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Advice from the BP Measurement Experts

Blood Pressure Measurement and Dialysis

Dialysis Patient

Dialysis is a medical treatment that performs the job of well-functioning kidneys in ridding the body of waste and helping it to maintain a proper balance of water and minerals. In hemodialysis, this is done by pumping a patient's blood through a dialyzer where the blood is cleansed, and the clean blood is returned to the patient.1 For the over 350,000 US 2and 40,000 UK residents3 who have lost their kidneys and/or kidney function and partake in dialysis regularly, the procedure provides for and defines the normalcy of daily life.

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Back to the Basics of Blood Pressure

Blood pressureAlmost everyone knows that blood pressure is one of the most important measurements in medicine. Every time a patient visits a physician's office or hospital, one of the first measurements taken is their blood pressure. Since blood pressure plays such a vital role in monitoring a person's overall health, I thought I would write about the basics of blood pressure and some of the terminology used in blood pressure measurement.

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Life's Simple 7 Heart Health Factors

Heart Health videoBlood Pressure is one of the American Heart Association's Life's Simple 7 factors included in the My Life Check to help Americans assess and improve their heart health. Small changes in any of the 7 categories lead to improved heart health. Check out your Heart Score today!

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Survey Shows that Family Physicians Overestimate Their Effectiveness in Treating Hypertension


Family physicians overestimate their effectiveness in treating hypertensionA recent survey published in BMC Family Practice shows that US internists and family practice physicians mistakenly believe they are adequately treating high blood pressure. All of the surveyed physicians felt like they treated hypertension adequately and many cited the biggest challenge in blood pressure control as patient noncompliance.

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'Tis the Season for High Blood Pressure

Holiday foodThe hustle and bustle of the holiday season can be a stressful time of year for most.  Overindulgence at holiday parties, long shopping lists and added financial burden is enough to raise anyone's blood pressure and put them at risk for a cardiovasular event.  The gift of health is the most important thing we can give ourselves this holiday season.  Read this article to see what you can do to promote a heart healthy holiday!

From all of us at SunTech Medical, we wish you a healthy holiday season and a happy new year!

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High Blood Pressure Leads To Memory Troubles:

Memory problems

Another Reason for Accurate BP Measurement

While many people view blood pressure as simply two numbers, the importance of accurate blood pressure measurement continues to gain visibility. Typically, problems associated with high blood pressure cause us to think about heart disease, stroke, kidney failure and diabetes, but there is another negative effect of hypertension. This week, U.S. researchers released information that suggests people as young as 45 with high blood pressure are much more likely to have memory troubles.[1] The indicating factor was a high diastolic blood pressure (the bottom number).

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Ambulatory Blood Pressure Monitoring Used for “The Dr. Oz Show”

Dr. Oz uses ABPMOn Tuesday, September 22, The Dr. Oz Show explored how stress is destroying women's bodies and revealed an Ultimate Anti-Stress Checklist. Ambulatory blood pressure monitoring was used to assess how stress affected a busy mom's blood pressure throughout the day. The data produced an overall blood pressure profile which is a key indicator of her overall health. Dr. Oz pointed out a few hypertensive readings during the test, which were directly related to stressful tasks (e.g. her son spilling candy all over the grocery store).

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The Importance of Ambulatory Blood Pressure Monitoring...continued

Oscar 2 ABPM in use

Part 2 of 2: What is ABPM?  Why should I get a test? ABPM Blood Pressure Guidelines.

Most hypertension opinion leaders regard ambulatory blood pressure monitoring as the gold standard for risk assessment since it is superior to both clinic and home BP measurement [4],[5]. Ambulatory blood pressure monitoring (ABPM) is a 24 hour blood pressure test in which readings are taken every 15-30 min during the day and 20-60 min during asleep hours. To learn more about ABPM, please, check out this ABPM video.


Why should I get an ambulatory blood pressure test?

