mmHg For Systolic Pressure Research Articles

Feasibility and Accuracy of Noninvasive Continuous Arterial Pressure Monitoring during Transcatheter Atrial Fibrillation Ablation

Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (IBP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a noninvasive alternative method used in ICU. No data on CNBP reliability are available in the electrophysiology lab during AF ablation, where rhythm variations are common. The objective of the present study was to compare continuous noninvasive arterial pressure measured with the ClearSight device (Edwards Lifesciences, Irvine, CA, USA) with invasive radial artery pressure used as the reference method during AF ablation. We prospectively enrolled 55 consecutive patients (age 62 ± 11 years, 80% male) undergoing transcatheter AF ablation (62% paroxysmal, 38% persistent) at our center. Standard of care IBP monitoring via a radial cannula and a contralateral noninvasive finger volume-clamp CNBP measurement device were positioned simultaneously in all patients for the entire procedure. Bland-Altman analysis was used to analyze the agreement between the two techniques. A total of 1219 paired measurements for systolic, diastolic, and mean arterial pressure were obtained in 55 subjects, with a mean (SD) of 22 (9) measurements per patient. The mean bias (SD) was -12.97 (13.89) mmHg for systolic pressure (level of agreement -14.24-40.20; correlation coefficient 0.84), -1.85 (8.52) mmHg for diastolic pressure (level of agreement -18.54-14.84; correlation coefficient 0.77) and 2.31 (8.75) mmHg for mean pressure (level of agreement -14.84-19.46; correlation coefficient 0.85). In patients undergoing AF ablation, CNBP monitoring with the ClearSight device showed acceptable agreement with IBP monitoring. Larger studies are needed to confirm the potential clinical implications of continuous noninvasive BP monitoring during AF ablation.

Central corneal thickness associations with systemic factors: The Colombian glaucoma study

Abstract Objective: To establish Central Corneal Thickness associations with systemic factors in six cities of Colombia. Methods: A cross-sectional study was conducted in Colombia among hypertensive and diabetic patients. Two thousand sixty-seven subjects older than 50 diagnosed with SH and DM were included. Participants underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurement by Goldmann tonometry, Central Corneal Thickness (CCT), and Blood pressure. The glaucoma diagnosis was confirmed by structural and functional evidence. Results: In multiple regression analysis, a trend of thinner corneal thicknesses was observed, with increasing decades of life, 60 - 69 years (-7.14 microns (μm) p: 0.58), 70- 79 years (-2.05 μm p: 0.38), > 80 years (-7.3 p <0.056) being almost statistically significant only in patients older than 80 years. Female patients had thinner CCT (- 5.04 μm) than male patients. African- Colombian patients had thinner corneas (-9.6 μm) than mestizo patients (P= 0.002). Patients with migraine had thicker CCT (6.83 μm p <0.024) compared with no- migraine patients. Diabetic patients had thicker CCT (3.91 μm) than non-diabetic patients (P= 0.039). Finally, a 0.66 μm increase per mm hg of the systolic pressure (P=0.024) and a 0.99 μm decrease per mm hg of Systolic Perfusion Pressure (P=0.038) was observed, but no association was found between CCT and Systemic Hypertension. Conclusion: Our study highlights the relationship between systemic factors such as age, sex, race, DM, systolic blood pressure, migraine, and systolic perfusion pressure with an ocular biomarker such as CCT

Central corneal thickness associations with systemic factors: The Colombian glaucoma study

Abstract Objective: To establish Central Corneal Thickness associations with systemic factors in six cities of Colombia. Methods: A cross-sectional study was conducted in Colombia among hypertensive and diabetic patients. Two thousand sixty-seven subjects older than 50 diagnosed with SH and DM were included. Participants underwent a complete ophthalmic examination, including intraocular pressure (IOP) measurement by Goldmann tonometry, Central Corneal Thickness (CCT), and Blood pressure. The glaucoma diagnosis was confirmed by structural and functional evidence. Results: In multiple regression analysis, a trend of thinner corneal thicknesses was observed, with increasing decades of life, 60 - 69 years (-7.14 microns (μm) p: 0.58), 70- 79 years (-2.05 μm p: 0.38), > 80 years (-7.3 p <0.056) being almost statistically significant only in patients older than 80 years. Female patients had thinner CCT (- 5.04 μm) than male patients. African- Colombian patients had thinner corneas (-9.6 μm) than mestizo patients (P= 0.002). Patients with migraine had thicker CCT (6.83 μm p <0.024) compared with no- migraine patients. Diabetic patients had thicker CCT (3.91 μm) than non-diabetic patients (P= 0.039). Finally, a 0.66 μm increase per mm hg of the systolic pressure (P=0.024) and a 0.99 μm decrease per mm hg of Systolic Perfusion Pressure (P=0.038) was observed, but no association was found between CCT and Systemic Hypertension. Conclusion: Our study highlights the relationship between systemic factors such as age, sex, race, DM, systolic blood pressure, migraine, and systolic perfusion pressure with an ocular biomarker such as CCT

