamine (0.2– 0.7mg/min, intravenously) during the application of the RPostC stimulus. FMD was determined before ischaemia and at 20 minutes of reperfusion. FMD (percentage change from baseline diameter) was compared statistically by ANOVA. IR alone caused a significant reduction in FMD (5.9±0.7% pre- versus 2.2±0.4% post-IR, n=9, P<0.001). This reduction was prevented by RPostC (5.8±0.4% pre- versus 5.4±0.3% post-IR, n=8, P>0.05). Systemic phentolamine blocked the protective effects of RPostC (FMD 6.1±0.5% pre- versus 2.0±0.3% post-IR, n=7, P<0.001). These data indicate, for the first time in humans, that protection from RPostC depends on preservation of adrenergic signalling. Alpha blockade neutralises one of the endogenous mechanisms of ischemic protection in humans; the clinical consequences of this remain to be determined.

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