bluuebunny/crossref_metadata_2025_split huggingface dataset:
NIGHT-TO-DAY BLOODE PRESSURE RATIO FROM 7 DAY/24H AMBULATORY BLOOD PRESSURE MONITORIN IN PATIENTS WITH CORONARY HEART DISEASE
Authors: Siegelova Jarmila , Havelkova Alena , Dusek Jiri , Pohanka Michal , Dunklerova Leona , Dobsak Petr , Cornelissen Germaine 
Published: May 2024

Objective:
Impairment of night-to-day blood pressure (BP) ratio led to an increase in cardiovascular outcomes. The aim of the present study was to examine night-to-day BP ratio variability in two repeated 7 day/2h ambulatory BP monitoring (AMBP) in patients with coronary heart disease (CHD).

Design and method:
The 20 patients with CHD were under therapy with ACE inhibitors, beta blockers and statins. The AMBP was in every patient provided twice and AMBP lasted 7 days/ 24-h repeatedly. The 20 patients were divided in subgroup 1 and 2. Subgroup 1 was monitored before and after 3months of cardiovascular rehabilitation 3 times a week. Subgroup 2 was monitored before and after usual every day activity. We evaluated night-to-day BP ration in 24-h in BP profile and 7 day mean value before and after cardiac RHB in SBP and DBP in subgroup 1 and also subgroup 2.

Results:
The mean values of night-to-day in SBP ration evaluated from 7 day/24-h AMBP in subgroup 1 with cardiovascular rehabilitation in the 1st monitoring: was 12.0±1.85%, in 2nd AMBP 8.4±1.89% (not significant).
The mean values of night-to-day DBP ratio evaluated from 7 day/24-h AMBP in subgroup 1was in 1st monitoring: was 13.7±1.54%, in 2nd monitoring was 11.4±1.34% (not significant).
The mean value of night to day SBP ratio evaluated from 7 day/24 hour AMBP in subgroup 2 was 1st monitoring was 17.3±2.23%, in 2nd monitoring was: 18.8±1.16% (not significant). The mean values of night to day DBP ratio evaluated from 7 day /24 hour AMBP in subgroup 2 was in 1st monitoring was 19.6±2.66%; 2nd monitoring: 20.7±1.33% (not significant).

Conclusions:
In patients with CAD night-to-day BP ration from 7 day/24 h AMBP varied in one BP in 24-h profile and also in mean values from 7 day/24-h AMBP in both subgroups in values from1st and 2nd BP measurement. We have not found significant difference between the subgroup 1 before and after cardiac rehabilitation. We have not found significant difference in repeated measurement in subgroup 2 with usual activities between repeated measurements.
UNATTENDED VERSUS ATTENDED BLOOD PRESSURE MEASUREMENT: PREDICTIVE VALUE FOR NORMAL 24-HOURS BP VALUES
Authors: Aggiusti Carlo , Paini Anna , Bertacchini Fabio , Stassaldi Deborah , Capellini Sara , Buso Giacomo , Gatta Roberto , Muiesan Maria Lorenza , Salvetti Massimo 
Published: May 2024

Objective:
Background: It has been suggested that measurement of “unattended” (UA) instead of “attended” (A) blood pressure (BP) values may provide advantages. Little is known on the relationship between UA, A and 24 hours BP.

Design and method:
Methods In 846 patients attending the outpatient clinic at an ESH Excellence Centre, BP values were measured by the physician with an automated oscillometric device (Omron HEM 9000Ai, mean of 3 measurements), after 5 minutes of rest. After the measurement of BP by the physician, the patient was left alone in the room, and the device was programmed to automatically perform 3 BP measurements after 5 minutes (UA). Ambulatory blood pressure monitoring (ABPM) was performed in all subjects within ± 3 days.

