bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIFFERENTIAL DETERMINANTS OF AMBULATORY VS. HOME MORNING BLOOD PRESSURE MEASURED BY A SINGLE MULTISENSOR BLOOD PRESSURE MONITORING DEVICE: THE HI-JAMP STUDY BASELINE DATA
Authors: Tomitani Naoko , Hoshide Satoshi , Kario Kazuomi 
Published: June 2023

Objective:
Out-of-office blood pressure (BP) monitoring using ambulatory BP (ABP) monitoring (ABPM) and home BP (HBP) monitoring (HBPM) is recommended for hypertension management. However, BP level measured by ABPM and HBPM may not be consistent even when evaluated the same time-window, morning. This study investigated the determinants of the difference between ABP and HBP in the morning time measured by a multisensor BP monitoring device equipped with a high-sensitivity actigraph and a thermometer.

Design and method:
Medicated hypertension patients enrolled in the Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective (HI-JAMP) Study consecutively underwent office BP monitoring, 24-h ABPM (with 30-min intervals), and 5-day HBPM (twice each morning and evening) using the same multisensor BP monitoring device (TM-2441; A&D Company, Tokyo). Morning ABP (average of 4 readings within 2-h after waking) and morning HBP (average of HBP readings measured in the morning over a HBPM period) were compared. In addition, this device recorded the wearer's fine-scale physical movement during a 24-h ABPM period and stored temperature data at the time of each BP measurement. Hourly averages of physical activity and temperatures at the time of HBPM (i.e., room temperature) were used for the analysis.

Results:
Among 2322 patients (males 53.2%, 69.2±11.5 years, average office systolic BP [SBP] 132.8±18.8 mmHg), morning home SBP was 2.4 mmHg higher than morning ambulatory SBP with standard deviation of 15.9 mmHg (ABP < HBP). In a multivariable analysis including conventional risk factors, older age and larger number of antihypertensive agents were significantly associated with [HBP > ABP], while history of cardiovascular disease (CVD) was significantly associated with [ABP > HBP]. In the analysis additionally including physical activity in the morning and room temperature at the morning HBP measurement, higher activity level was significantly contributed to [ABP > HBP] and lower room temperature was significantly contributed to [HBP > ABP].

Conclusions:
In treated hypertensive patients, HBPM is recommended especially if the patient is older, taking multiple antihypertensive agents, or living in an environment with lower room temperatures in the winter, while ABPM is recommended if the patient has a history of CVD.
RELIABILITY AND RELEVANCE OF 24H AMBULATORY BLOOD PRESSURE MONITORING IN DAY TO DAY TREATMENT OF ARTERIAL HYPERTENSION
Authors: Neumann Claas Lennart , Wietoska Torsten , Schulz Egbert G. 
Published: June 2023

Objective:
Blood pressure measurements are the basis of diagnosis, treatment and research of arterial hypertension and its sequelae. All decisions hinge on the validity of the measurement method. Here, the ABPM is considered best practice. Evaluation of ABPM, notwithstanding known issues like availability and economy, regarding its validity, accuracy and applicability to clinical practice was investigated.

Design and method:
We retrospectively consider 450 ABPMs executed using validated devices from Nephrology Center Göttingen (ESH-Excellence-Center). This work evaluates the measurements’ adherence to diagnostic guidelines (ESH) with respect to sources of error, count of valid measurements and cancellation by patient.
Criteria for validity are:
- Minimum 24 h recording duration.- At least 20 valid day and 7 valid night measurements- Minimum of 70 percent valid measurements in total

Cancellation by the patient is assumed if:
- Recording duration is below 22h without indication of technical fault or measurement is stopped prior to 7 30 a.m.

Results:
23 % (n = 106) of 450 ABPM considered to meet all guideline criteria. Remaining 77 % of measurements failed at least one criterion. In 27 % (n = 120), measurement duration was below 24 h and for 22 % (n = 98) it was below 22 h. In 2.6 % (n = 12) minimum amount of daytime (n = 3) and night-time (n = 9) data points was not met. Requirement for at least 70 % of valid data points was failed by 23.5 % (n = 105). Here the source of error were motion artefacts in about 50 % of cases, pressurisation issues during the day in 17 % (n = 15) and 27 % (n = 11) at night and kinks in tubing in 14 % (n = 12) during daytime. About 20.6 % (n = 93) of ABPM were preliminary cancelled by the patient which amounts to approximately a quarter (25.4 %) of all measurements failing the guideline criteria.

