bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE DIFFERENCE IN BLOOD PRESSURE BETWEEN THE TUNNEL BLOOD PRESSURE MONITORS IN THE WAITING AREA AND UPPER ARM BLOOD PRESSURE MONITORS IN THE CLINIC
Authors: Yang Shijie , Zhou Zhanyang , Miao Huanhuan , Zhang Yuqing 
Published: June 2023

Objective:
Tunnel blood pressure as an out-of-clinic screening program is often more casual, and its consistency with office blood pressure dominated by upper arm blood pressure and whether it can replace office blood pressure remains unclear. The aim of this study was to analyze the differences between the two blood pressure measurements.

Design and method:
The study dates from the Majiapu community, which is a big community in Beijing. We analyzed blood pressure with different measurements containing tunnel (waiting area,9002P) and upper arm (clinic, OMRON 1120U) blood pressure measurements. We compare the two measurements by the mean average value and standard deviation (SD) of the two measurements. Besides, we compare the mean blood pressure in the subgroups which contain the age, sex, blood lipids, blood glucose, and different blood pressure levels.

Results:
In this study, a cohort of 35069 individuals aged 0 to 105 years, 19443 were randomly assigned to the tunnel blood pressure measurement group (TBPG) and 15626 to the upper arm blood pressure measurement group (UBPG). The qualified rate of the UBPG was 64.76% in 140/90 mm Hg and 54.66% in 130/80 mm Hg. In baseline, the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.0±21.3 mm Hg and 76.3±12.0 in the TBPG, 134.9±22.3 mm Hg and 80.3±12.5 in the UBPG. In the age more than 60 years subgroup, the mean SBP in the TBPG with 139.0±21.1 mm Hg was similar to the other group, which was 138.5±22.4 mm Hg, the mean DBP was on the contrary, which was 74.8±11.4 and 79.6±11.9 mm Hg respectively. Similar results can be found in the age< 60 years, sex, blood lipids, and blood glucose subgroups. In the BP more than 140/90 mmHg subgroup, the SBP difference was only 0.1 mmHg, but the DBP was 5 mmHg, as same as the BP more than 130/80 mmHg subgroup. The DBP difference was much smaller in the low BP level.

Conclusions:
The clinic SBP for the tunnel (waiting area) and upper arm (clinic) blood pressure monitors were similar, but the DBP differ significantly between the two groups.
ASSESSING THE QUALITY OF PHOTOPLETHYSMOGRAPHY SIGNALS FOR ARTERIAL PULSE WAVE SENSING
Authors: Villeneuve Emma , Auclair Loïc , Prada-Mejia Robinson , Anglade Daniel , Sandre-Ballester Caroline , Gerbelot Rémi , Blandin Pierre , Perriollat Mathieu 
Published: June 2023

Objective:
Cardiovascular health has an impact on the arterial blood pulse wave features, such as shape and speed. Photoplethysmography (PPG) allows measuring the light absorption variation in the skin due to the blood pulse wave. This study aims at collecting good quality PPG signals for pulse wave sensing. First, the signal quality must be accurately defined and quantified. Then, it must be assessed for several sensor locations during both rest and exercise.

Design and method:
Based on ECG peaks, the PPG signal is split into beats, which are then fitted to a 4-long piece-wise linear function. Beats are valid only if they follow a specific slope pattern (the second slope has the opposite sign to the other three), and if they have a dichrotic notch. The signal quality is then quantified by the percentage of valid beats.
The initial cohort of the clinical trial (NCT05393401, approved by Human Research Review Board (CPP SM I) and Health French Ministry) includes five healthy subjects (1F/4M, age [37-60] years). Their brachial and radial arteries are located by ultrasound. Each subject is monitored with a multi-sensing homemade platform with PPG sensors and ECG; the distance between the LED and the photodiode is 9mm. Measurements are realized with sensors directly above the artery on the elbow, the wrist and the carotid, first at rest and then during a physical exercise.

Results:
Based on these preliminary results, the quality of PPG signals is best at the wrist whether at rest (48%) or exercise (44%). The second best option is the forearm and the worst is the carotid. The quality during exercise is similar, with a decrease of 4% at the wrist.

Conclusions:
The signal quality of PPG sensors is strongly impacted by the position along the arteries. The pressure applied on sensors and the extended arm posture also improve the signal quality. Further work should be undertaken to study the feasibility of pulse wave analysis for ambulatory blood pressure monitoring.
HIGH BLOOD PRESSURE IN WOMEN ACCORDING TO CARDIOVASCULAR RISK FACTORS AND ANTIHYPERTENSIVE TREATMENT: THE IMPORTANCE OF DETECTION
Authors: Barragan Adriana Puente , Hiciano Cecilia Jimenez 
Published: June 2023

Objective:
To evaluate the relationship between the presence of high blood pressure in a group of Mexican women, according to cardiovascular risk factors and antihypertensive treatment.

