bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C08-3: TOO-LARGE AND TOO-SMALL CUFF SIZES RESULTS RESULTS IN SUBSTANTIAL BLOOD PRESSURE MEASUREMENT ERROR: RESULTS FROM THE CUFF(SZ) RANDOMIZED TRIAL
Authors: Brady Tammy Mcloughlin , Charleston Jeanne , Ishigami Junichi , Prokopowicz Greg , Miller Edgar , Matsushita Kunihiro , Appel Lawrence 
Published: January 2023

Objective:
Proper cuff-size based on measured mid-arm circumference is recommended for accurate blood pressure (BP) determination. The impact of mis-cuffing (using a too-small or too-large cuff) on BP when using an automated BP device has not been rigorously tested. We aimed to determine the effects of mis-cuffing on automated BP.

Design and Methods:
We conducted a randomized cross-over trial of 195 community-dwelling adults [mean age 54 yrs, 34% male (n = 67), 68% Black (n = 132)]. Participants had 3 sets of triplicate BP measurements (WelchAllyn ProB 2000) using an appropriately sized cuff and two additional cuff sizes (too-small and/or too-large), in random order.

Results:
31% (n = 60) of the study participants had systolic BP (SBP) > = 130 mmHg, and 36% (n = 71) had a body mass index > = 30 kg/m2. As shown in the Figure, among persons in whom a small adult cuff was appropriately sized, too-large cuffs resulted in significantly lower SBP readings [regular adult cuff: -3.6 (-1.7 to -5.6) and large adult cuff: -7.5 (-5.5 to -9.6)]. In contrast, among persons in whom an extra-large adult cuff was appropriately sized, too-small cuffs resulted in significantly higher SBP readings [large adult cuff: + 9.6 (+7.3 to + 11.9) and regular adult cuff: + 19.5 (+16.1 to + 22.9)]. Similar effects were seen for mis-cuffing when an appropriate cuff was either a regular adult cuff or large adult cuff. We also observed similar patterns for diastolic BP.

Conclusions:
Appropriate cuff selection is essential for accurate BP measurement. Choosing a too-large or too-small cuff can result in clinically meaningful errors in BP reading which could lead to under- or over-treatment of hypertension.
PS-C08-6: COMPARING BLOOD PRESSURE MEASUREMENTS BETWEEN A NOVEL CUFF-LESS EARPHONE-TYPE DEVICE BASED ON GREEN REFLECTED PHOTOPLETHYSMOGRAPHY AND A STANDARD CUFF-BASED SPHYGMOMANOMETER
Authors: Kanai Daisuke , Wakui Hiromichi , Sato Shohei , Lee Jihyoung , Urate Shingo , Tanaka Shohei , Tamura Kouichi 
Published: January 2023

Objective:
Blood pressure (BP) measurement with conventional sphygmomanometers often causes discomfort and pain to the users due to arterial occlusion pressure caused by the inflatable cuff, making it difficult to perform continuous or frequent measurements for rigid blood pressure control. Developing unconstrained wearable electronics that can measure BP continuously would be useful in the healthcare field. We have developed a novel earphone-type device for cuff-less BP monitoring based on photoplethysmography with green light. In the present study, we compared the measured BP values between this novel cuff-less BP monitoring device and a conventional cuff-based sphygmomanometer.

Design and Methods:
From August 2020 to October 2021, 20 healthy subjects and 40 hypertensive patients (outpatients attending Yokohama City University Hospital and Yokohama Minami Kyosai Hospital, Yokohama, Japan) were recruited. Each participant's BP was measured using the novel cuff-less BP monitoring device as well as a standard cuff-based sphygmomanometer under four different conditions: static, BP rising and falling, and reproducible after the one-month interval. The results of measurements under the four conditions were integrated and analyzed. The BP measurements were determined to be comparable between the standard cuff-based sphygmomanometer and the novel cuff-less earphone-type device, if the mean absolute difference (MAD) of the measurements was within 7 mmHg. We also performed Bland-Altman agreement analyses.

