Oscillometric Measurement Research Articles

Health-Related Physical Fitness and Arterial Stiffness in Childhood Cancer Survivors.

Introduction: Despite decreasing mortality in pediatric oncology as a result of standardized treatment protocols, the high number of functional and cardiovascular late sequelae due to anticarcinogenic therapy remains unchanged. The aim of this study was to further assess functional limitations in Health-related Physical Fitness (HRPF) and cardiovascular risk by means of markers of arterial stiffness in Childhood Cancer Survivors (CCS).Materials and Methods: Between March 2016 and August 2017 a total of 92 CCS (Age 12.5 ± 4.2 years, 43 girls) were recruited from their routine follow-up outpatient visit. HRPF was assessed using five Fitnessgram® tasks. Pulse Wave Velocity (PWV) along with peripheral and central blood pressure were assessed using oscillometric measurements performed by Mobil-O-Graph. Z-scores were used to compare the test results either to German reference values or to a recent healthy reference cohort.Results: In CCS, the HRPF was significantly reduced (z-score: −0.28 ± 1.01, p = 0.011) as compared to healthy peers. The peripheral Systolic Blood Pressure (pSBP) was significantly increased (z-score: 0.31 ± 1.11, p = 0.017) and the peripheral Diastolic Blood Pressure (pDBP) was decreased (z-score: −0.30 ± 1.25, p = 0.040), resulting in an increased pulse pressure. The PWV (p = 0.649) and cSBP (p = 0.408), were neither increased nor showed any association to HRPF.Discussion: CCS showed functional limitations in HRPF and an increased pulse pressure, which acts as an early onset parameter of arterial stiffness. Both a low HRPF and impaired hemodynamics are independent cardiovascular risk factors and needs to be taken into consideration in tertiary prevention of CCS.

Functional outcomes in children with anatomically repaired transposition of the great arteries with regard to congenital ventricular septal defect and coronary pattern

ObjectiveDespite decreasing mortality, functional impairments in children with transposition of the great arteries (TGA) are still a concern. This study analyses health-related physical fitness (HRPF), arterial stiffness and health-related quality...

Statistical Approaches Based on Deep Learning Regression for Verification of Normality of Blood Pressure Estimates.

Oscillometric blood pressure (BP) monitors currently estimate a single point but do not identify variations in response to physiological characteristics. In this paper, to analyze BP’s normality based on oscillometric measurements, we use statistical approaches including kurtosis, skewness, Kolmogorov-Smirnov, and correlation tests. Then, to mitigate uncertainties, we use a deep learning method to determine the confidence limits (CLs) of BP measurements based on their normality. The proposed deep learning regression model decreases the standard deviation of error (SDE) of the mean error and the mean absolute error and reduces the uncertainties of the CLs and SDEs of the proposed technique. We validate the normality of the distribution of the BP estimation which fits the standard normal distribution very well. We use a rank test in the deep learning technique to demonstrate the independence of the artificial systolic BP and diastolic BP estimations. We perform statistical tests to verify the normality of the BP measurements for individual subjects. The proposed methodology provides accurate BP estimations and reduces the uncertainties associated with the CLs and SDEs using the deep learning algorithm.

Validity of transit time-based blood pressure measurements in patients with and without heart failure or pulmonary arterial hypertension across different breathing maneuvers.

