Sondre Heimark

• University of Oslo

Introduction Non-invasive cuffless blood pressure devices have shown promising results in accurately estimating blood pressure when comparing measurements at rest. However, none of commercially available or prototype cuffless devices have yet been validated according to the appropriate standards. The aim of the present study was to bridge this gap...

BACKGROUND Systolic blood pressure (BP) is a key predictor of cardiovascular events, but patients with peripheral artery disease (PAD) are rarely included in hypertension trials. The VALUE trial (Valsartan Antihypertensive Long-Term Use Evaluation) investigated the long-term effects of valsartan- or amlodipine-based treatments on cardiovascular out...

BACKGROUND Drug concentration in blood or urine is an acknowledged method to detect non-adherence. Observational studies suggest that informing patients about low or absent serum drug levels improves blood pressure (BP). We performed a multicenter randomized clinical trial to test the hypothesis that therapeutic drug monitoring (TDM) could improve...

Objective Accurate measurements are essential if cuffless blood pressure (BP) devices are to be used in hypertension care. The aim of the present study was to evaluate the ability of a prototype cuffless device (XXXXX) to track changes in BP compared to a non-invasive, continuous BP monitor (reference BP; Human NIBP Nano system, ADInstruments, Dune...

Objective Kidney function is preserved by achieving systolic blood pressure (SBP) primarily <140mmHg and possibly <130mmHg in hypertensive patients. We aimed to investigate kidney function when achieving SBP 130-139 and <130mmHg in high-risk hypertensive patients without cardiac hypertrophy who participated in a major prospective hypertension outco...

Objective Kidney function is preserved by achieving systolic blood pressure (SBP) primarily <140mmHg and possibly <130mmHg in hypertensive patients. We aimed to investigate kidney function when achieving SBP 130-139 and <130mmHg in type-2 diabetic and non-diabetic hypertensive patients without cardiac hypertrophy who participated in a major prospec...

BACKGROUND Patients with resistant hypertension is the group of hypertensive patients with the highest cardiovascular risk. METHODS All rules and guidelines for treatment of hypertension should be followed strictly to obtain blood pressure control in resistant hypertension. The mainstay of treatment of hypertension, also for resistant hypertension...

Objective 24-hour ambulatory blood pressure monitoring (24ABPM) is state of the art in out-of-office blood pressure (BP) monitoring. Due to discomfort and technical limitations related to cuff-based 24ABPM devices, methods for non-invasive and continuous estimation of BP without the need for a cuff have gained interest. The main aims of the present...

Chronic kidney disease is one of the most serious complications of diabetes. One of the challenges in the follow-up of patients with diabetes is to discover signs of kidney disease. Recent research shows that several drugs have renal protective effects. In this clinical review article we present markers used in the follow-up of patients with diabet...

Background: Approximately 40% of people with hypertension have left ventricular hypertrophy (LVH) detected by ECG or echocardiography. Because patients with LVH have poor myocardial microcirculation, they may be too sensitive to lowering systolic blood pressure (SBP) too much due to a lack of myocardial perfusion pressure. We aimed to investigate...

Objective Diabetes Mellitus Type-2 (DM2) is common in hypertensive patients, increasing the risk of cardiovascular disease. Current guidelines recommend targeting systolic BP (SBP) to 130 - 139 mmHg in diabetic patients >65 years. We investigated whether the middle-aged and elderly hypertensive DM2 patients in the VALUE Trial had reduced risk of ca...

Objective Methods to enable cuffless blood pressure (BP) have gained widespread interest. If proven to be comparable to standard cuff measurements and more accepted by patients, these methods can improve hypertension care. We investigated accuracy and patient acceptability of a pulse arrival time (PAT) based model using a prototype cuffless device...

Objective Drug concentration in urine or serum using liquid chromatography coupled to mass-spectrometry (UHPLC-MS/MS) may disclose non-adherence. Whether this direct method will improve adherence is still unknown. In this multicenter randomized controlled trial with a double-blinded approach, we aimed to investigate if measurements and standardized...

Objective Evidence that reducing blood pressure (BP) to <130/80 mmHg rather than to <140/90 mmHg by antihypertensive treatment in hypertensive patients is conflicting. Left ventricular hypertrophy (LVH) is common in hypertension, and low perfusion pressure may result in ischemia in patients with LVH. We investigated whether average achieved BP <130...