Septum Primum Malposition: An Uncommon Cause of Right Ventricular Volume Overload.

A 24-year-old woman was hospitalised for a systolic murmur with exertional fatigue. Transthoracic echocardiography found an enlarged right heart, mild pulmonary hypertension (39 mmHg systolic pressure), and an interatrial septum exhibiting a leftward deviation of its dorsocranial insertion (Figure 1A; Supplementary Video 1). On Doppler examination, partial anomalous pulmonary venous drainage (PAPVD) to the right atrium (RA) was suspected (Figure 1B; Supplementary Video 2). Transoesophageal echocardiography demonstrated an interatrial septum aneurysm and a patent foramen ovale with a right-to-left shunt (Figure 1C; Supplementary Video 3).

Effects of Mindfulness-Based Stress Reduction on Blood Pressure, Mental Health, and Quality of Life in Hypertensive Adult Women: A Randomized Clinical Trial Study.

Hypertension is one of the most important causes of cardiovascular diseases. Patients with hypertension have a lower quality of life. We aimed to evaluate the effects of mindfulness meditation on blood pressure, mental health, and quality of life in patients with hypertension. This randomized clinical trial was performed in 2019 in Isfahan. Eighty adult women with Stage I or II hypertension were included and assigned randomly to 2 groups: 12 weeks of mindfulness-based stress reduction (MBSR) and routine care. At baseline and 1 week after the end of the intervention, blood pressure, stress, depression, anxiety, and quality of life of the studied participants were measured using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and 36-Item Short Form Survey (SF-36) questionnaires. The data were analyzed using the independent t-test, the paired t-test, and the MANCOVA test. After the intervention, the mean systolic and diastolic blood pressures decreased significantly in the intervention group compared with the baseline (142.82±11.01 mmHg vs 133.7±510.43 mmHg for systolic pressure and 86.12±8.24 mmHg vs 79.15±6.26 mmHg for diastolic pressure) and the control group (140.18±14.27 mmHg vs 142.15±10.23 mmHg for systolic pressure and 84.62±9.22 vs mmHg 88.51±8.54 mmHg for diastolic pressure; P=0.001). There was also a significant increase in quality of life, stress, anxiety, and depression scores in the intervention group (P<0.05). The 12-week MBSR program resulted in a significant reduction in the mean systolic and diastolic blood pressures and improvement in mental health and different aspects of quality of life.

Risk factors for femoral-to-radial artery pressure gradient after weaning from cardiopulmonary bypass: a historical cohort study.

After weaning from cardiopulmonary bypass (CPB), the radial artery pressure is frequently lower than the central pressure as reflected by femoral pressure. This discrepancy may cause improper blood pressure management. In this study, we aimed to evaluate the risk factors related to developing a significant postbypass femoral-to-radial pressure gradient, including the incidence of complications related to femoral pressure monitoring. From January 2017 to May 2021, we studied consecutive adult cardiovascular surgical patients undergoing CPB in a historical cohort study. Patients were divided into two groups according to developing a significant femoral-to-radial pressure gradient, which was defined as a difference of ≥ 25 mm Hg for systolic pressure or ≥ 10 mm Hg for mean pressure, lasting ≥ 5 minutes for 30 minutes after CPB weaning. Factors associated with a significant pressure gradient and femoral pressure monitoring-related complications were analyzed. Among 2,019 patients, 677 (34%) showed a significant postbypass femoral-to-radial pressure gradient. Multivariable logistic regression analysis revealed the following factors related to the pressure gradient development: age (adjusted odds ratio [aOR] for an increase in 10 years, 1.09; 95% confidence interval [CI], 1.04 to 1.09; P < 0.001), body surface area (BSA) (aOR for an increase in 1 m2, 0.12; 95% CI, 0.07 to 0.21; P < 0.001), aortic cross-clamping time (aOR for an increase in 30 minutes, 1.05; 95% CI, 1.03 to 1.08; P < 0.001), and intraoperative epinephrine use (aOR, 1.55; 95% CI, 1.23 to 1.95; P < 0.001). The femoral pressure monitoring-related complications were observed in 11/2,019 (0.5%) patients. Our study showed that old age, smaller BSA, prolonged aortic cross-clamping time, and intraoperative epinephrine use were associated with developing a significant postbypass femoral-to-radial pressure gradient in cardiovascular surgery. Considering monitoring-related complications occurred very infrequently, it might be helpful to monitor both radial and femoral pressure simultaneously in patients with these risk factors for appropriate blood pressure management. Nevertheless, further studies are needed to confirm our findings because our results are limited by a retrospective design and residual confounding factors.