Results:
The participants’ characteristics were as follows. Male to female ratio was approximately 50% in both groups. Age was 27.5 [interquartile (IQR) 24.5–33.0] years old for the healthy subjects and 65.0 [IQR 49.5–74.0] years old for the patients with hypertension (HTN). BMI was 21.2 [IQR 20.1–22.5] kg/m 2 and 23.8 [IQR 21.8–24.9] kg/ m 2, respectively. MAD between the novel cuff-less device and the reference using the standard cuff-based sphygmomanometer among the healthy subjects was 5.8 mmHg for systolic BP (SBP) and 5.3 mmHg for diastolic BP (DBP). MAD in the patients with HTN was 7.8 mmHg for SBP and 4.4 mmHg for DBP. In Bland-Altman agreement analyses, mean difference in the healthy subjects was 2.7 (95% confidence interval [CI] −13.4, 16.8) mmHg for SBP and 2.4 (95% CI −10.7, 15.5) mmHg for DBP. Mean difference in the patients with HTN was 0.9 (95% CI −20.0, 21.9) mmHg for SBP and 0.7 (95% CI −10.9, 12.3) mmHg for DBP.

Conclusions:
Our newly developed cuff-less earphone-type device based on green reflected photoplethysmography able to predict BP in healthy subjects, but it was difficult to predict SBP in the patients with HTN.
PS-C09-2: EFFECT OF DIETARY APPROACHES TO STOP HYPERTENSION OR MEDITERRANEAN DIET ON BLOOD PRESSURE IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Filippou Christina , Thomopoulos Costas , Konstantinidis Dimitrios , Manta Eleni , Tatakis Fotis , Polyzos Dimitrios , Drogkaris Sotiris , Tsioufis Konstantinos 
Published: January 2023

Objective:
To determine whether the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet (MedDiet) is accompanied by blood pressure (BP) reduction in adults with and without hypertension.

Design and method:
We systematically searched Medline and the Cochrane Collaboration Library databases for randomized controlled trials (RCTs) investigating the BP effects of the DASH diet and the MedDiet in individuals with and without hypertension. We identified 30 RCTs (n = 5,545 participants) that explored the BP effects of the DASH diet compared to the control diet and 35 RCTs (n = 13,943 participants) that explored the MedDiet BP effects compared to the usual diet or another dietary intervention (e.g., lowfat diet). For each diet, the random-effects model was used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during followup.

Results:
Compared to the control diet, the DASH diet reduced SBP and DBP (difference in means: -3.2 mm Hg; 95% CI: -4.2, -2.3 mm Hg; P < 0.001, and -2.5 mm Hg; 95% CI: -3.5, -1.5 mm Hg; P < 0.001, respectively). Hypertension status did not modify the diets effects on BP reduction. Compared to the usual diet the MedDiet reduced SBP and DBP (difference in means: -3.1 mm Hg; 95% CI: -4.8, -1.3; P = 0.001, and -1.6 mm Hg; 95% CI: -2.6, -0.6; P = 0.002, respectively), while compared to all other active intervention diets or only to the low-fat diet the MedDiet did not reduce SBP or DBP. We were unable to compare the BP effects of the MedDiet between hypertensive and non-hypertensive patients, but in a limited number of studies conducted in normotensive individuals, the MedDiet BP effects were not significant.

Conclusions:
The adoption of the DASH diet or the MedDiet was accompanied by significant BP reduction in adults with and without hypertension. Our findings give further support to the current guidelines, supporting the adoption of a healthy, balanced diet, such as the DASH diet or the MedDiet.
PS-C09-4: PATIENTS PREFER HOME OVER AMBULATORY BLOOD PRESSURE MONITORING
Authors: Lustigova Eva , Wei Rong , Bowling Barrett , Cannavale Kimberly , Harrison Teresa N , Muntner Paul , Shimbo Daichi , Schwartz Joseph E , Sim John J , Qian Lei , Reynolds Kristi 
Published: January 2023

Objective:
Ambulatory blood pressure monitoring (ABPM) and home BP monitoring (HBPM) are two recommended approaches for measuring out-of-office BP. We assessed the willingness and preferences of older adults taking antihypertensive medication to complete out-of-office BP monitoring with ABPM or HBPM and if differences were present across demographic characteristics.

Design and method:
We conducted a survey within a prospective cohort study of patients aged 65 + years who were diagnosed with hypertension and taking antihypertensive medication within a diverse integrated health care system. Enrolled participants underwent 24-hour ABPM followed by HBPM for 7 days. Participants who completed both ABPM and HBPM were asked to fill out a self-reported survey on their willingness to undergo ABPM or HBPM if their healthcare provider suggested it, and their preferences for ABPM or HBPM. Group means were compared using t-tests. Chi-square or Fisher's exact test were used to compare group proportions.