Results:
Mean age was 60±13 yrs, 48% females, BMI 26±4, 74% hypertensives (82% treated). Mean BP values were as follows: UA 126±14/76±10, A 133±16/78±10mmHg, 24 hours 125±11/76±9mmHg. UA and A SBP were similarly correlated to 24 hours SBP, daytime SBP, nighttime SBP (Steiger's Z Test p ns). Similar results were obtained for DBP.
At Receiver Operator Curves (ROC) analysis UA SBP, as compared to A SBP, was superior in predicting a normal 24 hours SBP (defined as 24 hours SBP < 130 mmHg) (AUC, 0.803; 95% CI, 0.775–0.830 versus AUC, 0.784; 95% CI, 0.754–0.811; p for the comparison<0.05). Similar results were observed for the predictive value of UA DBP for a normal 24 hours DBP (defined as 24 hours DBP< 80 mmHg) (AUC, 0.864; 95% CI, 0.839–0.886 versus AUC, 0.844; 95% CI, 0.817–0.867; p for the comparison<0.05).

Conclusions:
Our findings suggest that “unattended BP” measurement might be slightly, but significantly superior in predicting normal values of 24 hours systolic and diastolic BP.
TRACKING NOCTURNAL BLOOD PRESSURE DIPPING WITH THE AKTIIA CUFFLESS MONITOR
Authors: De Almeida Tiago Paggi , Perruchoud David , Alexandre Jérémy , Vermare Pascale , Sola Josep , Shah Jay , Marques Luisa , Pellaton Cyril 
Published: May 2024

Objective:
Previous studies have highlighted the prognostic importance of night-time blood pressure (BP) dipping, associating non-dipping BP patterns with cardiovascular risk. Standard 24-h ambulatory BP monitors (ABPM) often show inconsistent reproducibility in nocturnal dipping. Cuffless BP monitors present a promising approach for continual measurement of night-time BP, yet their effectiveness is to be assessed. This study compares nocturnal BP dipping as recorded by a cuffless BP monitor with readings from a conventional 24-h ABPM.

Design and method:
63 subjects (NCT04548986, mean age 53.1±7.2 years, 21.2% female, arm circumference 29.0±2.5 cm) were enrolled in a 12-week cardiac rehabilitation program at RHNE – Réseau Hospitalier Neuchâtelois, Switzerland. Systolic BP (SBP) night-time dipping was assessed by comparing same-day daytime (9am–9pm) and night-time (11pm–7am) averages using both cuffless BP monitor (Aktiia SA, Switzerland) and ABPM (Dyasis 3, Novacor, France). Two sessions were analyzed: session 1 compared first day's ABPM and Aktiia data; session 2 compared final day's readings from both devices. Only sessions with >=20 daytime and >=7 night-time measurements for ABPM, and >=12 daytime and >=8 night-time measurements for Aktiia were considered for analysis. The performance of night dipping identification was evaluated as the area under the curve (AUC) of a Receiver Operating Characteristic (ROC) curve (reference: -10% ABPM night-dip), and as the concordance rate (CR, accuracy) of a Four-Quadrant Plot (FQP, ±6% exclusion zone around -10% ABPM night dips).

Results:
30 subjects fulfilled the data availability requirements per BP modality (26 in session 1, 12 in session 2). Figure 1A illustrates the ROC curve (AUC=0.72). The optimal operating point for Aktiia's night-time dip was found at -2.96% (red dot, 91% sensitivity, 63% specificity). Figure 1B shows the FQP comparing night-dips recorded by ABPM and Aktiia (78.9% CR, 83.3% precision).

