bluuebunny/crossref_metadata_2025_split huggingface dataset:
PREVALENCE OF MASKED ORTHOSTATIC HYPOTENSION MEASURED BY HOME BLOOD PRESSURE MONITORING IN ELDERLY HYPERTENSIVE SUBJECTS: RESULTS OF THE HYPAUTTENS STUDY
Authors: Le Jeune Sylvain , Suhl Jaehyo , Feit Bertrand , Bally Stephane , Lequeux Benoit , Le Coz Sylvie , Gil Bertrand , Delsart Pascal , Pointeau Odile , Boulestreau Romain , Lopez-Sublet Marilucy , Mourad Jean Jacques 
Published: April 2021

Objective:
Orthostatic hypotension (OH) is a common disease in the elderly, associated with an increased risk of falls and cardiovascular morbi-mortality. Its reproducibility in clinical setting is low. A recent, single-center study has shown the feasibility of home blood pressure monitoring (HBPM) for the detection of OH in subjects older than 65 years referred for a memory complaint, and reported a prevalence of 12% and 42% of HO in the office and ambulatory settings respectively. The prevalence of masked OH detected with HBPM in treated hypertensive elderly subjects is still not known.

Design and method:
42 hypertensive patients older than 65 years without office OH were included in 8 specialized hypertension centers. Their treatment has not been changed for at least 1 month. An ambulatory OH was sought according to the following protocol: 3 measurements in sitting position at 1 minute intervals after 5 min of rest, followed by 3 measurements in standing position at 1 minute intervals, every morning and evening for 3 consecutive days, recorded by an automated device with humeral cuff. HBPM was considered valid if more than 4 out of 6 series of measurements were completed. Ambulatory OH was defined as a fall of more than 20mmHg in SBP between one of the 3 measurements in orthostatism compared to the average of the 3 measurements taken while sitting.

Results:
100% of HBPM sessions were considered valid. The main characteristics of the patients were: 72 ± 6 years, 39% women, SBP/ DBP: 149 ± 20/82 ± 10 mmHg, 2.4 ± 0.9 antihypertensive drugs, 9.3% history of falls. 20 (47.6%) included patients had a masked OH according to the protocol detailed above, with an average of 2 ± 1.2 episodes and a maximum of 5 episodes. 86% of patients had at least one episode in the morning, and 57% in the evening. In multivariate analysis, no factor identified in the study was significantly associated with the existence of a masked OH.

Conclusions:
OH detection with HBPM in treated hypertensive elderly subjects is feasible and reveals a significant prevalence of masked OH. Prospective studies are needed to clarify the prognostic value of masked OH.
CONCORDANCE BETWEEN THE DIAGNOSIS OF HYPERTENSION BY OFFICE BLOOD PRESSURE AND HOME BLOOD PRESSURE MONITORING IN A FAMILY HEALTH CARE UNIT- LAPARC COHORT STUDY
Authors: Botelho Bruna Gopp , Barbalho Daniella Gomes , Louzada Vinicius Leiria Teixeira , Azevedo Rafael Bellotti , Sampaio Fernando Bizzo , Antequera Lucas Alves , Diniz Pedro Henrique Pimenta , Marinho Beatriz Deberaldini , Rocha Débora De Castro , Ferreira Leonardo Villa Leão , Velasco Pedro Julio Pacheco , Araujo Humberto Montilho , Monteiro Daniela Fiuza Gomes , Mallet Ana Luisa Da Rocha , Muxfeldt Elizabeth Silaid 
Published: April 2021

Objective:
To evaluate concordance between diagnosis of hypertension by Office Blood Pressure (OBP) and Home Blood Pressure Monitoring (HBPM) in a young adult population.

Design and method:
A cross-sectional population study enrolled adults between 20 and 50 years registered in a primary healthcare unit in the city of Rio de Janeiro, Brazil. Socio-demographic and anthropometric characteristics were registered at the entrance of the study. Also, the presence of CV risk factors was evaluated. OBP was determined by calculating the mean value of 2 consecutive measurements (Omron-705CP) while the HBPM followed a 7-day protocol with 2 measurements in the morning and 2 in the evening (28 measurements). Measurements of the first day were discarded and the average of the other 6 days was calculated. It was considered normal a Home BP < 135 x 85 mmHg and OBP < 140 x 90 mmHg. Patients were classified into 4 groups: normotension (controlled OBP and HBPM); white coat hypertension (uncontrolled OBP and controlled HBPM); masked hypertension (controlled OBP and uncontrolled HBPM) and sustained hypertension (uncontrolled OBP and HBPM).

