Essentials of hypertension measurement and its value to special types of hypertension / 中国实用内科杂志

With the rapid aging of China's population, the incidence of hypertension has increased year by year. The lack of awareness, treatment and control is still one of the important public health problems of China. In-depth understanding of blood pressure measurement, so that residents understand their blood pressure level. It is an important part of improving residents' health literacy. Therefore, the article briefly discusses the key points of blood pressure measurement and its value for special types of hypertension.

Redefining Effusive-Constrictive Pericarditis with Echocardiography

BACKGROUND: Effusive-constrictive pericarditis (ECP) is traditionally diagnosed by using the expensive and invasive technique of direct pressure measurements in the pericardial space and the right atrium. The aim of this study was to assess the diagnostic role of echocardiography in tuberculous ECP. METHODS: Intrapericardial and right atrial pressures were measured pre- and post-pericardiocentesis, and right ventricular and left ventricular pressures were measured post-pericardiocentesis in patients with tuberculous pericardial effusions. Echocardiography was performed post-pericardiocentesis. Traditional, pressure-based diagnostic criteria were compared with post-pericardiocentesis systolic discordance and echocardiographic evidence of constriction. RESULTS: Thirty-two patients with tuberculous pericardial disease were included. Sixteen had ventricular discordance (invasively measured), 16 had ECP as measured by intrapericardial and right atrial invasive pressure measurements and 17 had ECP determined echocardiographically. The sensitivity and specificity of pressure-guided measurements (compared with discordance) for the diagnosis of ECP were both 56%. The positive and negative predictive values were both 56%. The sensitivity of echocardiography (compared with discordance) for the diagnosis of ECP was 81% and the specificity 75%, while the positive and the negative predictive values were 76% and 80%, respectively. CONCLUSION: Echocardiography shows a better diagnostic performance than invasive, pressure-based measurements for the diagnosis of ECP when both these techniques are compared with the gold standard of invasively measured systolic discordance.

Clinical Significance of Home Blood Pressure and Its Possible Practical Application

This review represents the clinical significance of home blood pressure (BP) and its possible practical application. Home BP is highly reproducible and its reproducibility is better than ambulatory BP. According to this feature home BP has a greater prognostic value at least than clinic BP and is extremely effective for the evaluation of drug effects and their duration. The introduction of home BP to the diagnosis and treatment of hypertension facilitates long-term BP control. Home BP is particularly important for the diagnosis and treatment of hypertension in diabetes mellitus, pregnancy, children and renal diseases. Home BP measurements improve the adherence to medications and medical consultations, and are indispensable for diagnosis of white coat hypertension and masked hypertension. Such efficiency of home BP improves medical economy. Home BP can detect minimal charge in BP mediated by medication, and intrinsic and extrinsic stimuli and detect long-term change in BP. Thus, home BP is now indispensable for improvement in the management of hypertension in medical practice as well as for the recognition of hypertension in the general population. Standardization of the measurement procedure may elevate the position of home BP in the practice of diagnosing and treating hypertension.

Correlation between intrasac pressure measurements of a pressure sensor and an angiographic catheter during endovascular repair of abdominal aortic aneurysm

PURPOSE: To establish a correlation between intrasac pressure measurements of a pressure sensor and an angiographic catheter placed in the same aneurysm sac before and after its exclusion by an endoprosthesis. METHODS: Patients who underwent endovascular abdominal aortic aneurysm repair and received an EndoSureTM wireless pressure sensor implant between March 19 and December 11, 2004 were enrolled in the study. Simultaneous readings of systolic, diastolic, mean, and pulse pressure within the aneurysm sac were obtained from the catheter and the sensor, both before and after sac exclusion by the endoprosthesis (Readings 1 and 2, respectively). Intrasac pressure measurements were compared using Pearson's correlation and Student's t test. Statistical significance was set at p<0.05. RESULTS: Twenty-five patients had the pressure sensor implanted, with simultaneous readings (i.e., recorded by both devices) obtained in 19 patients for Reading 1 and in 10 patients for Reading 2. There was a statistically significant correlation for all pressure variables during both readings, with p<0.01 for all except the pulse pressure in Reading 1 (p<0.05). Statistical significance of pressure variations before and after abdominal aortic aneurysm exclusion was coincident between the sensor and catheter for diastolic (p>0.05), mean (p>0.05), and pulse (p<0.01) pressures; the sole disagreement was observed for systolic pressure, which varied, on average, 31.23 mmHg by the catheter (p<0.05) and 22 mmHg (p>0.05) by the sensor. CONCLUSION: The excellent agreement between intrasac pressure readings recorded by the catheter and the sensor justifies use of the latter for detection of post-exclusion abdominal aortic aneurysm pressurization.

Study on difference of noninvasive blood pressure measurement method based on oscillometric and auscultatory / 医疗卫生装备

This paper introduces and compares several blood pressure measurements, among which two noninvasive blood pressure measurements based on oscillometric and auscultatory methods are mainly compared. It also analyses the characteristics and advantages of oscillometric method as well as introduces a noninvasive blood pressure measurement monitor based on oscillometric. By using this monitor and a common auscultory method, we conducted a public survey. The result for statistical data analysis showed that the difference between oscillometric and auscultatory methods are quite small, and the accuracy of them are both quite good .This paper also previews the future of the noninvasive blood pressure measurement

Confiabilidade da medida de pressão arterial sanguínea em um estudo de hipertensão arterial / Reliability of arterial blood pressure measurements in an arterial hypertension study

Purpose - To evaluate the reliability of the blood pressure measurements in an arterial hypertension study. Methods - It was evaluated 502 nurse workers of a public hospital. After careful training and selection of the observers, for the quality control at the field work, it was analyzed the correlation between the 1st and 2st measuments, final digit preference and mean systolic (SBP) and diastolic pressure(DBP). 5% of the sample had their measures compared with those checked by an expert. Results - There was a great confiability intraobserver (96.2% in the SBP and 93.4% in the DBP). The final digit distribution was almost identical. At the 5% sample, there was a strong correlation between them (96. 0% in the SBP and 93.9% in the DBP). Conclusion - This methodology is feasible in national studies and confers validity to the results

Objetivo - Avaliar a confiabilidade das medidas de pressão arterial sanguínea em um estudo sobre hipertensão arterial (HA). Métodos - Foram examinadas 502 trabalhadoras de enfermagem em hospital de Salvador. Após cuidadoso processo de treinamento e seleção para controle de qualidade do trabalho de campo, os valores aferidos foram analisados, quanto à correlação entre as medidas e à distribuição dos dígitos terminais e das médias de pressão arterial sistólica (PAS) e diastólica (PAD). Comparou-se amostra de 5% das medidas com as efetuadas, de modo cego, na mesma ocasião, por supervisora médica. Resultados - Observou-se grande confiabilidade intra-observadora (96,2% na PAS e 93,4% na PAD). A distribuição entre os dígitos terminais foi praticamente eqüitativa. Na amostra, houve grande correlação entre as medidas (96,0% na PAS e 93,9% na PAD). Conclusão - As estratégias adotadas para a uniformização das medidas foram satisfatórias, garantindo a confiabilidade dos resultados e factíveis em estudos nacionais