Pulse transit time (PTT) derived by ECG and plethysmographic signal can be a promising alternative to invasive or oscillometry-based blood pressure (BP) monitoring in sleep laboratories because it does not cause arousals from sleep. Therefore, this study assessed the validity of PTT for BP monitoring under sleep laboratory-like conditions. Ten volunteers (55.8 ± 19.6years), 12 patients with heart failure with reduced ejection fraction (HFrEF; 67.3 ± 8.6years), and 14 patients with Nizza class I pulmonary arterial hypertension (PAH; 59.5 ± 13.4years) performed different breathing patterns to simulate nocturnal sleep-disordered breathing (SDB). BP was measured at least every 15min over 1h using oscillometry (Task Force Monitor™) and PTT (SOMNOscreen™) devices in free breathing conditions and during SDB simulation (alternating phases of hyperventilation and apneas). One hundred forty-two points of measurements were collected. No difference was found in both mean systolic BP (SBP) and diastolic BP (DBP) between oscillometric PTT-based BP measurements in the whole population and throughout the whole recording (SBP 111.3 ± 15.1mmHg versus 110.0 ± 14.7mmHg, p = 0.051; DBP 69.9 ± 12.2 versus 69.9 ± 14.2mmHg, p = 0.701). Likewise, no significant difference in SBP and DBP was found between the two methods in the subgroups of healthy subjects, HFrEF patients and PAH patients, both in free breathing conditions (p > 0.05) and during SDB simulation (p > 0.05). When monitoring BP in healthy subjects, and in patients with HFrEF or PAH, PTT provides a BP estimation comparable with oscillometric measurement, though slightly inaccurate, both in the condition of regular and unstable breathing.

Selective Blood Pressure Screening in the Young: Quantification of Population Wide Underestimation of Elevated Blood Pressure.

Universal blood pressure (BP) screening in children and adolescents is questioned in prevention guidelines, while measuring blood pressure in the young in the context of overweight, obesity, or parental hypertension is promoted. This study quantifies with population data the underestimation of elevated blood pressure that would result from limiting BP screening only to those with overweight, obesity, or parental hypertension in the young. Selective screening was simulated with representative national health examination data from Germany (age 3-17, N=14,633, KiGGS0 study 2003-2006; age 18-39, N=1,884, DEGS1 2008-2011 study), with mean of two oscillometric measurements on one occasion; cutoffs for hypertensive BP in children were the 95th percentile using KiGGS percentiles, and for sensitivity analyses Fourth Report percentiles, in adults 140/90 mmHg; childhood overweight and obesity were classified according to the International Obesity Task Force and for adults as BMI ≥25 and ≥30 kg/m2. In 3-17-year-olds, different selective BP screening scenarios were simulated: screening only in those with obesity, overweight, parental hypertension, combination of overweight and parental hypertension, resulting in screening 5.6%, 20.0%, 28.5%, and 42.6% of the population and detecting 17.2%, 38.6%, 30.3%, and 58.2% of all hypertensive cases in the population. In conclusion our results show a large screening gap that would result from selective BP screening only in those with overweight, obesity, or parental hypertension.

Effect of Diminazene aceturate treatment on some cardiovascular parameters and antioxidant status of apparently healthy horses

IntroductionApart from being a widely used antiprotozoal drug in many parts of Africa, Diminazene aceturate (DIZE), has been shown to have beneficial effects in experimental murine models of hypertension, pulmonary hypertension, myocardial infarction, stroke, atherosclerosis, type 1 diabetes, and eye disease. In this study, we investigated the effect of diminazene aceturate treatment after a single intramuscular administration on some cardiovascular parameters and antioxidant status in apparently healthy Nigerian horses.Materials and methodsTen male horses were divided into two groups comprising 5 horses each. Group A was the control group with no drug administered. Group B was treated with DIZE at 3.5 mg/kg, single dose. Baseline data were collected before the commencement of the experiment and thereafter, post‐administration at 0hrs, 24hrs, 48hrs and 96hrs. Base apex electrocardiogram was recorded using a computer ECG machine while oscillometric blood pressure measurement was recorded using a veterinary blood pressure monitor. Markers of oxidative stress were determined in the serumResultSingle intramuscular treatment caused a significant (p<0.05) increase in the systolic, diastolic and mean arterial blood pressure values when compared with the controls. From the electrocardiogram, sinus rhythm was recorded in both groups however, significant (p<0.05) increase in heart rate, p‐wave duration, QRS complex duration and QTc were observed in the treated group when compared with the control. Oxidative stress markers (malondialdehyde and hydrogen peroxide) significantly (p<0.05) increased while antioxidant enzymes (catalase, glutathione peroxidase and glutathione) were decreased when compared to the control.ConclusionThis study indicates that the use of DIZE in horses should be with great caution because of the associated cardiovascular physiological alterations, reduction in activities of antioxidant enzymes and increase in markers of oxidative stress.Support or Funding InformationNoneThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Oscillometric measurement of blood pressure: a simplified explanation. A technical note on behalf of the British and Irish Hypertension Society