Continuous cuffless monitoring of arterial blood pressure via graphene bioimpedance tattoos.

Continuous monitoring of arterial blood pressure (BP) in non-clinical (ambulatory) settings is essential for understanding numerous health conditions, including cardiovascular diseases. Besides their importance in medical diagnosis, ambulatory BP monitoring platforms can advance disease correlation with individual behaviour, daily habits and lifestyle, potentially enabling analysis of root causes, prognosis and disease prevention. Although conventional ambulatory BP devices exist, they are uncomfortable, bulky and intrusive. Here we introduce a wearable continuous BP monitoring platform that is based on electrical bioimpedance and leverages atomically thin, self-adhesive, lightweight and unobtrusive graphene electronic tattoos as human bioelectronic interfaces. The graphene electronic tattoos are used to monitor arterial BP for >300 min, a period tenfold longer than reported in previous studies. The BP is recorded continuously and non-invasively, with an accuracy of 0.2 ± 4.5 mm Hg for diastolic pressures and 0.2 ± 5.8 mm Hg for systolic pressures, a performance equivalent to Grade A classification.

Non-invasive continuous arterial pressure monitoring during transcatheter atrial fibrillation ablation: a feasibility prospective study

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (BP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a non invasive alternative method used in ICU. No data on CNBP reliability are available in the electrophysiology lab during AF ablation, where rhythm variations are common. Purpose The objective of the present study was to compare continuous noninvasive arterial pressure measured with the ClearSight device with invasive radial artery pressure, used as the reference method during AF ablation. Methods We prospectively enrolled 55 consecutive patients (age 62±11 years, 79% male) undergoing transcatheter AF ablation (62% paroxysmal, 38% persistent) at our center. Standard of care invasive BP monitoring via a radial cannula and a contro-lateral non-invasive finger volume-clamp continuous BP measurement device were positioned simultaneously in all patients for the entire procedure. Bland-Altman analysis was used to analyze agreement between the two techniques. Results A total of 1219 paired measurements for systolic, diastolic, and mean arterial pressure were obtained in 55 subjects, with a mean (SD) of 22 (9) measurements per patient. Mean bias (SD) was -12,97 (13,89) mmHg for systolic pressure (level of agreement -14,24–40,20; correlation coefficient 0,84), -1,85 (8,52) mmHg for diastolic pressure (level of agreement -18,54–14,84; correlation coefficient 0,77) and 2,31 (8,75) mmHg for mean pressure (level of agreement -14,84–19,46; correlation coefficient 0,85). Conclusion In patients undergoing AF ablation, non-invasive finger volume-clamp continuous BP monitoring with the ClearSight device showed acceptable agreement with standard of care invasive BP monitoring. Larger studies are needed to confirm potential clinical implications of a continuous non-invasive BP monitoring during AF ablation.

Angiotensin-converting enzyme (ACE) inhibitors for proteinuria and microalbuminuria in people with sickle cell disease.

