Difference In Average Blood Pressure Research Articles

Validation of the single-cuff oscillometric blood pressure monitor InBody BPBIO750 for public spaces according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard.

The aim of this study was to evaluate the accuracy of the single upper-arm cuff oscillometric blood pressure (BP) monitor InBody BPBIO750 developed for self-measurement by adults in public spaces (kiosk) 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). Subjects were recruited to fulfil the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. A total of 102 subjects were recruited and 85 were analyzed [mean age 56.7 ± 15.4 (SD) years, 40 men, arm circumference 32.3 ± 5.3 cm, range 22-42 cm]. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 2.2 ± 6.1/-2.2 ± 5.2 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 5.00/4.63 mmHg (systolic/diastolic). The InBody BPBIO750 device fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in general population and can be recommended for clinical use in adults.

Validation of the InBody BPBIO250 oscillometric blood pressure monitor for professional office use in general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard

The aim of this study was to evaluate the accuracy of the InBody BPBIO250 oscillometric upper-arm professional office blood pressure (BP) monitor in 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). Subjects were recruited to fulfil the age, gender, BP, and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. Two cuffs of the test device were used for arm circumference 22-32 (medium) and 32-42 cm (large). Ninety-seven subjects were recruited and 88 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 1.9 ± 5.9/0.9 ± 4.9 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 4.78/4.31 mmHg (systolic/diastolic). The InBody BPBIO250 professional oscillometric device for office BP measurement fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in general population and can be recommended for clinical use.

Validation of the InBody BP170 oscillometric home blood pressure monitor in general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard.

To evaluate the accuracy of the InBody BP170 oscillometric upper-arm home blood pressure (BP) monitor in 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). Subjects were recruited to fulfill the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. Two cuffs of the test device were used for arm circumference 22-32 (medium) and 32-42 cm (large). One-hundred five subjects were recruited and 88 were analyzed. For validation Criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 0.9 ± 6.9/0.5 ± 5.5 mmHg (systolic/diastolic). For Criterion 2, the SD of the averaged BP differences between the test device and reference BP per subject was 5.77/4.80 mmHg (systolic/diastolic). The InBody BP170 oscillometric home BP monitor fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) in general population and can be recommended for clinical use.

Validation of the mobile wireless digital automatic blood pressure monitor using the cuff pressure oscillometric method, for clinical use and self-management, according to international protocols.

The purpose of this study was to evaluate the accuracy of a mobile wireless digital automatic blood pressure monitor for clinical use and mobile health (mHealth). In this study, a manual sphygmomanometer and a digital blood pressure monitor were tested in 100 participants in a repetitive and sequential manner to measure blood pressure. The guidelines for measurement used the Korea Food & Drug Administration protocol, which reflects international standards, such as the American National Standard Institution/Association for the Advancement of Medical Instrumentation SP 10: 1992 and the British Hypertension Society protocol. Measurements were generally consistent across observers according to the measured mean ± SD, which ranged in 0.1 ± 2.6mmHg for systolic blood pressure (SBP) and 0.5 ± 2.2mmHg for diastolic blood pressure (DBP). For the device and the observer, the difference in average blood pressure (mean ± SD) was 2.3 ± 4.7mmHg for SBP and 2.0 ± 4.2mmHg for DBP. The SBP and DBP measured in this study showed accurate measurements that satisfied all criteria, including an average difference that did not exceed 5mmHg and a standard deviation that did not exceed 8mmHg. The mobile wireless digital blood pressure monitor has the potential for clinical use and managing one's own health.

Validation of the iHealth ambulatory blood pressure monitor in adults according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization standard.

To assess the accuracy of the iHealth oscillometric ambulatory blood pressure (BP) monitor in adults according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2:2013 standard. Adults were recruited to fulfil the age, sex, BP and cuff distribution criteria of the ANSI/AAMI/ISO standard using the same-arm sequential BP measurement method. Two cuffs of the test device were used for arm circumferences 22-34 and 30-42 cm. A total of 100 individuals were recruited and 85 were included in the analysis. For validation criterion 1, the mean±SD of the differences between the test device and reference BP was -0.7±6.0/0.7±4.8 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference per participant was 4.72/3.97 mmHg (systolic/diastolic). The iHealth ambulatory BP monitor fulfilled the requirements of the ANSI/AAMI/ISO validation standard in adults and can be recommended for clinical use.

Validation of the professional device for blood pressure measurement Microlife WatchBP Office in adults and children according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization standard.

