Recommendations for Blood Pressure Measurement in Humans and Experimental Animals: Part 1: Blood Pressure Measurement in Humans: A Statement for Professionals From the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research

Circulation (Impact Factor: 14.43). 03/2005; 111(5):697-716. DOI: 10.1161/01.CIR.0000154900.76284.F6
Source: PubMed


Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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Available from: Bonita Falkner, Sep 30, 2015
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    • "Resting blood pressure was based on the average of the 2nd and 3rd readings. A participant was identified as hypertensive if their average systolic was ≥ 140 mm Hg or average diastolic was ≥ 90 mm Hg based on the American Heart Association guidelines (Pickering et al., 2005). Spot urine samples were obtained for analyses of sodium excretion (Perry et al., 2010). "
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    ABSTRACT: Objective: To examine if employees with higher nutrition knowledge have better diet quality and lower prevalence of hypertension. Method: Cross-sectional baseline data were obtained from the complex workplace dietary intervention trial, the Food Choice at Work Study. Participants included 828 randomly selected employees (18-64. years) recruited from four multinational manufacturing workplaces in Ireland, 2013. A validated questionnaire assessed nutrition knowledge. Food Frequency Questionnaires (FFQ) measured diet quality from which a DASH (Dietary Approaches to Stop Hypertension) score was constructed. Standardised digital blood pressure monitors measured hypertension. Results: Nutrition knowledge was positively associated with diet quality after adjustment for age, gender, health status, lifestyle and socio-demographic characteristics. The odds of having a high DASH score (better diet quality) were 6 times higher in the highest nutrition knowledge group compared to the lowest group (OR. =. 5.8, 95% CI 3.5 to 9.6). Employees in the highest nutrition knowledge group were 60% less likely to be hypertensive compared to the lowest group (OR. =. 0.4, 95% CI 0.2 to 0.87). However, multivariate analyses were not consistent with a mediation effect of the DASH score on the association between nutrition knowledge and blood pressure. Conclusion: Higher nutrition knowledge is associated with better diet quality and lower blood pressure but the inter-relationships between these variables are complex.
    12/2015; 2:105-113. DOI:10.1016/j.pmedr.2014.11.008
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    • "The patients completed CAT and mMRC questionnaires and underwent pre-and post bronchodilatatory spirometry. Blood pressure was obtained according to the American Heart Association Guidelines (Pickering et al., 2005). A patient was considered as having arterial hypertension if taking antihypertensives. "
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    ABSTRACT: Introduction. The metabolic syndrome (MS) affects 21-53% of patients with chronic obstructive pulmonary disease (COPD) with a higher prevalence in the early stages of COPD, with results being highly variable between studies. MS may also affect natural course of COPD-number of exacerbations, quality of life and lung function. Aim. To examine the prevalence of MS and its correlation with comorbidities and COPD characteristics in patients with COPD admitted for exacerbation. Material and methods. 152 patients with COPD admitted for exacerbation were studied for presence of MS. All of them were also assessed for vitamin D status and diabetes mellitus type 2 (DM). Data were gathered for smoking status and exacerbations during the last year. All patients completed CAT (COPD assessment test) and mMRC (Modified Medical Research Council Dyspnea scale) questionnaires and underwent spirometry. Duration of current hospital stay was recorded. Results. 25% of patients have MS. 23.1% of the male and 29.5% of the female patients have MS (p > 0.05). The prevalence of MS in this study is significantly lower when compared to a national representative study (44.6% in subjects over 45 years). 69.1% of all patients and 97.4% from MS patients have arterial hypertension. The presence of MS is associated with significantly worse cough and sleep (1st and 7th CAT questions; p = 0.002 and p = 0.001 respectively) and higher total CAT score (p = 0.017). Average BMI is 27.31. None of the patients have MS and BMI <25. There is a correlation between the presence of MS and DM (p = 0.008) and with the number of exacerbations in the last year (p = 0.015). There is no correlation between the presence of MS and the pulmonary function. Conclusion. This study among hospitalized COPD patients finds comparable but relatively low prevalence of MS (25%) compared to previously published data (21-53%) and lower prevalence compared to general population (44.6%). MS may impact quality of life and the number of exacerbations of COPD. Having in mind that MS is more common in the early stages and decreases with COPD progression, the COPD patients admitted for exacerbation may be considered as having advanced COPD.
    PeerJ 07/2015; 3(Suppl. 56):e1068. DOI:10.7717/peerj.1068 · 2.11 Impact Factor
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    • "Hypertension remains a major public health problem associated with considerable morbidity and mortality. Accurate and ambulatory measurement of blood pressure (BP) is essential for efficient diagnosis, management and prevention of hypertension and related cardiovascular diseases [1]. Thanks to the fast development of biomodeling, wearable and mHealth technologies, unobtrusive and continuous BP monitoring with improved accuracy and convenience becomes possible. "
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    ABSTRACT: Recent advances in unobtrusive sensing technology, especially those in flexible, stretchable, and printable sensing, have given rise to various novel signal acquisition modalities, such as stretchable epidermal electrocardiography (ECG), organic photoplethysmography (PPG), and flexible tonoarteriography (TAG) which is the cuffless and continuous recording of arterial blood pressure (BP). With the fast development of wearable computing and wireless communication technologies, all these modalities can be integrated into a body sensor network (BSN) for remote physiological multi-parameter monitoring. In this paper, we propose a TAG-based BSN for unobtrusive BP measurement with possible automatic cuffless BP calibration, and our efforts focus on the effect of posture change on the various pulse transit time (PTT) calculated from different BSN nodes consisting of TAG, ECG, and PPG sensors. Specifically, correlations of different PTTs with reference continuous BP at different postures are examined. The results of this study demonstrate that the PTT from ECG and TAG sensors has higher correlation with the reference BP as compared to that from ECG and PPG sensors, which suggests that flexible TAG sensor may potentially be utilized not only for cuffless calibration, but also as an alternative node in the BSN for continuous, cuffless BP measurement with better accuracy. Keywords—body sensor network, flexible pressure sensor, unobtrusive sensing, blood pressure, tonoarteriography
    12th AnnualBody Sensor Networks Conference 2015; 06/2015
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