This study aimed to evaluate the efficacy of nifedipine combined with magnesium sulfate in pregnant women with gestational hypertension (GH) and its influence on blood lipid levels. Seventy pregnant women with GH were randomly assigned to either a control group (labetalol plus magnesium sulfate) or an observation group (nifedipine extended-release tablets plus magnesium sulfate) ( n = 35). Both groups were treated for 7 days. Posttreatment, changes in blood pressure (SBP and DBP), hemorheological parameters [whole blood high-shear viscosity, low-shear viscosity, plasma viscosity (PV)], blood lipid levels [high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC)], adverse reactions, and pregnancy outcomes were assessed. Posttreatment, both groups showed significant reductions in SBP and DBP, with greater decreases in the observation group ( P < 0.05). After 7 days of treatment, whole blood high-shear viscosity, low-shear viscosity, and PV decreased in both groups, with lower values for these in the observation group ( P < 0.05). Lipid profiles improved in both groups, with the observation group showing higher HDL-C and lower LDL-C, TG, and TC ( P < 0.05). The observation group had a higher overall efficacy rate (94.29 vs. 77.14%, P < 0.05) and fewer adverse pregnancy outcomes (8.57% vs. 28.57%, P < 0.05), while the incidence of adverse reactions was comparable between groups. Nifedipine combined with magnesium sulfate is more effective in managing GH. This regimen better improves blood pressure, hemorheological parameters, lipid profiles, and pregnancy outcomes, with good safety.

Recent guidelines recommend measuring blood pressure (BP) multiple times and averaging the results. The direction of the discrepancy between the first and second readings varies. This study aimed to examine whether directionality is associated with vascular aging indicators. 43 807 participants who underwent health checkups were first stratified by average systolic BP (SBP < 120, 120-129, 130-139, or ≥140 mmHg) and diastolic BP (DBP < 80, 80-89, or ≥90 mmHg). They were then categorized into three groups based on the absolute difference between the first and second BP readings (ΔBP): ΔBP < 5 mmHg (group A), 5-9 mmHg (group B), and greater than or equal to 10 mmHg (group C). Clinical parameters and vascular aging markers were compared between groups. In participants with SBP less than 130 mmHg or DBP less than 80 mmHg, the first BP reading tended to be lower than the second. In contrast, among those with SBP greater than or equal to 130 mmHg or DBP greater than or equal to 90 mmHg, the first reading was often higher. Group C showed a significantly higher prevalence of hypertension, obesity, diabetes, and dyslipidemia, along with increased brachial-ankle pulse wave velocity and maximum carotid intima-media thickness. The direction and magnitude of the discrepancy between the first and second BP measurements may reflect the underlying vascular aging. BP discrepancy patterns could serve as simple, noninvasive indicators of subclinical atherosclerosis.

To evaluate the accuracy of the automated oscillometric upper-arm cuff blood pressure (BP) monitor Microlife BP3KV1-5X (BP B6 Connect) for home use in a general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) and its amendments (1:2020 and 2:2024). Participants were recruited to fulfill the age, sex, BP, and arm distribution criteria of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and its amendments (1:2020 and 2:2024) in a general population using the same arm sequential measurement method. A single wide-range cuff of the test device was used for arm circumference 22-42 cm. One-hundred and twenty individuals were recruited and 85 were analyzed [mean age: 55.8 ± 15.6 (SD) years, 41 men, arm circumference 31.9 ± 5.1 cm, range: 23-41.8 cm]. For validation criterion 1, the mean difference ± SD between the test device and reference BP readings ( N = 255) was -0.8 ± 6.8/-2.3 ± 4.9 mmHg (systolic/diastolic; threshold ≤5 ± 8 mmHg). For criterion 2, the SD of the averaged BP differences between the test device and reference BP per individual ( N = 85) was 5.99/4.35 mmHg (systolic/diastolic; threshold ≤ 6.89/6.55 mmHg). The automated oscillometric home BP monitor Microlife BP3KV1-5X (B6 Connect) fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and its amendments (1:2020 and 2:2024) in a general population and can be recommended for home use.

Accurate blood pressure (BP) measurement is essential for effective health management. To ensure this, international standards for the validation of BP monitors have been established and revised over time, with ISO 81060-2:2018 being the most recent. While many studies have been published evaluating the accuracy of BP monitors based on this standard, we identified concerns regarding the reliability of some reported results and therefore conducted a comprehensive literature review. Using ISO 81060-2:2018 as the validation framework, we extracted relevant studies from PubMed and collected the SD values for criterion 1 to compare and analyze the reported measurement accuracy. While most SD values ranged from 5 to 8%, we identified six studies reporting values below 4%. On the basis of our experience, such low variability is highly implausible and raises questions about the credibility of these findings. Reports claiming exceptionally high measurement accuracy with unusually low SD values may lead to misconceptions and could potentially be misused for marketing purposes. Therefore, validation studies must be conducted in strict adherence to medical ethics. In addition, there is a need to raise awareness that the current international standards for BP monitor validation require further refinement.

