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Advice from the BP Measurement Experts

ESH Releases New Guidelines on Hypertension and BP Measurement

ESH and ESC Guidelines 2013This year marked the 23rd scientific meeting of the European Society of Hypertension (ESH) on "Hypertension and Cardiovascular Protection". While the ESH annual meeting is always filled with the latest in hypertension research, this year's highlight was the presentation of the newest edition of the ESH/ESC (European Society of Cardiology) Guidelines for the management of arterial hypertension.

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FDA Calls for Connector Standardization

Click to view the video on SunTech's Cuff Standardization ProgramTubing misconnections, wrong route errors, catheter misconnections or Luer misconnections: the FDA isn't picky about what you call them – they want them eliminated. Multiple and sometimes fatal connection errors between various medical devices, including blood pressure cuffs, have led to the need for standards designed to eliminate this potential. The intent is to achieve this by designating specific connectors for defined types of devices. Blood pressure cuffs are one of the device groups identified by the FDA for standardization1.

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ABPM Could Be Exactly What The Patient Needs

ABPM Can Catch Overnight DippingThe above title is how author Craig Bowron, MD capped off his recent article “Traditional blood-pressure cuffs not that reliable.” As I was reading the article, I was pleased to see how successful the 15-physician clinic in Minneapolis had been with implementing an Ambulatory Blood Pressure Monitoring (ABPM) program to identify, diagnose and manage their hypertensive patients. One physician was quoted as saying “It’s been breathtaking to see how much difference there can be between office blood pressure readings and what we’ve found with ambulatory [ABP] monitoring”. The practice was able to  lower or end treatment on 13% of their patients after ABPM testing revealed that they were being over-treated. Conversely, 18% had their medication added or increased as their ABPM results showed they were under-treated.

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Beet High Blood Pressure

 beetrootjuiceMy mother was recently diagnosed with high Blood Pressure (BP). She talked to her doctor about the best ways to help control her high BP. The doctor prescribed a blood pressure medication and recommended she should eat more fruits and vegetables in addition to adding 30 minutes of exercise to her daily routine.

I was happy that the doctor recommended a healthy lifestyle to her in addition to the medication. I wouldn't call myself a health nut, maybe an enthusiast – which is why I liked the idea of alternatives for her. Recently, I read a study in the American Heart Association journal Hypertension, about how drinking a cup (250ml) of beetroot juice a day could help lower High BP.

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May 17th is World Hypertension Day

World Hypertension DayEach year, the World Hypertension League designates May 17th as World Hypertension Day. With over 1.5 billion worldwide suffering from hypertension (high blood pressure), we at SunTech Medical would like to do our share to draw attention to this single biggest risk factor for death linked to heart disease, stroke, kidney disease and diabetes. For more information on World Hypertension Day and tips on prevention and treatment of Hypertension, you can visit the World Hypertension League website and download the World Hypertension Day brochure today.

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Telehealth Monitoring May Win Big with New Government Regulations

telemedicineDoes anybody like government imposed penalties? Well, as is normally the case , it depends where you are as a stakeholder.

Readmission penalties drafted in the Affordable Care Act are set to kick in starting October 2013 in the form of Medicare reimbursement cuts to hospitals who have high rates of readmissions for certain health conditions including heart attack, pneumonia and heart failure. Other conditions will be included starting in 2015.

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World Health Organization Releases 2013 Global Brief on Hypertension

Diagnosing Hypertension

On April 7th, the World Health Organization (WHO) celebrated their annual World Health Day in order to draw international attention to important global health issues. Each year, the WHO highlights a different global health concern and, and we found it noteworthy that the focus of this year is controlling high blood pressure.

 

As part of their efforts, the WHO released a new publication, “A Global Brief on Hypertension” (link below), which is now available as a free download at the official WHO website. The brief describes how hypertension is contributing to the growing burden of heart disease, stroke and kidney failure and premature death and disability. The WHO authors explain how hypertension is both preventable and treatable and provides guidance on how governments, health workers, civil society, the private sector and individuals can reduce hypertension and its impact.

