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Saramies J, Koiranen M, Auvinen J, Uusitalo H, Hussi E, Cederberg H, Keinänen-Kiukaanniemi S, Tuomilehto J. 22-year trends in dysglycemia and body mass index: A population-based cohort study in Savitaipale, Finland. Prim Care Diabetes 2021; 15:977-984. [PMID: 34649826 DOI: 10.1016/j.pcd.2021.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/09/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
AIMS We describe a 22-year prospective observational population-based study that determined the prevalence and incidence of type 2 diabetes (T2D) and intermediate hyperglycaemia (IH), obesity, hypertension, and disorders of lipid metabolism in a middle-age population in the Finnish municipality of Savitaipale. METHODS 1151 people participated in the baseline survey in 1996-1999, following two follow-up examinations, in 2007-2008 and 2018-2019. Follow-up studies comprised clinical measurements, 2-h oral glucose tolerance test and other biochemistry, questionnaires, and registry data. RESULTS The prevalence of T2D quadrupled to 27% and the proportion of normoglycemic people decreased from 73% to 44% while IH increased only slightly during the 22-year follow-up. A large proportion of people who died between the surveys were diabetic. The mean body mass index (BMI) did not, whereas mean waist circumference increased significantly, by 5-6 cm (P = 0.001) during the 22 years. Systolic blood pressure increased by 13-15 mmHg from baseline (P = 0.0001) but diastolic blood pressure did not. The mean plasma levels of total and LDL-cholesterol decreased 10.8% and 8.9% in women (P = 0.001), 21.5% and 22.2% in men (P = 0.001), respectively, while HDL-cholesterol and triglycerides remained stable. The proportion of those achieving targets in the treatment of dyslipidaemia increased significantly (P < 0.001). CONCLUSIONS In this 22-year prospective follow-up study of in middle-aged Europeans with high participation rates, the progression of dysglycaemia to overt diabetes with aging was rapid, even without a significant change in BMI.
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Affiliation(s)
- Jouko Saramies
- South Karelia Social and Health Care District, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Markku Koiranen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Hannu Uusitalo
- SILK, Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, PL 100, 33014 Tampere, Finland; Tays Eye Centre, Tampere University Hospital, Tampere, Finland
| | - Esko Hussi
- South Karelia Social and Health Care District, Finland
| | - Henna Cederberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Department of Endocrinology, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital, Oulu, Finland; Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
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Kirschbaum TK, Theilmann M, Sudharsanan N, Manne-Goehler J, Lemp JM, De Neve JW, Marcus ME, Ebert C, Chen S, Aryal KK, Bahendeka SK, Norov B, Damasceno A, Dorobantu M, Farzadfar F, Fattahi N, Gurung MS, Guwatudde D, Labadarios D, Lunet N, Rayzan E, Saeedi Moghaddam S, Webster J, Davies JI, Atun R, Vollmer S, Bärnighausen T, Jaacks LM, Geldsetzer P. Targeting Hypertension Screening in Low- and Middle-Income Countries: A Cross-Sectional Analysis of 1.2 Million Adults in 56 Countries. J Am Heart Assoc 2021; 10:e021063. [PMID: 34212779 PMCID: PMC8403275 DOI: 10.1161/jaha.121.021063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background As screening programs in low‐ and middle‐income countries (LMICs) often do not have the resources to screen the entire population, there is frequently a need to target such efforts to easily identifiable priority groups. This study aimed to determine (1) how hypertension prevalence in LMICs varies by age, sex, body mass index, and smoking status, and (2) the ability of different combinations of these variables to accurately predict hypertension. Methods and Results We analyzed individual‐level, nationally representative data from 1 170 629 participants in 56 LMICs, of whom 220 636 (18.8%) had hypertension. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or reporting to be taking blood pressure–lowering medication. The shape of the positive association of hypertension with age and body mass index varied across world regions. We used logistic regression and random forest models to compute the area under the receiver operating characteristic curve in each country for different combinations of age, body mass index, sex, and smoking status. The area under the receiver operating characteristic curve for the model with all 4 predictors ranged from 0.64 to 0.85 between countries, with a country‐level mean of 0.76 across LMICs globally. The mean absolute increase in the area under the receiver operating characteristic curve from the model including only age to the model including all 4 predictors was 0.05. Conclusions Adding body mass index, sex, and smoking status to age led to only a minor increase in the ability to distinguish between adults with and without hypertension compared with using age alone. Hypertension screening programs in LMICs could use age as the primary variable to target their efforts.
