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Advice from the BP Measurement Experts

Canadian Blood Pressure Study of Obese Children Yields Unexpected Results

Child on scaleA recent Canadian blood pressure study discovered that high blood pressure does not directly correlate with the rising obesity rate in pediatric patient populations.  Contrary to expected research outcomes, while most pediatric patients (ages 6-19) with high blood pressure were obese, not all overweight adolescents (a mere 3%) suffer from high blood pressure.

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Guidelines for Ambulatory Blood Pressure Monitoring in Children

Child patientHaving covered the recently rising awareness of childhood hypertension, we thought it appropriate to highlight the guidelines of using ambulatory blood pressure monitoring (ABPM) in children. The American Heart Association has published comprehensive recommendations on this topic...


 

...Which can be found here.  Additionally, separate commentary by Dr. Bruce Alpert, one of the contributing authors, can be found on the SunTech White Papers section.

In some ways, the guidelines for its use on children is not so different than for adults.  However, you should be aware of the following nuances:

  • Check the monitor’s qualification: While clinical validation to the US standard (AAMI) and to the British standard (BHS) are mandatory before a product is allowed on the market, an ABPM specifically needs to be validated for use on children and adolescents.  Make sure to inquire with the manufacturer or representative that the ABPM has been tested to and passed the validation with children as subjects.
  • Use equipment tuned for children: The ABPM should be lightweight, small, quiet, and well-protected when it is worn by the child.  More importantly, an appropriately-sized cuff must be used.
  • Use ABPM software that analyzes children’s BP readings according to the previously discussed thresholds based on age, gender, and height.

The AHA statement goes into significantly more detail.  However, the three guidelines above are the most important to successfully using ABPM on children in a medical practice.

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Physician Acquired Blood Pressure Measurement is Higher than Nurse Acquired BP

Doctor takes patient's blood pressureThere are several different types of mild and/or episodic hypertension that ambulatory blood pressure monitoring (ABPM) can help a physician diagnose. However, the summary data that ABPM provides, the average daytime or 24-hour blood pressure as two examples, provides significantly different information than the one or two measurements taken in a clinic. Although this difference is one of the reasons that ABPM correlates better to cardiovascular outcomes than in-clinic BP, making it the gold standard for BP measurement, there are few detailed guidelines on the targets or thresholds for ABP like there are for in-clinic BPs like the popular 120/80 as a threshold for normal BP and 140/90 for hypertensive.*

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ASH 2010: A Focus on Improving Blood Pressure Measurement Technique

ASH logoAt the recent 25th annual scientific meeting for the American Society of Hypertension, there was a new program track targeted specifically to clinicians in primary care. The aim was to present the latest hypertension strategies and guidelines in a format that would be appropriate for the primary care physician but also for physician's assistants, nurse practitioners as well as seasoned hypertension specialists. While the session covered various current issues related to hypertension, one clear area of attention was a re-focus on blood pressure measurement methods.

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Ambulatory Blood Pressure Monitoring

Dr. William White interview video

An interview with Dr. William White from the 25th American Society of Hypertension Scientific Meetings

Over the course of the most recent American Society of Hypertension (ASH) Meetings held in New York City May 1 - 4th, outgoing ASH President Henry Black, MD had an opportunity to interview incoming ASH President William White MD. While their discussion covered many topics related to blood pressure monitoring, the focus was on ambulatory blood pressure monitoring (ABPM) and when and how to use it. This interview has been made available for viewing through WebMD's Medscape Cardiology page.

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International Hypertension Report Calls for Increased Awareness of Childhood Hypertension

Girl listening to teddy bears heartWe’ve already discussed how hypertension is a costly drain on worldwide health care systems and society in general, but this cost is only based on adult hypertension.  A recently published report advocates improving the awareness, identification, and treatment of pediatric hypertension and clearly describes the implications of continuing to neglect this problem in the pediatric population.  The prevalence of hypertension in children is about 3-5% of the population, but as obesity continues to rise in children, high blood pressure will likely increase making it even more important to raise the awareness of pediatric hypertension.

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CMEF 2010: China and Growing Awareness of Hypertension

SunTech Medical at CMEF 2010Earlier this year we wrote a blog post about the similarities of current healthcare challenges in both China and the US. Of particular note was the fact that Hypertension is the leading cause of premature deaths in China. We recently had an opportunity to meet and speak with many folks involved with the delivery of healthcare in this rapidly evolving market at the China Medical Equipment Fair (CMEF) held in Shenzhen April 18 - 21, 2010.

