Average Values Of Systolic Blood Pressure Research Articles

Frequency of office blood pressure measurements and the seasonal variability of blood pressure: results of the Hungarian Hypertension Registry

Purpose Hypertension is a major public health problem, thus, its timely and appropriate diagnosis and management are crucial for reducing cardiovascular morbidity and mortality. The aim of the new Hungarian Hypertension Registry is to evaluate the blood pressure measurement practices of general practitioners (GPs), internists and cardiologists in outpatient clinics, as well as to assess the seasonal variability of blood pressure. Materials and methods Omron M3 IT devices were used during four-month periods between October 2018 and April 2023 in GP practices and in hypertension clinics. The blood pressure data were then transmitted online from the monitors’ cuffs to a central database using the Medistance system of Omron. Results Family physicians (n = 2491), and internists/cardiologists (n = 477) participated in the study. A total of 4804 821 blood pressure measurements were taken during 10 four-month evaluation periods. In the ten periods, the daily average number of measurements was between 3.0 and 5.6. Following ESH diagnostic criteria, the proportion of subjects in optimal, normal and high-normal blood pressure categories were 14, 13.4 and 16.7%, respectively. Altogether 56% of the measurements belonged to stage 1, stage 2 or stage 3 hypertension categories (31.6, 17.1 and 7.4%, respectively). On average, a difference of 5/2 mmHg was observed between winter and summer data in systolic and diastolic blood pressures, respectively. The average systolic blood pressure values were higher in GP practices with more than 2000 patients than in the ones with less than 1500 patients (141.86 mmHg versus 140.02 mmHg, p < 0.05). Conclusion In conclusion, the low daily average number of blood pressure measurements indicates a limited blood pressure screening awareness/capacity in the case of Hungarian family physicians. In GP practices with more patients, blood pressure is usually less well-controlled. These results suggest that the further promotion of home blood pressure monitoring is necessary.

FIRST RESULTS OF THE NEW HUNGARIAN HYPERTENSION REGISTRY: NUMBER OF DAILY MEASUREMENTS AND PROPORTION OF PATIENTS IN DIFFERENT BLOOD PRESSURE CATEGORIES

Objective: Hypertension is a major public health problem and its proper diagnosis and treatment are crucial points of cardiovascular morbidity and mortality reduction. The aim of the new Hungarian Hypertension Registry is to evaluate the features of blood pressure measurement practice of family physicians and hypertension care specialists and to overview the blood pressure values measured during everyday practice. Design and method: Omron M3 IT devices are located for four months periods in repeated times between October 2018 and October 2023 to family physician practices and to hypertension outpatient clinics. Blood pressure values are transmitted online to an evaluating center using the Medistance system of Omron. Results: Until now 1,691 family physicians, 111 internists, 112 cardiologists and 12 hypertension specialists were being involved into the study. During 4 four-months long evaluation periods between October 2018 and October 2020, 1 701 927 blood pressure measurements were registered. The daily average number of the measurements in the three periods were 3.5, 4.8, 5.4 and 3.6, respectively. Following the ESH diagnostic criteria, the proportion of subjects in optimal, normal and high-normal blood pressure categories were 13.4%, 13.4% and 17%, respectively. The proportion of patients in stage 1, stage 2 and stage 3 hypertension categories were 32.1%, 17% and 7.1%, respectively. The average systolic blood pressure values in family physician practices with more than 2500 patients were higher compared with practices with less, than 1500 patients (141.8 mmHg versus 139.84 mmHg, respectively). Conclusions: In conclusions, the low daily average number of blood pressure measurements refers for limited blood pressure screening capacity of the Hungarian family physicians. In practices with more patients the blood pressure is generally less controlled. These results suggest the need for reconsideration of the blood pressure measurement guidelines and the further promotion of home blood pressure measurement.

Does the duration of ambulatory blood pressure measurement matter in diagnosing arterial hypertension in children?

The aim of our study was to establish if 48-hour ambulatory blood pressure monitoring (ABPM) is more reliable than 24-hour monitoring in order to reduce the impact of external factors on blood pressure (BP) in children. Two hundred fifteen children with indications for ABPM underwent 48-hour ABPM. In the first part of the study, the values of systolic BP (SBP), diastolic BP (DBP) and heart rate between the first 24 hours and the total 48 hours were compared. In the second part, the same parameters between the first and second 24 hours were compared. In the third part, we determined whether the differences in measurements between the first and second 24 hours had clinical significance and meant a change of diagnosis. The results of the first part of the study showed no statistically significant differences. In the second part, the average values of SBP and DBP were statistically significantly higher during the first 24 hours as compared with the second 24 hours. In the second 24 hours, more children had normal BP (NBP) and a smaller number of them had high NBP or arterial hypertension (AH) compared with the first 24 hours, suggesting that this has clinical significance. Within certain limits, the results of our study suggest that 48-hour ABPM is more reliable than 24-hour ABPM, where especially the second 24 hours are a period of measurement that should be taken into consideration for this purpose. These results could impact the diagnostics of AH in children.

