Clinical applications for out-of-office blood pressure monitoring

Zhu, Hailan; Zheng, Haoxuan; Mai, Weiyi; Huang, Yuli

doi:10.1177/2040622320901660

Cited by 16 publications

(15 citation statements)

References 99 publications

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“…We found 16% of our study participants had white coat hypertension, which is within the range of white coat hypertension reported in documented literature of 9–23%. 45 This proportion is also similar to that found by investigators in South Africa where white coat hypertension was present in 18% of all participants in that study. 46 However, our findings contrast those obtained in a sample of rural individuals from Kenya 19 as well as from a cohort of elderly participants in Tanzania, 20 most likely due to differences in the studied populations.…”

Section: Discussionsupporting

confidence: 90%

“…We found in this study that the proportion of participants with masked hypertension was 11.5%, meaning these participants would have been considered normotensive if only office BP measurements were used to screen for hypertension. This figure lies within the world average prevalence of 6.7–20%, 45 as well as within the prevalence reported from studies in sub Saharan Africa (5.1–16.1%). 19 , 20 , 22 The slight differences from ours and the studies from the region are likely due to the differences in the studied population in terms of age and urban-rural settings between the studies.…”

Section: Discussionsupporting

confidence: 87%

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Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

Chuwa

Chillo

2020

IBPC

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Background Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania. Aim To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees. Methods A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson’s correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. P -value of <0.05 was considered statistically significant. Results In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01. Conclusion Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

Chuwa

Chillo

2020

IBPC

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“…ABPM use in research is limited by the potential interference it presents with a patient's activities in daily life and inaccurate readings if the cuff is placed incorrectly during measurement [243]. Therefore, more research is needed to develop less intrusive and more valid devices or protocols.…”

Section: Limitations Of Abpmmentioning

confidence: 99%

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Ray¹,

McMichael²,

Rivera-Santana³

et al. 2021

JMIR Diabetes

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Type 1 diabetes (T1D) is one of the most common chronic childhood diseases, and its prevalence is rapidly increasing. The management of glucose in T1D is challenging, as youth must consider a myriad of factors when making diabetes care decisions. This task often leads to significant hyperglycemia, hypoglycemia, and glucose variability throughout the day, which have been associated with short- and long-term medical complications. At present, most of what is known about each of these complications and the health behaviors that may lead to them have been uncovered in the clinical setting or in laboratory-based research. However, the tools often used in these settings are limited in their ability to capture the dynamic behaviors, feelings, and physiological changes associated with T1D that fluctuate from moment to moment throughout the day. A better understanding of T1D in daily life could potentially aid in the development of interventions to improve diabetes care and mitigate the negative medical consequences associated with it. Therefore, there is a need to measure repeated, real-time, and real-world features of this disease in youth. This approach is known as ecological momentary assessment (EMA), and it has considerable advantages to in-lab research. Thus, this viewpoint aims to describe EMA tools that have been used to collect data in the daily lives of youth with T1D and discuss studies that explored the nuances of T1D in daily life using these methods. This viewpoint focuses on the following EMA methods: continuous glucose monitoring, actigraphy, ambulatory blood pressure monitoring, personal digital assistants, smartphones, and phone-based systems. The viewpoint also discusses the benefits of using EMA methods to collect important data that might not otherwise be collected in the laboratory and the limitations of each tool, future directions of the field, and possible clinical implications for their use.

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“…The direct measurement of BP requires invasive BP (IBP) measurement, although IBP is not practical in most cases. The development of devices has led to the availability of several non-invasive means of measuring BP that have been found to have acceptable accuracy when standardized techniques and appropriate observer training are implemented (5,6). Thus, non-invasive BP measurements are widely used in clinical, ambulatory, home, and hospital settings (7).…”

Section: Introductionmentioning

confidence: 99%

Invasive Blood Pressure Measurement and In-hospital Mortality in Critically Ill Patients With Hypertension

Zhou

Lin

Xiao-ai

et al. 2021

Front. Cardiovasc. Med.

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Background: Invasive blood pressure (IBP) measurement is common in the intensive care unit, although its association with in-hospital mortality in critically ill patients with hypertension is poorly understood.Methods and Results: A total of 11,732 critically ill patients with hypertension from the eICU-Collaborative Research Database (eICU-CRD) were enrolled. Patients were divided into 2 groups according to whether they received IBP. The primary outcome in this study was in-hospital mortality. Propensity score matching (PSM) and inverse probability of treatment weighing (IPTW) models were used to balance the confounding covariates. Multivariable logistic regression was used to evaluate the association between IBP measurement and hospital mortality. The IBP group had a higher in-hospital mortality rate than the no IBP group in the primary cohort [238 (8.7%) vs. 581 (6.5%), p < 0.001]. In the PSM cohort, the IBP group had a lower in-hospital mortality rate than the no IBP group [187 (8.0%) vs. 241 (10.3%), p = 0.006]. IBP measurement was associated with lower in-hospital mortality in the PSM cohort (odds ratio, 0.73, 95% confidence interval, 0.59–0.92) and in the IPTW cohort (odds ratio, 0.81, 95% confidence interval, 0.67–0.99). Sensitivity analyses showed similar results in the subgroups with high body mass index and no sepsis.Conclusions: In conclusion, IBP measurement was associated with lower in-hospital mortality in critically ill patients with hypertension, highlighting the importance of IBP measurement in the intensive care unit.

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Clinical applications for out-of-office blood pressure monitoring

Cited by 16 publications

References 99 publications

Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania

Technological Ecological Momentary Assessment Tools to Study Type 1 Diabetes in Youth: Viewpoint of Methodologies

Invasive Blood Pressure Measurement and In-hospital Mortality in Critically Ill Patients With Hypertension

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