Management Of Hypertension Research Articles

Reviewing the path to balance: mechanisms and management of hypertension associated with targeting vascular endothelium in cancer therapy.

Contemporary anticancer drugs are often accompanied by varying degrees of cardiovascular toxicity, with hypertension emerging as one of the most prevalent side effects, particularly linked to inhibitors of vascular endothelial growth factor receptor (VEGFR) and tyrosine kinase inhibitors (TKIs). Hypertension induced by cancer therapies contributes to increased cardiovascular mortality in cancer patients and survivors. Given the shared common risk factors and overlapping pathophysiological mechanisms, hypertension is also a prevalent comorbidity in this patient population. The mechanisms underlying hypertension induced by therapies targeting the vascular endothelial growth factor (VEGF) signaling pathway primarily involve reduced nitric oxide (NO) synthesis, increased endothelin-1 (ET-1) production, oxidative stress, microvascular rarefaction and dysfunction, decreased natriuresis, activation of the renin-angiotensin system (RAS), and partial endothelial cell death. Research into hypertension associated with therapies targeting the VEGF signaling pathway (VSP) could facilitate the optimization of cancer treatments, improve the evaluation and management of hypertension during targeted therapy, and help to reduce cardiovascular event rates and overall patient mortality. This review aims to provide a comprehensive summary of the current advancements in this area.

Effect of individual health perception, health consultation, and other risk factors on undiagnosed hypertension in South Africa

BackgroundSimilar to other nations, hypertension control is a challenge for public health in South Africa. To control hypertension, the condition must be screened and diagnosed in the public health system. This study examines how the prevalence of undiagnosed hypertension is influenced by various risk factors including demographic, socioeconomic, environmental, and behavioural factors, with primary focus on self-perceived health well-being and time since the last healthcare consultation.MethodsThe study utilized data from the National Income Dynamics Study (NiDS), a panel survey conducted approximately every two years between 2008 and 2017. Participants aged 15 years and older with at least two blood pressure measurements were included. The sample included 15,712 unique individuals (60.0% women) and 31,340 observations from the five survey waves (5,357 in 2008; 5,206 in 2010/11; 6,385 in 2012; 7,060 in 2014/15; and 7,332 in 2017). Both descriptive and analytical methods were used to study undiagnosed hypertension. Multilevel logistic regression was used to explore the relationship between undiagnosed hypertension with various risk factors including perceived health well-being and time since last health consultation.ResultsThe study showed that in 2008 (wave 1) and in 2017 (wave 5), approximately 53.5% and 42.6% respectively, of individuals aged 15 and above were unaware they could be hypertensive. Those who perceived their health as very good or excellent were respectively 2.15, 95% CI [1.89–2.44] and 3.29, 95% CI [2.85–3.80] times more likely to have undiagnosed hypertension, compared to those who perceived their health as fair or poor. Additionally, the risk of having undiagnosed hypertension increased gradually with time since last consultation on one’s health. Those whose last consultation was more than two years ago were 12.10, 95% CI [10.50–13.90] times more likely to have undiagnosed hypertension compared to those who had consulted within the last 30 days.ConclusionGiven that hypertension is often asymptomatic, self-perceived health can be misleading. This underscores the need for health programs to emphasize the importance of regular blood pressure checkups. Regular consultations with healthcare providers are crucial for early detection and management of hypertension.

Tuberous sclerosis complex-associated kidney disease in children.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder which can have manifestations in the kidneys, along with other organ systems. Children with TSC may develop kidney lesions at any point during childhood, and typically these are angiomyolipomata (AML) and/or kidney cysts. Children may also have hypertension associated with TSC-associated kidney disease, and rarely reduced kidney function. New guidelines for the management of TSC-associated kidney disease in children and adults were published in 2024. This educational review summarises the relevant clinical aspects of these guidelines for paediatric nephrologists through a series of four clinical cases. These cases cover management of hypertension, frequency of follow-up and frequency of kidney imaging. Difficult clinical scenarios are reviewed, such as the management of TSC2-PKD1 contiguous gene syndrome and the management of large AMLs in children with TSC.