Relationship between alexithymia and variability of blood pressure measured with ABPM in hypertensive patients

ObjectiveStudies indicates that dysregulation of emotions plays an important role in the etiology of elevated blood pressure (BP). One of the signatures of emotional dysregulation is alexithymia defined as an impaired ability to experience and express emotions. Previous work indicated that primary hypertension (HT) is marked by higher alexithymia, but little research examined the relationship between alexithymia and variability of evaluated BP with 24 h Ambulatory Blood Pressure Monitoring (ABPM) in HT patients. MethodFifty-five participants diagnosed with hypertension and a matched group of thirty-nine healthy participants filled in The Toronto Alexithymia Scale (TAS-20), a clinical-demographic questionnaire, and were assessed with 24 h ABPM. ResultsAfter removing those with white coat HT, as expected, hypertensive individuals had a higher total score and all three alexithymia subscales. Furthermore, alexithymia was positively correlated with average values of systolic BP. ConclusionThese findings provided support for the contention that alexithymia is associated with elevated BP, the higher level of alexithymia the higher systolic BP in 24 h BP measurement. Future studies may examine the causal relationship between alexithymia and HT and evaluate the effectiveness of emotional regulation training interventions to reduce BP in people suffering from primary hypertension.

Prevalence of hypertension in a sample of schoolchildren in the Belgrade district.

The aim of this study was to estimate the prevalence of hypertension in a sample of schoolchildren in the district of Vozdovac (Belgrade). This study included 780 pupils from I, III, V and VII classes of a primary school and I and III classes of a high school in the district of Vozdovac (Belgrade). The anthropometric data were obtained from medical records of a regular health survey in 2014-2015. Blood pressure (BP) was measured three times using a mercury sphygmomanometer with a cuff of appropriate size at a 5 min interval. BP values at or above the 95th percentile for age, sex, and height were considered indicative of hypertension. Statistical analysis included descriptive statistics, χ-test, t-test, and correlation analysis. Of the participating students, 15.0% were overweight and 6.7% were obese. A significant negative correlation was observed between BMI categories and age (ρ=-0.126; P<0.01). The average systolic blood pressure values in boys and girls were 105.0±14.1 (range 80.0-150.0) and 102.5±12.3 (range 80-155) mmHg, respectively. The average diastolic blood pressure values in boys and girls were 67.6±8.8 (range 50-100) and 66.2±7.7 (range 50-95) mmHg, respectively. The prevalence of hypertension was 10.5%. A significant positive association was found between the presence of hypertension and age (ρ=0.150, P<0.01) and higher BMI level (ρ=0.115, P<0.01). In our sample of schoolchildren, a high prevalence of hypertension was found. Moreover, elevated BP values correlated strongly with age and BMI.

Effects of carbon disulfide on blood pressure and electrocardiogram for workers exposed to levels below the national maximum allowable concentration