Sickle cell disease is a group of disorders characterized by deformation of erythrocytes. Renal damage is a frequent complication in sickle cell disease as a result of long-standing anemia and disturbed circulation through the renal medullary capillaries. Due to the improvement in life expectancy of people with sickle cell disease, there has been a corresponding significant increase in the incidence of renal complications. Microalbuminuria and proteinuria are noted to be a strong predictor of subsequent renal failure. There is extensive experience and evidence with angiotensin-converting enzyme (ACE) inhibitors over many years in a variety of clinical situations for patients who do not have sickle cell disease, but their effect in people with this disease is unknown. It is common practice to administer ACE inhibitors for sickle nephropathy due to their renoprotective properties; however, little is known about their effectiveness and safety in this setting. This is an update of a Cochrane Review first published in 2013 and 2015. To determine the effectiveness of ACE inhibitor administration in people with sickle cell disease for decreasing intraglomerular pressure, microalbuminuria and proteinuria and to to assess the safety of ACE inhibitors as pertains to their adverse effects. The authors searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Hameoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of the most recent search: 18 October 2021. We also searched clinical trial registries. Date of the most recent search: 22 August 2021. Randomized or quasi-randomized controlled trials of ACE inhibitors designed to reduce microalbuminuria and proteinuria in people with sickle cell disease compared to either placebo or standard treatment regimen. Three authors independently applied the inclusion criteria in order to select studies for inclusion in the review. Two authors assessed the risk of bias of studies and extracted data and the third author verified these assessments. Seven studies were identified through the searches. Six studies were excluded. The included study randomized 22 participants (7 males and 15 females) having proteinuria or microalbuminuria with sickle cell disease and treated the participants for six months (median length of follow up of three months) with captopril or placebo. Overall, the certaintyof the evidence provided in this review was very low, since most risk of bias domains were judged to have either an unclear or a high risk of bias. Because of this, we are uncertain whether captopril makes any difference, in total urinary albumin excretion (at six months) as compared to the placebo group, although it yielded a mean difference of -49.00 (95% confidence interval (CI) -124.10 to 26.10) or in the absolute change score, although it yielded a mean difference of -63.00 (95% CI -93.78 to -32.22). At six months albumin excretion in the captopril group was noted to decrease from baseline by a mean (standard deviation) of 45 (23) mg/day and the placebo group was noted to increase by 18 (45) mg/day. Serum creatinine and potassium levels were reported constant throughout the study (very low-certainty evidence). The potential for inducing hypotension should be highlighted; the study reported a decrease of 8 mmHg in systolic pressure and 5 mmHg in diastolic and mean blood pressure (very low-certaintyevidence). Overall, we judged the certaintyof the evidence to be very low. The included study selectively reported its results, was not powered to detect a group difference, should it exist, and otherwise did not offer enough information to allow us to judge the bias inherent in the study. Indirectness (in relation to the limited age and type of population included) and imprecision (wide confidence intervals around the effect estimate) were observed. More long-term studies involving multiple centers and larger cohorts using a randomized-controlled design are warranted, especially among the pediatric age group. Detailed reporting of each outcome measure is necessary to allow a clear cut interpretation in a systematic review. One of the difficulties encountered in this review was the lack of detailed data reported in the included study. Overall, we judged the certaintyof this evidence to be very low.

Enhancement of blood pressure estimation method via machine learning

High Blood Pressure (BP) is one of the most dangerous and widespread diseases due to which uncontrolled BP increases the risk of health problems that affects many body organs. Unfortunately, accurate BP measurements require several medical devices and a specialist person who has experience in BP measurement and measured in separate times. Thus, this paper proposes a simple calibration-free method to estimate BP by training BP and Photoplethysmography (PPG) data signals on a machine learning (ML) regression model. The proposed method overcomes drawbacks of BP measurement accuracy and provides enough capability for reliable and calibration-free BP estimation. The obtained results clarify that the error standard deviation (STD) is about 5.3 and 6.4 mmHg of systolic pressure (SP) and diastolic pressure (DP), respectively. In addition, the mean absolute error (MAE) is about 4.2 and 4.5 mmHg of SP and DP, respectively. These results achieve grade “A” for both SP and DP based on the Britain Hypertension Society (BHS) standard. Finally, the results of BP estimation regression models meet the International Organization for Standardization (ISO) requirements for non-invasive BP devices and consequently they can be utilized later in life experiments.