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Affiliation(s)
- Tabea K Kirschbaum
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany
| | - Michaela Theilmann
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany
| | - Nikkil Sudharsanan
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases Massachusetts General HospitalHarvard Medical School Boston MA
| | - Julia M Lemp
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany
| | - Maja E Marcus
- Department of Economics and Centre for Modern Indian Studies University of Goettingen Germany
| | - Cara Ebert
- RWI-Leibniz Institute for Economic Research Berlin Germany
| | - Simiao Chen
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany.,Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Krishna K Aryal
- Monitoring Evaluation and Operational Research Project Abt Associates Kathmandu Nepal
| | | | | | | | - Maria Dorobantu
- Cardiology Department Emergency Hospital of Bucharest Romania
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Nima Fattahi
- Non-Communicable Diseases Research Center Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Mongal S Gurung
- Health Research and Epidemiology Unit Policy and Planning Division Ministry of Health Thimphu Bhutan
| | - David Guwatudde
- Department of Epidemiology and Biostatistics School of Public Health Makerere University Kampala Uganda
| | - Demetre Labadarios
- Faculty of Medicine and Health Sciences Stellenbosch University Stellenbosch South Africa
| | - Nuno Lunet
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica Faculdade de Medicina da Universidade do Porto Porto Portugal
| | - Elham Rayzan
- Non-Communicable Diseases Research Center Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Sahar Saeedi Moghaddam
- Endocrinology and Metabolism Research Center Endocrinology and Metabolism Clinical Sciences Institute Tehran University of Medical Sciences Tehran Iran
| | - Jacqui Webster
- The George Institute for Global HealthUniversity of New South Wales Sydney Australia
| | - Justine I Davies
- Institute of Applied Health Research University of Birmingham United Kingdom.,Centre for Global Surgery Department of Global Health Stellenbosch University Cape Town South Africa.,Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit Faculty of Health Sciences School of Public Health University of the Witwatersrand Johannesburg South Africa
| | - Rifat Atun
- Department of Global Health and Population Harvard T.H. Chan School of Public Health Boston MA
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies University of Goettingen Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany.,Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
| | - Lindsay M Jaacks
- Department of Global Health and Population Harvard T.H. Chan School of Public Health Boston MA.,Public Health Foundation of India New Delhi India.,Global Academy of Agriculture and Food Security The University of Edinburgh Midlothian United Kingdom
| | - Pascal Geldsetzer
- Heidelberg Institute of Global Health Medical Faculty and University Hospital University of Heidelberg Germany.,Division of Primary Care and Population Health Department of Medicine Stanford University Stanford CA
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Rugale C, Du Cailar G, Fesler P, Ribstein J, Mourad G, Mimran A. Effect of early stage kidney disease on cardiac mass: comparison to post-donation renal function. Am J Nephrol 2013; 38:168-73. [PMID: 23941801 DOI: 10.1159/000353931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Accepted: 06/23/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIM In chronic renal failure the increase in cardiovascular risk is in part related to the high prevalence of left ventricular hypertrophy. The aim of the present monocentric retrospective study was to evaluate the influence of the presence of parenchymal kidney disease on left ventricular geometry in normotensive (arterial pressure <140/90 mm Hg) patients (KD+, n = 50, mean age 39 ± 19 years) with mild to moderate renal failure (stage 2-3 chronic kidney disease). METHODS Left ventricular geometry was estimated by echocardiography and compared to a group of healthy subjects with similarly reduced renal function as a consequence of renal donation (KD-, n = 63, mean age 52 ± 12 years). RESULTS Subjects with and without kidney disease had similar blood pressure, body mass index and isotopic glomerular filtration rate. Left ventricular mass (LVM) indexed to body surface area was greater in KD+ as compared to KD- subjects and the difference was more pronounced in women than in men. The increase in LVM in KD+ patients was associated with lower albuminemia and hematocrit, and a higher plasma renin activity and aldosterone as compared to KD- subjects. In multivariate analysis, kidney disease emerged as an important determinant of LVM index independently of age, gender and blood pressure. CONCLUSION This observation suggests that the presence of kidney disease has an independent amplifying effect on LVM which could be related to volume overload and/or prohypertrophic factors such as aldosterone.
