Introduction: Pulse wave analysis is an emerging approach that analyzes parameters comprising strong predictors of cardiovascular (CV) events and all-cause mortality, especially in patients with high CV risk based on established risk factors. This study used the oscillometric method, provided by the Mobil-o-Graph (PWA-EMI GmbH, Stolberg, Germany) device, to compare data regarding the pulse wave analysis parameters in hypertensive nondiabetic and diabetic patients. Material and methods: In this cross-sectional study, 276 individuals were examined in the academic hypertension outpatient care unit of the Federal University of the Triângulo, in Mineiro, Brazil, from January to December 2016. The pulse wave analysis was performed by oscillometry, and its parameters were acquired from all patients. Results: Of the 276 patients, 99 were diabetic and 177 nondiabetic. The mean systolic and pulse central blood pressure were significantly higher in diabetic patients than in nondiabetic patients (P = .008 and.0003, respectively). The mean peripheral systolic blood pressure and pulse pressure were also significantly higher in the diabetic group (P = .001 and P < .0001, respectively). The average pulse wave velocity (PWV, m/s) was 9.4 ± 1.6 and 8.8 ± 1.6 in the diabetic and nondiabetic groups, respectively (P = .003). Conclusion: The group of hypertensive diabetic patients had significantly higher central blood pressure, peripheral blood pressure, and PWV than the hypertensive nondiabetic patients. The patients with overlapping established CV risk factors presented values of the pulse wave analysis parameters consistent with higher central pressure and greater arterial stiffness.
A terapia antitrombótica constitui a base do tratamento farmacológico das síndro-mes ccoronárias agudas (SCA), independente da sua forma clínica de apresentação. Atualmente, existem múltiplas medicações antitrombóticas disponíveis, antiplaquetárias e anticoagulantes, com diferentes mecanismos de ação e potência variável, tornando a sua combinação altamente complexa. A escolha da terapia antitrombótica mais ade-quada, assim como o seu tempo de administração, deve ser individualizada de modo a contemplar o delicado equilíbrio entre o risco de trombose e de sangramento.
Objective: Evaluate the correlation and agreement of blood pressure (BP) values from observed and non-observed measurements with awake blood pressure (ABP). Translate the results of the difference between observed and awake BP into SPRINTb Ambulatory Blood Pressure Study. Design and method: Two hundred seventy-eight patients over eighteen years old were eligible. After 5 minutes on rest, a nurse collected clinical characteristics, took three sequential observed (OBP) and non-observed (N-OBP) BP measurements (Microlife- BP 3AC1–1PC), in an alternate order, every fifteen seconds. Also, was recorded twenty-four hours of ABPM (DynaMAPA). BP measurements and ABPM recording followed recommendations of European Guidelines. We calculated Cardiovascular (CV) risk using the SCORE system. aa well as, the average of OBP, N-OBP, awake BP (ABP), and the difference OBP-ABP. We assessed the relationship of observed or non-observed BP values with ABP by calculating the Pearson coefficient (r), and the agreement using a Bland–Altman plot. The significance of differences between average BP values was evaluated using analysis of covariance and Student's T-Test into variance in OBP-ABP. Results: Among 278 patients, 48.6% performed non-observed BP measurements firstly. Demographic and main clinical characteristics were demonstrated in table 1, as well as, all BP media and the differences between OBP-ABP in four subgroups of the studied population. The table below shows p values p values to compared of BP average and differences on BP. Figure 1 shows a Bland Altman plot of the agreement between tested BP against ABP. Figure 2 shows the results of the correlation between the tested BP and ABP. The red marks on X-axis are the ABP values on standard (S - 138.8/78.6) and intensive (I - 126.5/72.0) groups at the end of 27 months of the ABP SPRINT Study, and those on Y-axis the corresponding values of OBP and N-OBP, according to the differences with ABP found in this study. Conclusions: In conclusion, the findings of this study showed a strong correlation and a significant difference to both observed, no observed BP values with awake BP. Our results could be useful in interpreting the ABP SPRINT Study.
Objective: To evaluate the association between arterial stiffness and short term blood pressure variability (BPV). Design and method: Four hundred fifty-five suspected hypertensive patients were referred to record a 24-hours ambulatory blood pressure monitoring (ABPM), and also were randomly enrolled from a population. They performed an oscillometric pulse wave analysis, using Mobil-O-Graph (I.E.M., Stolberg, Germany), following recommendations of Expert Consensus Document on the Measurement of Aortic Stiffness-2012. They also had a 24- hour of ABPM recorded. ABPM was made following protocols of European Guidelines. Short term BPV was evaluated by systolic or diastolic BP with: the standard deviation (SD) of 24 hs BP (24hBP-SD), Daytime BP-SD, Nighttime BP-SD, the 24 hs BP coefficient of variation (24hs CV), the weighted 24-h BP-SD and average real variability of 24-hour BP (ARV 24-h BP). Statistical Analysis: the Pearson correlation coefficient (r) was calculated by an univariate way comparing all systolic and diastolic BPV measures with brachial pulse wave analysis (bPWV). Partial correlation was adjusted to age and gender, and then for age, gender, 24 hs BP, and office BP do to avoid statistic influence of such confounders. Results: Data from 455 patients were analyzed. Clinical characteristics of the sample: age 48.8 ± 13.93 – women (41.9%), white people (69.5%), treated hypertensives (36%), diabetes (12.7%), statin use 22%, body mass index 28. 6 ± 5.8, smokers (8.6%), obese (36.3%). The findings are showed in table 1. All BPV variables had a significant correlation with bPWV. Daytime BP-SD and weighted 24-h BP-SD showed the best association. The worst results of the correlation were found, in systolic, in nighttime BP-SD, and in diastolic, in 24 hs CV. However, the comparison of diastolic 24hBP-SD and bPWV showed a negative correlation. Conclusions: Our data indicated an association between short blood pressure variability and oscillometric pulse wave velocity. A moderate correlation was demonstrated by systolic BPV and weak by diastolic. The best results of the association between the studied variables were shown in Daytime BP-SD and in weighted 24-h BP-SD.
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