Design and method:
We analyzed the data of 341 women, > 18 years, with multiple risk factors, who attended cardiovascular imaging department. Cardiovascular risk factors and antihypertensive treatment were analyzed. Hypertension was classified according to the European Society of Cardiology (ESC) Guidelines (SBP >140 mmHg and DBP > 90 mmHg). Statistical analysis: SPSS v23; descriptive and comparative analysis with chi-square, confidence level 95%.

Results:
Mean age 58±15.6; Cardiovascular risk factors: hypertension 201 (58.9%), diabetes126 (37%), 136 (40%) dyslipidemia, tobacco use 97 (27.8%), chronic kidney disease 63 (18.5%); 248 (72.7%) were menopausal. A total of 198 (58.1%) patients with hypertension were on pharmacological treatment: 88 (44.5%) with monotherapy, 85 (42.9%) on dual therapy, and 25 (12.6%) with multiple therapies; (46.4%) were non-controlled. There were 143 (41.9%) patients, that were detected and classified as hypertensive according to European Society of Hypertension guidelines: Grade 1 88 (61.5%), Grade 2, 22 (15.38%), Grade 3, 6 (4.1%). A relationship between hypertensive women, kidney disease (47.6%, p = 0.001), and menopause was found (37.9%, p: 0.039).

Conclusions:
Hypertension is an important cardiovascular risk factor in women. Most are associated with others risk factors; more than fifty percent were on multiple therapy and uncontrolled. It is necessary to optimize antihypertensive treatment to improve hypertension control, especially in postmenopausal women and with kidney disease. Screening also must be improved to prevent future complications.
CONICAL CUFFS SHOULD BE USED AS REFERENCE STANDARD FOR VALIDATION OF BLOOD PRESSURE MEASURING DEVICES IN OBESE PEOPLE WITH ARM CIRCUMFERENCE OF MORE THAN 42 CM
Authors: Palatini Paolo , Fania Claudio , Saladini Francesca , Battista Francesca , Ermolao Andrea , Benetti Elisabetta , Rattazzi Marcello 
Published: June 2023

Objective:
Previous research suggested that tronco-conical cuffs and bladders should be used for accurate blood pressure (BP) measurement in the very obese. However, criteria about size and shape of the reference cuff that should be used for device validations in people with arm size > 42 cm have not yet been established by regulatory bodies. Aim of this study was to investigate the performance of a tronco-conical versus a rectangular (cylindrical) cuff in obese subjects with mid-arm circumference of 43 cm or larger.

Design and method:
In 90 adults with upper arm circumference > 42 cm (X-large group), 90 subjects with arm circumference between 36 and 42 cm, and 211 subjects with arm circumference < = 35 cm, cylindrical and tronco-conical cuffs were compared. Five cylindrical cuffs of appropriate size in relation to arm circumference and 5 tronco-conical cuffs having the same length and width on the midpoint were used. In the X-large group, the cuffs had 20 cm width and 40 cm length. The tronco-conical cuff had an 85.0̊ slant angle. In each subject, BP was measured in triplicate by two observers using the cylindrical and tronco-conical cuffs in a random order.

Results:
The mean±SEM upper arm slant angle was 84.7±0.07̊ in the X-large group, 85.6±0.07̊ in the 36-42 cm group, and 87.1±0.05̊ in the < = 35 cm group (all between-group differences, p<0.0001). In the X-large group, the cylindrical cuff overestimated BP measured with the tronco-conical cuff by 4.4±0.3/3.1±0.2 mmHg, in the 36-42 cm group by 1.5±0.3/1.6±0.2 mmHg, and in the < = 35 cm group by 0.8±0.2/0.1±0.2 mmHg (X-large versus both smaller arm subgroups, p<0.0001/<0.0001). In the whole population (1173 BP readings), both arm circumference and conical shape were independent predictors of the between-cuff SBP and DBP discrepancies. Skinfold thickness improved the predictive model for diastolic (p = 0.004) but not systolic BP.