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Affiliation(s)
- Caroline Rugale
- Department of Internal Medicine and Nephrology, Centre Hospitalier Universitaire Montpellier, Montpellier, France.
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Páll D, Juhász M, Lengyel S, Molnár C, Paragh G, Fülesdi B, Katona É. Assessment of target-organ damage in adolescent white-coat and sustained hypertensives. J Hypertens 2010; 28:2139-44. [DOI: 10.1097/hjh.0b013e32833cd2da] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Páll D, Lengyel S, Komonyi É, Molnár C, Paragh G, Fülesdi B, Katona É. Impaired cerebral vasoreactivity in white coat hypertensive adolescents. Eur J Neurol 2010; 18:584-9. [DOI: 10.1111/j.1468-1331.2010.03209.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Obesity markers and blood pressure in a sample of Portuguese children and adolescents. ACTA ACUST UNITED AC 2008; 15:73-7. [DOI: 10.1097/hjr.0b013e3282f0e344] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Topouchian JA, El Assaad MA, Orobinskaia LV, El Feghali RN, Asmar RG. Validation of two automatic devices for self-measurement of blood pressure according to the International Protocol of the European Society of Hypertension: the Omron M6 (HEM-7001-E) and the Omron R7 (HEM 637-IT). Blood Press Monit 2006; 11:165-71. [PMID: 16702826 DOI: 10.1097/01.mbp.0000209078.17246.34] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Two electronic devices for self-measurement of blood pressure - a brachial monitor, the Omron M6, and a wrist monitor, the Omron R7 - were evaluated in two separate studies according to the International Protocol of the European Society of Hypertension. DESIGN The International Validation Protocol is divided into two phases: the first phase is performed on 15 selected participants (45 pairs of blood pressure measurements); if the device passes this phase, 18 supplementary participants are included (54 pairs of blood pressure measurements) making a total number of 33 participants (99 pairs of blood pressure measurements) on whom the final validation is performed. METHODS The same methodology recommended by the European Society of Hypertension protocol was applied for both studies. In each study and for each participant, four blood pressure measurements were taken simultaneously by two trained observers using mercury sphygmomanometers alternately with three measurements taken by the tested device. The difference between the blood pressure value given by the device and that obtained by the two observers (mean of the two observers) was calculated for each measure. The 99 pairs of blood pressure differences were classified into three categories (<or=5, <or=10 and <or=15 mmHg). The number of differences in each category was compared with the number required by the International Protocol. An individual analysis was then done to determine the number of comparisons <or=5 mmHg for each participant. At least 22 of the 33 participants should have two of their three comparisons <or=5 mmHg. RESULTS In both studies, the two tested devices passed the first and the second phases of the validation process. The average differences between the device and mercury sphygmomanometer readings were 0.8+/-2.7 and -1.9+/-3.3 mmHg for systolic and diastolic blood pressure, respectively, for the Omron M6 device, and 0.2+/-4.2 and 0.2+/-2.9 mmHg for systolic and diastolic blood pressure, respectively, for the Omron R7 device. For both devices, readings differing by less than 5, 10 and 15 mmHg for systolic and diastolic blood pressure values fulfill the recommendation criteria of the International Protocol as well as the individual analysis. CONCLUSIONS The Omron M6 (HEM-7001-E) and the Omron R7 (HEM 637-IT) devices fulfilled the validation recommendations of the International Protocol.