Conclusions:
Value of ABPM hinges on guideline conforming execution of measurements and should therefore be explicitly discussed with the patient. Quality of data obtained by an ABPM needs to be examined for every case to ensure its validity to justify a course of action.
RELATIONSHIPS OF OFFICE, AMBULATORY, AND HOME BLOOD PRESSURE WITH ORGAN INJURY BIOMARKERS
Authors: Narita Keisuke , Hoshide Satoshi , Kario Kazuomi 
Published: June 2023

Objective:
International guidelines recommend out-of-office blood pressure (BP) monitoring including ambulatory and home BP. Although the superiority of ambulatory and home BP is controversial, home BP is more prevalent in plactice and there is a gap with the guidelines. We assessed this issue by conducting the analysis of relationship of BP with clinical biomarkers.

Design and method:
We analyzed the relationship of office, ambulatory, and home BP with organ injury biomarkers including urine-albumin creatinine ratio (UACR), serum b-type natriuretic peptide (BNP), serum high-sensitive troponin T (hsTnT), echocardiographic left ventricular mass index (LVMI), and brachial-ankle pulse wave velocity (baPWV) in 1,172 outpatients who underwent both ambulatory and home BP measurements and examined serum and urine tests and others.

Results:
In the univariate analysis of Pearson's correlation, average of morning and evening home systolic BP (SBP) was strongly related with log-transformed BNP, log-transformed hsCRP, LVMI, and baPWV compared with 24-h ambulatory systolic BP (log-transformed UACR [n = 1432], r = 0.24 in home SBP versus r = 0.18 in ambulatory SBP, P = 0.17 in z-test for comparison of these correlations; log-transformed BNP [n = 1432], r = 0.17 vs. r = -0.04, P<0.01; log-transformed hsTnT [n = 1092], r = 0.19 vs. r = -0.03, P<0.01; LVMI [n = 1036], r = 0.23 vs. r = 0.10, P<0.01; baPWV [n = 1361], r = 0.31 vs. r = 0.08, P<0.01). In the multivariable linear regression models for log-transformed BNP, log-transformed hsTnT, and LVMI, the model-fit were improved when adding home SBP to the model including 24-h ambulatory SBP, but these relationships were not shown in vice versa. In addition, we also used Structural Equation Modeling for assessment of relationship of office, ambulatory, and home SBP with clinical biomarkers.

Conclusions:
Our findings suggested the superiority of home BP in the relationship with several biomarkers for hypertensive organ damage compared with ambulatory BP, which may provide a rationale for the management on hypertension using home BP monitoring in clinical practice conducted in many countries including Japan.
UNDERSTANDING THE REALITY OF HIGH BLOOD PRESSURE SCREENING AND MONITORING IN THE RURAL POPULATION FROM THE CROATIAN RURAL AREA DAMAGED BY AN EARTHQUAKE: “THE SILENT KILLER HUNT”
Authors: Kroflin Karla , Kristo Matej , Krstanovic Kristina , Luzaic Karla , Lasta Sven , Mijalic Lovro , Jelakovic Bojan 
Published: June 2023

Objective:
Arterial hypertension (AH) is the most important independent risk factor for cardiovascular diseases. Unfortunately, less than half of adults with hypertension are diagnosed and treated. It is well known that home blood pressure (BP) monitoring is a useful method for follow-up and for detecting patients with asymptomatic hypertension. Home BP monitoring is inexpensive and well-accepted by patients, which are both great benefits for the screening method. The prevalence of AH in Croatia differs by region, in addition, residents of rural areas have poorer access to healthcare. The aim of this study was to find the prevalence of AH in subjects who did not report a medical history of AH and to find the prevalence of subjects who own home BP monitors in rural areas.

Design and method:
A total of 214 participants (opportunistic screening) were asked about previous AH diagnoses and whether they own a home BP monitor in our cross-sectional survey. BP was measured following ESH guidelines using Microlofe oscillometric device. AH stage 1 was considered if systolic BP was 130 mmHg or higher, or diastolic 80 mmHg or higher.

Results:
Out of a total of 214 respondents, 120 respondents (56%) reported that they had AH. In a group who answered that either they didn’t have or didn’t know if they had AH, high BP was measured in 61.96%.
Interestingly, only 46 (21.5%) reported that they do not have a home BP monitor, and 168 participants (78.5 %) confirmed having a BP monitor at home.