Conclusions:
The Aktiia monitor effectively identifies nocturnal BP dipping with 78.9% accuracy, consistent with ABPM readings, despite some scaling differences. This indicates that the Aktiia monitor is sensitive to nocturnal BP dipping and holds potential for future use in continuous night-time monitoring. Further research is focused on improving nocturnal measurement accuracy.
ANALYSIS OF CIRCADIAN RHYTHM AND DETECTION RATE OF EARLY EVENING ELEVATED BLOOD PRESSURE IN HYPERTENSIVE PATIENTS
Authors: Ma Zhiyi , Zhang Yuqing , Xu Yang 
Published: May 2024

Objective:
The aim of the study is to investigate the circadian rhythm and detection rate of early evening elevated blood pressure (EEE) in treated and untreated hypertensive patients by ambulatory blood pressure monitoring.

Design and method:
From February 1, 2020 to February 28, 2023, the total of 1413 hypertensivs underwent ambulatory blood pressure monitoring in 13 medical institutions through the National 13th Five Year Plan Major Cooperation Group for Chronic Disease Prevention and Control (Research on the Application of Lifestyle and Nutritional Intervention Techniques and Strategies for Obesity and Hypertension, No. 2016YFC1300100). Among them, 1026 had taken antihypertensive drugs and 387 had not taken antihypertensive drugs. EEE is defined as average systolic blood pressure is higher or equal to 135mmHg or average diastolic blood pressure is higher or equal to 85mmHg from 6PM to 10PM. The definitions of dipper, non-dipper, super-dipper, and reverse-dipper blood pressure refer to the 2020 China Ambulatory Blood Pressure Monitoring Guidelines.

Results:
1. The detection rate of EEE in treated hypertensive patients was 60.4% (620 patients), while the detection rate of EEE in untreated hypertensive patients was 70.5% (273 patients); 2. The detection rate of dipper type in treated hypertensive patients was 21.7% (223 patients), while the detection rate of dipper type in untreated hypertensive patients was 21.7% (84 patients); 3. The detection rate of non-dipper type in treated hypertensive patients was 51.4% (527 patients), while the detection rate of non-dipper type in untreated hypertensive patients was 53.5% (207 patients); 4. The detection rate of super-dipper type in treated hypertensive patients was 1.6% (16 patients), while the detection rate of super-dipper type in untreated hypertensive patients was 1.8% (7 patients); 5. The detection rate of reverse-dipper type in treated hypertensive patients was 25.3% (260 patients), while the detection rate of reverse-dipper type in untreated hypertensive patients was 23% (89 patients).

Conclusions:
The detection rate of EEE is significantly higher than that of traditional non-dipper, super-dipper, and reverse-dipper blood pressure; It is possible that EEE become a new target for antihypertensive treatment.
BLOOD PRESSURE VARIABILITY AND HISTORY OF CARDIOVASCULAR EVENTS IN MAY MEASUREMENT MONTH 2019 PARTICIPANTS
Authors: Kerr Gabriele , Beaney Thomas , Schlaich Markus , Schutte Aletta , Stergiou George , Poulter Neil 
Published: May 2024

Objective:
Increased blood pressure variability (BPV) is associated with negative health outcomes, but its determinants, and how best to measure it, remain unclear. We aimed to explore differences in four commonly used measures of BPV by clinical factors in the May Measurement Month (MMM) 2019 global survey.

Design and method:
We performed an observational analysis of BP readings from MMM 2019 survey participants. Volunteer adult (18 years or older) participants were surveyed via convenience sampling from 92 countries in May 2019. Each participant had three seated BP readings. Four indices of diastolic and systolic BPV were calculated for participants with all three BP readings: the standard deviation (SD), coefficient of variation (CV), absolute difference between the second and first BP readings (AR), and the variation independent of the mean (VIM). Factors examined included use of antihypertensive medication, being obese (body mass index greater than 29 kg/m2), and having a diagnosis of diabetes, myocardial infarction, or stroke. For each BPV index and factor, a regression model was created with the index as the outcome. Each model was adjusted for mean BP (based on the average of the second and third BP readings), age, sex, an interaction between age and sex, and antihypertensive medication use. Age and mean BP were each included as natural cubic splines with five knots.

