Comparison of Blood Pressure and Blood Glucose Level Among Elderly with Non-communicable Disease

Due to increasing age, elderly are prone to non-communicable diseases (NCD), such as hypertension (HT) and diabetes mellitus (DM). Easy physical condition monitoring of people with HT and/or DM is by measuring their blood pressure (BP) and/or blood glucose level (BGL) periodically. This study aimed to compare and analyze the differences of BP and BGL among elderly with HT and/or DM in Bangkok and Surabaya. This cross-sectional study involved 100 and 96 elderly with HT and/or DM in communities of Bangkok and Surabaya respectively (n=196). There were three groups of samples which consisted of 60 DM, 68 HT, and 68 DM&HT cases. Instruments used were demography questionnaire, sphygmomanometer, and glucometer. Test of one-way ANOVA, Least Significant Difference (LSD), Kruskal-Wallis, and Mann-Whitney U were used for data analysis (α<.05). There was a significant difference of systolic and diastolic BP found between groups (p=.000 and p=.011 respectively), but no difference found between the groups of HT and DM&HT (p=.657 and p=.330 respectively). There was a significant difference of BGL found between groups (p=.002), but no difference found between the groups of HT and DM (p=.075) and between the groups of DM and DM&HT (p=.066). BP is significantly different between the group of HT and DM in term of systole and diastole, especially in elderly, but BGL is similar. The risk of being HT for elderly with DM is very high. Elderly with DM&HT have high BP and BGL similarly to those with single disease of HT or DM

Blood pressure control by home monitoring : meta-analysis of randomised trials

Objective To determine the effect of home blood pressure monitoring on blood pressure levels and proportion of people with essential hypertension achieving targets. Design Meta-analysis of 18 randomised controlled trials. Participants 1359 people with essential hypertension allocated to home blood pressure monitoring and 1355 allocated to the "control" group seen in the healthcare system for 2-36 months. Main outcome measures Differences in systolic (13 studies), diastolic (16 studies), or mean (3 studies) blood pressures, and proportion of patients achieving targets (6 studies), between intervention and control groups. Results Systolic blood pressure was lower in people with hypertension who had home blood pressure monitoring than in those who had standard blood pressure monitoring in the healthcare system (standardised mean difference 4.2 (95% confidence interval 1.5 to 6.9) mm Hg), diastolic blood pressure was lower by 2.4 (1.2 to 3.5) mm Hg, and mean blood pressure was lower by 4.4 (2.0 to 6.8) mm Hg. The relative risk of blood pressure above predetermined targets was lower in people with home blood pressure monitoring (risk ratio 0.90, 0.80 to 1.00). When publication bias was allowed for, the differences were attenuated: 2.2 ( − 0.9 to 5.3) mm Hg for systolic blood pressure and 1.9 (0.6 to 3.2) mm Hg for diastolic blood pressure. Conclusions Blood pressure control in people with hypertension (assessed in the clinic) and the proportion achieving targets are increased when home blood pressure monitoring is used rather than standard blood pressure monitoring in the healthcare system. The reasons for this are not clear. The difference in blood pressure control between the two methods is small but likely to contribute to an important reduction in vascular complications in the hypertensive population

Longitudinal assessment of high blood pressure in children with nonalcoholic fatty liver disease.

ObjectiveNonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD.MethodsCohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks.ResultsPrevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m2, 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05).ConclusionsIn conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD

Cell Phone Information Seeking Explains Blood Pressure in African American Women

Although cell phone use and Internet access via cell phone is not marked by racial disparities, little is known about how cell phone use relates to blood pressure and health information seeking behaviors. The purposes of this study were to (a) describe Internet activities, cell phone use, and information seeking; (b) determine differences in blood pressure and information seeking between cell phone information seekers and nonseekers; and (c) examine cell phone information seeking as a predictor of blood pressure in African American women. Participants ( N = 147) completed a survey and had their blood pressure measured. Independent-sample t tests showed a significant difference in systolic blood pressure in cell phone information seekers and nonseekers. Linear regression revealed cell phone information seeking as an independent predictor of systolic blood pressure, despite confounders. It is possible that cell phone information seekers were using health information to make decisions about self-management of blood pressure

Insufficient control of blood pressure and incident diabetes

OBJECTIVE: Incidence of type 2 diabetes might be associated with preexisting hypertension. There is no information on whether incident diabetes is predicted by blood pressure control. We evaluated the hazard of diabetes in relation to blood pressure control in treated hypertensive patients. RESEARCH DESIGN AND METHODS: Nondiabetic, otherwise healthy, hypertensive patients (N = 1,754, mean +/- SD age 52 +/- 11 years, 43% women) participated in a network over 3.4 +/- 1 years of follow-up. Blood pressure was considered uncontrolled if systolic was >or=140 mmHg and/or diastolic was >or=90 mmHg at the last outpatient visit. Diabetes was defined according to American Diabetes Association guidelines. RESULTS: Uncontrolled blood pressure despite antihypertensive treatment was found in 712 patients (41%). At baseline, patients with uncontrolledblood pressure were slightly younger than patients with controlled blood pressure (51 +/- 11 vs. 53 +/- 12 years, P < 0.001), with no differences in sex distribution, BMI, duration of hypertension, baseline blood pressure, fasting glucose, serum creatinine and potassium, lipid profile, or prevalence of metabolic syndrome. During follow-up, 109 subjects developed diabetes. Incidence of diabetes was significantly higher in patients with uncontrolled (8%) than in those with controlled blood pressure (4%, odds ratio 2.08, P < 0.0001). In Cox regression analysis controlling for baseline systolic blood pressure and BMI, family history of diabetes, and physical activity, uncontrolled blood pressure doubled the risk of incident diabetes (hazard ratio [HR] 2.10, P < 0.001), independently of significant effects of age (HR 1.02 per year, P = 0.03) and baseline fasting glucose (HR 1.10 per mg/dl, P < 0.001). CONCLUSIONS: In a large sample of treated nondiabetic hypertensive subjects, uncontrolled blood pressure is associated with twofold increased risk of incident diabetes independently of age, BMI, baseline blood pressure, or fasting glucose