Assessing the Blood Pressure Use of Doppler Ultrasound Flux Measurements Noninvasive Pressure in Pakistani Population

Present oscillometric procedures for calculating BP are not suitable for rotating blood syphon recipients with low circulatory tension plasticity. This research was aimed at using ultrasound Doppler flow calculations to regulate BP noninvasively in the current patient group. In 29 beneficiaries of rotating blood siphons, the pulse rate was estimated three times with the Doppler strategy created and contrasted with the intrusive blood vessel line (n=18) or with the Terumo Eleanor BP oscillometric screen (n = 18). The new Doppler sensor was registered during mango flattening at the blood velocity in the expulsion canal. A sigmoid bend was combined with the preprocessed velocity signal to exclude systolic and medium blood vessel pressures. From March 2019 to February 2020 our present research was performed at Lahore's Sir Ganga Ram Hospital. A total of 88 figures were made and 17 counts, due to apparent antiquities, were dismissed by further inquiry. Compared to the intrusively measured pressure (4.8 ± 5.7 mmHg for systolic pressure and -3.2 ± 9.5 mmHg for mean pressure factor), the systolic and mean pressure factors derived from Doppler technique were sufficient. The Doppler technique for the systolic (0,1 ± 6,1 mmHg) and the mean pressure (3.2 ± 6.8 mmHg) had a strong agreement. An alternative framework was developed and scientifically approved for Doppler pulse estimation. In contrast to commercial experiments, the counting sensor makes a clearer location on the propagation path.

MON-194 Phaeochromocytoma-Paraganglioma (PPGL): Post-Operative Hypotension Is a Vanishing Phenomenon

Background: Treatment of hemodynamic instability in patients with PPGL in the intra-and postoperative periods is challenging. Persistent postoperative hypotension is a common and serious complication, reportedly occurring in 30-60% of PPGL patients. This phenomenon reflects 1) high doses of pre-operative antihypertensive drugs; 2) low intravascular volume secondary to chronic catecholamine-induced vasoconstriction with pressure natriuresis; 3) the sudden drop in circulating catecholamines after surgery. It has been shown that tumor size and preoperative levels of catecholamines are directly related to the need for treatment with vasopressor agents in the early period after tumor removal. The aim of this study was to evaluate the efficacy and safety of the current perioperative treatment protocol for PPGL used in our Institute. Methods: We retrospectively reviewed the rate of hemodynamic instability and postoperative hypotension in relation to catecholamine levels, and the efficiency of preoperative pharmacological preparation in consecutive patients with PPGL treated between 2000-2019. Results: There were 39 patients (F/M 19/20; mean age 50.4 ±16.5 years) 33 of which had adrenal lesions and 6 had extra-adrenal tumors. Mean tumor size was 3.9 ±2.2 cm. Median metanephrine and normetanephrine levels were 5 and 10 fold the upper limit of the normal range respectively. All patients were treated with α-blockade (phenoxybenzamine-17, mean dose 60±38 mg/day; doxazosin-22; mean dose 9.6±6.1mg/day) along with β- blockade, and high sodium diet and IV saline 24 hours before the operation. The length of the preoperative preparation period was 3.4±2 weeks. Within the first 24-48 hours from surgery, no episodes of hypotension (<90 mmHg systolic pressure) were recorded. Mean systolic BP was 121 ±14 (range 95-150) with a mean diastolic BP of 70 ±11 (range 89-46). In contrast, intraoperative hypotension occurred in 22% of the patients; and BP surge occurred in 36% of patients, mostly during tumor manipulation. There were no differences between subjects with and without such BP rises/falls in terms of pre/post- surgical BP, catecholamine levels or type of medical treatment. Conclusion: In contrast with older literature and previous reports, the patients in our cohort did not experience postoperative hypotension. This is most likely due to tight BP control while avoiding pre-operative hypotension, and adequate volume control. We propose that proper preoperative management in the modern era can drastically minimize intraoperative hemodynamic instability and post-operative hypotension.

A Reflective Photoplethysmogram Array and Channel Selection Algorithm for Weighing Scale Based Blood Pressure Measurement

The most common form of blood pressure (BP) monitoring outside of clinical settings is an oscillometric cuff; however, such cuffs tend to be cumbersome and inconvenient. Less obtrusive systems requiring minimal effort from the user would allow for cardiovascular monitoring seamlessly in daily life and relieve much of the burden of regular blood pressure monitoring. In this work, we leverage the concept of pulse transit time (PTT) to track BP using a weighing scale-based system on which a subject simply stands quietly to obtain a measurement. To extract the proximal and distal timing references for PTT, a force plate measured the initial mechanical motion of the body in response to cardiac ejection while an optical sensor array mounted directly on the force place measured the pulse wave arrival at the sole. To evaluate the method, we recruited 16 young and healthy subjects. Seated and standing measurements first verified the effectiveness of the sensor array to extract a reliable distal timing reference. Then, subjects underwent various physiological perturbations to establish a correlation curve between measured BP and a best-case estimation of BP using PTT. By using the BCG and array of PPG sensors, PTT-estimated BP tracked changes well in diastolic ( r = 0.80 ± 0.12) and systolic ( r = 0.77 ± 0.23) pressures. This best-case estimation resulted in an error of 2.6 ± 1.2 mmHg for diastolic and 5.6 ± 2.7 mmHg for systolic pressures. Our work allows the user to passively monitor BP during common weighing scale measurement, potentially improving the ease of longitudinal at-home care.