Results:
Data from for 1,133,008 (75.1%) participants were included. The mean age was 45.6 (SD 16.6) and 52.0% were female. Coefficient estimates were similar for SD, VIM, and CV (Figure 1). Lower systolic and diastolic BPV were seen in participants who reported use of antihypertensive medication, and in those with a previous history of stroke, diabetes, or MI. There were small but statistically significant differences by obesity status.

Conclusions:
Diabetes, a history of myocardial infarction or stroke and the use of antihypertensive medication were associated with lower within-visit BPV, independent of age or sex. This may reflect underlying physiological differences between groups or differences in BPV-lowering effects resulting from different lifestyle choices or medication usage of these participants.
WHITE-COAT EFFECT AND MASKED HYPERTENSION IN HIGH-NORMAL OFFICE BLOOD PRESSURE: RESULTS OF THE HUNGARIAN ABPM REGISTRY
Authors: Nemcsik János , Takács Johanna , Farsang Csaba , Simon Attila , Páll Dénes , Torzsa Péter , Dolgos Szilveszter , Koller Ákos , Járai Zoltán 
Published: May 2024

Objective:
White-coat hypertension refers to the untreated condition in which BP is elevated in the office but is normal when measured by ambulatory blood pressure monitoring (ABPM), home blood pressure monitoring (HBPM) or both. However, white-coat effect can be present in high-normal blood pressure (BP) category as well. The aims of this study were to evaluate the presence of white-coat effect and masked hypertension in high-normal office BP (OBP) and also to explore the prevalence of untreated very high CV risk (CVD) patients with high-normal OBP.

Design and method:
Data of the Hungarian ABPM Registry were used in our analysis.

Results:
From 14 817 uploaded ABPM curves with clinical data 1 255 subjects were categorized as having high-normal OBP. 999 (79.6%) were on antihypertensive treatment. Based on the ABPM recordings apparent high-normal BP was found in 35.9% (n=450), white-coat effect was present in 28.5% (n=358) and masked hypertension was diagnosed in 35.6% (n=447). Similar results were found in treated and untreated subjects as well. Independent predictors of white-coat effect were age (OR: 1.014 (95%CI:1.006-1.023), p=0.001), male sex (OR: 0.565 (0.432-0.739), p<0.001), and obesity (OR: 1.994 (1.480-2.687), p<0.001). Independent predictors of masked hypertension were age (OR: 1.014 (95%CI:1.005-1.023), p=0.003), heart rate (OR: 1.028 (1.011-1.044), p=0.01) and obesity (OR:1.679 (1.262-2.234), p<0.001). 142 subjects had very high CV risk with high-normal OBP and only 7 of them were untreated. With ABPM only one of them had apparent high-normal BP.

Conclusions:
In high-normal OBP ABPM is a useful tool to diagnose white-coat effect and masked hypertension. Untreated high-normal OBP with very high CV risk is a very rare condition in the general practitioner practice when ABPM is also recommended to evaluate the true blood pressure phenotype before therapeutic decisions.
CUFFLESS BLOOD PRESSURE IN CLINICAL PRACTICE: CHALLENGES, OPPORTUNITIES AND CURRENT LIMITS
Authors: Henry Benoit , Merz Maxime , Hoang Harry , Ghaith Abdul Karim , Wosik Jedrek , Schoettker Patrick 
Published: May 2024

Objective:
Cuffless blood pressure measurement technologies have attracted significant attention for their potential to transform cardiovascular monitoring. This updated narrative review thoroughly examines the challenges, opportunities, and limitations associated with the implementation of cuffless blood pressure monitoring systems. By summarizing the current state of the art and identifying future directions, this article aims to participate in the debate around cuffless BP measurement while contributing substantial scientific value to this rapidly evolving field.

Design and method:
The search procedure involved using Google Scholar and PubMed databases. During the initial search, a substantial number of articles unrelated to this literature survey were retrieved. Authors then selected the articles that were relevant for this review on cuffless noninvasive BP measurement.