Conclusions:
Our results revealed poor awareness of AH and showed the utility of the AH screening intervention, particularly in rural areas. More research is needed to determine the best screening methods and further applications for the general population. Our findings may also help healthcare workers to understand the potential of home BP monitoring for their patients because a large number of survey respondents even in rural areas own a BP monitor. This discovery can enhance the quality of patient education, patient-physician relationship, and follow-up practice for successful BP monitoring.
THE FEASIBILITY OF CUFFLESS, NON-OCCLUSIVE BLOOD PRESSURE ASSESSMENTS USING THE NOVEL LIFELEAF WRISTWATCH AND PLATFORM
Authors: Almahmeed Wael , Kumar Dilip , Mbouombouo Benjamin , Banerjee Nilanjan , Sanyal Alodeep , Sen-Gupta Indranil 
Published: June 2023

Objective:
Hypertension affects 1.3 billion people worldwide and is the leading cause of myocardial infarction and stroke. Successful treatment of hypertension continues to be a global challenge, likely given that the most common tool for assessment is the sphygmomanometer, which can be time-consuming and cumbersome to utilize on a consistently compliant basis. More straightforward means of blood pressure (BP) measurement may facilitate earlier detection and closer monitoring of hypertension, thereby helping to alleviate potential comorbidities. The ability to seamlessly collect longitudinal BP data could also enhance ambulatory blood pressure monitoring, which is preferred over in-office BPs for tracking hypertension and decisions regarding pharmacotherapy. BP measurements in the ambulatory setting may also be more representative of true BPs by eliminating white coat syndrome. We therefore investigated the reliability of performing BP measurements via a novel cuffless, non-occlusive photoplethysmography (PPG)-based wristwatch compared to a standard automatic BP cuff reference.

Design and method:
The LIFELEAF® wristwatch (LifePlus, Inc., San Jose, CA) utilizes novel signal processing and machine learning (ML) algorithms to predict real-time systolic and diastolic blood pressures (SBP and DBP) using features extracted from PPG signal at the wrist. 274 total subjects from 3 centers (Cleveland Clinic Abu Dhabi, UAE; Hospital Sebarang Jaya, Malaysia; and iKure Clinic, India) were enrolled. Subjects were outpatients 18 years of age or older; females who were gravid or actively trying to conceive were excluded. Automatic BP cuff reference measurement on the left arm was immediately followed by 1 minute of wristwatch PPG signal acquisition on that arm. An average of 10.77 paired data acquisitions per subject were collected. Datasets were randomly split for model training (60%) and prediction (40%).

Results:
There were no significant differences in mean SBP or mean DBP between cuff reference measurements and wristwatch predictions. The wristwatch-predicted SBPs and DBPs also demonstrated significant linear correlation with cuff reference values.

Conclusions:
Longitudinal SBP and DBP measurements are feasible via non-occlusive methods incorporating sophisticated signal processing and machine learning (ML) applied to wrist PPG. Further algorithmic improvements to accuracy may improve BP/hypertension tracking by facilitating assessments compared to conventional sphygmomanometers.
CORRELATION BETWEEN CLINIC AND AMBULATORY BLOOD PRESSURE MEASUREMENT
Authors: Hamdani Achref , Bayar Mmohamed Fehmi , Ajra Zaineb , Gheni Refaat , Rashikou Lamia , Hmida Riadh Ben , Ounissi Taha , Elhadj Zied Ibn 
Published: June 2023

Objective:
Blood pressure (BP) measurements taken in the clinic provide limited information about the BP load. Ambulatory blood pressure monitoring (ABPM) provide a more comprehensive assessment of blood pressure over the course of a day. This study examined the correlation between clinic and ambulatory BP measurements.

Design and method:
We collated clinic and 24 hour ambulatory BP data of 100 patients aged > 18 years from the outpatient cardiology clinic of Mohamed Taher Maamouri University hospital in Nabeul (n = 100) over a six months period (July-December 2021).
Laying of ABPM was performed using a Bravo Mini validated device from Sun Tech Medical.
We used the Pearson correlation coefficient (r) to measure the strength of the relationship between these two measurements methods.

