RESUMO
A nocturnal home blood pressure (BP) monitoring device that measures nighttime BP levels accurately with less sleep disturbance is needed for the 24-h management of hypertension. Here we conducted the first comparison study of simultaneous self-monitoring by both a supine position algorithm-equipped wrist nocturnal home BP monitoring device, the HEM-9601T (NightView; Omron Healthcare) with a similar upper arm device, the HEM-9700T (Omron Healthcare) in 50 hypertensive patients (mean age 68.9 ± 11.3 years). Both devices were worn on the same non-dominant arm during sleep over two nights. The patients self-measured their nighttime BP by starting nocturnal measurement mode just before going to bed. In total, 694 paired measurements were obtained during two nights (7.2 ± 1.5 measurements per night), and the mean differences (±SD) in systolic BP between the devices was 0.2 ± 10.2 mmHg (p = .563), with good agreement. In the comparison of nighttime BP indices, the difference in average SBP at 2:00, 3:00, and 4:00 AM and the average SBP of 1-h interval measurements was -0.5 ± 5.5 mmHg (p = .337), with good agreement. The HEM-9601T substantially reduced sleep disturbance compared to the upper arm-type device. The newly developed HEM-9601T (NightView) can thus accurately measure BP during sleep without reducing the wearer's sleep quality.
Assuntos
Braço , Hipertensão , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Pressão Sanguínea , Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão Arterial , Humanos , Hipertensão/diagnóstico , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , PunhoRESUMO
Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the occurrence of cardiovascular and renal complications in patients with type 2 diabetes mellitus (T2DM) and represent guideline-recommended therapy in this indication. However, precise mechanisms underlying the beneficial cardiovascular effects of SGLT2 inhibitors are not fully understood. This study investigated the effects of the SGLT2 inhibitor, luseogliflozin, on arterial properties and home blood pressure (BP) in patients with T2DM. This multicenter, single-arm study enrolled adults with T2DM, glycosylated hemoglobin (HbA1c) 6.5%-8.9% in the previous 4 weeks, and an indication for new/additional antidiabetic therapy. Luseogliflozin 2.5 mg/d was given for 12 weeks. Primary outcome was change in cardio-ankle vascular index (CAVI) from baseline to Week 4 and Week 12. Home and office BP, BP variability, and metabolic parameters were secondary endpoints. Forty-seven patients (mean age 63.5 ± 10.7 years) treated with luseogliflozin were included in the full analysis set. CAVI did not change significantly from baseline (mean [95% confidence interval] 8.67 [8.37-8.97]) to Week 12 (8.64 [8.38-8.91]; P = .750), but there were significant reductions from baseline in morning home BP, HbA1c, body weight, body mass index, and serum uric acid levels during luseogliflozin therapy. The reduction in morning home systolic BP was ≥ 5 mm Hg and was independent of baseline BP and BP control status. In conclusion, there was no change in arterial stiffness (based on CAVI) during treatment with luseogliflozin, but changes in BP and metabolic parameters were consistent with the known beneficial effects of SGLT2 inhibitors in T2DM.