Results:
Diverse technologies, including photoplethysmography, tonometry, and ECG waveform analysis, enable cuffless blood pressure measurement and are integrated into devices like smartphones and smartwatches. Signal processing emerges as a critical aspect, dictating the accuracy and reliability of readings. Despite its potential, the integration of cuffless technologies into clinical practice faces obstacles, including the need to address concerns related to accuracy, calibration, and standardization across diverse devices and patient populations. The development of robust algorithms to mitigate artifacts and environmental disturbances is essential for extracting clear physiological signals. Based on extensive research, this review emphasizes the necessity for standardized protocols, validation studies, and regulatory frameworks to ensure the reliability and safety of cuffless blood pressure monitoring devices and their implementation in mainstream medical practice. Interdisciplinary collaborations between engineers, clinicians, and regulatory bodies are crucial to address technical, clinical, and regulatory complexities during implementation.

Conclusions:
While cuffless blood pressure monitoring holds immense potential to transform cardiovascular care. The resolution of existing challenges and the establishment of rigorous standards are imperative for its seamless incorporation into routine clinical practice. The emergence of these new technologies shifts the paradigm of cardiovascular health management, presenting a new possibility for non-invasive continuous and dynamic monitoring. The concept of cuffless blood pressure measurement is viable and more finely tuned devices are expected to enter the market, which could redefine our understanding of blood pressure and hypertension.
ENHANCING NOCTURNAL BLOOD PRESSURE ASSESSMENT THROUGH HYDROSTATIC PRESSURE CORRECTION: A CLINICAL STUDY
Authors: Heinz Viktor , Pilz Niklas , Bothe Tomas Lucca , Patzak Andreas 
Published: May 2024

Objective:
The evaluation of nocturnal blood pressure (BP) and corresponding dipping patterns is pivotal in understanding and managing arterial hypertension and cardiovascular health. However, poor reproducibility in determining dipping patterns is attributed to sleep-related positional changes and resultant variations in hydrostatic pressure. This study aimed to delve into the impact of hydrostatic pressure on nocturnal BP assessment and considering its clinical relevance.

Design and method:
52 subjects (26 aged 18-30 and 26 aged 50 or older) underwent nocturnal oscillometric BP measurements. The hydrostatic pressure difference between the heart and the BP cuff as well as the current body position was continuously monitored.

Results:
The study's results revealed a strong effect of correcting hydrostatic pressure differences between the cuff and the heart level on the nocturnal mean BP levels and dipping patterns. The mean nocturnal BP and the change in dipping pattern correlated strongly with the size of hydrostatic effects. Combining biometrical data with body position measurements allowed to partly estimate the direction and amplitude of hydrostatic effects on single measurements.

Conclusions:
This study underscores the influence of hydrostatic pressure variations on nocturnal BP assessment and dipping patterns. Our findings highlight the necessity of correcting for hydrostatic pressure differences between the heart level and the cuff, especially during the night while sleep-related positional changes might occur. Integrating biometric data and body position monitoring into nocturnal BP measurement protocols might pave the way for more accurate BP assessments and personalized hypertension management, catering to individual patient characteristics.
MEASUREMENT OF BLOOD PRESSURE OF VISITORS IN PRIMARY CARE UNITS BY MEDICAL STUDENTS: A QUALITATIVE ANALYSIS OF THEIR VIEWS ON THE ACTION
Authors: Triantafyllou Areti , Evangelidis Nikolaos , Kavvadas Dimitrios , Evangelidis Paschalis , Manti Sofia , Giormezi Anastasia , Gavana Magdalini , Ouzouni Styliani , Staikos Ioannis , Theodoropoulos Ilias , Vitoris Ioannis , Vlachopoulos Nikolaos , Haidich Anna-Bettina , Smyrnakis Emmanouil 
Published: May 2024

Objective:
Arterial Hypertension is a major public health issue, and its proper measurement is a key clinical skill for medical students. In this context, during the lesson of Primary Health Care (PHC) of the School of Medicine of Aristotle University of Thessaloniki, 6th-year students performed blood pressure (BP) measurements in adults visitors of the PHC facilities during 1 week. The purpose of this study was to record the views and experiences of the students who participated in the above action.