High Blood Pressure among Young Adults Aged 18 - 45 Years Presenting for Care to a Health Center in Karongi District in Rwanda

Hypertension is a major global health challenge, significantly contributing to morbidity and mortality. This study investigates the prevalence and associated risk factors of hypertension among young adults aged 18 – 45 years in Karongi District, Rwanda, to inform effective prevention and management strategies. Hypertension prevalence serves as a critical measure of community health, with further epidemiological data needed to address treatment gaps, elevated prevalence rates, and suboptimal blood pressure control. The study also aims to promote routine blood pressure monitoring and highlight the efficacy of lifestyle interventions, including reduced salt intake, regular physical activity, weight loss, alcohol moderation, and smoking cessation, in managing hypertension. A cross-sectional analytical design was employed, utilizing patient questionnaires and observation checklists at Rubengera Health Center. Data analysis was conducted using STATA version 15, with logistic regression identifying factors influencing hypertension. The study found an overall hypertension prevalence of 30.3%, with 9.09% representing newly diagnosed cases, consistent with trends in African populations. Significant sociodemographic factors included older age, lower education levels, urban residence, and marital status, with higher prevalence among married and widowed individuals. Key lifestyle contributors were high saturated fat intake, low physical activity, and excessive salt consumption, while regular exercise and a balanced diet were protective factors. The study concludes that hypertension is a prevalent health issue among young adults in Karongi District, driven by both sociodemographic and lifestyle factors. It underscores the need for data-driven strategies for hypertension management and control, providing essential insights for health planners in estimating disease burden and designing targeted interventions. Recommendations include public awareness campaigns, early detection initiatives, and policy measures addressing unhealthy dietary habits and physical inactivity. Further research is encouraged to examine the impact of occupation, gender, marital transitions, and intervention efficacy in reducing hypertension prevalence. These efforts aim to mitigate the burden of hypertension in Rwanda, contributing to improved health outcomes and population well-being. Keywords: Hypertension, Prevalence, Risk factors, Lifestyle interventions, Sociodemographic factors, Management strategies

Adapting self-measured blood pressure monitoring to reduce health disparities (ASPIRE): a pilot hybrid effectiveness‑implementation study protocol

BackgroundHypertension is the leading risk factor for cardiovascular disease (CVD). Despite advances in blood pressure management, significant racial and ethnic disparities persist, resulting in higher risks of stroke, heart disease, and mortality among non-White populations. Self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, has shown promise in improving blood pressure control, especially when combined with feedback from healthcare providers. However, the adoption of SMBP remains low, particularly among racial and ethnic minorities, due to various patient, provider, and system-level barriers.ObjectivesThis study aims to evaluate the feasibility of study methods implementing the ASPIRE (adapting self-measured blood pressure to reduce health disparities) toolkit in a primary care setting. The toolkit is designed to address barriers to SMBP adoption and improve hypertension management among underserved populations to increase SMBP adoption.MethodsThis pilot hybrid effectiveness-implementation randomized controlled trial (RCT) will be conducted at a primary care clinic in South Side Chicago, serving a diverse patient population. Eligible patients with uncontrolled hypertension will be randomized to either the intervention group, receiving the ASPIRE toolkit and support, or the control group, receiving usual care. The primary outcomes include feasibility measures including recruitment rates, attrition, and availability of data in the electronic health records.ResultsThe feasibility of the study methods will be analyzed to inform a larger multi-site RCT informed by progression criteria developed in this protocol. Qualitative interviews with patients and providers will explore the appropriateness and implementation success of the toolkit using the Consolidated Framework for Implementation Research (CFIR).ConclusionsThis pilot RCT will provide critical insights into the feasibility of study methods to evaluate the implementation success of the ASPIRE toolkit in a real-world primary care setting. By addressing barriers to SMBP adoption, this intervention has the potential to improve hypertension management and reduce health disparities in underserved populations.Trial registrationNCT: NCT06175793. Registered 19 December 2023, https://clinicaltrials.gov/study/NCT06175793.