Results:
The mean age of our population was 59.14±13.12 years (range 21-92 years), composed of 47 women and 53 men. The most frequent reason for carrying out ABPM was the monitoring of hypertensive patients in 84% of cases, 16% were done to confirm the diagnosis of hypertension. ABPM confirmed the diagnosis of hypertension in 62.5% and detected 18.75% isolated nocturnal hypertension in patients with suspected hypertension and 14.3% masked uncontrolled nocturnal hypertension in hypertensive patients.
Concordance was found in 66% of cases between clinic measurement and the 24-hour ABPM data. There was a weak correlation between clinic systolic BP and 24-hour ambulatory systolic BP (P <0.001; r = 0.349; Curve A) and moderate correlation between clinic diastolic BP and 24-hour ambulatory diastolic BP (P <0.001; r = 0.566; Curve B).

Conclusions:
The correlation between these two methods isn’t important mainly explained by variation of BP especially at night detected by ABPM which remains the reference method for diagnosing and monitoring hypertension
PREVALENCE OF WHITE-COAT AND MASKED HYPERTENSION AT DIFFERENT OFFICE BLOOD PRESSURE LEVELS IN UNTREATED SUBJECTS
Authors: Dragonas Damianos , Spiliopoulou Sotiria , Tsoutsoura Nefeli , Lykka Aikaterini , Dimitriou Athina , Manios Efstathios 
Published: June 2023

Objective:
The European Guidelines for the management of arterial hypertension support the use of out-of-office blood pressure (BP) measurements for confirming the diagnosis of hypertension and detecting BP phenotypes such as white-coat hypertension (WCH) and masked hypertension (MH), especially in patients with grade 1 hypertension and subjects with high normal BP. However, it is not clear enough, whether out-of-office blood pressure measurements should be performed in patients with higher grades of hypertension as well as in subjects with normal or optimal BP. The aim of our study was to investigate the prevalence of WCH in untreated patients with grade 1, grade 2 and grade 3 hypertension as well as the prevalence of MH in never treated subjects with high normal, normal and optimal BP values.

Design and method:
A total of 2357 untreated subjects referred to our Hypertension Unit for evaluation underwent 24-h ambulatory BP monitoring. According to their office BP levels were divided into 6 categories: optimal (<120/80mmHg), normal (120/80 – 129/84mmHg), high normal (130/85 – 139/89mmHg), grade 1(140/90 – 159/99mmHg), grade 2 (160/100 – 179/109mmHg) and grade 3 (> = 180/110mmHg). Subjects with office BP> = 140/90mmHg and 24-h BP<130/80mmHg were defined as WCHs and patients with office BP<140/90mmHg and 24-h BP> = 130/80mmHg as MHs. Statistical analysis was performed by means of chi-square test and one-way ANOVA.

Results:
The percentages of WCH were 53%, 31% and 24% for patients with grade 1, grade 2 and grade 3 hypertension, respectively. The percentages of MH were 34%, 29% and 17% for patients with high normal, normal and optimal BP, respectively.

Conclusions:
The prevalence of WCH is significantly higher in grade 1 hypertension, however patients with grade 2 and 3 hypertension present also high rates of WCH. Similarly, MH is more common in subjects with high normal BP, however high percentages are observed in subjects with normal and optimal BP. Our results support that out-of-office BP measurements should be performed across all office BP range for the optimal detection of WCH and MH.
EVALUATION OF DIAGNOSTIC ACCURACY OF NOCTURNAL HOME BP MONITORING IN HEMODIALYSIS PATIENTS: A PILOT STUDY
Authors: Leondifou Kalia , Kontogiorgos Ioannis , Kollias Anastasios , Vaios Vaslilios , Georgianou Eleni , Karpetas Antonios , Zebekakis Pantelis , Stergiou George S. , Liakopoulos Vassilios , Georgianos Panagiotis 
Published: June 2023

Objective:
A unique advantage of ambulatory blood pressure monitoring (ABPM) is that this technique enables the assessment of blood pressure (BP) during the period of sleep, facilitating the diagnosis of nocturnal hypertension. This study aimed to compare ABPM with home BP monitoring (HBPM) performed with a novel device that is designed to obtain daytime and also automated nighttime BP recordings in the assessment of nocturnal hypertension and detection of non-dipping BP pattern among patients on hemodialysis.