Oscillometric measurement of blood pressure: a simplified explanation. A technical note on behalf of the British and Irish Hypertension Society

Characterization of Impulse Oscillometric Measures of Respiratory Small Airway Function in Children

Children suffering from asthma are often undiagnosed or misdiagnosed as their symptoms are similar to other respiratory conditions. Spirometry, the golden pulmonary function test used for asthma diagnosis, is often unsuitable for young children since it requires them to perform extreme inhalation and exhalation maneuvers. Impulse Oscillometry (IOS) is an effortless, child-friendly, sensitive, and reliable testing technique that could be used in the effective diagnosis of asthma. However, the IOS requires a deep understanding of the mechanical and/or equivalent electrical circuit models of the human respiratory system, which hinders its broad acceptance and utility in clinics. This paper presents a data characterization study based on the statistical assessment of the IOS parameters. The main focus is to investigate four different manifestations of pulmonary conditions in children due to peripheral obstruction: Asthma (A), Small Airway Impairment (SAI), Possible Small Airway Impairment (PSAI), and Normal (N). The objective of this investigation is to pave the way for the feature selection stage of our future computer-aided classification work to distinguish between lung dysfunction and healthy lung function in children by identifying those IOS parameters that are most sensitive to discriminate between the different respiratory conditions mentioned above. Our ultimate goal is to facilitate the interpretation of the impulse oscillometric test results and provide clinicians with a reliable and proven method for accurate classification of children's lung function for an early asthma detection, diagnosis, and control.

An unambiguous definition of pediatric hypotension is still lacking: Gaps between two percentile-based definitions and Pediatric Advanced Life Support/Advanced Trauma Life Support guidelines.

Data are lacking to provide cutoffs for hypotension in children based on outcome studies and Pediatric Advanced Life Support (PALS), and Advanced Trauma Life Support (ATLS) definitions are based on normal populations. The goal of this study was to compare different normal population based cutoffs including fifth percentile of systolic blood pressure (P5-SBP) in children and adolescents from the German Health Examination Survey for Children and Adolescents (KiGGS), US population data (Fourth Report), and cutoffs from PALS and ATLS guidelines. Fifth percentile of systolic blood pressure according to age, sex, and height was modeled based on standardized resting oscillometric BP measurements (12,199 children aged 3-17 years) from KiGGS 2003-2006. In addition, we applied the age-adjusted pediatric shock index in the KiGGS study. The KiGGS P5-SBP was on average 7 mm Hg higher than Fourth Report P5-SBP (5-10 mm Hg depending on age-sex group). For children aged 3 to 9 years, KIGGS P5-SBP at median height follows the formula 82 mm Hg + age; for age 10 to 17 years, the increase was not linear and is presented in a simplified table. Pediatric Advanced Life Support/ATLS thresholds were between KiGGS and Fourth Report until age of 11 years. The adult threshold of 90 mm Hg was reached by KiGGS P5-SBP median height at 8 years, PALS/ATLS at age of 10 years, and Fourth Report P5-SBP at 12 years. The pediatric shock index, which is supposed to identify severely injured children, was exceeded by 2.3% nonacutely ill KiGGS participants. Our study shows that percentile cutoffs vary by reference population. The 90 mm Hg cutoff for adolescents targets only those in the less than 1% of the low SBP range and represents an undertriage compared with P5 at younger ages according to both KiGGS and Fourth Report. Finally, current pediatric shock index cutoffs when applied to a healthy cohort lead to a relevant percentage of false positives. Epidemiologic/prognostic, level III.

Ambulatory Blood Pressure Monitoring: Profiles in Chronic Kidney Disease Patients and Utility in Management.

Optimal control of blood pressure (BP) may reduce the risk of progression of CKD. Misclassification of hypertension (HTN) and status of control may result in suboptimal management. Clinic or home BP may overestimate or underestimate status of control compared with ambulatory BP monitoring (ABPM), which is considered the gold standard. The latter relates not only to the superiority of ABPM concerning outcome prognosis but also to its ability to accurately diagnose white coat and masked HTN, which is critical in assuring adequate BP control. However, ABPM has not gained widespread use in practice because of limited third-party reimbursement and a paucity of high quality randomized controlled intervention studies evaluating its use. Herein, we review HTN phenotypes that have been identified in patients with CKD, and the potential value of ABPM in this high-risk population.