Closing the Gap: Digital Innovations to Address Hypertension Disparities.

Significant inequities persist in hypertension detection and control, with minoritized populations disproportionately experiencing organ damage and premature death due to uncontrolled hypertension. Remote blood pressure monitoring combined with telehealth visits (RBPM) is proving to be an effective strategy for controlling hypertension. Yet there are challenges related to technology adoption, patient engagement and social determinants of health (SDoH), contributing to disparities in patient outcomes. This review summarizes the evidence to date for RBPM, focusing on the potential to advance health equity in blood pressure control and the existing levers for largescale implementation. Several studies demonstrate the promise of RBPM programs to address health disparities through: (1) the use of cellular-enabled blood pressure machines that do not require internet access or smart devices to connect readings into the medical record; (2) emphasis on home blood pressure monitoring to illuminate the daily factors that influence blood pressure control, thereby increasing patient empowerment; (3) adoption of standardized algorithms for hypertension management; and (4) integration of services to address SDoH. Multidisciplinary, non-physician care teams that include nurses, pharmacists, and community health workers are integral to this model. However, most studies have not embraced all aspects of RBPM, and implementation is challenging as current payment models do not support the digital components of RBPM or a diverse workforce of hypertension providers. To address hypertension disparities, RBPM programs need to integrate digital technology that is accessible to all users as well as multidisciplinary care teams that attend to the medical and social needs of populations experiencing health inequities.

Perioperative Management of Patients with Preeclampsia: A Comprehensive Review.

Preeclampsia is a common condition of pregnancy characterized by hypertension complicated by cerebral, cardiac, hepatic, renal, hematologic, and placental dysfunction. Patients with preeclampsia frequently undergo cesarean delivery, the most common major surgical procedure in the world. They represent a high-risk perioperative cohort suffering significant preventable morbidity and mortality. This review focuses on the anesthesiologist's role, through a perioperative lens, in reducing maternal complications through management of hypertension and strategies for preserving the function of the brain, heart, liver, kidney, hematologic and coagulation systems, and placenta in patients with preeclampsia undergoing cesarean delivery. Preeclampsia-specific resuscitation, individualized fluid administration, safe neuraxial and general anesthesia, and management of intraoperative bleeding are discussed along with strategies for postoperative analgesia, thromboprophylaxis, and antihypertensive agents in patients who breastfeed. This review discusses recently recognized postoperative deterioration in maternal mental health, the possibility of myocardial injury after cesarean delivery, and the need for long-term cardiometabolic follow-up.

Effectiveness of Mindfulness-Based Stress Reduction (MBSR) in Managing Hypertension among Adults in Indonesia

Purpose: The aim of the study was to investigate the effectiveness of mindfulness-based stress reduction (MBSR) in managing hypertension among adults Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Mindfulness-based stress reduction (MBSR) effectively reduces blood pressure by managing stress and enhancing relaxation. Studies show significant reductions in systolic and diastolic pressure, particularly in individuals with resistant hypertension. MBSR programs are most beneficial when tailored to cultural contexts and when participants maintain consistent practice. It serves as a valuable, non-pharmacological complement to traditional hypertension treatments, improving overall well-being and long-term health outcomes. Unique Contribution to Theory, Practice and Policy: Biofeedback theory, cognitive behavioral theory (CBT) & transactional model of stress and coping may be used to anchor future studies on the effectiveness of mindfulness-based stress reduction (MBSR) in managing hypertension among adults. It emphasizes the importance of addressing both mental and physical health, providing a complementary treatment to traditional medical interventions such as medication. As a non-drug treatment, MBSR can reduce reliance on expensive medications, offering a more affordable alternative for long-term hypertension management.