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Preeclampsia: Pregnancy and Hypertension

PreeclampsiaAn important health issue that expectant mothers may encounter during pregnancy is Preeclampsia, a condition in which the expectant mother is diagnosed with hypertension and has protein present in the urine.  Preeclampsia is the most common medical disorder of pregnancy and affects 10%-12% of all expectant mothers (Pickering et al, 2005).  Since blood pressure plays an important role in the health of mom and baby, accurate blood pressure measurement is extremely critical, because one would never want to be misdiagnosed with hypertension and be prescribed medications/medical interventions that could potentially injure both mom and baby.

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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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ABPM Reimbursement in the US

Stethoscope and moneyAs a follow-up to the previous post about hypertension neglect in the US, I wanted to provide a bit more information about ambulatory blood pressure monitoring (ABPM). As we've discussed in previous blog posts, ambulatory blood pressure monitoring is a commonly-used tool for the identification and treatment of hypertension. Many health care providers are still unaware that ABPM is a reimbursable procedure although Medicare approved reimbursement in 2001. Routine use of ABPM can serve as a source of revenue for physicians while also improving the quality of care for patients.


 

There are new guidelines for US ABPM Reimbursement.

Download the new copy today!

 

Get My Free US ABPM Reimbursement Guidelines

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Blood Pressure Fluctuations: 'Warning Sign for Stroke'

BP fluctuationsLast week we addressed a report from the Institute of Medicine indicating that high blood pressure is not on the minds of the general public. However, in the most recent issue of the Lancet, a different view of hypertension was posted: what if your physician is looking at the wrong BP values? What if there is more to clinic blood pressure, or the measurement that your physician takes, than the average value?

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Report Indicates US Neglects Hypertension

Hypertension

The Institute of Medicine (IOM) released a report last week recommending strategies to address the "neglected disease" of hypertension in the US. Many people do not realize that high blood pressure is one of the leading causes of death in the US, and it is a risk factor for heart attack, stroke, and kidney failure. One in three US adults has hypertension, and less than half of them have it in control, resulting in an estimated cost of $76 billion in 2010.

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ABPM Used to Identify Masked Hypertension in Children with Chronic Kidney Disease

Masked hypertensionA recent article published in the Journal of the American Society of Nephrology (JASN)1 emphasizes the key role of 24 hour ambulatory blood pressure monitoring (ABPM) as a means to identify masked hypertension in pediatric patients with Chronic Kidney Disease (CKD). The study, published in January 2010, showed that many children with CKD who have normal blood pressure readings at the doctor's office often have high blood pressure readings at home. The researchers used ABPM to collect blood pressure measurements throughout the day including periods of sleep and normal daily activity, which provides a more accurate BP profile for each pediatric patient.

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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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Hypertension in China presents similar challenges seen in the U.S.

Hypertension in ChinaI recently read an article indicating hypertension - or high blood pressure - as the leading preventable cause of premature deaths in China. As I was reading, it made me realize how similar healthcare issues in China and the U.S. truly are.

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February 5th is National Wear Red Day

The Heart Truth logoWear Red Day was created to raise awareness about the risk factors of heart disease, specifically for women. It is the #1 killer of American women, even surpassing deaths resulting from all forms of cancer. The Heart Truth provides tools for women to prevent and control risk factors like high blood pressure, high cholesterol, and obesity. Available materials to help women reduce their risk of heart disease include an Action plan, Heart Health Handbook, and a Heart Health Cookbook. To find out more about National Wear Red Day, check out The Heart Truth website and program overview.

®National Wear Red Day is a registered trademark of HHS and AHA.

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Learn why hypertension is called the 'silent killer'

Hypertension videoNearly 1 in 3 adult Americans have it.  African Americans are especially at risk.  Learn why hypertension is called the 'silent killer'.

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Blood Pressure Monitoring at 30 Thousand Feet?

RDT Tempus IC in flightBlood pressure is everywhere nowadays. While we are used to seeing it measured in the hospital, clinic, and even at home, what about on an airplane? RDT makes this possible with their product and service called Tempus ICTM, which is used by non-medically trained staff to save lives in remote locations such as in-flight or at sea.

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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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