Four-Limb Blood Pressure Measurement with an Oscillometric Device: a Tool for Diagnosing Peripheral Vascular Disease.

Traditionally, the term peripheral vascular disease (PAD) is restricted to the occlusive arterial disease in the leg, but now, the connotation of PAD is more widespread as it encompasses all extracoronary and extracerebral vascular disease. The incidence of PAD is increasing worldwide; therefore, it is necessary to diagnose PAD at an early stage. Oscillometric BP device is widely used for four-limb measurement in clinical practice and provides several parameters for evaluating inter-limb BP difference, such as ankle-brachial index (OS-ABI), inter-arm BP differences (IAD), and inter-ankle BP difference (IAND). Using angiographic results as reference, the ABI, IAD, and IAND from an oscillometric BP device have been demonstrated having high accuracy for diagnosis of PAD. Meanwhile, combination of these parameters could further improve the accuracy of PAD, including the occlusive artery disease in the arm, leg, and aorta. For example, some patients with severe PAD in the leg have normal ABI; in this situation, an increased sIAND could confirm the diagnosis of PAD in the leg. Because ABI, IAD, and IAND from inter-limb oscillometric BP measurement can also predict adverse prognosis, we encourage the use of an oscillometric device to measure four-limb BP and to evaluate the inter-limb BP difference.

Comparison of ankle-brachial index (ABI) measured by an automated oscillometric apparatus with that by standard hand-held doppler in patients with Type-2 diabetes.

Objective:To compare the difference between an automated oscillometric ABI measurement as compared to standard hand-held doppler ABI in patients with Type-2 diabetes.Methods:This prospective study was conducted at foot clinic of Baqai Institute of Diabetology and Endocrinology (BIDE), Baqai Medical University (BMU), a tertiary care unit, Karachi-Pakistan. The duration of study was February 2018 to March 2018. Patients with Type-2 diabetes attending the outpatient department (OPD) of foot clinic, irrespective of their symptoms were included. Baseline demographic, anthropometric measurements and biochemical parameters were recorded. The ABI was calculated with both devices by an automated oscillometric machine and standard hand-held doppler with the same investigator.Results:Total of 93 patients with Type-2 diabetes, 18 (19.4%) females and 75(80.6%) males were recruited. Mean age was 54.67±9.59 years and mean systolic/diastolic blood pressure was 131.38±20.2/ 80.36±10.23mmHg. Most of the patients had poor glycemic control at presentation with a mean HbA1c of 9.56±2.44%. Mean standard handheld doppler ABI and automated oscillometric ABI was 1.28±1.08 and 1.07±0.23 for right foot (mean difference = 0.21; P= 0.075), and 1.14±0.45 and 1.1±0.25 for left foot (mean difference =0.04; P=0.434), respectively. Similarly, sensitivity and specificity between two modalities was observed 60% and 93.90% for right foot, meanwhile, 60% and 97.40% for left foot, respectively.Conclusion:An automated oscillometric method is comparable with standard handheld-doppler method. It is cost effective, convenient and less time consuming, can be widely used to measure ABI without special training.

Cardiovascular Risk in Psoriasis Patients: Clinical, Functional and Morphological Parameters.