Conclusions:
In obese people with arm size > 42 cm, a cylindrical cuff causes an important overestimation of BP measured with a tronco-conical cuff. We suggest that the reference cuff for validation studies in this special population should have a conical shape with an 85̊ slant angle.
CLINICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY AS A POTENTIAL INDICATOR OF MASKED HYPERTENSION AMONG THE KOREAN ELDERLY
Authors: Lee Dongyoung , Park Sungkeun 
Published: June 2023

Objective:
Although masked hypertension links to adverse cardiovascular outcomes, it is challenging to distinguish individuals with masked hypertension. Studies have demonstrated a significant association between left ventricular hypertrophy (LVH) and masked hypertension. However, it remains unclear whether electrocardiographic LVH has the predictability for masked hypertension.

Design and method:
The study participants were 511 Korean elderly with well-controlled blood pressure (BP) or normotension who underwent electrocardiography and ambulatory blood pressure monitoring (ABPM). We categorized them into two groups by presence or absence of electrocardiographic LVH. We conducted Pearson correlation analysis (beta coefficient [95% confidence interval] and logistic regression analysis (odd ratio (OR) [95% CI]) to evaluate the association of electrocardiographic LVH with components of ABPM. The area under the receiver operator curve (AUC) was calculated to assess the predictability of electrocardiographic LVH for 24-hour average masked hypertension.

Results:
Electrocardiographic LVH significantly correlated with 24-hour mean systolic blood pressure (SBP) (5.83 [2.16-9.51]), daytime SBP (5.0 [1.27-8.72]), and nighttime SBP (7.89 [3.49-12.30]). Electrocardiographic LVH showed the increased OR for masked hypertension in 24-hour average BP (2.18 [1.17-4.07]), in daytime average BP (2.03 [1.09-3.79]), and nighttime average BP (1.83 [0.86-3.88]). The receiver operating curve indicated the significant predictability of electrocardiographic LVH for 24-hour average masked hypertension (area under the curve: 0.706 [0.604-0.809]).

Conclusions:
Electrocardiographic LVH is potentially effective in distinguishing individuals with masked hypertension.
PREVALENCE OF THE WHITE COAT EFFECT IN A POPULATION OF HYPERTENSIVE PATIENTS
Authors: Hamdani Achref , Bayar Mohamed Fehmi , Ajra Zaineb , Gheni Refaat , Rashikou Lamia , Hmida Riadh Ben , Ounissi Taha , Elhadj Zied Ibn 
Published: June 2023

Objective:
The white coat effect (WCE), defined as elevated office blood pressure (BP) and normal out-of-office BP, is of great importance in medical practice since it leads to overestimate the degree of BP figures. The objective of the study is to determine the prevalence of WCE in treated and untreated hypertensive patients.

Design and method:
we conducted an analytical cross-sectional study including 100 patients aged > 18 years, followed at the outpatient cardiology clinic of the Mohamed Taher Maamouri university hospital in Nabeul over a six months period (July-December 2021). The BP measurement in the office was performed on the day of inclusion.
Patients were asked to measure BP at home as instructed by the physician using validated blood pressure self-measurement devices (MICROLIFE BP A3 PLUS, MICROLIFE BP A2 Basic and Beurer BM 40 ). These devices were loaned to the patient who had to return them on the day of the ABPM installation. Laying of ABPM was performed immediately after the HBPM using a Bravo Mini validated device from Sun Tech Medical.
The comparisons of percentages were carried out by the Chi-square test.

Results:
The average age of our population was 59.14±13.12 years (range 21-92 years), composed of 47 women and 53 men. 84% of the population has treated hypertension. The prevalence of WCE was 30% in HBPM and 27% in ABPM, 26 patients (31%) and 21 patients (25%) were objectified in treated hypertension respectively by HBPM and ABPM. The difference between these two methods was not statistically significant (p = 0.198).

Conclusions:
The prevalence of WCE was high in this population. HBPM and ABPM are two effective methods for diagnosing and confirming this phenomenon.
KOROTKOFF SOUNDS DO NOT PROVIDE AN ACCURATE ESTIMATE OF SYSTOLIC AND DIASTOLIC PRESSURE IN SPHYGMOMANOMETRY AND CANNOT BE USED AS A CALIBRATION STANDARD FOR NIBP DEVICES
Authors: Celler Branko , Yong Andy , Rubenis Imants , Butlin Mark , Argha Reza , Rehan Rajan , Avolio Alberto 
Published: June 2023

Objective:
Noninvasive blood pressure (NIBP) devices are calibrated against validated auscultation sphygmomanometers using Korotkoff sounds. This study aimed to investigate the timing of Korotkoff sounds in relation to pulse appearance in the brachial artery and values of intra-arterial blood pressure.