Results:
A total of 462 individuals were evaluated [37.7% males with mean age 37.4 ± 8.8 years]. Sedentary lifestyle (43%), dyslipidemia (38%) and obesity (28%) were the main CV risk factors. By OBP, the prevalence of hypertension was 13.4% while by HBPM was 18.6%. Kappa coefficient demonstrated a low concordance between the two diagnostic methods (kappa = 0.472). After HBPM, 68 individuals (16.9%) changed the diagnosis, being 21 (5.6%) with white coat hypertension and 45 (11.3%) with masked hypertension. The variables that were independently associated with hypertension diagnosed by OBP were male gender (OR 1.83, CI95%, 1.01–3.33, p = 0.04) and increased neck circumference (OR 3.77, CI95%:1.59–8.93, p = 0.003). Hypertension diagnosed by HBPM was associated with obesity (OR 2.18, CI95%, 1.27–3.76, p = 0.005) and increased neck circumference (OR 2.37, CI95%, 1.05–5.33, p = 0.04).

Conclusions:
Concordance between office BP and HBPM was low in this young adult population. Thus, If the diagnosis was based only in the office BP values, 17.5% of the subjects would have an erroneous diagnosis of hypertension.
BLOOD PRESSURE RESPONSE TO THE PRESENCE OF A PHYSICIAN DURING BLOOD PRESSURE MEASUREMENT
Authors: Filipovsky Jan , Seidlerova Jitka , Kordikova Veronika 
Published: April 2021

Objective:
Automated blood pressure (BP) measurement has attracted attention since the SPRINT study had been published. It can be measured either with (attended) or without the presence of the staff (unattended). Although it is well known that attended measurements are higher, studies that quantify the effect in well defined conditions are scarce.

Design and method:
We performed a study on 38 stable treated hypertensive subjects, mean age 66.5 ± 8.1 years, 45% males. Two sets of BP measurement, attended and unattended, were done with the Omron 907 device in a random order; each set consisted of three measurements separated by a one-minute interval. During attended BP measurements, a physician unknown to the patient was present. The physician was either in close (n = 22) or loose (n = 16) contact with the subject. During the close contact, the physician placed the stethoscope to the cubita as if he measured BP with auscultatory method so that the distance from the patient was standardized but all the measurements were oscillometric. With the loose contact, the physician was sitting in the room at a two-meter distance from the patient.

Results:
Means of three BP attended and unattended measurements were 129.3/73.5 mm Hg and 123.7/70.3 mm Hg, respectively, difference: 6.1 ± 7.6/3.2 ± 5.1 mm Hg, p < 0.0004. The difference was higher with close contact (8.2/4.3 mm Hg, p = 0.0023) than with loose contact (3.2/1.7, p = 0.16). Predictors of BP increase during attended measurements were studied in a multivariate linear regression. While no factor was associated with systolic BP increase, diastolic BP increase was positively related to smoking (p = 0,028) and negatively to the room temperature (p = 0,018).

Conclusions:
Our study shows that circumstances under which BP is measured are crucial even in the subjects treated for hypertension for a long time. The BP reaction is higher when the physician is close to the patient, imitating auscultatory measurement.
ASSESSMENT OF CENTRAL AORTIC BLOOD PRESSURE IN PATIENTS WITH HYPERTENSION: RESULTS FROM A PAN-INDIA ASSESS CABP REGISTRY
Authors: Bhasin Neeraj , Potdar Anil 
Published: April 2021

Abstract

Objective:
Although central aortic blood pressure (CABP) has shown to be better predictor of cardiovascular events than brachial BP in randomized trials, the real-world clinical practice data are scarce. Our study aimed to assess brachial and CABP and illustrate the correlation between them in patients with hypertension. It also aimed to assess the therapeutic drug classes prescribed in hypertensive patients.

Design and method:
This was a single-visit, prospective, non-interventional, observational study of hypertensive outpatients. Data collection included clinical and demographic characteristics, brachial (sphygmomanometer) and CABP (Agedio B900 device (IEM, Stolberg, Germany) and antihypertensive treatment.