Design and method:
44 medical students participated in the action. Measurements have been done on 289 persons. The students recorded their experiences in a short open report. Two independent researchers analysed the reports using Braun and Clarke's qualitative analysis method.

Results:
The qualitative analysis resulted in 5 themes: facilitators and obstacles to action, benefits for students, patients and health care system. The good organization, preparation, and support from the staff of the PHC settings contributed positively to the implementation of the action. Although in most cases, patients showed willingness, there were also cases of refusal to participate either due to time pressure, or fear of identifying their BP increased, and due to stereotypes-perceptions if measurements performed by the students could be correct. Significant obstacles were the lack of certified BP monitors in several structures. The analysis revealed benefits for students, among which were the acquisition of knowledge for the diagnosis of hypertension, the development of BP measurement skills, communication skills with patients and attitudes, and most importantly, the recognition of their role in PHC hypertension screening. The benefits for patients were significant, as they found people undiagnosed or unregulated but also, through the action, patients increased their knowledge about the measurement procedure and the risks of increased pressure. Finally, multiple benefits for the health care system itself were identified.

Conclusions:
This action highlights the importance of students’ active participation in prevention programs in PHC structures. Testing people for AH is a modern medical education tool with multiple benefits for both students and public health.
EVALUATION OF SELF-MONITORING OF BLOOD PRESSURE ACCORDING TO THE PERHIT STUDY AND THE IMPACT ON GLOMERULAR FUNCTION
Authors: Ekholm Mikael , Andersson Ulrika , Nilsson Peter M , Kjellgren Karin , Midlöv Patrik 
Published: May 2024

Objective:
The relationship between hypertension and chronic kidney disease (CKD) is bidirectional. Although intensive blood pressure (BP) control has not been shown to slow the progression of CKD, intensive BP control has been shown to reduce the risk for adverse cardiovascular outcomes in the CKD population. The aim of this study was to help us understand the interplay between self-monitored BP and progress of kidney disease.

Design and method:
This study is a post-hoc analysis of data from our previous randomised controlled study, PERson-centredness in Hypertension management using Information Technology (PERHIT). We included 949 hypertensive participants who underwent visits at baseline, eight weeks and 12 months. Blood samples were taken at every visit. Half of the participants received a BP monitor and installed a mobile phone program. During eight weeks they daily measured and reported their BP values. Systolic BP (SBP) and diastolic BP (DBP) were used to calculate pulse pressure (PP) and mean arterial pressure (MAP) The association between estimated glomerular filtration rate (eGFR) and BP components were analysed in mixed linear regression models.

Results:
BP for the intervention and the control group were similar at baseline. Within the intervention group BP and SBP decreased from baseline to eight weeks and 12 months (P<0.001). Also, PP and MAP decreased from baseline to eight weeks (P=0.021 and P=0.004) and 12 months (P=0.035 and P=0.008). Within the control group, a decrease was observed from baseline to 12 months for SBP, DBP and PP (P=0.025, P=0.023 and P=0.036). In the intervention group we observed an association between a decrease in SBP, DBP, PP and MAP and a decline in eGFR (P<0.001, P<0.001, P=0.013 and P<0.001), (table). In the control group similar results was observed only for PP (P=0.027). eGFR decreased significantly (P<0.001) within the intervention group, but not within the control group (P=0.051).

Conclusions:
In this randomised study we observed an association between a decrease in all BP component and an eGFR decline. Improved BP reduction in the intervention group was associated with a greater reduction in eGFR within the normal range.