Diastolic Blood Pressure In Pregnancy Research Articles

The Effect ofAdditional Nanoparticles Supplementation of Indonesian Bay Leaf (SyzigiumPolyanthum) on Blood Pressure in Pregnancy Hypertension

Bay leaf (Syzygiumpolyanthum) or Daun Salam is one of the plants that has many benefits, one of them is to reduce blood pressure. The aim of this study is to prove the effect of adding nanoparticles supplementation of bay leaf (Syzygiumpolyanthum) to systolic and diastolic blood pressure in pregnancy hypertension.The study was quasi-experiment. 39 respondents were divided into 19 pregnant women in intervention group and 20 pregnant women in the control group. The intervention was given for 14 days by consumingnifedipine 10mg plus 80mg bay leaf nanoparticle capsules to the intervention group.The results of data analysis showed a decrease in systolic blood pressure (p = 0.000) and diastolic blood pressure (p = 0.004) when compared with the control group, which means that there were differences in the mean systolic and diastolic blood pressure between the two groups after treatment. The addition of bay leaf nanoparticle supplementation 1x80 mg for 14 days affected the decrease in systolic and diastolic blood pressure in pregnancy hypertension. So that the supplementation of bay leaf nanoparticles can be used as adjunctive therapy in pregnancy hypertension

Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial

To assess if hypertension during the last part of pregnancy could be prevented by magnesium supplementation. Pregnant primagravida women from a local antenatal care unit were given an oral supply of 300 mg magnesium as citrate or placebo from pregnancy week 25 in a randomised double-blind setup. Blood pressure was recorded during pregnancy as well as pregnancy outcome. In the magnesium-supplemented group, the average diastolic blood pressure at week 37 was significantly lower than in the placebo group (72/1.4 mean/SEM vs 77/1.4, p = 0.031). The number of women with an increase in diastolic blood pressure of ≥15 mmHg was significantly lower in the magnesium group compared with the women who received placebo (p = 0.011). There was an inverse relation between the urinary excretion of magnesium during pregnancy and the diastolic blood pressure (p = 0.005). Magnesium supplementation prevented an increase in diastolic blood pressure during the last weeks of pregnancy. The relation between diastolic blood pressure and urinary excretion of magnesium suggests that magnesium is involved in the regulation of blood pressure and that the increase in diastolic blood pressure in pregnancy could be due to a lack of magnesium.

Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: prospective study

Objective To investigate the relation of diastolic blood pressure in pregnancy with birth weight and perinatal mortality.Design Prospective study.Setting 15 maternity units in one London health region, 1988-2000.Participants 210 814...

Inflationary oscillometry provides accurate measurement of blood pressure in pre-eclampsia

Objective To evaluate the accuracy of the OMRON-MIT inflationary oscillometric device for blood pressure measurement in pregnancy and pre-eclampsia. Design Prospective observational study, using validation methods recommended by the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). Settings Antenatal clinics and ward, Guy's Hospital, London. Population Normotensive pregnant women and those diagnosed with pre-eclampsia according to the definition of the International Society for the Study of Hypertension in Pregnancy. Methods Validation according to BHS protocol. Main outcome measures Proportion of readings within 5, 10 and 15 mmHg (absolute differences) between the automated device and two trained, blinded observers, according to the BHS and AAMI criteria. Results The OMRON-MIT achieved an overall BHS grade B for systolic and grade A for diastolic blood pressure measurement in both pregnancy and pre-eclampsia. The mean (SD) differences between the standard and the test device were −5 (7) mmHg for systolic and 2 (6) mmHg for diastolic blood pressure in pregnancy and −4 (6) mmHg for systolic and 2 (7) mmHg for diastolic blood pressure in pre-eclampsia. This device therefore fulfils the AAMI criteria. Conclusion The OMRON-MIT is the only automated oscillometric device that has proven to be accurate for blood pressure measurement in pre-eclampsia according to the BHS protocol in pregnancy. Inflationary oscillometry may correct the error associated with oscillometric devices in pre-eclampsia.

Which Korotkoff sound should be used for the diastolic blood pressure in pregnancy?