Design and method:
Experiments were carried out on 15 participants, (14 males, 64.3 ±10.4 years; one female, 86 yo), undergoing coronary angiography. A conventional (oscillometric) BP cuff, with a microphone for Korotkoff sounds, was placed on the upper arm. Intra-arterial brachial artery pressure (IABP) was measured below the cuff with a fluid-filled catheter inserted via the radial artery and an external transducer. Finger photoplethysmography was used to measure brachial pulse wave velocity (PWV). Korotkoff sounds were processed electronically and custom algorithms identified the cuff pressure (CP) at which the first and last Korotkoff sounds were heard. PWV and max slope of the IABP pressure pulse were recorded to estimate arterial stiffness.

Results:
The brachial artery closed at a CP of 132.0±17.1 mmHg. Systolic (SBP), and diastolic (DBP) pressure were 147.6±14.3 and 72.7±10.1mmHg; mean pressure (MP, 100.1±10.4 mmHg) was similar to MP derived from the peak of the oscillogram (98.5±13.6 mmHg). Difference between IABP and CP recorded at first and last occurrence of Korotkoff sounds were, SBP: 18.9±8.3 (range 2-29) mmHg, DBP: 4.0±4.3 (range -1.6 -12.4) mmHg. Multiple linear regression showed that differences increase with arterial stiffness and can be compensated for using a prediction equation for calculation of true SBP (tSBP) using heart rate (HR) and Korotkoff derived systolic (SBPk) and diastolic (DBPk), at least over the limited age range for this study cohort.

Conclusions:
SBP and DBP derived from the onset and termination of Korotkoff sounds can underestimate IABP by up to 29 mmHg. Since Korotkoff sounds are the recommended method mandated by the universal standard for the validation of blood pressure measuring devices, these errors are propagated through to all NIBP measurement devices irrespective of whether they use auscultatory or oscillometric methods thus explaining the well known differences recorded between NIBP measurements and intra-arterial BP measurements.
AN EQUIVALENT MEASUREMENT PERFORMANCE OF THE AKTIIA BRACELET IS OBSERVED IN THE ADULT AND ELDERLY POPULATIONS
Authors: Almeida Tiago Paggi de , Damianaki Aikaterini , Sola Josep , Theiler Kenji , Alexandre Jérémy , Vermare Pascale , Perruchoud David , Shah Jay , Wuerzner Grégoire 
Published: June 2023

Objective:
It remains unclear whether non-occlusive blood pressure (BP) monitoring devices yield equivalent performance across different age categories. We sought to compare the performance of BP measurements conducted by the Aktiia cuffless monitor in the adult and elderly populations, in different body positions.

Design and method:
Two cohorts of patients (adult, 21-65 years; elderly, 65-85 years) were recruited for a prospective clinical study (NCT04027777, Lausanne University Hospital, Switzerland, August/2019–March/2022). During 4 visits spread over a month, systolic/diastolic BP (SBP, DBP) measurements obtained by the cuffless Aktiia G1 Bracelet (Aktiia SA, Switzerland) were compared to double-blinded auscultation in sitting, standing and lying positions after initial calibration. The two ISO 81060-2 criteria were used to compare BP measurements by Aktiia and auscultation (BP-reading-level – criterion 1; subject-level – criterion 2) in the sitting position – as no ISO criteria exists so far for other body positions.

Results:
96 adult (38±12 years)/35 elderly (73±6 years) were included in the study. Of those, 84 adult/35 elderly patients were investigated in sitting position; 91 adult/35 elderly in all body positions. Average SBP and DBP were higher in the elderly cohort (SBP 133.9±17.7 vs. 116.4±20.3 mmHg, P<0.0001; DBP 77.9±11.7 vs. 74.5±12.0 mmHg, P<0.0001). On sitting position at BP-reading-level, SBP and DBP for both cohorts were within ISO targets for mean error and SD (Table 1). At subject-level, the SD of the mean paired differences per subject were within individual ISO targets for SBP and DBP on both cohorts. Statistically significant differences between cohorts were found only at BP-reading-level for all body positions (SBP: P = 0.0127; DBP: P = 0.0199). Figure 1 highlights the biases and correlations of SBP and DBP readings between the cuffless BP monitor and auscultation for both adult and elderly cohorts.

