Reliability of automated blood pressure devices used by hypertensive patients

Wong, Wai-Man; Shiu, Ivan K L; Hwong, Thomas M T; Dickinson, James A

doi:10.1258/jrsm.98.3.111

Cited by 13 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The standard mercury sphygmomanometer is the most common device used to measure blood pressure [ 2 ]. The accuracy of automatic blood pressure measurement is still controversial [ 20 , 21 ]; therefore, the mercury sphygmomanometer is considered to be the 'gold standard' for measuring blood pressure. To avoid the white-coat effect [ 22 ], the CRC will not wear a white coat during this clinical study.…”

Section: Discussionmentioning

confidence: 99%

A trial for the use of qigong in the treatment of pre and mild essential hypertension: a study protocol for a randomized controlled trial

Park

Liu

Park

et al. 2011

Trials

View full text Add to dashboard Cite

BackgroundHypertension is a risk factor for cardiovascular disease, and the prevalence of hypertension tends to increase with age. Current treatments for hypertension have side effects and poor adherence. Qigong has been studied as an alternative therapy for hypertension; however, the types of qigong used in those studies were diverse, and there have not been many well-designed randomized controlled trials.Our objectives are the following: 1) To evaluate the effects of qigong on blood pressure, health status and hormone levels for pre- or mild hypertension. 2) To test the methodological appropriateness of this clinical trial and calculate a sample size for future randomized trials.MethodsForty subjects with pre- or mild hypertension will be randomized to either the qigong exercise group or the non-treated group. Participants in the qigong group will conduct qigong exercises 5 times per week for 8 weeks, and participants in the non-treated group will maintain their current lifestyle, including diet and exercise. The use of antihypertensive medication is not permitted. The primary endpoint is a change in patient blood pressure. Secondary endpoints are patient health status (as measured by the SF-36 and the MYMOP2 questionnaires) and changes in hormone levels, including norepinephrine, epinephrine, and cortisol.DiscussionThis study will be the first randomized trial to investigate the effectiveness of qigong exercises for the treatment of pre- and mild hypertension. The results of this study will help to establish the optimal approach for the care of adults with pre- or mild hypertension.Trial registrationClinical Research Information Service KCT0000140

show abstract

Section: Discussionmentioning

confidence: 99%

A trial for the use of qigong in the treatment of pre and mild essential hypertension: a study protocol for a randomized controlled trial

Park

Liu

Park

et al. 2011

Trials

View full text Add to dashboard Cite

show abstract

“…Obese individuals may not fit available cuff sizes, and patients with anxiety syndromes may overuse these devices and suffer panic attacks with secondary blood pressure elevations. Studies have shown that 40% of patients do not read the instructions, 50% of patients lack any training in measuring blood pressure, and patients frequently fabricate low numbers and omit elevated numbers 10,11 . These are obstacles that can be overcome by careful selection of patients, training with regard to blood pressure technique, and the use of home devices containing memory chips.…”

Section: Discussionmentioning

confidence: 99%

Managing White‐Coat Effect

Handler

2008

J of Clinical Hypertension

View full text Add to dashboard Cite

A 68-year-old woman was referred to the hypertension clinic for evaluation of resistant hypertension. She had been receiving antihypertensive medication for approximately 30 years. Good control had been demonstrated on 2 and 3 medications until the prior year. After that, her blood pressure was consistently elevated in the clinic despite an increasing drug regime; home blood pressure was controlled. A few years before her referral, intolerance to hydrochlorothiazide with hyponatremia had been noted, and she was placed on lisinopril and atenolol. however, her serum potassium level rose to 6.4 meq/dL, and lisinopril was discontinued. felodipine was added to atenolol, with office systolic blood pressure levels in the 150-and 160-mm hg range. hydralazine and clonidine were not effective. There was no history of diabetes mellitus or target organ damage.On evaluation, blood pressure measured by a medical assistant was 178/102 mm hg, and levels measured by a physician were 152/98 mm hg (both arms, supine) and 150/104 mm hg (right arm, standing). results of physical examination were unremarkable. The patient indicated complete adherence to her regime of felodipine 10 mg/d and atenolol 50 mg/d. Laboratory tests revealed a creatinine level of 1.1 mg (normal, 0.6-1.1 mg), a fasting glucose level of 124 mg/dL (normal, 70-125 mg/dL), and a low-density lipoprotein cholesterol level of 128 mg/dL (normal, <130 mg/dL). findings on electrocardiography were normal.felodipine was increased to 20 mg/d, atenolol was maintained at 50 mg/d, and furosemide 10 mg twice daily was initiated and increased to 20 mg twice daily. The patient steadfastly indicated complete adherence to her medical regimen, and a record of medication refills showed timely pickups. Systolic blood pressure levels in the clinic continued mostly in the 160-mm hg range. her 2-year-old home blood pressure apparatus was validated in the office, and a mean of 18 home recordings, mostly in the morning after awakening, was 112/66 mm hg. A mean of 44 blood pressure readings taken from a 24-hour ambulatory blood pressure recording was 113/63 mm hg. On clinic follow-up, an initial blood pressure measured by a medical assistant was 172/64 mm hg, followed by readings of 154/74 mm hg, 149/72 mm hg, 148/74 mm hg, and 152/76 mm hg. DISCUSSIONOn the continuum where blood pressure determinations are generally higher at the physician's office than at home, white-coat effect with drugtreated hypertension is probably more common than white-coat hypertension in the absence of drug treatment. White-coat effect describes an alerting reaction, either transient or persistent, observed in a majority of patients. 1 Whereas the true prevalence of white-coat hypertension may be about 15%, 2 in the majority of patients with true hypertension, drug treatment reduces but does not eliminate the white-coat effect. fortunately, multiple blood pressure readings taken by nurses and trained clinic assistants, rather than physicians, can obviate the large amount of white-coat effect. figure 1 depicts th...

show abstract

“…This brings us to the use of blood pressure devices by patients. On p. 111 of this issue, Professor Wong and his colleagues 5 report an investigation of automated blood pressure devices used by hypertensive patients (usually on their own initiative) in Hong Kong. They found that the patients' self-measurements agreed only poorly with readings from a mercury sphygmomanometer, especially for diastolic blood pressures.…”

mentioning

confidence: 99%