Dataset Information

Could the arm blood pressure measured with simultaneous bilateral arm method be used for hypertension diagnosis?

ABSTRACT:

Objective

Simultaneous bilateral arm blood pressure (BP) measurement (bilateral arm method) is suggested for the first BP measurement in clinical practice, but whether the arm BP measured with bilateral arm method (RA-2) is similar to that with unilateral arm method (RA-1) is unclear.

Design

Quantitative research, paired sample T-test, Bland-Altman and multivariate linear regression analyses were used.

Setting

This study included 295 subjects (18-90 years, 60.0±14.6 years old, 126 males) in the clinic of cardiovascular medicine of the Second Affiliated Hospital of Nanchang University. They were randomly instructed to one of two BP measurement proposals: (1) right-arm-bilateral arm-right-arm-bilateral arm, or (2) bilateral arm-right-arm-bilateral arm-right-arm to attenuate bias induced by BP measurement order.

Participants

From June to October of 2019, 295 outpatients (18-90 years, 60.0±14.6 years old, 126 males and 169 females) with sinus rhythm (SR) were enrolled. The exclusion criteria were acute myocardial infarction, congenital heart disease, acute heart failure, syncope, hemiplegia, arrhythmia and pulseless (by palpation).

Outcome measures

We compared the BP differences between bilateral arm method and unilateral arm method. The difference between RA-2 and RA-1 was calculated as Dif-RA. Data are expressed as means±SD for continuous variables. The percentage increase (PI) was calculated on the formula: (RA-2-RA-1)/RA-1.

Results

The RA-2 on systolic blood pressure (SBP)/diastolic blood pressure (DBP) was slightly, but statistically higher by 1.2/0.4 mm Hg against the RA-1. Multivariate regression analyses showed that hypertension therapy type was positive impact factor, but RA-1 was negative factor for PI of Dif-RA on SBP, DBP and pulse pressure.

Conclusion

The SBP and DBP of right arm measured with bilateral arm method are slightly, but statistically higher (1.2 and 0.4 mm Hg) than those with the unilateral arm BP method.

SUBMITTER: Wan T

PROVIDER: S-EPMC7497520 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Could the arm blood pressure measured with simultaneous bilateral arm method be used for hypertension diagnosis?

Wan Taixuan T Wu Yuanhao Y He Ziqiang Z Su Hai H

BMJ open 20200916 9

<h4>Objective</h4>Simultaneous bilateral arm blood pressure (BP) measurement (bilateral arm method) is suggested for the first BP measurement in clinical practice, but whether the arm BP measured with bilateral arm method (RA-2) is similar to that with unilateral arm method (RA-1) is unclear.<h4>Design</h4>Quantitative research, paired sample T-test, Bland-Altman and multivariate linear regression analyses were used.<h4>Setting</h4>This study included 295 subjects (18-90 years, 60.0±14.6 years o ...[more]

PMID: 32938597

Similar Datasets

Project description:BackgroundTwenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalents to clinic blood pressure thresholds for diagnosis and treatment of hypertension.MethodsWe collated 24 hour ambulatory blood pressure data, recorded with validated devices, from 11 centres across six Australian states (n=8575). We used least product regression to assess the relation between these measurements and clinic blood pressure measured by trained staff and in a smaller cohort by doctors (n=1693).ResultsMean age of participants was 56 years (SD 15) with mean body mass index 28.9 (5.5) and mean clinic systolic/diastolic blood pressure 142/82 mm Hg (19/12); 4626 (54%) were women. Average clinic measurements by trained staff were 6/3 mm Hg higher than daytime ambulatory blood pressure and 10/5 mm Hg higher than 24 hour blood pressure, but 9/7 mm Hg lower than clinic values measured by doctors. Daytime ambulatory equivalents derived from trained staff clinic measurements were 4/3 mm Hg less than the 140/90 mm Hg clinic threshold (lower limit of grade 1 hypertension), 2/2 mm Hg less than the 130/80 mm Hg threshold (target upper limit for patients with associated conditions), and 1/1 mm Hg less than the 125/75 mm Hg threshold. Equivalents were 1/2 mm Hg lower for women and 3/1 mm Hg lower in older people compared with the combined group.ConclusionsOur study provides daytime ambulatory blood pressure thresholds that are slightly lower than equivalent clinic values. Clinic blood pressure measurements taken by doctors were considerably higher than those taken by trained staff and therefore gave inappropriate estimates of ambulatory thresholds. These results provide a framework for the diagnosis and management of hypertension using ambulatory blood pressure values.