Abstract P3024: Tangential Wall Stress In The Thoracic Aorta Affects The Structure And Function Of Associated Perivascular Adipose Tissue

Perivascular adipose tissue (PVAT) dynamically modifies contractile function of the blood vessel it surrounds (outside-in signaling). Sparse evidence points to inside-out signaling, i.e. the blood vessel actively affecting its surrounding PVAT. We hypothesized that inside-out signaling to PVAT could occur in response to changes in tangential vascular wall stress. We created a coarctation of the thoracic aorta in male Sprague-Dawley rats to chronically expose PVAT to higher (above) and lower (below) pressures (and thus wall stresses). This allows comparison of PVAT from the same animal to different vascular pressures with confounding factors (neurohormonal environment) presumably being equal. In some animals, dual-channel pressure telemeters were used to simultaneously measure arterial pressure in the aorta of conscious rats above and below the coarctation. Post-surgery (4-8 weeks), thoracic aortic samples + PVAT were dissected above and below coarctation to determine elastin and collagen content of PVAT. Functionally, the adipogenic capacity of PVAT preadipocytes, PVAT-assisted stress relaxation and contraction to phenylephrine (PE) were compared. Telemetry revealed a ~22 mmHg systolic pressure gradient across the coarctation. Collagen deposition (picrosirius red) in PVAT above coarctation increased by 92% vs below (above=1.13±0.23% vs below=0.65±0.23% of PVAT area, n=4, P&lt;0.05); elastin content did not change. Differentiated adipocytes derived from the PVAT above the coarctation accumulated 31% less triglycerides vs those below, and vs retroperitoneal adipose tissue [below=1 (set), above=0.69±0.1%, retroperitoneal=4.15±0.1%, n=4 P&lt;0.05]. Finally, the ability of PVAT to assist stress relaxation (greater relaxation in +PVAT vs -PVAT) over a 6 gram tension range was reduced ~50% (N=5) in PVAT above vs below the coarctation; the anti-contractile function of PVAT in PE-induced contraction did not differ above vs below. In summary, PVAT of thoracic aorta under different distending pressures/wall stress exhibit significantly different structural and functional properties. These data support the hypothesis that signaling (factors derived) from the vascular wall influences the function of its PVAT.

일개 제조업체 근로자의 혈압, 총콜레스테롤, 공복혈당, BMI의 10년간의 변화

Purpose : The findings of physical examination for workers show that the number of people with hypertension, hyperlipidemia, diabetes, or obesity is increasing day by day and the diseases are known as risk factors for cerebrocardiovascular diseases. Methods : The subjects of this study were 201 adult workers who were possible to be followed up for their records of physical examination over the last ten years. Additionally the changes in risk factors according to general characteristics, health related habits and job related characteristics were investigated along with the affecting factors on the change. Results : Blood pressure was increased by 6.7㎜Hg in systolic pressure and 1.4㎜Hg in diastolic pressure, total cholesterol 15.7㎎/㎗, fasting blood sugar 10.1㎎/㎗ and BMI 0.8±1.49kg/㎡ respectively. In case of long work experience, systolic blood pressure was changed. There is a significant change in diastolic blood pressure when no current shift is performed. In married people, fasting blood sugar was more likely to change. There is a significant change in BMI in those who do not currently smoke and young. Conclusion : In order to effectively carry out workers' health management, it is necessary to carry out systematic and comprehensive management by occupational health manager in the workplace.

Smartphone-Based Blood Pressure Measurement Using Transdermal Optical Imaging Technology.