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Topouchian JA, El Assaad MA, Orobinskaia LV, El Feghali RN, Asmar RG. Validation of two devices for self-measurement of brachial blood pressure according to the International Protocol of the European Society of Hypertension: the SEINEX SE-9400 and the Microlife BP 3AC1-1. Blood Press Monit 2005; 10:325-31. [PMID: 16330959 DOI: 10.1097/00126097-200512000-00008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Two electronic devices for self-measurement of blood pressure at the brachial artery -- the Seinex SE-9400 and the Microlife BP 3AC1-1 -- were evaluated in two separate studies according to the International Protocol of the European Society of Hypertension. DESIGN The international validation protocol is divided into two phases: the first phase is performed on 15 selected participants (45 blood pressure measurements); if the device passes this phase, 18 supplementary participants are included (54 blood pressure measurements) making a total number of 33 participants (99 blood pressure measurements) on whom the final validation is performed. METHODS The same methodology recommended by the European Society of Hypertension protocol was applied for both studies. In each study and for each participant, four blood pressure measurements were taken simultaneously by two trained observers using mercury sphygmomanometers alternately with three measurements by the tested device. The difference between the blood pressure value given by the device and that obtained by the two observers (mean of the two observers) was calculated for each measure. The 99 differences were classified into three categories (< or =5, < or =10, < or =15 mmHg). The number of differences in each category was compared with the number required by the ESH protocol. An individual analysis was then done to determine, for each participant, the number of comparisons < or =5 mmHg. At least 22 of the 33 participants should have two of their three comparisons < or =5 mmHg. RESULTS In both studies, the two tested devices passed the first phase of the validation process. For the complete analysis (phase 1 and phase 2), the average differences between the device and mercury sphygmomanometer readings were in the first study for the Seinex SE-9400 device 0.9+/-5.2 and -1.7+/-4.7 mmHg for systolic and diastolic blood pressure, respectively, and -0.2+/-4.5 and -2.0+/-4.8 mmHg for the Microlife BP 3AC1-1 device in the second study. For both devices, readings differing by less than 5, 10 and 15 mmHg for systolic and diastolic blood pressure values fulfill the recommendation criteria of the International Protocol as well as the individual analysis. CONCLUSIONS The Seinex SE-9400 and the Microlife BP 3AC1-1 devices fulfilled the validation recommendations of the International Protocol.
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Sims AJ, Menes JA, Bousfield DR, Reay CA, Murray A. Automated non-invasive blood pressure devices: are they suitable for use? Blood Press Monit 2005; 10:275-81. [PMID: 16205447 DOI: 10.1097/01.mbp.0000173487.82766.be] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Measurement of blood pressure by a trained observer using a mercury sphygmomanometer is accepted as the gold standard, but there has been an increase in the use of automated devices employing the oscillometric technique. Not all such devices have been clinically validated, and some do not carry an appropriate CE mark. This survey aimed to assess the state of the European Union market for automated non-invasive blood pressure devices in terms of information provided by companies relating to compliance, validation and intended use. METHODS A total of 116 companies were identified as being potentially active (i.e. manufacturer, supplier, agent or distributor). Of these, 110 that could be contacted were asked to provide details of their company and their non-invasive blood pressure products via a questionnaire. RESULTS Eighty-six companies were found to be actively involved in the supply of 158 different models of automated non-invasive blood pressure device. These included 54 devices for use on the arm and 62 for use on the wrist (total 116 in our main categories), and 42 others (ambulatory monitors, patient monitors, defibrillators or finger devices). We received responses for 61% (71/116) of the main category arm and wrist devices and 80% (57/71) of these provided claims for CE marking. Of the CE marked devices for which we received a response, 41% (12/29) of arm devices and 39% (11/28) of wrist devices claimed some form of clinical validation, or evidence was found subsequent to the survey. Of these claims, 65% (15/23) related to an earlier, or similar, product and 48% (11/23) were based on published studies. Inconsistencies were found between claims for diagnostic suitability and claims for clinical validation. CONCLUSIONS A majority of models available on the European Union market were not validated by clinical trial to one of the recognized protocols.
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Affiliation(s)
- Andrew J Sims
- Regional Medical Physics Department, Freeman Hospital, Newcastle Upon Tyne, UK.