Results:
A total of 3989 patients were enrolled with the mean age of 56.6 ± 12.2 years. About 58.6% were male and 66.4% were obese. Mean systolic (SBP) and diastolic blood pressure (DBP) was 156 ± 15.2/ 95.6 ± 12.9 mm Hg. Mean arterial pressure was 119.4 ± 21.8 mm Hg and heart rate was 83.1 ± 14.6 bpm. The central blood pressure parameters were: central systolic blood pressure (CSBP), 139.8 ± 16.3 mm Hg; central diastolic blood pressure (CDBP), 96.1 ± 13.2 mm Hg; central pulse pressure (CPP), 43.4 ± 15.3 mm Hg; augmentation index (%), 29.1 ± 16.6; pulse wave velocity, 8.8 ± 3.8 m/s. A positive correlation was observed between SBP and CSBP (r = 0.6809, p < 0.0001); DBP and CDBP (r = 0.7413, p < 0.0001); and PP and CPP (r = 0.638, p < 0.0001). About 83.1% patients were taking antihypertensive medications and 76.94% (n = 3163) patients were receiving monotherapy: ACE inhibitors, 6.96%, angiotensin receptor blockers, 30.92%, beta-Blockers, 12.6%, calcium channel blockers, 17.93%, diuretics, 8.54%, and alpha/central blockers, 0.17%. Combinations of two and three drugs were received by 21.6% and 1.46%, respectively

Conclusions:
Brachial BP was positively correlated to CABP in hypertensive patients. Majority of patients were receiving angiotensin receptor blockers as antihypertensive monotherapy.
SMARTPHONE-BASED BLOOD PRESSURE MEASUREMENTS VALIDATION USING THE AAMI/ESH/ISO UNIVERSAL PROTOCOL: RESULTS FROM THE FIRST FORTY PATIENTS
Authors: Wuerzner Gregoire , Degott Jean , Hofmann Gregory , Proença Martin , Bonnier Guillaume , Lemkaddem Alia , Lemay Mathieu , Schorer Raoul , Christen Urvan , Knebel Jean -Francois , Brenet Fanny , Eliott Jones , Wuerzner Arlène , Burnier Michel , Schoettker Patrick 
Published: April 2021

Abstract

Objective:
Hypertension is a preventable disease but only half of the affected population is aware of it. Digital health approaches, in particular mobile health diagnostics, have been shown to be effective and scalable for chronic disease detection and management. Smartphones are widely available and have the potential to be used as a “cuffless” blood pressure (BP) measuring devices. Using a smartphone-based pulse wave analysis algorithm (oBPMâ) trained with invasive blood pressure measurements, the objective was to assess the performance and accuracy of the oBPMâ in an outpatient setting.

Design and method:
We collected optical signals from patient's fingertip via a smartphone in an outpatient setting. After an initial calibration, smartphone optical BP were generated and compared to simultaneous acquired auscultatory systolic (SBP), diastolic (DBP) and mean (MBP) blood pressure in an initial set of participants in accordance with the AAMI/ESH/ISO universal consensus for the validation of BP measuring devices.

Results:
Signals acquired from 40 patients (range of age 21–78 years) generated 140 smartphone BP measurements. The prevalence of low, normal or elevated systolic blood pressure (SBP) was respectively 12.9%, 70.00% and 17.1 %. The prevalence of low, normal or elevated diastolic blood pressure (DBP) was respectively 25.0%, 61.4% and 13.6%. The mean difference in BP and its standard deviation between the optical vs. reference value were -0.7 ± 7·7 mmHg for the SBP, -0·4 ± 4·5 mm Hg for DBP and -0·6 ± 5·2 mmHg for mean blood pressure. These results were within the range of the ISO standards.

Conclusions:
These results demonstrate that BP can be measured with accuracy after an initial calibration using a smartphone and newly developed algorithm. If the accuracy of these smartphone-based measurements can be confirmed in various subtypes of population, it may become an important tool to detect and manage hypertension in various settings, in particular low income countries, where the availability of smartphones is high but access to health care is scarce.
ASSESSMENT OF BLOOD PRESSURE MEASUREMENT AT VARIOUS WORK PLACE IN HYDERABAD, PAKISTAN
Authors: Shaheen Sumera 
Published: April 2021

Objective:
According to JNC guidelines, Blood Pressure measurement is one the mandatory part for hypertension management. By knowing the values, a patient can better his/her blood pressure. The current study was conducted to know the KAP values at different work places in Hyderabad, Pakistan

Design and method:
The cross-sectional descriptive study was conducted in 3 different work places including Hospital, universities and bank. The total number of participants are 200. The sampling technique was purposive who had confirmed diagnosis of Hypertension. The duration of study was one years during 2019. The data were transferred in excel sheet and then compared with standard references

Results:
200 samples from each work place were enrolled. The age range was from 20 to 58 years. The mean age of the participants were 46 years. The male was more than female. The systolic and diastolic work are not known by the majority of the samples. The normal values of blood pressure are known by 53% of the participants. The KAP values are low in female as compared to male. While KAP values are good in university samples.