 

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Striving for Interoperability of BP Devices and Vital Signs Data at HIMSS 2013

Healthcare InteroperabilityWhen thinking about the healthcare industry it is easy to become overwhelmed due to the sheer volume of what it encompasses and its ever-evolving nature. One continuing focus and challenge that cuts across the entire industry is the management of healthcare information, including BP measurement and other vital signs data. I had the opportunity earlier this month to attend the 2013 Healthcare Information and Management Systems Society (HIMSS) conference and exhibition held in New Orleans, LA which is entirely dedicated to this topic. Specifically, the HIMSS show brings together professionals from the healthcare industry with a goal of leveraging information technology (IT) and management systems for the improvement of healthcare delivery.

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5 Observations about EMR Integration and Interoperability

EMR IntegrationIt’s no secret that information technology is quickly becoming one of the most important components of the healthcare system, and device interoperability with the EMR is undoubtedly a key piece of the HIT puzzle. Here are five observations about EMR integration and interoperability that should help shed some light on the importance and complexity of this issue.

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Love Lowers BP and Healthcare Costs

Love Lowers BPAh, love. Valentines Day brings it front and center – roses, candy, and sentiments to loved ones. Aside from the moments of terror and corresponding spike in blood pressure that can be brought on by the realization that you have forgotten to plan for this celebration, the emotion of love can be of invaluable help in reducing stress and blood pressure.

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New 3rd Edition Standards for NIBP (Part 2)

OEM NIBP from SunTechIn my last blog post I provided 4 out of 8 new 3rd edition regulatory requirements that impact automated non-invasive blood pressure. These included out of range values, nominal blood pressure ranges, service modes and shock/vibration changes. Here are the final four regulatory requirements that must be addressed if you are designing a product with your own non-invasive blood pressure (NIBP) or with NIBP supplied by an OEM provider.

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New 3rd Edition Standards for NIBP (Part 1)

Medical Design RegulationIf you're a medical device developer or active in the design process, you've probably been involved with creating a list of "must have" and "nice to have" features and requirements for a new or updated medical device. Some come from market feedback, industry trends, competitor analysis, R&D and others come from medical equipment Regulatory standards. When it comes to safety and meeting regulatory standards, this is always in the mandatory column. With several deadlines looming on the horizon, meeting the latest 3rd edition standards as well as being RoHS compliant are on almost everyone's must have list when starting a new project. So whether you are developing your own NIBP or purchasing OEM NIBP modules, you now have new requirements that need to be a part of your design not only in hardware and software but also in the product's technical documentation.

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Top 5 Blog Posts of 2012

Holiday trees illustration

As we look forward to the coming new year, we wanted to take a moment to look back at the most popular posts from this year. We'd like to wish all of our friends and followers of Blog@SunTech a Happy Holidays and safe New Year. Unless claims that the end of the world is upon us are true, we'll see you next year!

  1. You're Doing It Wrong: New Study on BP Measurement
  2. Top 7 Reasons You Should Be Using Automated Blood Pressure for Cardiac Stress Testing
  3. Determining BP Device Accuracy: Who Has It Right
  4. 5 Myths About Vital Signs Automation and EHR's
  5. 3 Things to Consider When Measuring Your BP at a Kiosk
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Don't Break a Hip: How ABPM Can Help

As we have all heard time and time again hypertension is a prevalent public health issue, but it affects the elderly at a much higher rate. A newly published study now warns that "caution" is needed when initiating new antihypertensive drugs to treat elderly patients. The findings, published last month in the Archives of Internal Medicine (AIM), showed that elderly patients had a 43% increased risk of having a hip fracture within the first 45 days following the start of new antihypertensive treatment.1 It is reportedly "'the first study to demonstrate an immediate increased risk of hip fracture on initiation of antihypertensive drug therapy in community-dwelling hypertensive elderly patients'". The researchers also hypothesized that the most likely cause of the hip fractures were falls related to orthostatic hypotension, which can have symptoms such as dizziness and fainting.2


The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC), the American Society of Hypertension (ASH) and the National Institute for Clinical Excellence (NICE) recommend regular monitoring for patients who start antihypertensive therapy. So how can we best monitor these patients? JNC and NICE both recommend the use of in-office measurement.3,4 ASH encourages the use of Ambulatory or Home BP monitoring.5
"elderly patients had a 43% increased risk of having a hip fracture within the first 45 days following the start of new antihypertensive treatment"

Ambulatory BP monitoring (ABPM) is widely recognized as a tool for diagnosing hypertension. But it is also a useful tool for monitoring the efficacy of antihypertensive treatment, evaluating optimal BP control in patients with postural hypotension, and aiding in the assessment of patients with hypotensive symptoms that occur with antihypertensive medication.4,6

Clearly, as the AIM study has shown, monitoring could be beneficial for some patients at the onset of antihypertensive treatment and ABPM would be an ideal candidate given its proven value for this specific application. But we want to hear your thoughts. How do you monitor elderly patients starting antihypertensive drug treatments in order to monitor for orthostatic hypotension?

