Transforming blood pressure control in primary care through a novel remote decision support strategy based on wearable blood pressure monitoring: The NEXTGEN-BP randomized trial protocol

Gnanenthiran, S.; Tan, Isabella; Atkins, Emily; Avolio, Alberto; Bennett, Belinda; Chapman, Niamh; Chow, Clara K; Freed, Ruth S.; Gnjidic, Danijela; Hespe, Charlotte; Kaur, Baldeep; Liu, Huei Ming; Patel, Anushka; Peiris, David; Reid, Christopher M.; Schlaich, Markus; Sharman, James E.; Stergiou, George S.; Usherwood, Tim; Gianacas, Christopher; Rodgers, Anthony; Schutte, Aletta E.

doi:10.1016/j.ahj.2023.07.005

American Heart Journal

2023

DOI: 10.1016/j.ahj.2023.07.005

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Transforming blood pressure control in primary care through a novel remote decision support strategy based on wearable blood pressure monitoring: The NEXTGEN-BP randomized trial protocol

S. Gnanenthiran

Isabella Tan

Emily Atkins

et al.

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2024

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Cited by 2 publications

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Blood pressure time at target and its prognostic value for cardiovascular outcomes: a scoping review

Li,

Gnanenthiran,

Schutte

et al. 2024

Hypertens Res

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The proportion of time that blood pressure (BP) readings are at treatment target levels, commonly referred to as time at target or time in therapeutic range (BP-TTR), is emerging as a useful measure for evaluating hypertension management effectiveness and assessing longitudinal BP control. However, method of determination for BP-TTR differs across studies. This review identifies variations in BP-TTR determination methodologies and its potential prognostic value for cardiovascular outcomes. Following PRISMA extension for scoping reviews guidelines, literature was systematically searched in Embase, PubMed, Scopus, Web of Science, and CINAHL. Relevant clinical trials, observational studies, cohort studies, cross-sectional studies, and systematic reviews published in English were screened. Of 369 articles identified, 17 articles were included. Studies differed in the BP targets used (e.g., BP < 140/90 mmHg or 130/80 mmHg; systolic BP within 110–130 mmHg or 120–140 mmHg), BP-TTR measurement duration (range 24 h to 15 years), and calculation method (linear interpolation method, n = 12 [71%]; proportion of BP readings at target, n = 5 [29%]). Regardless of method, studies consistently demonstrated that higher BP-TTR was associated with reduced risk of cardiovascular outcomes. Six of eight studies found the association was independent of mean achieved BP or last measured BP. Despite variation in methods of BP-TTR determination, these studies demonstrated the potential prognostic value of BP-TTR for cardiovascular outcomes beyond current BP control measures. We recommend standardization of BP-TTR methodology, with preference for linear interpolation method when BP measurements are few or less frequent, and proportion of BP readings method when large number of BP readings are available.

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Blood pressure time at target and its prognostic value for cardiovascular outcomes: a scoping review

Li,

Gnanenthiran,

Schutte

et al. 2024

Hypertens Res

View full text Add to dashboard Cite

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History and evolution of blood pressure measurement

Noh,

Kim,

Kang

et al. 2024

Clin Hypertens

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Hypertension is the leading cause of morbidity and mortality worldwide. Hypertension mostly accompanies no symptoms, and therefore blood pressure (BP) measurement is the only way for early recognition and timely treatment. Methods for BP measurement have a long history of development and improvement. Invasive method via arterial cannulation was first proven possible in the 1800’s. Subsequent scientific progress led to the development of the auscultatory method, also known as Korotkoff’ sound, and the oscillometric method, which enabled clinically available BP measurement. However, hypertension management status is still poor. Globally, less than half of adults are aware of their hypertension diagnosis, and only one-third of them being treated are under control. Novel methods are actively investigated thanks to technological advances such as sensors and machine learning in addition to the clinical needs for easier and more convenient BP measurement. Each method adopts different technologies with its own specific advantages and disadvantages. Promises of novel methods include comprehensive information on out-of-office BP capturing dynamic short-term and long-term fluctuations. However, there are still pitfalls such as the need for regular calibration since most novel methods capture relative BP changes rather than an absolute value. In addition, there is growing concern on their accuracy and precision as conventional validation protocols are inappropriate for cuffless continuous methods. In this article, we provide a comprehensive overview of the past and present of BP measurement methods. Novel and emerging technologies are also introduced with respect to their potential applications and limitations. Graphical Abstract

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Transforming blood pressure control in primary care through a novel remote decision support strategy based on wearable blood pressure monitoring: The NEXTGEN-BP randomized trial protocol

Cited by 2 publications

References 33 publications

Blood pressure time at target and its prognostic value for cardiovascular outcomes: a scoping review

Blood pressure time at target and its prognostic value for cardiovascular outcomes: a scoping review

History and evolution of blood pressure measurement

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