BackgroundPsoriasis correlates with metabolic disorders, early atheromatosis and increased cardiovascular risk.ObjectivesTo assess markers of cardiovascular disease in psoriatic patients.MethodsCross-sectional, observational study involving 11 psoriatic participants and 33 controls. Anthropometric, biochemical, hemodynamic and imaging parameters were evaluated. Arterial stiffness was assessed by oscillometric measurement of the brachial artery. Intima-media thickness (IMT) and left ventricular diastolic function were assessed by Doppler echography and echocardiography. Between-group comparisons of numerical variables were performed by the Student’s t-test or Wilcoxon Mann-Whitney test for independent samples. Significance level was set at 5%.ResultsPsoriatic patients showed increased pulse wave velocity (PWV) (9.1 ± 1.8 vs 8.0 ± 2 m/s, p = 0.033), IMT of the left common carotid artery (p = 0.018) and a higher percentage of patients above the 75th percentile according to the ELSA table when compared with controls (54.5 vs 18.2%, p = 0.045). Psoriatic patients also showed an increase in peripheral/central systolic blood pressure (137.1 ± 13.2 vs 122.3 ± 11.6 mmHg, p = 0.004)/(127 ± 13 vs 112.5 ± 10.4 mmHg, p = 0.005), peripheral/central diastolic blood pressure (89.9 ± 8.9 vs 82.2 ± 8, p = 0.022)/(91 ± 9.3 vs 82.2 ± 8.3, p = 0.014), total cholesterol (252 ± 43.5 vs 198 ± 39.8 mg/dL, p < 0.001), LDL cholesterol (167 ± 24 vs 118 ± 40.8 mg/dL, p < 0.001) and C-reactive protein (7.6 ± 35.4 vs 1 ± 1.2 mg/L p < 0.001) compared with controls.ConclusionPsoriasis patients show increased PWV, IMT, peripheral and central blood pressures, and serum cholesterol and C-reactive protein levels, denoting a higher cardiovascular risk.

Dempster–Shafer Fusion Based on a Deep Boltzmann Machine for Blood Pressure Estimation

We propose a technique using Dempster–Shafer fusion based on a deep Boltzmann machine to classify and estimate systolic blood pressure and diastolic blood pressure categories using oscillometric blood pressure measurements. The deep Boltzmann machine is a state-of-the-art technology in which multiple restricted Boltzmann machines are accumulated. Unlike deep belief networks, each unit in the middle layer of the deep Boltzmann machine obtain information up and down to prevent uncertainty at the inference step. Dempster–Shafer fusion can be incorporated to enable combined independent estimation of the observations, and a confidence increase for a given deep Boltzmann machine estimate can be clearly observed. Our work provides an accurate blood pressure estimate, a blood pressure category with upper and lower bounds, and a solution that can reduce estimation uncertainty. This study is one of the first to use deep Boltzmann machine-based Dempster–Shafer fusion to classify and estimate blood pressure.

Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients.

BackgroundStage 5 chronic kidney disease patients on haemodialysis (HD) often present with dizziness and pre-syncopal events as a result of the combined effect of HD therapy and cardiovascular disease. The dysregulation of blood pressure (BP) during orthostasis may be implicated in the aetiology of falls in these patients. Therefore, we explored the relationship between baroreflex function, the haemodynamic responses to a passive orthostatic challenge, and falls in HD patients.MethodsSeventy-six HD patients were enrolled in this cross-sectional study. Participants were classified as “fallers” and “non-fallers” and completed a passive head up tilting to 60o (HUT-60°) test on an automated tilt table. ECG signals, continuous and oscillometric BP measurements and impedance cardiography were recorded. The following variables were derived from these measurements: heart rate (HR) stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR), number of baroreceptor events, and baroreceptor effectiveness index (BEI).ResultsThe forty-four participants who were classified as fallers (57.9%) had a lower number of baroreceptor events (6.5±8.5 vs 14±16.7, p = .027) and BEI (20.8±24.2% vs 33.4±23.3%, p = .025). In addition, fallers experienced a significantly larger drop in systolic (-6.4±10.9 vs -0.4±7.7 mmHg, p = .011) and diastolic (-2.7±7.3 vs 1.8±6 mmHg, p = .027) oscillometric BP from supine to HUT-60° compared with non-fallers. None of the variables taken for the analysis were significantly associated with falls in multivariate logistic regression analysis.ConclusionsThis cross-sectional comparison indicates that, at rest, HD patients with a positive history of falls present with a lower count of baroreceptor sequences and BEI.Short-term BP regulation warrants further investigation as BP drops during a passive orthostatic challenge may be implicated in the aetiology of falls in HD.

Associations Between Characteristics of Obstructive Sleep Apnea and Nocturnal Blood Pressure Surge.