Design and method:
Within a period of 2 weeks, 70 stable patients on thrice-weekly hemodialysis underwent assessment of BP with 2 methods: (i) 44-hour interdialytic ABPM (20-min intervals; Microlife WatchBP O3 device) and (ii) HBPM (duplicate morning and evening BP recordings for 7 days and 3 BP recordings per night for 3 nights over the 3-day interdialytic interval; Microlife WatchBP Home N).

Results:
The mean age of the patients was 65.3 (±13.3) years; 45 (64%) were males, and 62 (88.7%) were receiving antihypertensive therapy. The average ambulatory daytime and nighttime SBP/DBP were 122.8±15/68.7±10.5 mmHg and 117.2±16.5/63.4±10.2 mmHg, respectively. The mean [95% confidence interval (CI)] difference between home daytime SBP and ambulatory daytime SBP was 8.61 (6.1, 11.2) mmHg. Similarly, the mean (95% CI) difference between home nighttime SBP and ambulatory nighttime SBP was 5.94 (3.5, 8.4) mmHg. In receiver-operating-characteristics (ROC) analysis, the technique of HBPM provided high accuracy for the detection of an average ambulatory daytime SBP equal or higher than 135 mmHg [area under the curve (AUC): 0.934; 95% CI: 0.871-0.996] as well as for the detection of an average ambulatory nighttime SBP equal or higher than 120 mmHg (AUC: 0.876; 95% CI: 0.794-0.957). Of the overall population, 44 patients (63%) were classified as non-dippers by ABPM and 42 (60%) by HBPM. There was acceptable agreement between these 2 techniques in the identification of patients with a non-dipper BP pattern (77%, k-coefficient = 0.324).

Conclusions:
The present study shows that among patients on hemodialysis, HBPM serves as a reliable alternative to 44-hour interdialytic ABPM for the diagnosis of nocturnal hypertension and detection of non-dipping BP status.
FEWER ANTIHYPERTENSIVE DRUGS ACHIEVE STRICTER BLOOD PRESSURE TARGET IN LESS SEVERE HYPERTENSIVE PATIENTS: A RETROSPECTIVE STUDY IN A COMMUNITY IN BEIJING
Authors: Zhanyang Zhou , Shijie Yang , Miao Huanhuan , Zhang Yuqing 
Published: June 2023

Objective:
Nowadays, it is not clear how many antihypertensive drugs should be used to achieve treatment goals from real-world studies. This study aims to analyze the BP control situation and the burden of anti-hypertensive drugs in a big community in Beijing.

Design and method:
We conducted a retrospective study of 4991 residents living in the Majiapu community and collected the baseline and the follow-up data including blood pressure (BP) and drug prescription. BP was analyzed by the mean average value. Hypertension is defined as office systolic BP > = 140mmHg and/or diastolic BP > = 90mmHg. We divided the patient with antihypertensive treatment into a strict control group (BP<130/80mmHg) and a standard control group (BP range from 130-139/80-89mmHg). The comparison of baseline and follow-up data were used to recognize the burden of anti-hypertensive drugs for residents with hypertension and estimate the BP control rate in this population.

Results:
Of 4991 residents, the prevalence of hypertension was 54%, 34.80% (939) of the patients were under 140/90mmHg and 14.46% (390) were under 130/80mmHg. The control rate of standards of 140/90mmHg and 130/80mmHg among the whole population was 64.7% and 35.3%. And the treatment rate in the whole group of hypertension was 62.5%. In the standard control group, the average number of antihypertensive drugs was 1.66 keeping their BP range from 130-139/80-89mmHg, and the mean BP was 132.1±5.39/79.6±6.71mmHg. However, in the strict control group, the average number of antihypertensive drugs was 1.55, and the mean BP was controlled at 118.8±8.45/71.6±5.79mmHg (P<0.05). There were no differences between the two subgroups by age and smoking status. BMI in the strict group (24.6±3.3 kg/m2) was lower than the mild group (25.5±3.3kg/m2, p<0.01). About 49.2% in the strict control group and 47.0% in the standard control group were combined with lipid-lowing drugs. The LDL levels in the standard control group (2.8±0.8mmol/l) tended to be higher than that in the strict control group (2.7±0.9mmol/l, p = 0.06).

Conclusions:
In the Majiapu community where BP controls were insufficient, patients had fewer antihypertensive drugs to achieve stricter targets may be due to the lower risk profile of the patients.