Conclusions:
Conclusion: The study was revealed that Blood pressure measurement values are not known by the majority of samples. Proper CMEs will be conducted to aware them.
COMPARISON OF OFFICE BP MEASUREMENTS BY VARIOUS BP MONITORS IN DIFFERENT CONDITIONS
Authors: Muzik Jan , Peleska Jan , Holubova Anna , Canek Rene , Navratil Vojtech , Fiala Dominik , Doksansky Marek , Kaspar Jan , Vranka Jakub , Hronova Julie , Chrolenko Anna , Jiravova Maria , Dolezil David , Jozifova Marie , Jedlickova Petra 
Published: April 2021

Objective:
Comparison of various types of BP measurement (BPM) is controversial. It also depends on a study design used.

Design and method:
Dabl validated BP monitors Nissei DM-3000 (both auscultatory and oscillometric), SunTech-CT40 (mean of 5 successive automated unattended BPMs - quiet room) and Fora P30Plus in both conditions were used for office BPM in triplets by one physician at the entry and exit of the 3 monthś home BP telemonitoring study. 93 treated essential hypertensives aged 26–85 years, 57% males, were referred by their physicians as well controlled. Their therapy was not changed during this study. Those starting BPMs in the office at the entry started BPMs in the quiet room at the exit and vice versa, approximately at the same time.
The effect of methods of BPM at the entry and exit of the study on the systolic BP was evaluated using a linear mixed model adjusted for gender, age and BMI.

Results:
The interaction of BPM method vs. study phase (entry/exit) showed a significant effect on systolic BP (SBP) values (p < 0.001). Significantly higher SBP values were measured using Fora in the quiet room in comparison with all the other methods of BPM and/or settings only at the entry (Table 1), whereas those measured at the exit did not differ significantly. There were no significant differences among other methods either.
SBP measured by Fora was not dependent on the measurement order (physician/quiet room) significantly (p = 0.279). The first self-measurement SBP values of the study in the quiet room were higher probably due to a stress from the first contact with a telemonitoring equipment.

Conclusions:
In this pilot study we found significant differences between BPM methods used in systolic BP measurement, Fora showed higher SBP values in the quiet room only at the entry. We did not prove any influence of measurement order when Fora was used in both attended and unattended conditions. Contrary to others, our results suggest that different BPM methods/conditions could give comparable SBP values, if performed correctly.
PREVALENCE OF HYPERTENSION IN THE FRENCH GENERAL POPULATION BY AUTOSCREENING OR HOME BLOOD PRESSURE MONITORING: FLAHS 2020 SURVEY
Authors: Girerd Xavier , Pathak Atul , Silhol François , Wimart Marie Catherine , Hanon Olivier 
Published: April 2021

Objective:
To assess the prevalence of hypertension in the general population based on the completion of an autoscreening or self-measurement protocol using an automatic home blood pressure monitor.

Design and method:
The FLAHS 2020 survey questioned individuals aged 35 and over from the Kantar Health Metascope permanent sample base (a representative panel of the population living in metropolitan France) with the question: Do you have a blood pressure monitor at home? The respondents assessed their blood pressure according to the protocol suiviHTA (6 sessions of 3 measurements, 3 sessions in the morning, 3 sessions in the evening, 3 consecutive days, 1 minute interval between each measurement, sitting position, without getting up between each measurement). The analysis calculated for each subject the average of the 18 measurements (protocol suiviHTA) and the average of the last 2 measurements of the first session (protocol depistHTA). High blood pressure was determined with thresholds >135/85 and >140/90 based on data from both protocols (mmHg).