Results:
We included 167 participants (mean age 74.3 years [range 65–95 years]; 55.7% female; 46.7% non-Hispanic white, 16.8% Hispanic, 15.6% non-Hispanic Black and 17.3% Asian and Pacific Islander; mean research office systolic/diastolic BP 131/68 mm Hg). Overall, 84.4% and 67.1% of participants reported that they would be completely or very willing to perform HBPM for a week and a 24-hour ABPM, respectively, if their doctor thought it would be helpful to measure out-of-office BP. Also, 77.2% (n = 129) of participants preferred HBPM, 21.0% (n = 35) preferred ABPM and 1.8% (n = 3) did not have a preference. A higher proportion of females versus males preferred HBPM (Table). There were no statistically significant differences in preference for ABPM or HBPM by age, race/ethnicity or mean research office BP.

Conclusions:
The study results suggest that most older adults taking antihypertensive medication may be willing to undergo either ABPM or HBPM if recommended by their physician. However, HBPM was preferred to APBM.
PS-C10-5: CORRELATION OF SERUM URIC ACID LEVELS WITH CERTAIN ANTHROPOMETRIC PARAMETERS AND ARTERIAL BLOOD PRESSURE IN OVER WEIGHT AND OBESE SUBJECTS
Authors: Verma Shivam 
Published: January 2023

Background:
Asymptomatic hyperuricemia without comorbidities predicts the development of hypertension. Moreover, hyperuricemia also contributes to the development of hypertension from prehypertension.

Aim:
To find out correlation of serum uric acid levels with certain anthropometric parameters and arterial blood pressure in over weight and obese subjects

Methodolgy:
The study included 224 urban drug naive over weight and obese Indian subjects above 18 years of age from general population of city of north India. Uric acid concentrations were estimated by the uricase method. Blood pressure was measured by using Automatic Digital Sphygnomanometer with mean of 3 readings following all standard pre requisite. Anthropometric measurements and information on lifestyle factors and disease history were collected by inperson meeting.

Results:
All participants of the study subjects had BMI more than 23.5. Correlation of weight, BMI, SAD, WHR, SBP & DBP was positively correlated & statistically significant. Pearsons Correlation between Anthropometric parameter and Serum Uric Acid

Conclusion:
Statistical data shows remarkable results for significant correlation of uric acid level with BMI, WHR, SAD, SBP & DBP. Hypertrophy results into and oxidative stress when the supply of energy starts to exceed the storage capacity of adipocytes, as a result adipokines such as interleukin-1, interleukin-6 and tumor-necrosis factor alpha are released more frequently which lead to low-grade chronic inflammation. Evidence indicates that uric acid can cause direct endothelial injury and dysfunction. Uric acid levels are much lean towards visceral obesity than overall body fat content.
PS-C10-9: EFFECTIVENESS OF AMLODIPINE ON 24-HOUR AMBULATORY BLOOD PRESSURE IN ADULT PATIENTS WITH MILD-MODERATE ESSENTIAL HYPERTENSION: A MULTICENTRE OBSERVATIONAL, REAL-WORLD STUDY
Authors: Dorairaj Prabhakar , Guha Santanu , Sharma Shweta , Pinto Colette , Gaurav Kumar , Rathod Rahul , Kotak Bhavesh 
Published: January 2023

Objective:
Inadequate 24-hour blood pressure control could cause complications, especially in high-risk hypertensive individuals. Hence, it is recommended that the targeted blood pressure levels be maintained round the clock. This prospective, observational study assessed the 24-hour ambulatory blood pressure (ABP) control with 8-week amlodipine therapy 5/10 mg/day in patients with hypertension.

Methods:
Adult patients (62 m, 42 f) with mild-to-moderate essential hypertension received oral amlodipine 5 mg/day (n = 68) or 10 mg/day (n = 36) for 8 weeks. The study was approved by the independent ethics committee and informed consent was obtained from all participants. Primary outcome was change at 8 weeks from baseline in mean 24-hr ABP (systolic and diastolic), and secondary outcomes were change from baseline in mean morning, daytime, night-time, and last 6-hr dosing interval ABP. A repeat measures analysis of covariance (ANCOVA) was done for changes in ABP over 8 weeks, with age, gender, BMI and associated comorbidities as covariates. Nocturnal dippers were assessed as those greater than or equal to 10% reduction in ABP at 8 weeks. Sub-groups were created based on age, duration of hypertension, occupation, baseline BMI and amlodipine dose. Safety was evaluated based on clinical adverse events and 12-lead electrocardiogram.