To assess the accuracy of the professional oscillometric blood pressure (BP) monitor Microlife WatchBP Office in adults and children according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2:2013 standard. Adults and children (aged 3-12 years) were recruited to fulfil the age, sex, BP and cuff distribution criteria of the ANSI/AAMI/ISO standard using the same-arm sequential BP measurement method. Three cuffs of the test device were used for arm circumferences of 14-22, 22-32 and 32-42 cm. A total of 115 participants were recruited and 88 were included in the analysis (51 adults and 37 children). For criterion 1, the mean±SD of the differences between the test device and reference BP was -1.0±7.0/-4.7±5.4 mmHg (systolic/diastolic). For criterion 2, the SD of the averaged BP differences between the test device and reference per participant was 5.15/4.77 mmHg (systolic/diastolic). The professional Microlife WatchBP Office BP monitor fulfilled the requirements of the ANSI/AAMI/ISO validation standard for adults and children and can be recommended for clinical use.

Agreement between finger plethysmography‐ and brachial oscillometry‐derived blood pressure measurements

Blood pressure (BP) is commonly assessed by brachial oscillometry in clinical practice, whereas in physiological studies, finger plethysmography is often employed. This study assessed the limits of agreement between BP metrics obtained from each device. In 96 participants, we simultaneously recorded BP by brachial oscillometry (BP+; Uscom, Sydney, NSW, Australia) and finger plethysmography (Finometer MIDI, MLE1054-V; Finapres Medical Systems B.V., Amsterdam, the Netherlands). Agreement between the two devices was assessed by correlation and Bland-Altman analysis. We assessed average BP differences between the two devices using the criteria of the Association for the Advancement of Medical Instruments (AAMI), which require systolic and diastolic BP differences to be within ≤5±8 (mean±SD). Bland-Altman analysis showed wide limits of agreement (±~17mmHg or greater) between finger-derived brachial and oscillometric BP. Both systolic and mean BP exhibited positive proportional biases (both P<0·05). Systolic BP differed significantly between devices (7·4±17·7mmHg, P<0·001), which did not meet the AAMI criteria. No mean bias was observed for diastolic BP (-1·5± 8·6mmHg, P=0·097), and the SD of ±8·6mmHg is potentially acceptable given the finger signal may be expected to capture biological variability in BP. Mean BP showed poor concordance (3·7±10·5mmHg, P<0·001). These findings indicate that systolic and mean BP measurements made by brachial oscillometry do not agree with those from finger plethysmography. In contrast, diastolic BP values show acceptable agreement.

LBPS 03-05 CHANGE IN BLOOD PRESSURE FOLLOWING NEPAL'S EARTHQUAKE

Objective: On 14th June 2015, a famous media house in Nepal published an article suggesting that blood pressure decreased followed the recent Nepal earthquake. According to the article, two cardiologists were reporting a 50 percent decrease in blood pressure following the earthquake in circa 900 patients. To address this apparent paradox we had the opportunity to contrast blood pressure in the community the earthquake and nine-days after the earthquake. Design and Method: This study is part of a baseline study of a larger community-based cluster randomized controlled trial being conducted in Nepal (NCT02428075). We compared 505 randomly selected respondents whose blood pressure was measured before the earthquake with additional randomly selected 505 respondents whose blood pressure was measured 9 days after the initial earthquake from the same study area. The pre quake and post quake difference in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) was estimated through regression analysis in two cross sectional populations, adjusting for sex, age, tobacco, alcohol, body mass index, and fruit and vegetable servings a day. Results: Average Blood Pressure (BP) before and after the earthquake were 125.56/82.24 mmHg and 123.04/80.49 mmHg respectively. The average blood pressure difference at 9 days post earthquake compared to the before 9 days was −0.83 (95% CI: − 2.88; 1.22) mmHg / -−0.74 (95% CI: -−2.02; 0.52) mmHg. In a separate analysis among hypertensive participants (>=120/80 mmHg), SBP and DBP differences were 2.02 (95% CI: -−1.78; 5.83) mmHg and 1.11 (95% CI: -−1.03; 3.26) mmHg respectively after the earthquake. Conclusions: The above results showed no statistically significant difference on the average BP level before and after the earthquake for two randomly selected cross-sectional populations (p > 0.05). The claims by the national daily from Nepal of changes in blood pressure may have been based on other factors that we cannot account for.

