scholarly journals ECONOMIC JUSTIFICATION OF THE APPLICATION OF THE AUTOMATIC REMOTE BLOOD PRESSURE MONITORING

2019 ◽  
Vol 63 (1) ◽  
pp. 14-21
Author(s):  
V. E. Oleynikov ◽  
O. V. Chizhova ◽  
I. N. Dzhazovskaya ◽  
Ekaterina A. Shigotarova ◽  
L. I. Salyamova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Cloud Base ◽  
Insurance Fund ◽  
State University ◽  
Pressure Monitoring ◽  
Financial Model ◽  
Economic Justification ◽  
The Cost

Introduction. Among the priorities of the strategic development of the health care system there is the telemedicine technologies implementation. Material and methods. The project was developed in the Penza State University. For the economic justification of the remote BP monitoring, the project technological scheme has been prepared, the market capacity has been assessed and competition has been analyzed, the business model and financial model of the project have been developed, and risks have been evaluated. Results. The project is deployed at the base and with the participation of the budget medical institution. The patient is provided with a tonometer with built-in GSM or blutooth module. After the patient’s BP has been measured, the data in an encrypted format is transmitted to the remote monitoring center and stored in the cloud base. For each patient, the doctor sets target and individual thresholds for blood pressure. Intermediate monitoring of BP is carried out by paramedical personnel who, in case of deviations from reference values, notify the attending physician. The patient receives feedback in the form of SMS-messages to his mobile phone: time for BP measuring, taking drugs and recommendations for the therapy correction. Payment is carried out according to the approved Mandatory Medical Insurance Fund tariff. Conclusion. The introduction of remote blood pressure monitoring will reduce the cost of providing medical care by reducing the number of hypertension complications, open up prospects for research and development of medical professionals. Fundamentally new conditions will arise for the study of chronopharmacology of antihypertensive drugs in patients with hypertension.

Ambulatory Blood Pressure Monitoring: Measurement Implications for Research

2001 ◽  
Vol 9 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Carolyn B. Yucha
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Computer Software ◽  
Research Assistant ◽  
Pressure Monitoring ◽  
Ambulatory Bp Monitoring ◽  
The Cost

Although blood pressure (BP) is a frequently used variable in nursing studies, measurements are likely to be inaccurate for a variety of reasons: incorrect technique, operator error, and environmental factors. Ambulatory BP monitoring (ABPM) reduces measurement error, is relatively easy to use, and yields many more BP parameters than do clinic BP measurements. The cost of equipment for ABPM ranges from $2,500 to $5,000 per monitor and from $2,000 to $3,000 for computer software. A research assistant can easily be trained to follow a standardized procedure. Researchers have used ABPM to study normal BP patterns, complications of hypertension, effects of antihypertensive drugs, and the prognosis of cardiovascular events. This article provides the nurse researcher with an introduction to this technology and an overview of information gained from ambulatory blood pressure monitoring.

Applications of ambulatory blood pressure monitoring in clinical practice

1991 ◽  
Vol 37 (10) ◽  
pp. 1880-1884 ◽  
Author(s):  
M A Weber ◽  
D H Smith ◽  
J M Neutel ◽  
D G Cheung
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Ambulatory Monitoring ◽  
White Coat Hypertension ◽  
Portable Devices ◽  
Pressure Monitoring