Results:
Of the 104 patients from 2 study centers, 49 completed 8-weeks therapy and were included for per-protocol analysis. Significant reductions in the mean 24-hr blood pressure were seen for both SBP and DBP (figure 1). The mean 24-hr. reduction was -10.82 and -6.25 mmHg with 5 mg amlodipine and -19.81 and -11.19 mmHg with 10 mg amlodipine for SBP and DBP respectively (p < 0.0001). The mean morning, daytime, night-time, and last 6-hr reductions in SBP were -14.06, -18.63, -20.42, and -13.51 respectively (p < 0.0001), and DBP reductions were -7.78, -10.27, -11.07, and -6.44 respectively (p < 0.0001). Significant reduction in ABP was seen in all sub-groups (p < 0.0001). Greater reduction in SBP and DBP were observed in patients with stage-2 hypertension. At baseline, there were 30 (61.2%) non-dippers which decreased to 18 (36.7%) at 8 weeks. At the end of the study, 40% of non-dippers were converted to dippers by Amlodipine, whereas none of the dippers were converted to non-dippers. No adverse effects were reported.

Conclusion:
Amlodipine significantly reduces the 24-hr. mean morning, daytime, night-time, and last 6-hr. ABP and converted non dippers to dippers in adult patients with mild to moderate essential hypertension. The Study highlights the consistent effects of amlodipine on both quantity and quality of 24 hours BP control which is important for associated CV risk reduction.
PS-C10-11: COMPARISON OF MEASUREMENT OPTIONS FOR NOCTURNAL HYPERTENSION. STUDY PROTOCOL
Authors: Kocianova Eva , Stanke Ladislav , Genzor Samuel , Vohralik Tomas , Obrova Jana , Kamasova Monika , Jelinek Libor 
Published: January 2023

Background:
Nocturnal hypertension is strongly associated with adverse cardiac events and affects patients prognosis. However, to distinguish between true night hypertension and sleeping disorder might be tricky as patients often misinterpret sleep pattern and the role of standard device inconvenience during the 24 hour ABPM measurement. The effect of sleep disturbance on the validity of the results has not been thoroughly investigated.

Aim:
The main objective is to examine the validity of currently used conventional methods of ABPM in patients with nocturnal hypertension potentially disturbed by monitoring itself. The secondary objective is to determine whether the new (less obtrusive) methods are more effective in detecting true nocturnal hypertension and whether they are applicable to patients.

Methods:
The study will enter patient treated for arterial hypertension. They will be recruited consecutively and randomized. The study will have an intrasubject experimental design. Patients will first be measured sleep quality using an actigraph and a proposed questionnaire for this purpose (PSQI + own questionnaire of relation to technologies). We plan to enrol two groups of at 100 probands, with the first group being measured in the following way after baseline actigraphy is detected: 1. Measurement using the Spacelab Healthcare ABPM tonometer. 2. Measurement using a wrist tonometer (Beurer BC54) 3. Measurement using a smart watch tonometer (OMRON HeartGuide). In all of these cases, the actigraphy, or other variables indicating quality and sleep progression (HRV), will be measured simultaneously. For the second group, the order will be reversed, moving from the least obtrusive methods to the more obtrusive ones to eliminate bias sequencing. For the testing of the tonometer obtrusivity during the nigh time BP monitoring BP tonometers were improved by additional Blueetooth receivers, so they can be externally triggered by the command send from the tablet equipped with the specifically designed application. The application can trigger the measurement, consequently collect the measured data and securely send them to the hospital server. Measured sound level is used as one of the correlates of the tonometers obtrusivity along with the actigraphy and subjective perception of the obtrusiveness and sleep disturbance that is also evaluated by the developed questionnaire.

Results:
Number of true verus pseudonocturnal hypertension will be provided according to whether the root problem is poor sleep quality, which causes changes in blood pressure, or pathological changes in blood pressure itself, which causes a deterioration in sleep quality.
Supported by MH CZ DRO (FNOl, 0098892), Mex reg. n.: 8787
PS-C11-6: SIMULTANEOUS MEASUREMENT OF 24-HOUR AMBULATORY BLOOD PRESSURE IN BOTH ARMS REVEALS CLINICALLY RELEVANT DIFFERENCES: A WAKEUP-CALL FOR HYPERTENSION MANAGEMENT
Authors: Bothe Tomas Lucca , Patzak Andreas , Pilz Niklas 
Published: January 2023

Objective:
Cuff-based 24-hour ambulatory blood pressure measurement is the gold standard for hypertension diagnosis and treatment monitoring. The clinical value of ambulatory blood pressure (BP) measurement is ubiquitously accepted. This study wants to quantify the measurement discrepancies in simultaneous and synchronized 24-hour ambulatory BP measurements on both arms. Identifying and understanding measurement uncertainties could improve future hypertension management and originate true confidence in alternative, cuff-less systems with equal measurement precision.

Methods:
We conducted simultaneous 24-hour ambulatory blood pressure measurements on both arms in 52 healthy young adults. The broadly used and validated cuff-devices (BoSo TM-2430) were synchronized to start BP measurement within one second of each other. Further, we recorded, cuff-pressures of both cuff-based devices and the hydrostatic pressure differences between both cuffs. We then scored pressure curves for disturbances (e.g., pressure spikes during deflation) and were able to correct measurements for hydrostatic differences between the arms. This enabled us to not only quantify the extent of measurement uncertainty but to describe its origins and possible countermeasures.

Results:
Measured BP levels from left and right arm showed limits of agreement in the Bland Altman Plot of > 33 mmHg for systolic and > 30 mmHg for diastolic values over 24 h. Daytime values deviated more than nocturnal values (systolic: > 35 mmHg vs. > 27 mmHg systolic, and diastolic: > 32 mmHg vs. > 24 mmHg). Linear regression retrieved R2 = 0.39 (p < 0.001) for systolic and R2 = 0.20 (p < 0.001) for diastolic values. Exclusion of disturbed cuff pressure curves improved limits of agreement to > 23 mmHg for systolic and > 19mmHg for diastolic measurements. Subsequently, it improved correlation coefficients to R2 = 0.54 (p < 0.001) for systolic and R2 = 0.35 (p < 0.001) for diastolic values. Correction of hydrostatic differences between the arms had an negligible effect on limits of agreement and strength of correlation.

Conclusion:
Comparison of synchronized 24-hour BP measurements on both arms showed large measurement uncertainties with possible implications on clinical grading of hypertension and dipping pattern. Exclusion of disturbed cuff pressure curves, not detected by the conventional software of BP devices, mitigates the effect but still results in worrying discrepancies. These results are an imperative to further investigate the clinical implications of BP measurement uncertainty. It further inspires the courageous exploration of alternative means of BP measurement which might offer comparable measurement certainty.
PS-C12-2: VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CLINICAL EVENTS IN OLDER PATIENTS RECEIVING HOME MEDICAL CARE: THE OHCARE STUDY
Authors: Koujiya Eriko , Takeya Yasushi , Kabayama Mai , Yamamoto Mariko , Murakami Naoko , Yano Tomoko , Nakamura Chika , Rakugi Hiromi , Kamide Kei 
Published: January 2023

Aim:
We investigated the associations of visit-to-visit variability(VVV) of blood pressure (BP) with clinical events (death, hospitalization, falling) in older patient around 85 years old receiving home medical care.

Methods:
This study was performed in OHCARE (Osaka Home CAre REgistry), which is a prospective cohort study targeted old patients receiving home-based medical care in Japan. There were 103 eligible patients fulfilling the inclusion criteria: aged 65 years or older; BP measurements at least three occasions before the baseline date (median 4.78 occasions); BP measurement interval in 16 ± 13 days (median ± 1SD). We used the standard deviation (SD), Coefficient of variation (CV) of SBP measured at baseline as the VVV of BP. Main outcomes were clinical events including hospitalizations, falling and death during follow-up period.

Results:
It was clarified that VVV of BP was exists in older patients receiving home medical care (10.7 / 7.2 mmHg). Regarding the relationship between VVV and clinical events during follow-up, the rate of hospitalization was significantly higher in the group with the largest SBP-SD than in the group with the smallest. Furthermore, multivariate analysis adjusted by age, sex, ADL and current diseases showed that SD and CV of SBP were independent positive association of hospitalization events.

Conclusion:
In older patients with frailty requiring home medical care, a higher VVV in SBP may be related to the occurrence of events leading hospitalizations. Furthermore, higher VVV in SBP could be a predictive marker of clinical events leading to hospitalization.