Project description:BackgroundWhile there is a strong association between adhering to a healthy dietary pattern and reductions in blood pressure, adherence remains low. New technologies aimed to help facilitate behavior change may have an effect on reducing blood pressure among individuals with hypertension.ObjectiveThis study aims to evaluate characteristics of participants with stage 2 hypertension who used Foodsmart and to assess changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP).MethodsWe analyzed demographic, dietary, and clinical characteristics collected from 11,934 adults with at least two blood pressure readings who used the Foodsmart platform. Stage 2 hypertension was defined as SBP ≥140 mmHg or DBP ≥90 mmHg. We calculated mean changes in blood pressure among participants with stage 2 hypertension and stratified by length of follow-up and the covariates associated with achieving blood pressure levels below stage 2 hypertension. We compared changes in diet quality and weight between participants with stage 2 hypertension at baseline who achieved stage 1 hypertension or below and those who did not.ResultsWe found that 10.63% (1269/11,934) of participants had stage 2 hypertension at baseline. Among Foodsmart participants with stage 2 hypertension at baseline, SBP and DBP decreased, on average, by 5.7 and 4.0 mmHg, respectively; 33.02% (419/1269) of participants with stage 2 hypertension at baseline achieved blood pressure levels below stage 2 hypertension (SBP <140 mmHg and DBP <90 mmHg). Using a multivariable ordinal logistic regression model, changes in Nutriscore (P=.001) and weight (P=.04) were statistically significantly associated with changes in blood pressure categories for users with stage 2 hypertension at baseline. Using a multivariable logistic regression model, we found that baseline Nutriscore, change in Nutriscore, and change in weight were associated with greater likelihood of users with stage 2 hypertension at baseline achieving a lower blood pressure category.ConclusionsThis study evaluated changes in SBP and DBP among users (with hypertension) of the Foodsmart platform and found that those with stage 2 hypertension, on average, improved their blood pressure levels over time.

Project description:ImportanceHypertension remains the major cardiovascular disease risk factor globally, but variability in measured blood pressure may result in suboptimal management. Whether genetic contributors to elevated blood pressure may complementarily inform cardiovascular disease risk assessment is unknown.ObjectiveTo examine incident cardiovascular disease by blood pressure polygenic risk score independent of measured blood pressures and antihypertensive medication prescriptions.Design, setting, and participantsThe cohort study (UK Biobank) recruited UK residents aged 40 to 69 years between March 2006 and August 2010. Participants without a prior physician diagnosis of cardiovascular disease, including myocardial infarction, stroke, or heart failure, were included. Excluded were individuals with mismatch between self-reported and genotypically inferred sex, sex aneuploidy, missing genotype rates of 1% or greater, and excess genotypic heterozygosity. Data analyses were performed from September 25, 2021, to July 21, 2022.ExposuresMeasured blood pressure and externally derived blood pressure polygenic risk score stratified by hypertension diagnosis and management, which included normal blood pressure (<130/80 mm Hg without antihypertensives), untreated hypertension (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg without antihypertensives), and treated hypertension (current antihypertensives prescriptions).Main outcomes and measuresComposite of first incident myocardial infarction, stroke, heart failure, or cardiovascular-related death.ResultsOf the 331 078 study participants included (mean [SD] age at enrollment, 56.9 [8.1] years; 178 824 female [54.0%]), 83 094 (25.1%) had normal blood pressure, 197 597 (59.7%) had untreated hypertension, and 50 387 (15.2%) had treated hypertension. Over a median (IQR) follow-up of 11.1 (10.4-11.8) years, the primary outcome occurred in 15 293 participants. Among those with normal blood pressure, untreated hypertension, and treated hypertension, each SD increase in measured systolic blood pressure was associated with hazard ratios of 1.08 (95% CI, 0.93-1.25), 1.20 (95% CI, 1.16-1.23), and 1.16 (95% CI, 1.11-1.20), respectively, for the primary outcome. Among these same categories, each SD increase in genetically predicted systolic blood pressure was associated with increased hazard ratios of 1.13 (95% CI, 1.05-1.20), 1.04 (95% CI, 1.01-1.07), and 1.06 (95% CI, 1.02-1.10), respectively, for the primary outcome independent of measured blood pressures and other covariates. Findings were similar for measured and genetically predicted diastolic blood pressure.Conclusions and relevanceBlood pressure polygenic risk score may augment identification of individuals at heightened cardiovascular risk, including those with both normal blood pressure and hypertension. Whether it may also guide antihypertensive initiation or intensification requires further study.

Dataset Information

Could the arm blood pressure measured with simultaneous bilateral arm method be used for hypertension diagnosis?

Objective

Design

Setting

Participants

Outcome measures

Results

Conclusion

Publications

Could the arm blood pressure measured with simultaneous bilateral arm method be used for hypertension diagnosis?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets