Diagnostic Criteria For Hypertension Research Articles

Quantitative diagnostic criteria of hypertension according to 24-hour blood pressure monitoring

Objective. To study the opportunities of 24-h blood pressure (BP) monitoring in verifi cation of arterial hypertension (AH). Design and methods. The retrospective analysis of the 24-hour BP monitoring results of 395 patients was performed. Sensitivity and specifi city of the hypertensive indices were studied. Results. Ambulatory BP monitoring revealed 90 % of patients, who had BP over 140/90 mm Hg; however within 100 % sensibility, specifi city of this method was only 17 %. Based on the average daily BP (over 130/80 mm Hg) AH was verifi ed in 51 %. This index has 100 % sensitivity and 64 % specifi city. According to the time hypertensive indices ( HISx и HIDx ≥ 50 %) that show the same specifi city and sensitivity AH was established in 28 %, but these values ranging from 30 to 50 % made diffi cult the interpretation of the results The maximal density of BP, refl ecting the range of systolic and diastolic BP values at 10 mm Hg stepout, demonstrates both presence and stage of AH with the specifi city and sensitiviy 82 and 87 % respectively. Conclusion. The application of several highly sensitive and specifi c quantitative indices of 24-h BP monitoring in complex diagnostic approach allows diagnosing AH.

Study of the heart rate variability and blood pressure variability in hypertension grading

Objective To study the heart rate variability(HRV) and blood pressure variability(BPV) in patients with different grades of hypertension.Methods 120 cases of patients with hypertension,according to 1999 WHO/ISH hypertension diagnostic criteria are:1 hypertension in 40 cases,2 of hypertension in 40 cases,3 of hypertension in 40 cases and 40 cases of normal control group were detected heart rate variability and blood pressure variability.Results HRV was significantly different between the two groups(P <0.05 or p <0.01).The blood pressure increased and HRV tended to decrease.The BPV was significantly different(P < 0.01) between the two groups;the blood pressure increased and the BPV tended to increase.Conclusion The grade of hypertension is related to HRV and BPV. Key words: Hypertension; Heart rate variability; Blood pressure variability

Devices and techniques for blood pressure measurement and criteria for hypertension adopted by Brazilian physicians: exploratory study.

To determine technical procedures and criteria used by Brazilian physicians for measuring blood pressure and diagnosing hypertension. A questionnaire with 5 questions about practices and behaviors regarding blood pressure measurement and the diagnosis of hypertension was sent to 25,606 physicians in all Brazilian regions through a mailing list. The responses were compared with the recommendations of a specific consensus and descriptive analysis. Of the 3,621 (14.1%) responses obtained, 57% were from the southeastern region of Brazil. The following items were reported: use of an aneroid device by 67.8%; use of a mercury column device by 14.6%; 11.9% of the participants never calibrated the devices; 35.7% calibrated the devices at intervals < 1 year; 85.8% measured blood pressure in 100% of the medical visits; 86.9% measured blood pressure more than once and on more than one occasion. For hypertension diagnosis, 55.7% considered the patient's age, and only 1/3 relied on consensus statements. Despite the adequate frequency of both practices, it was far from that expected, and some contradictions between the diagnostic criterion for hypertension and the number of blood pressure measurements were found. The results suggest that, to include the great majority of the medical professionals, disclosure of consensus statements and techniques for blood pressure measurement should go beyond the boundaries of medical events and specialized journals.

Prevalence of hypertension in a Mexican population according to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.

Hypertension in Mexico represents a challenging public health problem. The National Survey on Chronic Diseases published in 1993 reported that hypertension affects more than 10 million Mexicans. No information has been published regarding the prevalence of hypertension in Mexico using the new diagnostic criteria established by the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI). The Mexico City Diabetes Study is a prospective study designed to estimate the prevalence and incidence of cardiovascular risk factors in a low-income area. The survey included 941 men and 1341 non-pregnant women aged 35-64 years. Blood pressure measurements were performed using a random zero sphygmomanometer. The diagnostic criteria for hypertension were those recommended by the JNC VI. The crude prevalence of hypertension was 17.2% and 18.1% in men and women, respectively. We found significant associations between hypertension and obesity, body fat distribution, very-low-density lipoprotein cholesterol, fasting and 2-h post-glucose in both sexes, and between hypertension and total cholesterol, low-density lipoprotein cholesterol and triglycerides levels in women. In 40% of hypertensive men and 23% of women, hypertension was undiagnosed and untreated. Of the previously diagnosed hypertensive individuals, 38% of men and 30% of women reported not taking antihypertensive medicine. The prevalence++ of associated risk factors in this population is 12.3% for tobacco consumption, 22.4% for diabetes, 49.8% for hypertriglyceridemia and 40.9% for hypercholesterolemia. Hypertension occurs in 18% of this population. There is a high prevalence of undiagnosed and untreated cases. Associated cardiovascular risk factors are highly prevalent.

Influence of parental socioeconomic status on casual blood pressures of Nigerian school children

The purpose of this study was to determine the effect of parental socioeconomic status on blood pressures of Nigerian school children. The weight, height, blood pressure and heart rate of 807 school children in Ile-Ife, Nigeria were measured. The subjects' ages ranged between 8 and 20 years. The subjects were classified into three (lower, middle and upper) groups based on the socioeconomic status of their parents. The findings revealed that parental socioeconomic status has no effect on the systolic and diastolic pressure, heart rate, rate pressure product and pulse pressure of Nigerian children. We found the 95th centile blood pressure to be 133 92 mm Hg . If the 95th centile is considered the diagnostic criteria for hypertension, then Nigerian children with sustained blood pressure in excess of 133 92 mm Hg should be investigated.

Vascular responses to noradrenaline in patients with essential hypertension

Many studies on effects of noradrenaline infused to patients with essential hypertension have been performed in order to clarify an etiology of essen-tial hypertension. In the present report, the author determined the vascular reactivity to noradrenaline infused to normotensives and hypertensive patients at various infusion rates. The hemodynamic effects of noradrenaline infused to both groups were compared statistically. Patients with essential hypertension diagnosed by blood pressure were classified into 3 groups according to the values of basal blood pressure. Clinical findings and vascular reactivity to the infused noradrenaline in each group were studied. The antihypertensive drugs were administered orally to the patients with essential hypertension, and the vascular responses to the infused noradrenaline before and after the administration were compared. The findings obtained would have im-portant clinical implications. Materials and Methods Ten normotensives and 27 patients with essential hypertension who were admitted to our Hospital in Iwate Medical University were the subjects in this research. Their age ranged 25 to 60 years in both the normotensives and the patients with essential hypertension (mean age; 38 years in the normotensives and 41 years in the hypertensives). The normotensive patients were free from any sign of cardiovascular disease. The diagnostic criteria of hypertension was referred to the report of WHO Expert Committee on arterial hypertension, using blood pressure recording: (1) below 140/90 mmHg-normal range; (2) 160/95, mmHg and above- hypertensive range. These hypertensive patients by such casual blood pressure were classified into 3 groups mentioned above as follows: Group I; Basal blood pressure was in a normal range . Group II; Basal blood pressure 140-159 mmHg in systolic and/or 90-95 mmHg in diastolic. Group III; Basal blood pressure was in a hypertensive range. Electrocardiography and ocular fundscopic examination were carried out in all cases of hypertension. The subjects, who shows depression of above 1mm in ST segments in left ventricular leads and/or grade I and above in Keith-Wagner classification was regarded to be positive. Heart rate and brachial blood pressure were measured as the hemodynamic examination. Digital blood pressure and digital blood flow were determined as the peripheral vascular hemodynamics and peripheral vascular resistance was calculated from these values according to the law of Poisuille. The technics of these measurements were employed by method of KIMURA and KATO.

Clinical study of juvenile hypertension

From the relatively high rate of uremic death observed in young hypertensives it is clear that the liability to develop malignant hypertension in those young subjects is considerable and the recognition and treatment in the early stages of the disease is important. In order to study these young hypertensives, especially those with juvenile arterial hypertension (defined as juvenile hypertension), 209 hypertensive patients under 40-year old were selected from 7176 patients studied at the second medical clinic of Juntendo University Hospital from 1957-to 1966. The diagnostic criteria of hypertension were bases on BP values above 150/90mmHg at rest in the lying position. The distribution of various hypertensive states among these patients was as follows. [table]To investigate the possible mechanisms involved in the development of juvenile hypertension together with the clinical pathological findings, the results of precise clinical examinations of these patients were summarized and compared with the findings in chronic gromerulonephritis and in arterial hypertension of older age groups. The characteristics of juvenile hypertension were as follows. 1) There are two types of juvenile hypertension, namely a labile hypertension (A type) and a sustained hypertension (B type). 2) The relative incidence of hypertension in the family history was markedly higher than that of chronic glomerulonephritis. 3) The subjective symptoms of these patients were relatively slight and were limited to CNS symptoms as headache, dizziness or shoulder-stiffness. 4) The urinary findings, renal function tests, blood pictures and the biochemical patterns were relatively normal except for the consistent finding of a lower level of serum potassium especially in the A type. 5) The catecholamines, especially noradrenalin, excretion in the urine were increased, particulary in the A type.