Sources

  1. Archives of Internal Medicine: The Risk of Hip Fracture After Initiating Antihypertensive Drugs in the Elderly, http://archinte.jamanetwork.com/article.aspx?articleid=1392493#METHODS
  2. Heart Wire: Starting BP meds ups risk of hip fracture in elderly, http://www.theheart.org/article/1477231.do?utm_medium=email&utm_source=20121121_EN_Heartwire&utm_campaign=newsletter
  3. NICE Quick Reference Guide: Hypertension, http://www.nice.org.uk/nicemedia/live/13561/56015/56015.pdf
  4. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, http://hyper.ahajournals.org/content/42/6/1206.long
  5. ASH Position Paper: When and how to use self (home) and ambulatory blood pressure monitoring, http://www.ashjournal.com/article/S1933-1711(08)00047-8/abstract
  6. New England Journal of Medicine: Ambulatory Blood-Pressure Monitoring, http://www.nejm.org/doi/full/10.1056/NEJMra060433
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Should Manual BP Get the Boot

Manual BP MeasurementThere's a bit of a debate going on in October's issue of the Journal of Hypertension about the best way to measure blood pressure. Everyone agrees that it should be done using a cuff placed over the brachial artery, but the similarities sort of end there.

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Our Blood Pressure is Rising Over Pediatric Studies

Pediatric Hypertension ScreeningAt Blog@SunTech, monitoring blood pressure on a regular basis is a common point of discussion especially as it relates to hypertension. Blood pressure measurement is an important part of overall health assessment and is typically the first piece of data collected for any office visit...with the exception of one rather important field of practice.

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American Society of Hypertension Urges CDC to Use ABPM

Oscar 2 ABPM Device

Last week, we blogged on the recent report from the Centers for Disease Control and Prevention (CDC) that noted some pretty serious concerns about our national state of health as it relates to hypertension and its potentially deadly effects.

This week, we want to draw your attention to a press release from the American Society of Hypertension urging the CDC to incorporate ambulatory blood pressure monitoring (ABPM) as a way to apply a more "sensitive and specific tool for assessing blood pressure in its national surveys."1

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Silent Killer Ravages US Population

Silent KillerHypertension, often called "the silent killer", is a medical condition that does not strike fear into the hearts of many people. Why? It often presents no noticeable symptoms.

Many people (myself included) don't feel the need to go to the doctor until they have (unbearable) symptoms of something being "wrong". It is a fair assumption then that if they are not going for regular check-ups with a healthcare provider, they are probably not monitoring blood pressure levels on their own either. It is also likely that some are even unaware that their blood pressure is at an unhealthy level.

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Increasing Time Between BP Screenings: Not Such a Dynamite Idea

DynamiteMost folks being treated for hypertension are quite familiar with routine BP measurement because their doctor measures and discusses their blood pressure data with them at almost every visit. Many patients will even monitor their own BP at home on a regular basis. Shucks, even people with completely normal BP (<120mmHg systolic, <70mmHg diastolic) are never surprised when a nurse slaps a BP cuff on their arm anytime they visit a doctor's office. Taking BP has simply become 'par for the course' during most any clinical office visit for just about everyone.

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Medical Devices that Protect and Serve

EMS takes pulseAt SunTech, blood pressure measurement is our religion. In fact, we have a saying about it: "It's more than just a strength; it's who we are; it's what we do." With this singular focus, we get to see how blood pressure measurement is used across all different clinical applications. We see the nuanced experience that clinicians in different specialties and their patients encounter and that makes a difference in their use of automated BP. While it's rare that one of these nuances becomes the basis for policy, that's exactly what the state of New York is recommending in its advisory on patient care in moving ambulances.

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