There is a gathering momentum favouring the adoption of the 5th Korotkoff sound to identify diastolic blood pressure in pregnancy. Our objective was to measure interobserver reliability for indirect blood pressure measurement in pregnancy for systolic and diastolic measurements and to calculate the difference in diastolic pressure measured by the 4th and 5th Korotkoff sounds. To minimize bias we used trained but previously inexperienced observers with proven, normal auditory acuity. The observers were paired in 4 teams and performed a series of 334 blinded, simultaneous observations of systolic and diastolic blood pressure measurements taken from pregnant women between 12-41 weeks' gestation. Reliability was measured by intraclass correlation coefficient for paired measures and kappa for the detection or nondetection of 4th (K4) and 5th (K5) Korotkoff sounds. K4 was undetected in 36% of observations and K5 was undetected in 2% of observations. Reliability for detection or nondetection of Korotkoff sounds was fair for K4 (kappa 0.36) and moderate for K5 (kappa 0.58). Reliability was good between observers for systolic, K4 and K5 diastolic measurements (intraclass correlation > or = 0.80). The mean difference between the diastolic pressure measured by K4 and K5 was 15 mmHg for all measurements and 8 mmHg for the top quartile of measurements (p <0.001). We found K5 to be more often and more reliably detected than K4. If units adopt K5 in preference to K4, consideration will need to be given to lowering treatment thresholds for women with borderline or mild hypertension.

Diastolic Blood Pressure in Pregnancy: Phase Iv or Phase V Korotkoff Sounds?

Diastolic Blood Pressure in Pregnancy: Phase Iv or Phase V Korotkoff Sounds?

Lack of reproducibility in pregnancy of Korotkoff phase IV as measured by mercury sphygmomanometry

SummaryBackground Since hypertensive disorders of pregnancy are common, blood pressure is frequently measured in all pregnant women. Many authorities recommend that Korotkoff phase IV (K4, muffling of sound) is taken as the diastolic identification point measured on mercury sphygomanometry in pregnancy because of reports that phase V (K5, disappearance of sound) is at or near to zero cuff pressure in some pregnant women. We compared the identification and reproducibility of K4 and K5 by observers unaware of each other's results.Methods In the first part of the study, two pairs of observers each took 340 measurements in 85 pregnant women. The second part of the study consisted of 1120 measurements in 80 pregnant and 80 non-pregnant women by five pairs of observers. Measurements were taken simultaneously by sphygmomanometry with a shared cuff and diaphragm; the observers were in separate booths.Findings K5 was identified in all measurements by both observers and never approached zero. K4 was heard in only 52% of measurements; in 33% of cases it was heard by only one of the pair of observers, so the pair agreed on its detection in only 19% of readings. Visual analogue scores used to assess Korotkoff sound quality indicated that systolic blood pressure was perceived significantly more clearly than diastolic blood pressure (K4 or K5). Even when K4 was heard by both observers, agreement on its value was poor (78% within 5 mm Hg vs 86% for K5, p<0·05). K4 was heard significantly less often in non-pregnant women (32% of measurements). There was also no consistency in the identification of K4 within individual women.Interpretation K4 has little value in clinical management because it cannot be reproduced accurately. We recommend that K4 should be replaced by K5 as the measure of diastolic blood pressure in pregnancy.

Interobserver Variability in the Measurement of Diastolic Blood Pressure in Pregnancy

Objective: The objective of this study was to evaluate and compare the magnitude of interobserver variability present when measuring Korotkoff phase 4 versus phase 5 in pregnant women.Methods: Three observers with different backgrounds simultaneously measured both phase 4 and phase 5 on 98 gravidas. Data were used to estimate detectability rates, perform an analysis of variance to assess interobserver variability, examine the distribution of interobserver differences, and evaluate the magnitude of the difference between the two diastolic end points.Main Outcome Measures: Detectability rates of phase 4 and phase 5 diastolic pressure and measures of interobserver variability in diastolic readings.Results: Detectability rates were observer dependent, ranging from 81% to 96% for phase 4 and from 79% to 85% for phase 5. Analysis of variance demonstrated similar degrees of interobserver variability for both end points. Likewise, for any two observers measuring either end point, there was a similar number of mea...

Measuring blood pressure in pregnant women: A comparison of direct and indirect methods

Our goals were to determine (1) whether Korotkoff phase IV or V sound was a more accurate measure of diastolic blood pressure in pregnancy and (2) interobserver variability of mercury sphygmomanometry of pregnant women. Direct (intraarterial) and indirect (mercury sphygmomanometry) blood pressures were compared in 28 pregnant women. Interobserver variability was assessed in a separate study of 86 pregnant women using four highly trained observers. (1) Routine sphygmomanometry underestimated direct systolic pressure by 11 (3, 18) mm Hg, p < 0.001 (median, interquartile range of differences). Phase IV Korotkoff sound overestimated direct diastolic pressure by 9 (2, 12) mm Hg (p < 0.001) and phase V by 4 (2, 7) mm Hg (p = 0.04). Phase V-recorded diastolic pressure was closer to direct diastolic pressure significantly more often (75%) than was phase IV-recorded diastolic pressure (21%) (p = 0.003). Mean arterial pressures did not differ significantly according to the method used. (2) Median blood pressures did not differ among the four observers for systolic, diastolic phase IV, or phase V recordings. Maximum difference for blood pressure recording among observers was 4 (2, 6) mm Hg. Auscultatory sphygmomanometry in pregnant women underestimates systolic and overestimates diastolic blood pressure, but the phase V Korotkoff sound is more likely to represent the true diastolic pressure than is the phase IV sound.