Research suggests that oxygen desaturation and sleep stage during obstructive sleep apnea (OSA) are related to the magnitude of high blood pressure (BP) in a laboratory setting. However, in a clinical setting, these associations have not been well studied. We used a noninvasive oscillometric BP measurement device to investigate the association between oxygen-triggered BP levels at the end of each OSA episode and the characteristics of the preceding OSA episode. In 42 newly diagnosed OSA patients (average age, 63.5±12.5 years; average apnea-hypopnea index, 32.6±18.2 per hour), 258 BP measurements were obtained at the end of OSA episodes. Hypoxia-peak systolic BP (SBP), defined as the maximum oxygen-triggered SBP value, was significantly higher in rapid eye movement sleep (144.9±19.9 mm Hg) than in non-rapid eye movement stage 1 sleep (129.5±15.1 mm Hg; P<0.001) and non-rapid eye movement stage 2 sleep (129.4±14.7 mm Hg; P<0.001). In a multivariate-linear mixed model, the lowest oxygen saturation percentage during each OSA episode was associated with increased hypoxia-peak SBP (-0.501 mm Hg; P<0.001), nocturnal SBP surge (-0.395 mm Hg; P<0.001), defined as the difference between the hypoxia-peak SBP and the mean nocturnal SBP, and maximum value of SBP surge (-0.468 mm Hg; P<0.001), defined as the difference between the hypoxia-peak SBP and the minimum nocturnal SBP independent of sleep stage. These values were not associated with the duration of each OSA episode. The contribution of rapid eye movement sleep and severe oxygen desaturation to OSA-related BP elevation measured with a noninvasive oscillometric method was determined in a clinical setting.

NOVEL METHOD FOR ASSESSING ARTERIAL STIFFNESS BASED ON OSCILLOMETRIC BLOOD PRESSURE MEASUREMENT

Arterial stiffness is a major contributor to cardiovascular diseases. The aim of this study is to explore the physiological significance of the brachial mechanical parameters, which could be estimated from oscillometric blood pressure (BP) measurement, and investigate on the potential of these arterial parameters as an index of arterial stiffness. The mechanical characteristics of brachial artery were modeled based on the collapsible tube theory, which includes two important parameters to describe the compliance of brachial artery. After the model validation, the arterial parameters were estimated from the measured oscillometric envelope of 56 subjects by solving an inverse problem. The physiological significance of these parameters was explored by analyzing their association with pulse wave velocity (PWV) as well as with the BP. Arterial compliance parameters were successfully estimated from the envelope of the oscillometric pulse wave in the BP measurement. The parameters were found to be linearly associated with age, PWV, and BP. These results suggest that our method may provide a potential approach to assess arterial compliance based on oscillometric measurement of BP.

Continuous Non-Invasive Blood Pressure Measurement Using Pulse Transit Time in Children and Adolescents

As an alternative to ambulatory 24-h blood pressure monitors, the continuous, non-invasive blood pressure recording using pulse transit time (PTT) was compared with both oscillometric and intra-arterial measurement. In 144 pediatric patients (9.4±5.2 years) acute blood pressure was determined using three different methods of measurement. In 57 patients (11.4±4.9 years) of the pediatric normal ward, the blood pressure was simultaneously determined continuously by means of PTT compared to the intermittent oscillometric long-term measurement. In 9 patients (9.8±6.8 years) of the pediatric intensive care unit with continuous intra-arterial blood pressure measurement, the blood pressure was measured in parallel by means of PTT. Compared to the gold standard sphygmomanometry, mean systolic blood pressure values were comparable to 2 different oscillometric devices, but in the case of diastolic pressure measurement the pressure values were significantly lower or higher than with sphygmomanometry and auscultation. The results of the non-invasive comparative long-term measurements showed better correlations for systolic rather than diastolic pressure. Similar results were obtained comparing the direct intra-arterial blood pressure measurement with the SOMNOtouch™ NIBP device which measures blood pressure using the PTT. Continuous, indirect blood pressure recording using pulse transit time provides good correlations to the reference measurements for long-term measurement of blood pressure in children and adolescents and appears to be a usable method to measure the blood pressure of children especially at rest.