Home-based yoga intervention in hypertensive patients: changes in anthropometric and blood pressure parameters Running title: Home based yoga in hypertension

Introduction: The present study aimed to determine whether practicing yoga at home leads to significant improvements in hypertension and obesity compared to non-yoga practitioners. To compare these changes in yoga and control hypertensive patients at baseline and after invention of three months yoga program. Materials and methods: The present study was a non-randomised controlled trial, conducted for a period of two years, from December 2021 to December 2023 at a tertiary care teaching institute in Indore. Total 300 participants were divided into four groups (two intervention and two control groups) that were followed up for three months to assess the changes in their antropometric and blood pressure parameters after yoga intervention in the intervention group. Results: The intervention group reported a statically significant improvement in systolic blood pressure (P <0.01) and diastolic blood pressure (P <0.05). The quality of life was assessed based on the WHOQOL-BREF questionnaire and it was observed that the overall quality of life was perceived to be better in the intervention group which was statistically significant (P <0.05). Conclusions: Yoga’s ability to lower blood pressure through stress reduction, autonomic regulation, and improved cardiovascular function makes it a promising non-pharmacological option for hypertension management

THE ROLE OF HEALTH EDUCATION IN THE PREVENTION AND MANAGEMENT OF HYPERTENSION IN THE ELDERLY: A LITERATURE REVIEW

Introduction: Hypertension is a significant health problem that, if not properly managed, can lead to more severe complications. Hypertension requires proper and accurate treatment. Systolic blood pressure over 140 mmHg and diastolic blood pressure over 90 mmHg is known as hypertension. Objective: To understand the role of health education in the prevention and management of hypertension in the elderly. Methods : The method used in this study is a literature review. Academic articles were searched through online databases such as PubMed and Google Scholar from 2019-2024, resulting in 10 relevant articles. Results : Based on the review and analysis of the 10 selected articles, it was concluded that education can increase respondents' knowledge regarding the prevention and management of hypertension. Conclusion : The role of nurses in assisting patients can improve health by providing information about the care and medical treatments they receive, and by offering nursing care to meet the needs of hypertensive patients and provide the necessary treatment.

Continual Versus Occasional Blood Pressure (COOL-BP) in Remote Hypertension Management.

Remote hypertension management programs have emerged as potential solutions to improve poor rates of blood pressure (BP) control. The Continual Versus Occasional Blood Pressure (COOL-BP) Study investigated the feasibility and efficacy of using a cuffless wrist BP monitor in a remote hypertension (HTN) program. COOL-BP was a prospective single-arm study within a larger HTN management program at Mass General Brigham (MGB). Participants had uncontrolled HTN, were already engaged in the MGB Remote Hypertension Program, and used a smartphone. The study involved patients wearing the Aktiia cuffless wrist BP monitor and performing traditional home BP monitoring (HBPM). The primary endpoint was the correlation of BP measurements between devices. Secondary endpoints included concordance between HBPM and cuffless pressures following a medication titration, and patient satisfaction with the cuffless device. We enrolled 38 patients, of whom 25 provided BP data on overlapping dates with both devices. There was moderate correlation between average non-simultaneous daytime BPs within the same time periods (r=0.57, 95% CI: 0.39-0.71 for systolic BP [p<0.001]; r=0.64, 95% CI: 0.48-0.76, for diastolic BP [p<0.001]). The concordance of systolic BP changes detected by the two devices post-medication titration was 87.5%. Most patients (91%) preferred the cuffless device, citing ease of use and convenience. Cuffless BP devices demonstrate promise in enhancing patient compliance and effectiveness in HTN management. Their integration into clinical practice could offer a more patient-friendly and reliable approach to BP monitoring, though more research is needed to establish their utility in large populations.

Comparative study on blood pressure and metabolic improvements in hypertensive patients using copper bianstone scraping.