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Verberk WJ, Kroon AA, Kessels AGH, de Leeuw PW. Home Blood Pressure Measurement. J Am Coll Cardiol 2005; 46:743-51. [PMID: 16139119 DOI: 10.1016/j.jacc.2005.05.058] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Revised: 05/02/2005] [Accepted: 05/16/2005] [Indexed: 11/20/2022]
Abstract
The purpose of this research was to review the literature on home blood pressure measurement (HBPM) and to provide recommendations regarding HBPM assessment. Observational studies on HBPM, published after 1992, as identified by PubMed, EMBASE, and Cochrane literature searches were reviewed. Studies were selected if they met the following criteria: 1) self-measurements had been performed with validated devices; 2) measurement procedures were described in sufficient detail; and 3) papers clearly explained how final HBPM results were calculated upon which conclusions and/or treatment decisions were based. Office blood pressure measurement (OBPM) yields higher blood pressure values than HBPM. For systolic blood pressure, differences between OBPM and HBPM increase with age and the height of office pressure. Differences also tend to be greater in men than in women and greater in patients without than in those with antihypertensive treatment. Furthermore, HBPM can diagnose normotension with almost absolute certainty; it correlates better with target organ damage and cardiovascular mortality than OBPM, it enables prediction of sustained hypertension in patients with borderline hypertension, and it proves to be an appropriate tool for assessing drug efficacy. Despite some limitations and although more data are needed, HBPM is suitable for routine clinical practice.
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Affiliation(s)
- Willem J Verberk
- Department of Medicine, University Hospital Maastricht and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, the Netherlands
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Abstract
Increasingly, automated blood pressure devices are replacing mercury sphygmomanometers to monitor blood pressure in primary care settings. Practitioners have raised questions about the accuracy of these new devices, so a mini-review was undertaken to examine the evidence. A systematic search of the Medline database identified seven studies that were of sufficient quality. Eight devices were examined, all of which had passed validation procedures, achieving A or B grades according to current protocols. All were 'recommended for clinical use', despite the tendency of the devices to produce inaccurate measurements in high blood pressure ranges. The review demonstrates that 'accuracy' of the new devices does not equate to the accustomed accuracy of the mercury sphygmomanometer.
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El Assaad MA, Topouchian JA, Asmar RG. Evaluation of two devices for self-measurement of blood pressure according to the international protocol: the Omron M5-I and the Omron 705IT. Blood Press Monit 2003; 8:127-33. [PMID: 12900590 DOI: 10.1097/00126097-200306000-00006] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Two devices for self-measurement of blood pressure at the brachial artery-the Omron M5-I and the Omron 705IT-were evaluated according to the international protocol of the European Society of Hypertension. DESIGN The international validation protocol is divided into two phases: the first phase is performed on 15 selected subjects and if the device passes this phase, 18 supplementary subjects are included making a total number of 33 subjects on which the final validation is performed. METHODS For each subject, four blood pressure (BP) measurements were performed simultaneously by two trained observers using mercury sphygmomanometers alternately with three measurements by the tested device. The difference between the BP value given by the device and that obtained by the two observers (mean of the two observers) was calculated for each measure. The 99 differences were classified into categories (<or=5, <or=10, <or=15 mmHg). The number of differences in each category was compared to the number required by the international protocol. An individual analysis was then done to determine for each subject the number of comparisons <or=5 mmHg. At least 22 of the 33 subjects should have two of their three comparisons <or=5 mmHg. RESULTS The two tested devices passed the first phase of the validation process. For the second phase, the average differences between the device and mercury sphygmomanometer readings were -0.9+/-5.8 and -0.8+/-4.8 mmHg for systolic blood pressure (SBP) and diastolic blood pressure (DBP) respectively for the Omron M5-I device and -0.2+/-4.5 and -2.0+/-4.8 mmHg for the Omron 705IT device. Readings for the two devices differing by less than 5, 10 and 15 mmHg for systolic and diastolic values fulfil the recommendation criteria of the international protocol as well as the individual analysis. CONCLUSIONS The Omron M-5I and the Omron 705IT devices pass the validation recommendations of the international protocol.