Conclusions:
The investigated cuffless BP monitor yielded equivalent BP measurements compared to auscultation, with similar performance in the adult and elderly populations.
IMPACT OF CELIPROLOL THERAPY ON BLOOD PRESSURE AND HEART RATE IN PATIENTS WITH VASCULAR EHLERS-DANLOS SYNDROME
Authors: Buso Giacomo , Paini Anna , Ciuceis Carolina De , Rosei Claudia Agabiti , Bertacchini Fabio , Stassaldi Deborah , Aggiusti Carlo , Orlando Maria , Ritelli Marco , Venturini Marina , Salvetti Massimo , Colombi Marina , Muiesan Maria Lorenza 
Published: June 2023

Objective:
Vascular Ehlers-Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol is a beta1-adrenoceptor antagonist with partial beta2 agonist activity that has been shown to reduce rates of vascular events in this setting, though the underlying mechanisms are not yet fully understood. Aim of the present study was to assess the impact of Celiprolol on blood pressure (BP) and heart rate (HR) in patients with vEDS.

Design and method:
Patients with genetically confirmed disease referred to our Institution between 2011 and 2022 were divided into two groups according to whether or not they were on Celiprolol therapy. The former were included if on Celiprolol at the dose of 400 mg daily for at least 12 months. Each participant underwent office blood pressure (BP) measurement, 24-h ambulatory BP monitoring (ABPM), and pulse wave analysis (PWA) of the radial artery with calculation of central pulse pressure (PP) and augmentation index (AIx).

Results:
Overall, 18 patients (11 females) were included. Mean age was 36 years and mean body mass index (BMI) was 22.1 kg/m2. Eleven patients were on Celiprolol therapy. No significant differences were found between groups in terms of age, sex, BMI, and presence of hypertension (p>0.05). Patients on Celiprolol therapy displayed higher values of systolic BP (SBP) (124 vs 113 mmHg; p = 0.128), diastolic BP (DBP) (76 vs 67 mmHg; p = 0.236), mean BP (92 vs 83 mmHg; p = 0.173), and HR at office BP measurement, as well as lower AIx (126 vs 140%; p = 0.176) at PWA, although the difference was not statistically significant. Similarly, no significant difference was found for all ABPM parameters (24-h, day-time, and night-time SBP, DBP, mean BP, and HR), as well as central SBP, central DBP, central mean BP, and PP at PWA between groups (p>0.05).

Conclusions:
Our study suggests little impact of Celiprolol therapy on both BP and HR in patients with vEDS, which hints additional mechanisms behind its protective effect in this clinical setting. Further studies on larger cohorts are needed to clarify these aspects.
COMPARISON BETWEEN CENTRAL AND AUTOMATED PERIPHERAL BLOOD PRESSURE MEASUREMENT FOR EARLY DETECTION OF KIDNEY DYSFUNCTION IN HYPERTENSIVE PATIENTS
Authors: Abdel-Galeel Ahmed , Fawzy Nader , Ali Wageh , Fouad Doaa 
Published: June 2023

Objective:
To assess the difference of blood pressure measurements using central and automated peripheral blood pressure measurement (oscillometric) devices among patients with primary hypertension for early detection of kidney dysfunction and the validity of automated BP measurement device compared with non-invasive central BP measurement device for diagnosis of hypertension.
Also, to link between parameters such as augmentation index and pulse wave velocity index and early kidney dysfunction markers.

Design and method:
The study is a case-comparative study that included 201 patients with primary hypertension (108 patients with chronic kidney disease and 93 patients without kidney disease). Exclusion criteria were patients presenting with secondary hypertension, diabetes mellitus (DM), end stage renal disease (ESRD) on regular dialysis, young patients below 40 and above 70 years old and patients with collagen diseases. All patients underwent blood pressure measurement by OMRON M2 and Mobil-O-Graph devices, kidney function assessment and abdominal ultrasonography.

Results:
Patients with chronic kidney disease were significantly older (60.02±9.1 vs. 55.33±8.5; P < 0.001), with longer duration of hypertension (7.56±5.9 vs. 6.05±5.8; P = 0.020) in comparison to those without chronic kidney disease. Automated peripheral measurement of systolic blood pressure, diastolic blood pressure and pulse pressure were significantly higher in comparison to central blood pressure. Patients with chronic kidney disease had significantly higher augmentation index (24.06±12.6 vs. 19.02±10.8; P < 0.001) and pulsed wave velocity (8.66±1.5 vs. 8.69±6.8; P = 0.004) in comparison to those without chronic kidney disease. Augmentation index had positive correlation with pulse wave velocity (r = 0.183, P = 0.005). There was negative correlation between both pulse wave velocity and augmentation index and estimated glomerular filtration rate (r = -0.318, P < 0.001), and (r = -0.236, P < 0.001), respectively. Hence, arterial stiffness parameters are good positive test for prediction of chronic kidney disease.

Conclusions:
There is a strong agreement between non-invasive centrally and automated peripherally measured blood pressure in diagnosis of hypertension. But non-invasive central measurements are preferred over automated measurements for early prediction and detection of renal impairment.