2019 Guidelines for the Management of Hypertension — Part 1–7

Abstract

Patient preparationPatients should refrain from drinking coffee, smoking cigarettes, and using other stimulants for at least 30 minutes before the measurement Measurement should be performed after at least 5 minutes of rest, in a sitting position with the back supported, in a quiet room at comfortable ambient temperature. The arm on which BP is measured should be flexed at the elbow and loosely supported at the level of the heart. The upper arm should be free from any restrictive clothing Measurement techniqueWhen measuring using the classical (auscultatory) technique, the cuff should be inflated to 30 mm Hg above the audible sounds (palpable pulse). The cuff should be deflated at a rate of 2 mm Hg/s Initially, BP should be measured on both arms, with further measurements on the arm with the higher BP reading for long-term BP monitoring and evaluation of the effectiveness of antihypertensive therapy With the auscultatory technique, systolic blood pressure (SBP) is defined as the appearance of the first tone during cuff deflation -Korotkoff phase I, and diastolic blood pressure (DBP) is defined as the disappearance of the last tone during cuff deflation -Korotkoff phase V BP should be calculated as the mean of 2 last measurements, the standard being at least 3 BP measurements performed 1-2 minutes apart during the same visit. If BP values differ between subsequent measurements (> 10 mm Hg), additional measurements should be performed BP measurements in patients with arrhythmia (e.g., atrial fibrillation) should be performed using the auscultatory technique At the initial evaluation, orthostatic challenge (active standing) test should be performed in all patients, with BP measurements at 1 and 3 minutes after standing up from the sitting position. Orthostatic hypotension is defined as SBP fall by ≥ 20 mm Hg or to < 90 mm Hg or DBP fall by ≥ 10 mm Hg. Active lying-to-standing test (standing up from the lying position) should be considered in the elderly, diabetic patients, and patients with other conditions associated with an increased risk of orthostatic hypotension. Extending orthostatic BP measurements to 5 minutes should be considered in these groups Pulse rate should be measured to exclude significant arrhythmia. Resting heart rate is also used for cardiovascular risk evaluation If a BP difference is found between the arms, the higher value should be taken as actual BP (preferred simultaneous BP measurement, and if not available -sequential BP measurement) BP -blood pressure; DBP -diastolic blood pressure; SBP -systolic blood pressure

Assessment of Selected Clock Proteins (CLOCK, CRY1) and their Relationship with Biochemical, Anthropometric and Lifestyle Parameters in Hypertensive Patients

“…Hypertension is a modifiable risk factor for cardiovascular disease. It often occurs with other cardiovascular risk factors such as central obesity, dyslipidaemia and glucose intolerance [24,40]. The mean BMI in both studied populations was above 24.9 kg/m2, which indicates overweight, however, BMI values were significantly higher in women with hypertension compared to control group.…”

“…In accordance with this ESC/ESH guidelines hypertension is defined as office systolic blood pressure (SBP) values at least 140 mmHg and/or diastolic blood pressure (DBP) values at least 90 mmHg (Table 1) [24]. Most of the other definition is also based on these criteria [40].…”

Screening Services in a Community Pharmacy in Poznan (Poland) to Increase Early Detection of Hypertension

“…As a result of blood pressure screenings in a community pharmacy, 16.9% of participants with elevated blood pressure (≥140/90 mmHg) were unaware of it and were referred to a physician. In Poland, almost 40.0% of adults do not know their own blood pressure, and about 30.0% are unaware of having hypertension [ 10 ]. Education level showed a correlation with patient reaction to the results of the blood pressure screening.…”

“…The patient was not included in the study when drinking coffee and/or smoking at least 30 min before the visit. Based on the information obtained in the first step, each patient was assigned to one of three categories: standard consultation (SC: normal blood pressure, without risk factors), intensive consultation (IC: normal blood pressure with risk factors, e.g., family history, elevated blood glucose level and cholesterol), and high-risk consultation (HRC: blood pressure reading ≥ 140/90 mmHg) [ 10 ]. Subsequently, participants in each category received specific counseling and intervention in an especially designed, quiet, intimate place in the community pharmacy.…”

Factors determining acceptance of illness in patients with arterial hypertension and comorbidities

“…According to forecast data, there will be approximately 1.5 billion people with the disease by 2025 [1]. According to the latest edition of the NATPOL study conducted in 2011, approximately 32% of the adult population in Poland suffer from arterial hypertension [2]. In fact, the prevalence of the disease is extremely high throughout the world, regardless of the wealth of a given country.…”