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Pàll D, Katona E, Fülesdi B, Zrínyi M, Zatik J, Bereczki D, Polgàr P, Kakuk G. Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. J Hypertens 2003; 21:41-7. [PMID: 12544434 DOI: 10.1097/00004872-200301000-00012] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the blood pressure characteristics and distribution of all adolescent high school students (aged 15-18 years) in Debrecen (total population 230 000), Hungary. To define threshold values for normal blood pressure by age-, sex- and height-specific groups. To compare our data with results from a USA meta-analysis, which forms the basis of current guidelines. PARTICIPANTS AND METHODS All young people attending high school in Debrecen (final sample = 10 359) participated in the study. After they had rested for 10 min, three blood pressure measurements were taken from the right upper arm, separated by 5 min intervals. All measurements were obtained by a validated, automated, digital Omron M4 device. RESULTS The 50th, 90th and 95th percentile values of blood pressure were defined by dividing the adolescent population into age-, sex- and height-specific subgroups. In comparison with USA guidelines, in our sample the systolic blood pressure of boys in the different subgroups was 6-11 mmHg greater, whereas this difference was less marked for girls (1-5 mmHg). There were no marked differences in diastolic blood pressure, but our values were slightly lower. CONCLUSIONS Our findings demonstrate the influence of geographical and ethnic variations on blood pressure. Acceptance and use of non-population-specific blood pressure distributions may lead to under- or overdiagnosis of adolescent hypertension. The use of geographically more relevant data should be encouraged.
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Affiliation(s)
- Dénes Pàll
- 1st Department of Medicine, Medical and Health Science Centre, University of Debrecen, H-4012 Debrecen, Nagyerdei krt 98, Hungary.
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Ng KG. A simulation-based evaluation of nine oscillometric blood pressure monitors for self-measurement. Blood Press Monit 2000; 5:297-322. [PMID: 11153054 DOI: 10.1097/00126097-200010000-00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the performance of nine self-measurement oscillometric blood pressure monitors using a simulator. METHODS For each monitor, simulation data from 48 sets of simulated waveforms with four simulations for each set were used for analysis. The waveforms represent a wide range of blood pressure. The monitor-simulator blood pressure differences were analyzed according to the 1992 Association for the Advancement of Medical Instrumentation (AAMI) and 1993 British Hypertension Society (BHS) protocols, except that corrections were made to take into account simulation variability. One-way analysis of variance was used to compare the differences for various combinations of monitors. The monitors' heart rate readings were compared with the rated accuracy. RESULTS First, the mean blood pressure differences in general vary from monitor to monitor, the absolute mean differences ranging from 1.2 to 18.2mmHg. This can be partly explained by the likely use of different blood pressure determination criteria. Second, the Omron HEM-711 and HEM-712C gave about the same mean difference for systolic pressure and for diastolic pressure, suggesting that the two monitors may be using the same or approximately the same set of determination criteria. Third, the quantitative assessments for some of the monitors, for systolic or diastolic pressure or both, satisfy the clinical-use accuracy criteria of the AAMI or BHS protocol or both. These assessments alone cannot, however, be used to conclude whether or not any of the monitors fulfils the accuracy requirements of either protocol. Fourth, the corrected standard deviations of the differences range from 1.5 to 16.6mmHg, most of them being substantially less than the 8mmHg limit stipulated in the AAMI protocol. The different standard deviations suggest a varying robustness of the signal-processing methods used by the monitors. Fifth, for 7 out of the 9 monitors, more than 94% of the heart rate readings fall within +/-5% of their reference readings. CONCLUSIONS The nine monitors in general performed differently with respect to the simulator. The results cannot be used fully to reflect the monitors' performance on human subjects because they were not based on clinical evaluation. Studies that lead to a more realistic simulation of oscillometric blood pressure are needed. Protocols integrating both clinical and simulation-based evaluations need to be developed.
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Affiliation(s)
- K G Ng
- Research & Development Department, Becton Dickinson Critical Care Systems Pte. Limited, 198 Yishun Avenue 7, Singapore 768926, Singapore.
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