Results:
Of the 4069 participants in FLAHS 2020, 827 had a blood pressure monitor of which 488 (59%) were on at least one antihypertensive therapy. With the protocol suiviHTA, the mean BP in treated subjects was 129.0/75.5, compared to 119.5/72.7 in untreated subjects. The table details the % prevalence [IC95] of high blood pressure by blood pressure threshold and protocol:

Conclusions:
Significant differences in the prevalence of high blood pressure according to the protocol performed are observed, particularly in the population of subjects treated with antihypertensive drugs.
With the protocol suiviHTA, which is the one recommended by the French Health Authority, the prevalence of high blood pressure in France is 28% in the population of subjects aged 35 years and over.
USING A NOVEL NON-INVASIVE, CUFF-LESS, WIRELESS DEVICE FOR 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING
Authors: Gepner Yftach , Nachman Dean , Gilan Adi , Goldstein Nir , Constantini Keren , Littman Romi , Eisenkraft Arik , Grossman Ehud 
Published: April 2021

Objective:
Ambulatory blood pressure monitoring (ABPM) using cuff-based devices is used for diagnosis and treatment of hypertension. Technical limitations, low compliance and complex procedure limit their use. The aim of the present study was to compare a new technique of 24H ABPM using a photoplethysmography (PPG)-based, wearable device to the standard cuff-based device.

Design and method:
In this prospective study, 24H ABPM was performed using a standard cuff-based device and the PPG-based device (Wrist-monitor) in parallel on volunteers aged 18–65 years, while documenting their daily activities. Level of comfort and activity disturbance of both devices were recorded. Linear regression and Bland-Altman were used to evaluate the agreement between the Wrist-monitor and Holter. Receiver Operating Characteristic (ROC) curve analysis was used to assess the ability of the Wrist-monitor to identify abnormal BP values.

Results:
The study included 28 subjects (18 men) mean age 41.5 ± 16.2 years. Bland-Altman analysis results in 24H bias of -1.1 mmHg for both diastolic blood pressure (DBP) and systolic blood pressure (SBP). Mean daytime bias was -1.9 mmHg for DBP and SBP, while nighttime bias was smaller (0.7 and 0.4 mmHg for DBP and SBP respectively). ROC curve analysis on all BP readings (n = 2381) yielded a mean area under the curve (AUC) for 24 hours of 0.965 for both SBP and DBP. 24H ABPM with the Wrist-monitor caused significantly less inconvenience compared to the Holter (p < 0.001).

Conclusions:
The cuff-less device provides comparable measurements to those obtained with the currently used ABPM device, with significantly less inconvenience to the subject.
PREVALENCE OF ARTERIAL HYPERTENSION AND CHARACTERISTICS OF NOCTURNAL BLOOD PRESSURE PROFILE OF ASTHMA PATIENTS ACCORDING TO THERAPY AND SEVERITY OF THE DISEASE: THE BADA STUDY
Authors: Musiari Gaia , Di Raimondo Domenico , Benfante Alida , Battaglia Salvatore , Rizzo Giuliana , Tuttolomondo Antonino , Scichilone Nicola , Pinto Antonio 
Published: April 2021

Objective:
Several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. Available data reports that asthmatics were 36 to 43 % more likely to have high blood pressure than non-asthmatics. None of these studies evaluated the event of an unrecognized hypertension and/or the 24-hours blood pressure profile of asthmatic patients through an Ambulatory Blood Pressure Monitoring (ABPM).

Design and method:
The BADA (Blood pressure levels, clinical features and markers of subclinical cArdiovascular Damage of Asthma patients) Study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. In this pilot study forty patients affected by asthma were consecutively recruited. Forty consecutive individuals referring for ambulatory examination due to medical reasons different from respiratory diseases served as the control group. Main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ABPM.

Results:
The overall percentage of asthmatics having also hypertension was 75 % (30 patients) vs 45 % (18 patients) of the control group (p: 0,012). Reduced level of FEV1 (but neither inhaled steroid therapy or other asthma-related factors) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). A comparison of nocturnal dipping patterns between asthmatics and controls, do not found any statistically significant differences between the two groups.
The regression analysis performed taking into account sex, age, diabetes, fasting glucose, Body Mass Index confirms the independent role played by asthma towards the overall hypertension (both already note adn newly diagnosed): Odds Ratio (OR): 3.66 (CI: 1.29–11.1).

Conclusions:
Arterial hypertension in asthma is more prevalent than how supposed before, emphasizing the need for a deeper cardiovascular screening for asthma patients. In particular, our data highlights the need for a more extensive use of ABPM.