A15480 Pattern of Inter-arm difference in blood pressure and ankle-brachial index in building construction workers

Objectives: Inter-arm blood pressure difference (IAD) has received increased attention recently since it has been found to be associated with peripheral vascular disease (PAD). An inter-arm difference in blood pressure of less than 10mmHg is classified as normal based on the new clinical guideline for hypertension. The ankle-brachial index (ABI) is the ratio of the systolic blood pressure at the ankle compared with the brachial artery pressure. When the ABI is ≤ 0.9, a diagnosis of PAD is made upto a 90% accuracy. Oscillometric blood pressure measurement is commonly used for screening and follow-up monitoring of arterial hypertension, may also used as automated tools for simplified ABI-measurements rather than pinpoint detection of a vessel by a Doppler probe. The purpose of present study is to see the pattern of inter-arm difference in blood pressure and also validate oscillometric ABI measurement by assessing and comparing the results with the current gold standard of Doppler assisted measurement of ABI in building construction workers Methods: Inter-arm difference in blood pressure and ABI was measured in 50 building construction workers with age group between 20- 40 years using Automated Oscillometric device Microlife watchBP office (model- Twin200 AFS), Switzerland with appropriate cuff size for arm and leg circumference. Doppler ABI measurements were made with a commercially available HI-dop (BT-200 vascular Doppler in all building construction workers. Results: Increased systolic inter-arm difference was present in significant number of participants. Oscillometric measurement of ABI was performed significantly faster than Doppler-assisted ABI. Conclusion: In primary care setting, blood pressure should be actively measured in both arms. Oscillometric ABI is feasible and operator- independent.

Do Changes in Hemodynamic Parameters Depend Upon Length of Sleep Deprivation? Comparison Between Subjects With Normal Blood Pressure, Prehypertension, and Hypertension.

The main objective of the study was to analyze the impact of sleep deprivation upon hemodynamic and autonomic parameters in subjects with normal blood pressure (BP) compared to prehypertension and hypertension at 24, 28, and 32 h of total sleep deprivation (TSD). Thirty volunteers, healthy men with current medical tests indicating the absence of disease took part in the study. After physical examination (basic neurological, clinical examination, echocardiography and doppler ultrasound of the renal arteries, evaluation of the autonomic nervous system) subjects were divided into three groups: I – normotensive, II – pre-hypertensive, III – hypertensive (age: 31.2 ± 2.1 vs. 33.5 ± 2.7 vs. 36.8 ± 2.7 years, p > 0.05; BMI: 25.2 ± 0.8 vs. 29.0 ± 1.5 vs. 26.4 ± 1.0 kg/m2, p > 0.05). Hemodynamic and autonomic parameters were automatically measured at rest and in a tilted position with a Task Force Monitor. The Task Force Monitor consists of electrocardiography, impedance cardiography, oscillometric, and continuous BP measurement. Mixed models with random effects was applied in order to analyze the parameters’ dependence on the time and the group of patients. One-way ANOVA or Kruskal–Wallis test were used to detect differences between normotensive, pre-hypertensive and hypertensive groups in each time point. In the pre-hypertensive group 28-h TSD resulted in increased vagal outflow [changes in high frequency heart rate (HR) variability, p = 0.0189], as evidenced by decreased HR (p = 0.0293). Moreover after 24-h TSD and 28-h TSD we observed changes in BP parameters. In hypertensive group, the most important changes in hemodynamic parameters: systolic blood pressure (sBP, p = 0.0031), diastolic blood pressure (dBP, p = 0.0136), cardiac output (CO, p = 0.0439) and changes in HR (p = 0.0063) after tilt test were observed after 32-h TSD. In conclusion, our results show that changes in hemodynamic parameters during sleep deprivation depend on the baseline BP and duration of TSD. What is important, both groups reported a decrease of sBP and dBP during the TSD (pre-hypertensive group after 24, 28-h TSD; hypertensive group after 32-h TSD. In our opinion, this is the first study which considers three homogenous groups in terms of gender: only men, during different points of acute TSD: 24, 28, and 32 h of TSD in laboratory condition.