To evaluate the effectiveness and feasibility of the copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy program by comparing and analyzing the improvement of blood pressure, blood lipids and blood glucose in hypertensive patients who received copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy intervention. We selected 160 cases of hypertensive patients from July 2022 to March 2024 for the study. They were divided into 80 cases in the comparison group and 80 cases in the observation group according to whether or not they underwent copper bianstone scraping combined with Chinese modified dietary therapy for termination of hypertension. In the comparison group, conventional Chinese dietary therapy with improved termination of hypertension was used, and in the observation group, copper bianstone scraping combined with Chinese dietary therapy with improved termination of hypertension (DASH) was used on the basis of the comparison group. Differences in vitamin D, Homocysteine and serum calcium levels, blood pressure, blood glucose and lipid levels were compared between the 2 groups. The decreases of glycosylated hemoglobin, fasting blood glucose and 2-hour postprandial blood glucose in the observation group were greater than those in the comparison group; the decreases of blood pressure and BMI in the observation group were greater than those in the comparison group. The difference in comparison was statistically significant (P-value < 0.05). After the intervention, the improvement of homocysteine, vitamin D, serum calcium, albumin, hemoglobin and transferrin in the observation group was greater than that in the comparison group, and the difference was statistically significant (P-value < 0.05). Copper bianstone scraping combined with Chinese modified termination of hypertension dietary therapy in hypertensive patients has a better effect, can effectively improve the patient's blood glucose and lipid levels, improve the nutritional status of the patient, can be promoted in the rehabilitation management of hypertension.

The role of clinical pharmacist in the management of resistant hypertension.

Hypertension is a major contributor to global cardiovascular morbidity and mortality. Treatment-resistant hypertension (TRH) presents a significant management challenge, requiring a pharmacist-physician collaborative model to achieve sustained blood pressure (BP) control. This study aims to evaluate the impact of a clinical pharmacy interventions on BP control, medication adherence, and patient outcomes in patients with TRH in a primary care setting. A randomized controlled trial was conducted involving 142 patients with TRH at two primary care clinics. Participants were randomly assigned to either the intervention group, receiving clinical pharmacy services including medication reviews and personalized counseling, or the control group, receiving standard care. Medication adherence was assessed using the Medication Adherence Rating Scale, and patient outcomes, including BP control and quality of life (QoL), were measured over a 6-month period. The intervention group demonstrated a significant improvement in medication adherence compared to the control group (p < 0.001), with an effect size of - 1.75. Clinical parameters, such as BP (mean reduction in BP: 27.9/13.4mmHg), showed more favorable outcomes in the intervention group (p = 0.003). Furthermore, patients receiving clinical pharmacy services reported higher QoL scores (p < 0.001) and expressed higher satisfaction with medication management. Clinical pharmacy interventions significantly enhance medication adherence and improve patient achievement of target BP goals in TRH patients. Incorporating clinical pharmacy services into routine care can lead to better health management and increased patient QoL. Further research is needed to explore long-term benefits and cost-effectiveness.

CHild -in-mothEr Approach for DeliverING Renal Denervation System: The HEADING-IN Technique.

Renal denervation is an emerging strategy for the management of uncontrolled hypertension. However, real-world experience is still modest, in particular for the management of complex anatomy, with available data being limited to the selected population of randomized clinical trials. We first describe the feasibility of delivering the renal denervation system to the target site with a child-in-mother technique, using a common coronary guiding extension, in a patient with severe tortuosity and double renal arteries.

Diuretics in patients with chronic kidney disease.