Abstract Traditionally, blood pressure has been measured by the sphygmomanometer in the medical office. There is growing evidence, however, that office blood pressures may not be typical of values throughout the day. Between 20% and 30% of patients diagnosed with hypertension in the office actually are normotensive at other times. Ambulatory blood pressure monitoring with small, portable devices that automatically measure blood pressure every few minutes throughout the day appears to be an appropriate tool when "white-coat" hypertension is suspected--i.e., for individuals whose hypertension in the physician's office is not associated with other physical or historical evidence for cardiovascular disease or with other risk factors. Used prudently, ambulatory monitoring is a cost-effective technique that potentially can prevent unnecessary treatment of patients. Moreover, whole-day measurements may correlate more closely than office measurements may correlate more closely than office measurements do with findings of cardiovascular disease. This new approach also has highlighted the circadian pattern of blood pressure, especially the sharp early to mid-morning increase that coincides with an increased tendency to major cardiovascular events. This has focused attention on directing antihypertensive therapy towards the morning hours. Ambulatory monitoring is now used routinely in studies of antihypertensive drugs. This technique has no placebo effect and takes fewer patients to assess drug efficacy than do conventional methods.

scholarly journals Assessing the impact of antihypertensive therapy on ambulatory blood pressure monitoring in patients with isolated systolic hypertension

2014 ◽  
Vol 5 (1) ◽  
pp. 5-9
Author(s):  
V. A Aydarova ◽  
Z. T Astahova ◽  
F. U Kanukova ◽  
M. M Besaeva
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Systolic Hypertension ◽  
Fixed Combination ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Isolated Systolic Hypertension ◽  
Pressure Monitoring ◽  
Group 2 ◽  
The Impact

The study examined the effectiveness of drug correction of high numbers of blood pressure (BP) by means of modern groups of antihypertensive drugs, the effect of a fixed combination of perindopril and indapamide on circadian blood pressure monitoring, and a commitment to patients of antihypertensive therapy, based on the opened simple randomization three groupswere formed: 1st comprised of 21 patients with isolated systolic hypertension (ISAH) and 22 patients with systolic-diastolic hypertension (SDAH) - they all received monotherapy with calcium antagonists (amlodipine 10 mg/day); Group 2 - of 16 ISAH patients and 24 SDAH patients - who received monotherapy with perindopril (2 mg/day) and the third group - of 17 patients with ISAH and 14 patients with SDAH - who received combination therapy with the drug noliprel (Servier) with a fixed combination of perindopril (2 mg) and indapamide of 0,625 mg. Treatment efficacy was assessed primarily to reduce the absolute numbers of blood pressure, and taken into account as a reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP), uncontrolled drop of which, according to the literature, in elderly patients can have fatal consequences

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.

Methodology to Determine Duration of Action for Antihypertensive Drugs

2002 ◽  
Vol 36 (5) ◽  
pp. 874-881 ◽  
Author(s):  
Jean Lefebvre ◽  
Luc Poirier ◽  
Yves Lacourcière
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Antihypertensive Agents ◽  
Pressure Monitoring ◽  
Duration Of Action ◽  
Short Acting ◽  
Acting Agent

OBJECTIVE: To review and comment on methods used to assess the duration of action of antihypertensive drugs. DATA SOURCES: A MEDLINE search (1966–June 2000) using key terms such as trough-to-peak ratio and ambulatory blood pressure monitoring was conducted. STUDY SELECTION: An article was considered for this review if it pertained to the assessment of the duration of action of antihypertensive drugs. Special attention was given to articles dealing with methodologic aspects. DATA SYNTHESIS: Antihypertensive drugs with a long duration of action are thought to provide better therapeutic coverage against hypertensive complications compared with that of short-acting agents. Measuring blood pressure at the end of the dosing interval may be a way to assess the duration of action of a drug. However, the use of high doses of a short-acting agent to obtain sufficient effect when at trough concentrations can potentially cause dose-related adverse effects at the peak time, contributing to nonadherence to therapy and thus to adverse outcomes. To alleviate this problem, the US Food and Drug Administration (FDA) has conceptualized the trough-to-peak (T:P) ratio. Although this arithmetic index has since been widely used to characterize the duration and safety of blood pressure control achieved by antihypertensive agents, several methodologic flaws limit its interpretation in the clinic. Ambulatory blood pressure monitoring (ABPM) is a more reliable approach to assess the duration of action and outcome of antihypertensive therapy. CONCLUSIONS: Different methodologic approaches exist to evaluate the duration of action of antihypertensive drugs. Although the T:P ratio has been suggested by the FDA, it is difficult to establish a fair comparison among various antihypertensive agents based solely on this index. Treatment evaluation based on ABPM may be preferable to those guided by T:P because ABPM is more reproducible and is now established as a predictor of cardiovascular risk.

