A matter of degree
Waltraud Ernst in Histories of the Normal and the Abnormal, 2006
Well into the 1950s, hypertension was quite a different matter from what we take it to be today. Hypertension was conceived of as a disease, and a pressure reading of, say, 140/80 mmHg alone (classified as stage 1 hypertension in the new US guidelines) would definitely not have raised a doctor’s eyebrows. With only very few, drastic treatment options available, whether a patient was to receive treatment or not was a matter of judgement for the physician rather than the expected (and officially sanctioned) response to a series of sphygmomanometer readings. In general, the hypertensives who received treatment had malignant hypertension, severely increased blood pressure with manifest pathological effects, a disease that not only posed a long-term risk but led to clearly distinguishable, acute symptoms and possibly the death of the patient. According to one of the pioneers of hypertension research in Britain, Sir Colin Dollery, malignant hypertension has all but disappeared from the industrialised world since effective drug treatments became available in the 1950s.5 Simultaneously, hypertension was redefined as a quantitative disease, the upper end of a bell-shaped normal distribution. In the absence of symptoms, hypertension has come to be framed by epidemiological data, notions of risk, and a succession of new drug treatments.
General Principles for Measuring Arterial Waves
Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos in McDonald's Blood Flow in Arteries, 2022
Several blood pressure measuring devices are available (at least 35 different brands) that use the oscillometric method to measure systolic and diastolic blood pressure and heart rate. Accuracy studies have shown that, if used properly, these devices usually measure blood pressure within 5.0 mmHg or less of that measured with a centrally placed arterial catheter (Ramsey, 1991; Watson et al., 1998) or mercury sphygmomanometer (Topouchian et al., 2005; Stergiou et al., 2006; Pini et al., 2008). If the monitor has not been clinically validated for accuracy, it should be avoided. Peripheral systolic blood pressure is higher than central systolic pressure; therefore oscillometric blood pressure devices tend to overestimate systolic and underestimate diastolic blood pressure when compared to central blood pressure measured with a catheter in the central aorta. Also, oscillometric devices are inaccurate in patients with atrial fibrillation and irregular rhythm (Anastas et al., 2008) when compared to the ausculta-tory method (Goonasekera and Dillon, 1995; van Ittersum et al., 1998). The overestimation in systolic blood pressure is more pronounced in older individuals (Brinton et al., 1998) and in patients with diabetes (van Ittersum et al., 1998), which may be due to increased arterial stiffness (van Popele et al., 2000). The oscillometric signal derived using a cuff sphygmomanometer has also been used to estimate arterial compliance (Brinton et al., 1996, 1997). The applicability of home blood pressure measurements in clinical practice has been reviewed recently by Verberk et al. (2007).
Cardiovascular system
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
The subject must be lying horizontally, so that the limbs to be measured are all at the same height. A sphygmomanometer cuff is inflated proximally to occlude arterial flow and released slowly to allow return of the flow. When a pulse is detected by the ultrasound probe, the systolic pressure is the same as the pressure in the cuff and can be read off by the operator (Figs 9.52a,b). The pressure in both arms should be measured, in case there is peripheral vascular disease in the upper limbs [111]. If the brachial pressures differ, the highest of these two readings should be used to calculate the ABPI [112].
Blood pressure patterns of hypertensive disorders of pregnancy in first and second trimester and contributing factors: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2023
Jie Ren, Zhuoran Fan, Jing Li, Yujie Wang, Junnong Zhang, Shaofang Hua
This study included the 4299 pregnancies who laboured in the Second Hospital of Tianjin Medical University from January 2019 to December 2020. In Tianjin, pregnancies usually got their prenatal cares in the local community health service centre before 28 weeks of gestation and the materials such as gestational age, weight and blood pressure values were uploaded and recorded in the website: Tianjin Maternal and Child Health Care Information System (60.29.92.68:82/Site/NewTjsfezxSite/Default.aspx), and into the third trimester, they chose their preferred hospital to continue their visits until delivery. In-hospital materials including maternal age, blood pressure values of delivery, gender, length and weight of offspring were recorded in the In-patient Management Information System. Considering that most mothers experienced the first prenatal care and created the pregnancy file during 8 + 0 weeks to 10 + 6 weeks and the last care they got in the local centre is around 28 + 0 weeks. So we chose seven average time periods (8 + 0 weeks to 10 + 6 weeks, 11 + 0 weeks to 13 + 6 weeks, 14 + 0 weeks to 16 + 6 weeks, 17 + 0 weeks to 19 + 6 weeks, 20 + 0 weeks to 22 + 6 weeks, 23 + 0 weeks to 25 + 6 weeks, 26 + 0 weeks to 28 + 6 weeks) to represent the first and second trimester. The electronic sphygmomanometer (arm or wrist) was used for measuring blood pressure. Pregnancies were in a sitting position and asked to rest for 5–10 min before measurement. Our data came from the two systems and this study had been reviewed and approved by the Ethics Committee.
Evaluation of correlation between digital vs. mercury sphygmomanometer in a middle-income country: The role of socio-economic situation
Published in Clinical and Experimental Hypertension, 2022
Alireza Khosravi, Mohaddeseh Behjati, Asieh Mansouri, Mahnaz Jozan, Noushin Mohammadifard, Marzieh Taheri, Somayeh Khodarahmi, Rezvan Ansari, Mohammad Hadi Mansouri, Pejman Mansouri, Nizal Sarrafzadegan
Medical equipment are growing rapidly. Various instruments have been used for digital and manual digital sphygmomanometers but each of them has its own advantages and disadvantages. Despite of this progress in development of digital sphygmomanometers which could be used easily and simply, these devices are supposed to have low sensitivity. Using manometer sphygmomanometers as a standard measurement tool, it has been shown that digital sphygmomanometers have inappropriately lower level of accuracy and validity for measurement of systolic and diastolic blood pressure measurement. The reported high error rate has limited their widespread application. While other investigations showed similar sensitivity and accuracy of these methods. Comparisons and differences in manometer and digital sphygmomanometer are discussed in several studies in detail (6–9).
Association Between Dietary Selenium Intake and the Prevalence of Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study
Published in Journal of the American College of Nutrition, 2020
Jing Wu, Chao Zeng, Zidan Yang, Xiaoxiao Li, Guanghua Lei, Dongxing Xie, Yilun Wang, Jie Wei, Tubao Yang
Venous blood samples were collected from subjects, after an overnight fast of 12 hours, into serum separation tubes (containing silica clot activators and gel separator), and were immediately centrifuged at 4 °C for 10 minutes at 3000 relative centrifugal force. Fasting blood glucose (FBG) was measured using the glucose oxidase enzyme method on a Beckman Coulter AU 5800 (Beckman Coulter Inc., Brea, CA, USA). The mean intra-and inter-assay coefficients of variation for FBG were 1.7% and 2.2%, respectively. An electronic sphygmomanometer was used to measure blood pressure (BP). A diagnosis of diabetes was made if the FBG of the subject was ≥ 7.0 mmol/L or if he/she was using any anti-diabetic therapy at the time. A subject had diagnosed hypertension if he/she had a systolic BP ≥ 140 mm Hg or a diastolic BP ≥ 90 mm Hg or if he/she was taking any antihypertensive agent at the time.
Related Knowledge Centers
- Arteriosclerosis
- Auscultation
- Blood Pressure
- Clinical Trial
- Palpation
- Stethoscope
- Systole
- Cuff
- Mercury
- Gold Standard