Cuff-based blood pressure measurement lacks comfort and convenience. Here, we examined whether blood pressure can be determined in a contactless manner using a novel smartphone-based technology called transdermal optical imaging. This technology processes imperceptible facial blood flow changes from videos captured with a smartphone camera and uses advanced machine learning to determine blood pressure from the captured signal. We enrolled 1328 normotensive adults in our study. We used an advanced machine learning algorithm to create computational models that predict reference systolic, diastolic, and pulse pressure from facial blood flow data. We used 70% of our data set to train these models and 15% of our data set to test them. The remaining 15% of the sample was used to validate model performance. We found that our models predicted blood pressure with a measurement bias±SD of 0.39±7.30 mm Hg for systolic pressure, -0.20±6.00 mm Hg for diastolic pressure, and 0.52±6.42 mm Hg for pulse pressure, respectively. Our results in normotensive adults fall within 5±8 mm Hg of reference measurements. Future work will determine whether these models meet the clinically accepted accuracy threshold of 5±8 mm Hg when tested on a full range of blood pressures according to international accuracy standards.

Blood Pressure Lowering and Sodium-Glucose Co-transporter 2 Inhibitors (SGLT2is): More Than Osmotic Diuresis.

This is an update of data regarding changes in blood pressure using sodium-glucose co-transporter 2 inhibitors (SGLT2i) for the treatment of diabetes. The mechanism of blood pressure lowering by SGLT2i was thought to be due to their osmotic diuretic effects. New data, however, has emerged from meta-analyses and studies of people with impaired kidney function demonstrating similar or greater magnitudes of blood pressure reduction in the absence of significant glycosuria. Potential additional mechanisms are proposed and reviewed. Two separate meta-analyses in over 10,000 participants combined demonstrate an average of 4/2 mmHg reduction in blood pressure by SGLT2i. This includes consistency between measurements of in-office and ambulatory blood pressure monitoring. This reduction extends to decreases in nocturnal blood pressure of 2.6 mmHg systolic pressure. These reductions in blood pressure by SGLT2i are also present when added to ongoing treatment with ACE inhibitors or ARBs. In one study, dapagliflozin, when added to a regimen of a renin-angiotensin-aldosterone system (RAAS) antagonist and a diuretic, further lowered in-office systolic pressure by 2.4 mmHg. In contrast, when prescribed to those on a RAAS antagonist plus a calcium channel blocker or RAAS antagonist plus a beta blocker, systolic pressure decreased 5.4 mmHg. Lastly, post hoc analyses of major cardiovascular outcome trials across the spectrum of estimated glomerular filtration rates from 30 to 80 ml/min/1.73 m2 demonstrated similar magnitudes of BP reduction in spite of far less reduction in glucosuria among those with advanced kidney disease. Moreover, recent data implicate the potential for increased ketones associated with SGLT2i contributing to blood pressure lowering in advanced-stage kidney disease. SGLT2i are well established to lower blood pressure. Their mechanism appears to be multifactorial and has a hemodynamic as well as metabolic component contributing to this reduction.

Suíno como modelo experimental na pesquisa biomédica: valores fisiológicos normais