Abstract P403: Blood Pressure Differences Associated With OMNIHEART-like Lower Sodium Compared With Typical American Higher Sodium Nutrient Profile: INTERMAP USA

Background: The DASH-Sodium trial demonstrated beneficial effects on blood pressure (BP) of the DASH diet with lower sodium intake, compared to typical American diet with higher sodium. The subsequent OMNIHEART trial reported additional benefits for BP by replacing carbohydrate in the DASH diet with either protein or monounsaturated fats. Objective: Assess possible BP benefits of a lower sodium OMNIHEART-like diet in free-living Americans using two statistical methods: a linear OMNIHEART nutrient score, and a Bayesian approach comparing estimated BP levels with an OMNIHEART-like lower sodium nutrient profile (“OMNIHEART”) and with a typical American higher sodium profile (“Control”). Methods: Cross-sectional data include four 24-h dietary recalls, two timed 24-h urine collections, eight BP readings for 2,195 individuals ages 40-59 from the International Study on Macro/Micronutrients and Blood Pressure (INTERMAP). An OMNIHEART score (with 9 nutrient targets, based on the protein arm of the trial) was calculated for each participant and regressed on BP. For Bayesian profile regression, participants were assigned to clusters based on similarity of their nutrient profiles; pre-specified OMNIHEART and Control profiles were assigned to clusters. Posterior distributions were obtained for mean BP levels associated with OMNIHEART and Control profiles. Results: With adjustment for potential confounders, an OMNIHEART score higher by one point was associated with systolic/diastolic BP differences of 1.0/ 0.5 mmHg (both P&lt;0.001). Mean systolic/diastolic BPs were 111.3/68.4 and 115.2/70.6 mmHg for Bayesian OMNIHEART and Control profiles respectively; controlled for possible confounders, average BP differences were 3.9/ 2.2 mmHg (P(diff≥0) =0.98/0.96). Findings were comparable for men and women, for non-hypertensive participants, and with adjustment for antihypertensive treatment. Conclusions: These findings indicate broad generalisability of DASH and OMNIHEART trial results, and support recommendations for reduced sodium OMNIHEART-style diet for prevention/control of population-wide adverse BP levels.

Dietary glycine and blood pressure: the International Study on Macro/Micronutrients and Blood Pressure

Available data have indicated independent direct relations of dietary animal protein and meat to the blood pressure (BP) of individuals. In this study, we aimed to assess whether BP is associated with the intake of dietary amino acids higher relatively in animal than in vegetable protein (alanine, arginine, aspartic acid, glycine, histidine, lysine, methionine, and threonine). The study was a cross-sectional epidemiologic study that involved 4680 persons aged 40-59 y from 17 random population samples in the People's Republic of China, Japan, the United Kingdom, and the United States. BP was measured 8 times at 4 visits; dietary data (83 nutrients and 18 amino acids) were from four 24-h dietary recalls and two 24-h urine collections. Dietary glycine and alanine (the percentage of total protein intake) were considered singly related directly to BP; with these 2 amino acids together in regression models (from model 1, which was controlled for age, sex, and sample, to model 5, which was controlled for 16 possible confounders), glycine, but not alanine, was significantly related to BP. Estimated average BP differences associated with a 2-SD higher glycine intake (0.71 g/24 h) were 2.0-3.0-mm Hg systolic BP (z = 2.97-4.32) stronger in Western than in East Asian participants. In Westerners, meat was the main dietary source of glycine but not in East Asians (Chinese: grains/flour and rice/noodles; Japanese: fish/shellfish and rice/noodles). Dietary glycine may have an independent adverse effect on BP, which possibly contributes to direct relations of animal protein and meat to BP.

Frequent Change of Intra-group Drug Effect on the Blood Pressure Control and Adaptation of Therapy in Hypertensive Patients

Introduction: In this study, we investigated the effects of frequent and unnecessary change in medication to control of blood pressure. Also we investigated the role of the regular use of drugs in the treatment of hypertension. Patients and Methods: Nine hundred hypertensive patients (509 males and 391 females; mean age 62.4 ± 12.1 years) were evaluated retrospectively. Only the patients taking anti-hypertensives for at least six months were included. Patients' records were examined in terms of anti-hypertensive treatment. Intra-group exchange and use of regularly in anti-hypertensive drugs were investigated. Effects of the change in blood pressure and patient compliance were investigated. Results: When intra-group drug change was examined, rates of drug changes were as follows; angiotensin receptor blocker group, 62.3%; angiotensin converting enzyme group, 55.1%; betablockers group, 39.9%; calcium channel blocker group, 20.9%. While the ratio of non-compliance was 28.7% in the patient group with drug change, it was only 9.3% in the group without change in treatment. Average blood pressure difference was found 6.1 ± 7.6 mmHg and 7.6 ± 7.5 mmHg respectively (p < 0.001). The average number of drug usage with and without change of antihypertensive drug were 2.5 ± 0.87 and 2.2 ± 0.89 (p < 0.001) respectively. Conclusion: In patients under angiotensin converting enzyme inhibitors and angiotensin receptor blocker treatments, intra-group change of medication is common. Frequent intra-group change of anti-hypertensive drugs has negative effects on blood pressure control.

Poster presentations

Poster presentations

What Happens to Blood Pressure when On-Call?

ARCO-GALAN, CARMEN DEL; SUAREZ-FERNANDEZ, CARMEN; GABRIEL-SANCHEZ, RAFAEL Author Information