scholarly journals EFFECTIVENESS OF APPLICATION OF TELEMONITORING OF BLOOD PRESSURE IN PATIENTS WITH NORMAL WEIGHT AND OVERWEIGHT

2021 ◽  
Vol 121 (1) ◽  
pp. 32-42
Author(s):  
Inna Berdnyk
Keyword(s):  
Blood Pressure ◽  
Primary Care Physicians ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Normal Weight ◽  
Main Group ◽  
Control Group ◽  
Adherence To Treatment ◽  
Pressure Monitoring ◽  
Number Of Patients

The article summarizes the arguments and counterarguments within the scientific discussion on the methods of diagnosing hypertension and features of blood pressure control. The main purpose of this study is to evaluate the effectiveness of blood pressure monitoring in patients with normal weight and overweight and to determine their level of adherence to treatment. The relevance of the study about this pathology is that hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of hypertension among the adult population is 30-45%, in 2018 the number of patients with hypertension in the world was about 1.38 billion, with more than 165 million living in Central and Eastern Europe. Systematization of literature data showed that despite the widespread use of antihypertensive drugs, only about 30% of patients have optimal blood pressure. The methodology of the study is to evaluate the use of telemedicine technologies for self-monitoring of blood pressure in patients with normal weight and overweight and increase their compliance. The study was conducted in Kyiv, Ukraine during 2018-2020, and included 111 patients aged 18 to 65 years with a previously diagnosed hypertension. By randomization, they were divided into the main group (used blood pressure monitoring) and the control group (used office and home blood pressure monitoring). The article presents the results that in the patients of the main group at the end of the study the average daily systolic and diastolic blood pressure were significantly lower in comparison with both the initial level of the group and in comparison with the control. The baseline adherence to treatment in patients in both groups was low. However, at the end of the study, the adherence of patients in the main group to treatment increased by 40.3%, while in the control group no significant changes were detected. In addition, a correlation was found between patients with overweight and less adherence to regular medication, more frequent skipping of the drug and self-withdrawal with improvement compared to patients with normal body weight. It was also noted that the patients in the main group at the end of the study significantly reduced the level of anxiety compared with the control. The study empirically confirms and theoretically proves that the use of blood pressure telemonitoring can be considered as an alternative to the standard approach that increases adherence to treatment. The results of the study will be useful for primary care physicians, cardiologists, therapists.

scholarly journals Peculiarities of hypertension during acute and early regenerative period repeated ischemic stroke in patients with recurrent stroke

2015 ◽  
pp. 24-26
Author(s):  
V. Lipko
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Antihypertensive Drugs ◽  
Recurrent Stroke ◽  
Blood Pressure Monitoring ◽  
Cerebral Atrophy ◽  
Average Difference ◽  
Pressure Monitoring ◽  
Significant Drop ◽  
Lesion Localization

To evaluate possible features of MRI lesion localization, we examined 30 patients with recurrent stroke. We have examined the localization of cerebral atrophy changes, lacunar infarction, acute ischemic lesions and postischemic changes lesions. The research showed that cerebral atrophy changes significantly grow along with the progression of the disease. In patients with recurrent ischemic stroke, we established significant correlation (p <0.01) of average difference in clinical and ambulatory blood pressure monitoring, which should be taken into consideration when choosing antihypertensive drugs. When analyzing the dynamics of reduction of blood pressure after 4 weeks and 6 months of treatment we saw a significant drop in blood pressure compared with baseline after the onset of ischemic stroke, which can be used when choosing a treatment strategy.

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