Background: The use of animals in biomedical research is of great importance. It is fundamental for the development and improvement of new practices and technologies. The selection of the species must take into consideration the practicality of handling and the suitability for the experiment, and it must have low operational costs. Swine are important as an experimental model in several experiment areas, because the functionality of many of their organic systems is developed similarly as it is in humans. Swine are animals that become easily stressed. For that reason, their conditioning is necessary to allow the obtainment of data that is closer to normal parameters. This study aims at reporting the physiological values obtained from awake swine, under normal conditions and minimum stress. Materials, Methods & Results: The animals were maintained under ideal environmental conditions, and they were always handled and conditioned by the same persons. Twenty crossbred swine were evaluated, aged between 60 and 90 days and with a body mass ranging between 17 and 25 kg. The parameters considered were cardiac frequency (FC), emoglobin oxygen saturation (pulse oxymetry – SPO 2 ), respiratory frequency (fR), end tidal carbon dioxide (ETCO 2 ), systolic (PAM), diastolic (PAD) and mean (PAM) arterial pressure and arterial blood gas values – pH, arterial pressure of CO 2 (PACO 2 ), arterial pressure of O 2 (PAO 2 ), total CO 2 (TCO 2 ), base excess (EB), bicarbonate (HCO 3 ) and O 2 saturation (SATO 2 ). The experiment was developed in compliance with the Standards of Animal Ethics and Welfare recommended by the National Council on the Control of Animal Experiments and with Law 11.794 of October 2008, being further approved by the Ethics Committee of the Hospital de Clinicas de Porto Alegre. To obtain the FC, fR, ETCO 2 and SPO 2 values, 20 animal samples were used. FC presented mean values (± standard deviation) of 134 ± 20.67 beats per minute (bpm), showing a maximum value of 180 bpm and a minimum of 103 bpm. The mean fR was 24.5 ± 5.61 breaths per minute (bpm), with a maximum value of 34 bpm and a minimum of 14 bpm, and SPO 2 was 96 ± 2.10 %. Moreover, the values obtained in the analysis of exhaled gases showed a ETCO 2 at 44.6 ± 5.41 mmHg, with a maximum value of 53 mmHg and minimum value of 34 mmHg. The arterial pressure was obtained from 19 animals, yielding the following values: 135.8 ± 16.29 mmHg for systolic pressure, 81.6 ± 14.10 mmHg for diastolic pressure and 103.3 ± 12.65 mmHg for mean pressure. Samples from 18 animals were used to measure the arterial blood gas. The values obtained were as follows: 7.497 ± 0.019 for Mean pH , 41.7 ± 6.95 mmHg for partial O 2 pressure, 90.65 ± 2.5 mmHg for partial CO 2 pressure, 32.8 ± 2.18 mmol/L for total CO 2 , 7.57 ± 1.9 mmol/L for base excess, 31.5 ± 2.12 mmol/L for bicarbonate and 97.55 ± 0.64 for oxygen saturation. Discussion : The animals seemed submissive and able to be conditioned and therefore it was easy to obtain basal values. These data were slightly different from the values obtained in other studies, thus becoming more reliable to be used as parameters in exsperiments employing this species. There seem to be interspecies differences when one intends to make a comparison with human beings. Values such as O 2 concentration in arterial blood are normally lower in swine, possibly due to a lower hemoglobin concentration and a higher body temperature in the species. Despite some differences, there are many physiological similarities with human beings, which allows for the conclusion that swine is a great species to be employed in the biomedical research.

Rationale and evidence for the development of a durable device-based cardiac neuromodulation therapy for hypertension

We assessed the feasibility of achieving acute, sustained blood pressure reductions through the use of cardiac pacing algorithms delivered via standard dual-chamber pacing based on introducing short atrio-ventricular (AV) delays (SAVD). Eighteen hypertensive subjects (57.3 ± 9.8 years old; 10 male and 8 female) with average initial systolic and diastolic blood pressures of 151.2 ± 17.6/92.2 ± 12.7 mmHg already scheduled to undergo an invasive electrophysiology procedure were included in this study. Pacing sequences were applied for ∼1-minute intervals with AV delays of 80, 40, 20 and 2 ms, while making high fidelity blood pressure measurements. Average reductions of 19.6 ± 7.7 mmHg in systolic pressure and 4.3 ± 3.8 mmHg in diastolic pressure (P < .001 each) were demonstrated with 2 ms AV delay pacing. Initial SBP reductions were followed by rebound effects which diminished the SBP reducing effects of SAVD pacing, likely due to baroceptor activation causing increased peripheral resistance. This effect was eliminated by intermittent introduction of longer AV delay pacing which modulated the baroreflexes. These findings provide the rationale and evidence underlying recent data showing significant and long-term blood pressure reductions in response to this cardiac neuromodulation therapy in hypertensive patients despite medical therapy.

Preprocessing PPG and ECG Signals to Estimate Blood Pressure Based on Noninvasive Wearable Device

Accurate systolic and diastolic blood pressure measurement is still an open problem in biomedical engineering. This paper introduced a method how to preprocess the PPG and ECG signals to get a series of parameters to estimate blood pressure. It developed a threshold detector to extract characteristic points of PPG and ECG waves and calculated several useful features such as pulse wave velocity. The paper also introduced a BP-feature based model by using those features to estimate SBP and DBP. The accuracy of detection algorithm reached 98.2% by comparing with SFM database. The estimation results were validated by a large-scale dataset we acquired by strict experiment procedures. The average deviation error in estimating SBP and DBP was 0.25 and 2.24 mmHg respectively. The standard deviation between the measured and predicted blood pressure was 8.92 mmHg for systolic pressure and 8.13mmHg for diastolic pressure, which met the standard of AAMI. The results indicated that the BP-feature based model has a reliable estimation of blood pressure.