How should diastolic blood pressure be defined during pregnancy?

Controversy exists concerning the most accurate method for defining diastolic blood pressure in pregnancy. Both disappearance (phase V) and muffling (phase IV) of Korotkoff sounds have been advocated. We previously reported an objective noninvasive method for measuring blood pressure, called K2 analysis, which in nonpregnant subjects was not different from intra-arterial diastolic blood pressure and was more accurate than the auscultatory technique. For determination of the relation of diastolic blood pressure (using K2) in pregnancy with muffling and disappearance of Korotkoff sounds, 58 women (42 hypertensive, 16 normotensive) underwent 556 blood pressure evaluations in the supine position at various stages of pregnancy. K2 analysis was compared with simultaneous auscultation by two observers, A1 (n = 461 observations; 364 hypertensive, 97 normotensive) and A2 (n = 415; 316 hypertensive, 99 normotensive). Overall, muffling was detected by observer A1 52.9% (244/461) and by observer A2 44.3% (184/415) of the time. When evaluated by clinical classification, muffling was found by both observers to be present less often in the hypertensive group (A1: 47.5%; A2: 37.3%) compared with the normotensive group (A1: 73.2%; A2: 66.7%) (P < .0001). When both observers were present (n = 348), they agreed that muffling was present only 112 times. Disappearance of sound was detected by both observers 98.3% (A1: 453/461; A2: 408/415) of the time. Muffling overestimated K2 diastolic pressure by 7 to 10 mm Hg, whereas there was no statistically significant difference between disappearance and K2 diastolic pressure for hypertensive subjects and a 2.5-mm Hg underestimation of K2 diastolic pressure for normotensive subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Diastolic Blood Pressure in Pregnancy: Phase Iv Or Phase V Korotkoff Sounds?

Objective: To determine the magnitude of Phase IV-V diastolic blood pressure differences in human pregnancy.Methods: Blood pressure was measured by a standardized technique, using a Hawkesley random zero sphygmomanometer, in 221 pregnant women. Measurements were made in the second and third trimesters of pregnancy. The study included a number of women with chronic hypertension and a number with preeclampsia.Main Outcome Measures: Magnitude of Phase IV-V differences in normal and hypertensive pregnant women.Results: As expected, values for Phase V diastolic blood pressure were lower than for those for Phase IV, both in the second and in the third trimesters of pregnancy. In the third trimester, the median difference between Phase IV and V Korotkoff sounds was 5 mm Hg in normals, 7 mm Hg in chronic hypertensives, and 5 mm Hg in women with preeclampsia.Conclusion: These differences are within the error of the measurements as made in clinical practice. The smallest differences were found in women with preecla...

Recording diastolic blood pressure in pregnancy.

Recording diastolic blood pressure in pregnancy.

Recording diastolic blood pressure in pregnancy.

Recording diastolic blood pressure in pregnancy.

Recording diastolic blood pressure in pregnancy: Authors' reply

<h3>Abstract</h3> Plants release volatiles in response to caterpillar feeding that attract natural enemies of the herbivores, a tri-trophic interaction which has been considered an indirect plant defence against herbivores. The caterpillar-induced plant volatiles have been reported to repel or attract conspecific adult herbivores. Apple seedlings infested with <i>Pandemis pyrusana</i> larvae uniquely release five compounds (benzyl alcohol, benzyl nitrile, phenylacetaldehyde, indole, and (<i>E</i>)-nerolidol). These compounds and other known caterpillar-induced plant volatiles were tested to investigate the response of both herbivores and natural enemies. In field tests, binary blends of benzyl nitrile and acetic acid or 2-phenylethanol and acetic acid attracted a large number of conspecific male and female adult moths. On the other hand, a ternary blend of benzyl nitrile, 2-phenylethanol and acetic acid attracted the largest numbers of the general predator, the common green lacewing, <i>Chrysoperla carnea.</i> This study provides the first record of caterpillar-induced plant volatile attraction to conspecific adult herbivores as well as predators under natural conditions.

85 Disappearance rather than muffling of Korotkoff sounds accurately reflects diastolic blood pressure in pregnancy

85 Disappearance rather than muffling of Korotkoff sounds accurately reflects diastolic blood pressure in pregnancy

Recording diastolic blood pressure in pregnancy.

Recording diastolic blood pressure in pregnancy.