To study the effects of carbon disulfide exposure within the national maximum allowable concentration(MAC) on blood pressure and electrocardiogram, and associations with selected factors. Workers in a chemical fiber factory were divided into two groups based on the type of work: a high exposure group (HEG) of 821 individuals and a low exposure group (LEG) of 259. The CS2 concentration at workplace was controlled under the national MAC. A set of 250 randomly selected people taking routine physical check-ups in the same period and hospital constituted the control group. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured on the arm, and the pulse pressure (PP) and mean arterial blood pressure (MABP) were calculated based on SBP and DBP. The blood pressure data, along with the results of the routine 12-lead electrocardiography taken at rest and records on gender, age, years of work, type of work, and concentrations of triglycerol, cholesterol, and glucose in blood, were compiled for analyses. Risk factors upon CS2 exposure for the increase of blood pressure and occurrence of electrocardiogram abnormalities were identified and rationalized. Significant difference (P < 0.01) in the average values of SBP, DBP, MABP, and the corresponding abnormality incident rates was found between HEG and LEG, and between HEG and the control group. For both HEG and LEG, the incident rate of DBP abnormality (high DBP) is nearly two times as high as that of SBP. Type of work is the largest risk factor in both the high SBP and high DBP subgroups, with odds ratios (OR) of 2.086 and 2.331 respectively, and high CS2 exposure presents more than double the risk than low exposure. On the incident rate of ECG abnormalities, both exposure groups are significantly different (P < 0.01) to the control group. High SBP in LEG and high DBP in HEG were found to be significant risk factors (OR = 3.531 and 1.638 respectively), while blood glucose appears to be a protective factor (OR = 0.747), appealing to further investigation. Meanwhile, factors like years of work and cholesterol were found to be risk factors in the high SBP subgroup with low exposure, and in the high DBP subgroup with high exposure. Within HEG, high DBP is the only blood pressure-related risk factor found for the incident of left ventricular high voltage (OR = 4.140), as is high SBP for LEG (OR = 4.776). High PP is the only risk factor found for repolarization disturbances within LEG (OR = 20.417). While blood sugar is a risk factor for origin disturbances, it is a protection factor for left ventricular high voltage (OR = 0.633). The damage of CS2 done to the cardiovascular system is a gradual process. Both early and very low level exposures are detrimental to the human circulatory system. Below the National MAC limit, the toxic effect of CS2 to the cardiovascular system increases with time and level of exposure. The effect of CS2 on DBP is more significant than on SBP, which indicates that CS2 may affect peripheral resistant blood vessels more than the artery. The abnormalities of ECG of workers exposed to CS2 are not only the result of high blood pressure on the heart, but also of the direct toxicity of CS2 on heart and blood vessels.

Blood pressure relates to sodium taste sensitivity and discrimination in adolescents.

To investigate salt perception and discrimination and their possible association with blood pressure (BP), 72 healthy adolescents (42 boys) aged 9-21 years (mean 16.1 years) were studied. BP was measured with a standardized technique. Anthropometric measurement and conventional renal function tests were performed. Sensitivity tests to recognize the presence of salt when given simultaneously distilled/deionized water and a low sodium concentration water solution, and discrimination tests consisting of six graded samples of different saline solutions presented in randomized order were used to assess individual gustatory sensitivity. Average systolic BP values were 113.2+/-1.6 mmHg in boys and 109.6+/-1.9 mmHg in girls. Mean threshold level for salt sensitivity was 4.55+/-0.6 mmol/l. Systolic BP and salt sensitivity showed a significant correlation ( r=-0.33, P<0.01) even when adjusting for weight. Discrimination score was correlated with salt sensitivity ( r=0.27, P<0.05). There is a significant association between gustatory perception and BP in Spain adolescents, although a real cause-effect relationship has not been established.

Spectral analysis of the systolic blood pressure signal in secondary hypertension

To seek in hypertensive patients rhythmic variations of the systolic blood pressure signal obtained by ambulatory blood pressure monitoring of any inherent cycle of intermediate value between 1 and 24 h. Subjects (62 hypertensive, 39 normotensive) were evaluated by 24-h ambulatory blood pressure monitoring. The hypertensive group consisted of 48 patients with essential hypertension, nine with renovascular hypertension and five with phaeochromocytoma. The groups were matched for age and weight. The ambulatory systolic blood pressure recording served as the input for a filtering procedure that rejected unacceptable values according to predetermined criteria. The whole-day systolic blood pressure series thus obtained were subjected to Fourier analysis to obtain a spectral analysis of daily systolic blood pressure fluctuations. Daily (first 12 h), nightly (second 12 h) and whole-day average systolic blood pressure values were calculated and compared for the various groups. The average nocturnal systolic blood pressure was found to be lower than its daily counterpart in the normal subjects and in the patients with essential hypertension, whereas in the patients with renovascular hypertension or phaeochromocytoma no such nocturnal decrease was found. The power spectrum of patients with phaeochromocytoma was statistically different from that of other aetiologies of hypertension. This was achieved due mainly to a statistically significant difference in the power spectrum integral over the low-frequency band (0-0.2 cycles/h) of the power spectrum of the 24-h systolic blood pressure signal. Resection of the phaeochromocytoma normalized the power spectrum as found by analysis of the postoperative ambulatory blood pressure monitoring data in two patients who underwent a repeat recording. The technique described enables the discrimination of patients with phaeochromocytoma as a cause of hypertension from other aetiologies of hypertension. Patients with renovascular hypertension could not be distinguished from those with essential hypertension on the basis of their power spectrum. However, this technique may prove to be a valuable modality for characterizing hypertensive patients of different aetiologies.