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Home Blood Pressure
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
George S. Stergiou, Anastasios Kollias
Automated BP measurement using the oscillometric method in AF faces several difficulties (23). However, the available evidence suggests that the oscillometric method is feasible and appears to be accurate, at least for systolic BP measurement, which is more important for AF patients, who are almost exclusively elderly (24). Screening for AF with automated BP measurement is an attractive strategy in the context of the guideline-recommended opportunistic screening. A specific algorithm for AF detection during automated BP measurement has been developed and implemented in a novel oscillometric home BP monitor (Microlife WatchBP Home-A) with satisfactory diagnostic accuracy (25). In 2013, the UK National Institute for Health and Care Excellence recommended this device for AF screening in subjects ≥65 years (26).
General smarts
Published in Patrick Rabbitt, The Aging Mind, 2019
We must remember that, since these are average scores, half of all volunteers showed smaller declines. Of course, this is not entirely encouraging because it also means that many changed by slightly more. This seemingly uncomfortable finding is, in fact, reassuring. The amount of change that each of us can expect to experience is not a fixed number, perhaps set by our genes, but is just a probability estimate. It is only a rough guide to the odds of expected change within quite a narrow range. Those interested will find David Spiegelhalter’s mathematical explorations of how to make the best sense of such comparisons cheerfully illuminating. They are wittily described in his book written with Michael Blastland, The Norm Chronicles [7], which I urge you to read. Spiegelhalter and Blastland point out that demographic counts of deaths at different ages that are associated with dangerous habits such as such as skydiving, smoking or immoderate consumption of coffee, alcohol or nitrate-rich sausages do not actually give definite predictions of how long we have left to live but rather only provide data for estimates of the risks of death that can be computed in units called “micromorts”. A micromort is a one in a million chance of death during weeks, months or years. A companion index is the “microlife” – one millionth of your adult lifespan – which they estimate to be about 30 minutes. These useful new words let us discuss the probable effects of two cigarettes (estimated cost 1 microlife), two pints of strong beer (1 microlife) or an inch on the waistline (cost 1 microlife a day seven days a week, the same as two hours a day watching TV).
Renal sympathetic denervation lowers systemic vascular resistance in true treatment-resistant hypertension
Published in Blood Pressure, 2021
Kaja K. Bergo, Anne C. Larstorp, Pavel Hoffmann, Ulla Hjørnholm, Alessandro Cataliotti, Aud Høieggen, Morten Rostrup, Fadl Elmula M. Fadl Elmula
Procedures performed in each group are illustrated in Figure 1 [10]. The hemodynamic status of patients was measured in the supine position, with impedance cardiography and simultaneous BP measurement at baseline, and at three and six months follow-up. Microlife WatchBP O3 (Microlife Health Management Ltd, Cambridge, United Kingdom) was used for all BP measurements. Thoracic impedance cardiography measurements were performed with the validated non-invasive HOTMAN System (Hemo Sapiens Inc., Sedona, AZ, USA) [16–18], the supplemental online material provide details on the procedure. The HOTMAN System also provided us with an algorithm that calculated deviations in systemic vascular resistance, volume load and cardiac inotropy, i.e. the patients’ hemodynamic status [13]. In the control group, medications were adjusted at study visits after a pre-specified algorithm based on the hemodynamic status and according to the ESH-ESC hypertension guidelines [13,19], e.g. increase the diuretic dose in patients with volume overload and increase vasodilatory agents if the patient had a high level of vasoconstriction. The Symplicity Catheter System was used for the RDN procedure [10,20,21], and medical therapy in the RDN group was kept unchanged from baseline until the six months follow-up visit. This allows an assessment of hemodynamic alterations in the RDN group without the interaction of simultaneous drug changes.
Environmental and intrinsic factors shaping gut microbiota composition and diversity and its relation to metabolic health in children and early adolescents: A population-based study
Published in Gut Microbes, 2020
Sofia Moran-Ramos, Blanca E. Lopez-Contreras, Ricardo Villarruel-Vazquez, Elvira Ocampo-Medina, Luis Macias-Kauffer, Jennifer N. Martinez-Medina, Hugo Villamil-Ramirez, Paola León-Mimila, Blanca E. Del Rio-Navarro, Isabel Ibarra-Gonzalez, Marcela Vela-Amieva, Francisco J Gomez-Perez, Rafael Velazquez-Cruz, Jorge Salmeron, Zyanya Reyes-Castillo, Carlos Aguilar-Salinas, Samuel Canizales-Quinteros
Anthropometric measurements were determined as previously described34 and included weight, height, waist and hip circumferences. All instruments were calibrated following the standard methods of the manufacturers. Blood pressure (BP; mmHg) was measured using an automatic manometer (Microlife). Body fat mass percentage was obtained by bioelectrical impedance analysis (Quantum X Body Composition Analyzer, RJL Systems). Centers for Disease Control and Prevention 2000 growth charts were used as reference to determine body mass index (BMI) percentiles. Obesity status was defined as BMI percentile ≥95th, overweight between 85th and 95th percentile, normal-weight between the 5th and 85th percentile and underweight <5th BMI percentile for age and gender.68 National Heart, Lung, and Blood Institute reference data were used to determine BP percentiles based on height, age and gender.69 As suggested by the Expert Panel on Integrated Guidelines for Cardiovascular Health Risk Reduction in Children and Adolescents, hypertriglyceridemia was defined as serum triglyceride levels ≥100 mg/dL in children under 10 and ≥130 mg/dL in children ≥10 y old. While hypoalphalipoproteinemia was defined as HDL levels <40 mg/dL.36 Metabolic syndrome was defined as established by De Ferranti,70 with 3 or more of the following characteristics: TG≥100 mg/dL, HDL cholesterol <50 mg/dL, BP percentiles >90, glucose ≥ 110 mg/dL and waist circumference >75th percentile.
Association of non-invasive hemodynamics with arterial stiffness in rheumatoid arthritis
Published in Scandinavian Cardiovascular Journal, 2018
Panagiota Anyfanti, Areti Triantafyllou, Eugenia Gkaliagkousi, Nikolaos Koletsos, Spyros Aslanidis, Stella Douma
Demographic and anthropometric characteristics, medical history and medication use were recorded and body mass index (BMI) was calculated in kg/m2. Systolic/diastolic blood pressure was measured in the sitting position in the arm with the higher blood pressure using a validated oscillometric device (Microlife Exact BP, Microlife AG, Widnau, Switzerland), and was determined as the mean of the second and third value of three consecutive measurements. Hypertension was defined as office systolic and/or diastolic blood pressure ≥140/90 mm Hg, and/or current antihypertensive medication use [16]. Previous cardiovascular events were defined as history of stroke or transient ischemic attack, angina, and myocardial infarction based on self-report and ascertained by a medical record and medication review. After completion of physical examination and vascular and other non-invasive measurements analyzed below, fasting total cholesterol, triglycerides, LDL- and HDL-cholesterol were estimated in blood samples.