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Blood Pressure Monitoring
Published in Rajarshi Gupta, Dwaipayan Biswas, Health Monitoring Systems, 2019
Arterial pressure is defined as the hydrostatic pressure exerted by the circulating blood over the arteries as a result of the pumping action of the heart. Systolic pressure (SBP) is the highest pressure in a cardiac systole (ventricular contraction), while diastolic pressure (DBP) refers to the lowest (ventricular relaxation) one. Mean arterial pressure (MAP) is the algebraic difference between the SBP and DBP determined by dividing the area under the BP curve of one cardiac cycle by its period [1]. Pulse pressure (PP) is the algebraic difference between SBP and DBP. Periodic BP measurements are essential for cardiovascular patients, especially those with hypertension. Under normal activity of a patient, non-invasive and automatic electrical type BP monitors have become popular since many years due to their portability, quick response, and moderate accuracy level. The ambulatory blood pressure (BP) measurement devices are lightweight (often less than 300 g) can be worn for 24 h by a patient, and can be used to record SBP, DBP, and MAP at regular intervals, with each record estimated over several cardiac periods (normally less than 30 s). These can be operated by the patients themselves and do not require any ‘clinical skill’.
Hypertension and Correlation to Cerebrovascular Change: A Brief Overview
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Heba Kandil, Dawn Sosnin, Ali Mahmoud, Ahmed Shalaby, Ahmed Soliman, Adel Elmaghraby, Jasjit S. Suri, Guruprasad Giridharan, Ayman El-Baz
Currently, the treating physician obtains additional measurements or ambulatory blood pressure monitoring over a 24-hour period to confirm hypertension diagnosis. The patient may be asked to return to the medical care provider up to two times, with the visits timed to be at least two days apart, for additional pressure measurements. The pressure measurements from the two visits are then averaged to obtain the patient's blood pressure measurement [5]. In a recent study, average variability of at least 5 mmHg was found between automated office blood pressure and daytime ambulatory blood pressure monitoring (ABPM) in 90% of participating patients, with a greater degree of underestimation among hypertensive patients [10]. ABPM can be conducted with the use of an automated system. A radial pulse wave acquisition device is worn on the wrist and captures and records data wirelessly. Measurements are taken automatically, typically every 15 minutes and enables the capture of circadian variation of blood pressure. Arm cuff and finger monitors are also options for ABPM. The patient returns to the clinician's office the following day, and the information is downloaded for evaluation and diagnosis. Patient self-measurement is sometimes a suitable and practical alternative and can in some cases provide a better picture of blood pressure fluctuations in patients who smoke.
Earthquakes and Medical Complications
Published in Ramesh P. Singh, Darius Bartlett, Natural Hazards, 2018
Scarlet Benson, Laura Ebbeling, Michael J. VanRooyen, Susan A. Bartels
Furthermore, earthquakes have been known to adversely affect blood pressure in patients with hypertension. For two weeks after the 1995 Japan earthquake, during the period when aftershocks were common, mean systolic blood pressure was 14 ± 16 mm Hg greater and mean diastolic blood pressure was 6 ± 10 mmHg greater than baseline readings in patients wearing ambulatory blood pressure monitors (Kario et al. 2001). These blood pressure elevations typically resolved by 3–5 weeks after the earthquake except in patients with microalbuminuria, for whom the increases persisted for at least 2 months (Kario et al. 2001). Increased cardiovascular morbidity and mortality following earthquakes is likely multifactorial in nature. Increased physical and psychological stress with an associated sympathetic nervous system activation, interruption of prescribed cardiovascular drug regiments and disruption of pre-hospital care and emergency medical services are all likely contributing factors (Hata 2009).
Telemonitoring for hypertensive disease in pregnancy
Published in Expert Review of Medical Devices, 2019
Asma Khalil, Helen Perry, Dorien Lanssens, Wilfried Gyselaers
Ambulatory blood pressure monitoring (ABPM) consists of wearing a BP monitor for a prolonged period (typically 24 h). The monitor is programmed to measure and record BP at selected intervals to provide a trend and average. ABPM is commonly used in the general population to diagnose hypertension and can be useful in distinguishing white coat hypertension. Higher ambulatory readings have been shown to correlate with subclinical echocardiographic changes and microalbuminuria in normotensive women with a previous history of preeclampsia [19] and are more closely associated with pregnancy outcomes including preterm birth and low birthweight (<10th centile) compared to clinic readings [20]. Rhodes et al. conducted a feasibility randomized controlled trial of ABPM in pregnancy and found it acceptable to patients and clinicians but that it did not reduce the amount of obstetric input; however, the study was underpowered for the main outcome measures [21].