Diuretic drugs act on electrolyte transporters in the kidney to induce diuresis and are often used in chronic kidney disease (CKD), given that nephron loss creates a deficit in the ability to excrete dietary sodium, which promotes an increase in plasma volume. This rise in plasma volume is exacerbated by CKD-induced systemic and intra-renal activation of the renin-angiotensin-aldosterone-system, which further limits urinary sodium excretion. In the absence of a compensatory decrease in systemic vascular resistance, increases in plasma volume induced by sodium retention can manifest as a rise in systemic arterial blood pressure. Management of sodium and volume overload in patients with CKD is therefore typically based on restriction of dietary sodium intake and the use of diuretic agents to enhance urinary sodium excretion. Thiazide and thiazide-type diuretics are foundational therapies for the management of hypertension, whereas loop diuretics are often needed for volume overload, which might also require combination therapies. Mineralocorticoid receptor antagonists have an important role in the management of diuretic-resistant volume overload or treatment-resistant hypertension. Additionally, diuretics can be used for the diagnosis of kidney diseases and in the management of hyperkalaemia or hypokalaemia, hyponatraemia, hypercalcaemia and hypomagnesaemia.

Prevalence and management of hypertension in Turner syndrome: data from the International Turner Syndrome (I-TS) registry

Introduction: Cardiovascular disease is the commonest cause of death in Turner syndrome (TS) for which, arterial hypertension has a direct influence and is a key modifiable risk factor. Objective: To investigate the prevalence and patterns of hypertension diagnosis and management in adult patients with TS who are registered in a large international multicentre database (TS-HTN study). Methods: Retrospective multi-centre observational study of patients aged ≥18 years, included in the I-TS (International-TS) registry (2020-2022) utilising registry and participating centre collected data. Results: Twelve international centres participated, including 182 patients with the median age of 28 years (IQR 23,37.2). Arterial hypertension was recorded in 13.2% (n=24). The median age at hypertension diagnosis was 27 years (range 10,56), with 92% aged less than 50 years at the diagnosis. The majority (75%) were classified as primary hypertension (n=18). In binomial regression analysis, higher body-mass-index (BMI) was the only parameter significantly associated with the occurrence of hypertension (B=1.487, p=0.004). Among patients with aortic disease (n=9), 50% had Systolic BP ≥130 mmHg, and 66.6% had Diastolic BP ≥ 80 mmHg during the last clinic review. Angiotensin converting enzyme inhibitors (ACEi) were the commonest (n=16) medication prescribed, followed by Angiotensin receptor blockers (n=6), beta blockers (n=6), and calcium channel blockers (n=6). Conclusions: Arterial hypertension is common in TS and occurs form a young age. Overweight/obesity was a notable risk factors for hypertension. The frequency of sub-optimal BP control among high-risk patients highlights the importance of increased awareness and TS-specific consensus guidance on management.

Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders.

Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events. In this review article, we discuss current evidence regarding the management of elderly patients with hypertension and common neurological disorders, including stroke and neurodegenerative diseases. In elderly patient with a history of stroke, the blood pressure management strategy is generally similar to that for young patients, however the benefits of stroke prevention from blood pressure control are less significant. For patients with neurodegenerative disorders such as cognitive dysfunction and Parkinson's disease, achieving adequate blood pressure control may be beneficial in reducing cardiovascular risks, although the higher risk of adverse events from antihypertensive treatment may offset some of these benefits. Special considerations for factors such as orthostatic hypotension, risk of falls, polypharmacy, and significant drug-drug interactions are required but frequently neglected in clinical practice. More efforts are warranted to determine the optimal treatment strategy for elderly populations with neurological disorders.

Amlodipine versus nifedipine ER for the management of postpartum hypertension: a noninferiority randomized controlled trial.