This study evaluated the accuracy of the automated oscillometric upper-arm cuff blood pressure (BP) measuring device Prolife PA5 Comfort AF (BP 136A) for home use in a general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2 : 2018) and its amendments (1 : 2020 and 2 : 2024). The requirements of the Universal Standardand its amendments for a validation study in a general population using the same arm sequential measurement method were applied. Participants were recruited to fulfill the age, sex, BP level, arm circumference, and cuff size distribution criteria. The test device measures BP during inflation and uses a wide-range cuff for arm circumference 22-42 cm. One-hundred-twenty-eight individuals were recruited and 85 were analyzed [mean age: 54.9 ± 15.0 (SD) years, 36 (42%) men, arm circumference: 31.7 ± 5.4 cm, range: 22.5-41.9 cm). For validation Criterion 1, the mean difference ± SD between the test device and reference BP readings (N = 255) was -2.1 ± 7.5/-0.3 ± 5.3 mmHg (systolic/diastolic; threshold: ≤5 ± 8 mmHg). For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per individual (N = 85) were 6.44/5.07 mmHg (systolic/diastolic; threshold: ≤6.62/6.95 mmHg). The automated oscillometric home BP monitor Prolife PA5 Comfort AF (BP 136A) fulfills all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018) and its amendments (1 : 2020 and 2 : 2024) for a general population and can be recommended for clinical use.

The objective of this report is to evaluate the overall effectiveness and safety of the JOYTECH DBP-6286B arm-type fully automatic digital blood pressure monitor in adults and adolescents with an arm circumference of 40-56 cm. Subjects were recruited in adults and adolescents with large arm circumference. The test device was JOYTECH DBP-6286B and the reference device was a mercury sphygmomanometer. Using BP readings obtained from the mercury sphygmomanometer as the reference standard, the accuracy of the noninvasive BP module of the test device meets the specified requirements is evaluated. This study analyzed valid BP data from 85 subjects. According to Criterion 1, the mean difference of SBP between the test and reference device was -1.09 mmHg and the SD was 3.93 mmHg. The mean difference of DBP was -0.49 mmHg and the SD was 3.43 mmHg. The mean difference of both SBP and DBP was less than ±5 mmHg, and the SD was less than 8 mmHg, which met the requirements. According to Criterion 2, SD of SBP was 2.47 mmHg, which was less than 6.86 mmHg and met the requirements. The SD of DBP was 2.48 mmHg, which was less than 6.92 mmHg and met the requirements. The JOYTECH DBP-6286B complies with Association for the Advancement of Medical Instrumentation (AAMI)/European Society of Hypertension (ESH)/International Organization for Standardization (ISO) Universal Standard (ISO 81060-2:2018 + Amd 1:2020), and the requirements of the Recognized Consensus Standards published by the FDA completely, and is recommended for BP measurement in adults and adolescents with an arm circumference of 40-56 cm for home and clinical use.

Nocturnal hypertension, especially with well-controlled daytime blood pressure (BP), has emerged as a significant risk factor for cardiovascular disease. This study investigated its prevalence by morning home BP cut-off values and examined associated patient characteristics using data from the Japan Morning Surge-Home Blood Pressure (J-HOP) study. This post hoc analysis included 2675 participants from the J-HOP study who had complete data on nighttime home BP, measured using validated automatic oscillometric devices. Nocturnal hypertension was defined as a nighttime systolic BP greater than or equal to 120 mmHg and diastolic BP greater than or equal to 70 mmHg. Among the participants, 60.5% had nocturnal hypertension. The proportion of patients with nocturnal hypertension decreased as the cut-off value for morning home BP was lowered: 40.5, 32.1, 23.7, and 14.6% for less than 135/85 mmHg, less than 130/80 mmHg, less than 125/75 mmHg, and less than 120/70 mmHg, respectively. The prevalence of nocturnal hypertension was significantly higher in individuals with diabetes compared with those without, at morning home BP thresholds of less than 135/85 mmHg (48.1 vs. 39.3%; P = 0.03) and less than 130/80 mmHg (41.0 vs. 30.6%; P = 0.01). Individuals taking diuretics had a significantly lower prevalence of nocturnal hypertension compared with those not taking diuretics, at a morning home BP threshold of less than 135/85 mmHg (35.3 vs. 42.9%; P = 0.01). A considerable number of patients continued to show nocturnal hypertension even at lower morning home BP thresholds. Diabetes may contribute to nocturnal hypertension despite well-controlled morning BP, while diuretic use may help prevent it.