Objective Continuous non-invasive cuffless blood pressure (BP) monitoring may reduce adverse outcomes in hospitalized patients if accuracy is approved. We aimed to investigate accuracy of two different BP prediction models in critically ill intensive care unit (ICU) patients, using a prototype cuffless BP device based on electrocardiogram and photo...

We previously reported increased mortality in hypertensive patients > 55 yrs. (average 67 yrs., n = 9,193) with left ventricular hypertrophy (LVH) who achieved in-treatment systolic blood pressure (SBP) < 130 mmHg during an average of 5 yrs. of treatment. Possibly hypertrophic myocardium with degenerated microcirculation becomes ischemic causing fa...

Introduction: There is a lack of data describing the blood pressure response (BPR) in well-trained individuals. In addition, continuous bio-signal measurements are increasingly investigated to overcome the limitations of intermittent cuff-based BP measurements during exercise testing. Thus, the present study aimed to assess the BPR in well-trained...

Objective: Wearable cuff-less blood pressure (BP) devices may overcome cuff limitations and offer continuous non-invasive BP monitoring. However, their accuracy in different clinical settings is not yet clarified. This study aimed to evaluate the accuracy of mean arterial pressure (MAP) measurements from a novel continuous cuff-less chest belt aga...

Objective: Pulse arrival time (PAT) is a potential main feature in cuff-less blood pressure (BP) monitoring. However, the precise relationship between BP parameters and PAT under varying conditions lacks a complete understanding. We hypothesize that simple test protocols fail to demonstrate the complex relationship between PAT and both SBP and DBP...

Nonadherence to drugs is a challenge in hypertension treatment. We aimed to assess the prevalence of nonadherence by serum drug concentrations compared with 2 indirect methods and relate to the prescribed drug regimens in a nationwide multicenter study. Five hundred fifty patients with hypertension using ≥2 antihypertensive agents participated. We...

Objective Automated cuff-based blood pressure (BP) monitoring is limited to intermittent measurements vulnerable to movement. Pulse arrival time (PAT), calculated using electrocardiography (ECG) and photo plethysmography (PPG), has shown promise for non-invasive, continuous BP monitoring. The precise relationship between BP parameters and PAT under...

The Systolic Blood Pressure Intervention Trial (SPRINT) suggested a favourable effect of lowering blood pressure to < 120/80 mmHg in high-risk hypertensive patients; however, new American guidelines in 2017 have not followed SPRINT but lowered its recommended treatment target to < 130/80 mmHg. We aimed to review the latest research from large rando...

Background: Poor drug adherence is a major cause of apparent treatment-resistant hypertension. As a consequence, several methods have been developed and attempted implemented in clinical practice to reveal non-adherence and to monitor drug adherence. There are, however, several hitherto unresolved ethical aspects regarding potential methods for dru...

Although high blood pressure (BP) is the leading risk factors for cardiovascular (CV) disease, the optimal BP treatment target in order to reduce CV risk is unclear in the aftermath of the SPRINT study. The aim of this review is to assess large, randomized, and controlled trials on BP targets, as well as review selected observational analyses from...

Lack of adherence to medication may be the explanation for unsatisfactory drug efficacy and is often misinterpreted as resistance to treatment. When encountering patients with persistent high blood pressure despite antihypertensive treatment, it is therefore important to discover whether they are actually taking their medication. This article aims...

Objective: Treatment-resistant hypertension (TRH) has regained attention with development of new methods for treatment. However, the prevalence of TRH varies considerably from primary to secondary and tertiary care. We aimed to assess the prevalence of true TRH in a population of patients with apparent TRH in a university hospital setting of terti...

Poor drug adherence is one of the main reasons for the failure to achieve treatment targets in hypertensive patients. In patients who receive pharmacological treatment, assessment of drug adherence is of the utmost importance. The aim of this review is to present an update of the methods available to reveal and monitor non-adherence in patients wit...

Objective: Treatment resistant hypertension is a challenge for the physician and represents a substantial cardiovascular risk for patients. While many patients are referred to specialists for resistant hypertension, the true resistant subjects are hard to find. We aimed to report the reasons for noneligibility in the Oslo Renal Denervation (RDN)Stu...