ABPM provides information which home BP and clinic BP cannot including:

  1. an estimate of true, or mean, blood-pressure level
  2. diurnal rhythm of blood pressure
  3. blood pressure variability

More benefits to ABPM are summarized in the table below.

Benefits of Ambulatory Blood Pressure Monitoring over Home BP and Office BP [4]

  ABPM
Home BP
Office BP
Mean (true blood pressure)
Yes Maybe No
White-coat hypertension Yes Maybe No
Masked hypertension
Yes Maybe No
Diurnal blood pressure rhythm Yes No No
Dipping status
Yes No No
Morning surge
Yes Maybe No
Blood pressure variability
Yes Maybe No
Duration effects of BP meds
Yes Maybe No

You can see from the table above that there are several key benefits to ABPM, but you may not know why they are important. I'll highlight a few on the list.

  • White-coat hypertension: White-coat hypertension is when a patient's BP is measured high in the office because the patient might be nervous in that environment. As many as 30% of diagnosed hypertensive patients are later found to have white-coat hypertension. It is important to differentiate between white-coat and sustained hypertension, since white-coat patients do not actually need anti-hypertensive medications.
  • Night-time BP: ABPM also provides a night-time BP profile. Night-time hypertension is correlated with higher risk of cardiovascular end outcomes.
  • BP medication assessment: Finally, ABPM is especially useful for recently diagnosed hypertension or the assessment of BP meds. As mentioned earlier, the majority of Americans with hypertension do not have it under control, but they may not know that. An ABPM test can help physicians prescribe the right medications to keep blood pressure in control and reduce future cardiovascular risk. In fact, when ABPM is incorporated into the hypertension diagnostic and treatment process, up to a 14% savings in the cost of healthcare has been calculated.[6]

What are blood pressure guidelines for ABPM?

Most people are familiar with the 140/90 mmHg guidelines for blood pressure. Blood pressure guidelines for ambulatory monitoring are a little lower. The American Heart Association recommends an overall 24-hr average of 130/80 or lower. The 7th Joint National Committee states that awake ambulatory bp measurements should be below 135/85 and asleep measurements should be below 120/75. The European Society of Hypertension (ESH) states that normal awake bp is 135/85, but optimal awake 130/80. The ESH also recommends that normal asleep bp is 120/70, but optimal asleep 115/65.

If you have any questions or comments regarding your experiences with ABPM, we'd love to hear about it!

 

Back to Part 1 of "The Importance of Ambulatory Blood Pressure Monitoring"

 


 

[1] http://familydoctor.org/online/famdocen/home/common/heartdisease/treatment/770.html

[2] World Health Organization. (2003). 2003 World Health Organization (WHO)/ International Society of Hypertension (ISH) statement on the management of hypertension. Journal of Hypertension, 21, 1983-1992.

[3] American Heart Association Statistics Committee and Stroke Statistics Committee. (2009). Circulation, 119, e21 - e181.

[4] Pickering, TG, Shimbo, D, and Haas, D. (2006). Ambulatory Blood-Pressure Monitoring. New England Journal of Medicine, 354, 2368-2374.

[5] Urbina, E. et al. (2008). Ambulatory Blood Pressure Monitoring in Children and Adolescents: Recommendations for Standard Assessment. A Scientific Statement from the American Heart Association Arthrosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young and the Council for High Blood Pressure Research. Hypertension, 52, 433-451.

[6] Krakoff, LR. (2006). Cost-Effectiveness of Ambulatory Blood Pressure. Hypertension, 47, 29-34.

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"Know Your Blood Pressure Numbers!" Week

SphygmanometerApparently millions in the UK don't! And the Blood Pressure Association, a UK charity dedicated to lowering the nation's BP, wants to raise awareness of the so-called "silent killer" by promoting its largest event of the year, Know your Numbers! Week 2009. It's happening this week, 7-13 September, at thousands of Pressure Stations across the country.

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