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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.
Blood Pressure Measurement
Published in John G. Webster, Halit Eren, Measurement, Instrumentation, and Sensors Handbook, 2017
Shyam Rithalia, Mark Sun, Roger Jones
There is great significance for ambulatory monitoring of blood pressure. Over a period of 24 h, blood pressure is subject to numerous situational and periodic fluctuations [1]. The pressure readings have a pronounced diurnal rhythm in an individual, with a decrease from 10 to 20 mmHg during sleep and a prompt increase on getting up and walking in the morning. Readings tend to be higher during working hours and lower at home, and they depend on the pattern of activity. After a bout of vigorous exercise or strenuous work, blood pressure may be reduced for several hours. The readings may be raised if the patient is talking during the measurement period. Smoking a cigarette and drinking coffee, especially if they are combined, may both raise the pressure [16]. When assessing the efficacy of antihypertensive drugs, ambulatory blood pressure monitoring can provide considerable information and validation of the drug treatment [17].
Designing for Upper Torso and Arm Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
As described in Chapter 2, blood pressure is the pressure of blood on the walls of the arteries generated by the force of the pumping heart. Typically, blood pressure is measured at a single point in time. An inflatable cuff attached to a recording device is wrapped around an arm or leg, inflated and then deflated, producing a blood pressure reading (BP). The cuff is then removed. Ambulatory blood pressure monitoring is used to record pressures over hours or days but is less common than ambulatory ECG monitoring. Stergiou et al. (2016) review the current limitations and future research and development needs for ambulatory BP monitoring.
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].