Postpartum hypertension is an increasingly prevalent problem and optimizing its treatment is imperative in reducing maternal morbidity and improving long-term health outcomes. Despite this, data on treatment of postpartum hypertension is limited. While most available studies focus on labetalol and nifedipine ER, these medications are not frequently used for hypertension treatment in the non-obstetric setting. As we aim to establish best practices for managing postpartum hypertension, use of more commonly encountered antihypertensives should be evaluated. To evaluate the use of amlodipine for the treatment of postpartum hypertension, as assessed by postpartum length of stay. In a pragmatic, randomized controlled noninferiority trial, patients were assigned to amlodipine or nifedipine ER for treatment of postpartum hypertension. The primary outcome was time from delivery until discharge with a noninferiority limit of 24 hours. A sample size of 132 was needed to achieve 80% power with a 2-tailed alpha of 0.05. Intent-to-Treat and Per Protocol analyses were performed. Prespecified secondary outcomes included the need for additional antihypertensives, side effects, medication discontinuation, breastfeeding satisfaction, and readmission rate. A post-hoc analysis of time from medication initiation until hospital discharge was also performed. From April 2021 to December 2022, 7618 patients were screened and 175 patients were randomized, with 132 meeting criteria for antihypertensive initiation. Baseline demographics were similar between groups. Amlodipine had a non-inferior length of stay compared to nifedipine ER (Intent-to-Treat Wilcoxon pseudo-median amlodipine=73.5 hours, nifedipine ER=72.0 hours, 95% CI -8.00 to 6.00). The remainder of analyses were performed only on the Per Protocol cohort. Time from medication initiation until hospital discharge was similar between groups (amlodipine=45.0 hours, nifedipine ER=45.5 hours, 95% CI -8.00 to 13.00). There were no differences in use of additional antihypertensives or patient-reported side effects or breastfeeding outcomes, but hypotension and tachycardia were less common with amlodipine use. Amlodipine was significantly less likely to be discontinued due to side effects (amlodipine n=0, nifedipine ER n=7 (10.1%), p=.02). Readmission rates were similar between groups. Amlodipine is noninferior to nifedipine ER for postpartum hypertension treatment, as defined by median length of postpartum stay. Rates of side effects were similar between groups, but there was a statistically significant difference in medication discontinuation rates. Clinicaltrials.gov, www. gov, NCT04790279.

Role of Multidisciplinary Team Approach in the Management of Chronic Thromboembolic Pulmonary Hypertension

Role of Multidisciplinary Team Approach in the Management of Chronic Thromboembolic Pulmonary Hypertension

BLOOD PRESSURE MEASURING TECHNIQUES AMONG HEALTHCARE PROFESSIONALS IN KSA: A SYSTEMATIC REVIEW

Background: Accurate blood pressure (BP) measurement is critical for the diagnosis and management of hypertension, a leading cause of global morbidity and mortality. However, challenges in measurement techniques and knowledge gaps among healthcare professionals can lead to inaccurate readings, compromising patient care. This systematic review aimed to evaluate the difficulties healthcare professionals face in BP measurement and explore the variability in measurement practices. Methods: A comprehensive search of PubMed, Embase, Cochrane Library, and CINAHL databases was conducted to identify relevant studies. A total of 627 articles were initially identified. After removing 524 irrelevant articles, 103 studies were screened for eligibility. Of these, 60 full-text articles were reviewed, and two studies met the inclusion criteria. Data were synthesized to highlight common challenges and discrepancies in BP measurement practices among healthcare professionals. Results: The two included studies revealed significant challenges in BP measurement. One study identified that 60% of hospital staff in a teaching hospital lacked sufficient knowledge of fundamental BP measurement techniques. Key issues included improper understanding of cuff size, arm positioning, and deflation rates, which led to inconsistent and inaccurate readings. The other one examined BP measurement devices and methods in primary healthcare settings across Saudi Arabia. The study found that mercury sphygmomanometers were most commonly used (69.8%), followed by electronic devices (16.5%) and aneroid manometers (11.8%). However, electronic and aneroid devices were prone to measurement variations, especially in rural areas, emphasizing the need for standardized devices to reduce bias. Conclusion: This review highlights critical gaps in knowledge and variability in BP measurement methods among healthcare professionals, which can adversely impact hypertension management. Addressing these challenges requires targeted educational programs and the adoption of reliable and standardized devices to improve measurement accuracy. Enhancing BP measurement practices is essential for achieving better patient outcomes and reducing the burden of hypertension-related complications.