Cardiovascular disease (CVD) is the leading global cause of death, with elevated blood pressure (BP) in young adults being linked to CVD in adulthood. Pulse wave velocity (PWV) is a noninvasive measure of arterial stiffness, a predictor of CVD, and can be influenced by exercise. Exercise, like stair climbing, improves vascular health and reduces BP. The primary aims of this study were to examine whether the change in BP after a single stair climb is associated with PWV and whether it is associated with 24-h BP averages. Fifty-four young adults (23.8 ± 3.56 years) underwent back-to-back sessions of vascular health assessment, a 24-h ambulatory BP (ABP) monitoring, and a single stair climb exercise consisting of 42 steps. Pre- to post-climb BP response was calculated. Our population was normotensive (119.4/73.7 mmHg) and had an increase in SBP (126.4-138.5 mmHg, P < 0.05) and heart rate (HR) (85.6-94.2 bpm, P < 0.05) with climb. We found an inverse relationship between PWV (5.4 ± 0.85 m/s) and change in SBP with climb (r = -0.340, P = 0.012). We found no relationship between 24-h BP averages and post-stair climb response. The first to report an inverse relationship between SBP response to exercise and PWV in young adults emphasizes subtle differences in vascular compliance. While the stair climb elicited a significant vascular response, there was no association with 24-h ABP averages. The potential of stair climbing as a practical exercise for assessing vascular health underscores the need for future research.

To evaluate 24-h ambulatory systolic blood pressure (BP), diastolic BP, and pulse rate patterns in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), and their association with major adverse cardiac events (MACE). We conducted a prospective cohort study in ACS patients in who ambulatory BP monitoring was recorded during 2 weeks post-PCI. Clinical and laboratory factors correlated with dipping BP and pulse rate were analyzed by multivariable logistic regression analysis. A Cox proportional hazard model was applied to find the associated factor(s) with their MACE. We included 141 patients with ST-elevation myocardial infarction (STEMI) ( n = 47) and non-STEMI ( n = 94). The average age was 61.7 ± 11.1 years. Most of them are men (63.8%), had non-STEMI (66.7%), and triple vessel disease (51.1%). Upon assessment of nocturnal dipping BP, 22% were dippers, while the others were nondippers and reverse dippers (39.7 and 38.3%, respectively). Nocturnal hypertension, neutrophil-to-lymphocyte, and mean platelet volume were significantly associated with nondippers [adjusted odds ratio: 5.71, 95% confidence interval (CI): 2.51-12.99; 1.29, 95% CI: 1.01-1.63; 1.84, 95% CI: 1.16-2.93, respectively]. Nondipping pulse rate was found in 66.0% with a mean pulse rate of 75.4 ± 10.9 beats per minute (bpm) (awake) and 70.0 ± 11.2 bpm (sleep). Nondipping pulse rate was only found as an independent factor associated with MACE (hazard ratio: 2.69, 95% CI: 1.06-6.86, P = 0.04). This study demonstrated a significant association of MACE with nondipping pulse rate in patients with ACS who underwent PCI.

Isometric exercise has emerged as an effective strategy for blood pressure (BP) management, offering potential advantages over traditional exercise modalities; however, evidence regarding its 24-h effects in medicated hypertensive postmenopausal women remains limited. This study investigated the effects of a single session of multijoint isometric exercise on 24-h ambulatory hemodynamic variables in medicated hypertensive postmenopausal women. In this randomized crossover trial, 10 medicated hypertensive postmenopausal women (59 7 years) completed two experimental sessions: an isometric exercise session and a control session. The isometric exercise consisted of six multijoint exercises (upper and lower limbs), each performed for three sets of 1 min at 30% of 1-repetition maximum, with 2-min rest intervals. The control session involved sitting at rest for an equivalent duration. Following each session, 24-h ambulatory BP monitoring was conducted. Significant systolic BP reductions were observed following the isometric exercise session compared with the control session at 1 h (P < 0.05), 6 h (P < 0.05), and 24 h (P < 0.05). Diastolic BP was also reduced at 1 h (P < 0.05) and 12 h (P < 0.05). Both awake and asleep periods showed significant BP reductions for systolic and diastolic BP (all, P < 0.05). A single session of multijoint isometric exercise effectively reduces ambulatory BP over a 24-h period in medicated hypertensive postmenopausal women, including both awake and asleep periods. These findings support the potential clinical utility of isometric exercise as an adjunctive strategy for BP management in this population.