Cuff-less continuous blood pressure monitoring system using pulse transit time techniques

This paper describes the development of a continuous cuff-less blood pressure system based on the pulse transit time (PTT) technique. In this study, PTT is defined by two different approaches denoted as PTT1 and PTT2. PTT1 is the time difference between the R-wave peak of the Electrocardiogram (ECG) and the peak of the Photoplethysmogram (PPG). PTT2 is the time difference between two peak PPG signals on same cardiac cycle at different positions on the body. The ECG is acquired on the chest using 3 lead electrodes and a reflection mode optical sensor is deployed on brachial artery and fingertip to monitor the PPGs. These data were synchronized using a National Instruments data acquisition card along with Matlab software for subsequent analysis. A wrist-type cuff-based blood pressure device was used to measure blood pressure on the right hand. Brachial blood pressure was measured on the upper left arm using oscillometric blood pressure monitor. Experiments were conducted by elevating the right hand at different position to investigate variability of PTT under the effects of hydrostatic pressure. Next the variability of PTT due to blood pressure changes during a Valsalva maneuver was investigated. The result shows that the PTT1 is inversely proportional to blood pressure in both experiments. Meanwhile, there is weak correlation between PTT2 and blood pressure measurement which suggests that by excluding the pre-ejection period (PEP) time in PTT calculation may reduce the accuracy of PTT for blood pressure measurement. In conclusion, PTT measurement between ECG and PPG signals has potential to be a reliable technique for cuff-less blood pressure measurement

Insufficient control of blood pressure and incident diabetes

OBJECTIVE: Incidence of type 2 diabetes might be associated with preexisting hypertension. There is no information on whether incident diabetes is predicted by blood pressure control. We evaluated the hazard of diabetes in relation to blood pressure control in treated hypertensive patients. RESEARCH DESIGN AND METHODS: Nondiabetic, otherwise healthy, hypertensive patients (N = 1,754, mean +/- SD age 52 +/- 11 years, 43% women) participated in a network over 3.4 +/- 1 years of follow-up. Blood pressure was considered uncontrolled if systolic was >or=140 mmHg and/or diastolic was >or=90 mmHg at the last outpatient visit. Diabetes was defined according to American Diabetes Association guidelines. RESULTS: Uncontrolled blood pressure despite antihypertensive treatment was found in 712 patients (41%). At baseline, patients with uncontrolledblood pressure were slightly younger than patients with controlled blood pressure (51 +/- 11 vs. 53 +/- 12 years, P < 0.001), with no differences in sex distribution, BMI, duration of hypertension, baseline blood pressure, fasting glucose, serum creatinine and potassium, lipid profile, or prevalence of metabolic syndrome. During follow-up, 109 subjects developed diabetes. Incidence of diabetes was significantly higher in patients with uncontrolled (8%) than in those with controlled blood pressure (4%, odds ratio 2.08, P < 0.0001). In Cox regression analysis controlling for baseline systolic blood pressure and BMI, family history of diabetes, and physical activity, uncontrolled blood pressure doubled the risk of incident diabetes (hazard ratio [HR] 2.10, P < 0.001), independently of significant effects of age (HR 1.02 per year, P = 0.03) and baseline fasting glucose (HR 1.10 per mg/dl, P < 0.001). CONCLUSIONS: In a large sample of treated nondiabetic hypertensive subjects, uncontrolled blood pressure is associated with twofold increased risk of incident diabetes independently of age, BMI, baseline blood pressure, or fasting glucose

Blood Pressure Measurements in 780 Apparently Healthy Cats

BACKGROUND: Mean systolic blood pressure in apparently healthy cats has been reported as approximately 125 mmHg using direct assessment, but there is greater variability in reported values using indirect assessment. Increasing age and the white‐coat effect are associated with increased systolic blood pressure. HYPOTHESIS/OBJECTIVES: To report Doppler‐derived blood pressure measurements from a large population of apparently healthy cats and to assess epidemiologic factors associated with recorded blood pressures. ANIMALS: A total of 780 cats in rehoming centers enrolled in a screening program for heart murmurs and cardiac disease. METHODS: Cats were considered healthy based on history and physical examination. Cats with known hypertension, hyperthyroidism, or clinical signs of systemic disease and pregnant or nursing queens were excluded. After an acclimatization period, systolic blood pressure was measured using the Doppler sphygmomanometry method following the recommendations of the ACVIM Consensus Statement. General linear model analysis was performed to identify factors associated with variation in systolic blood pressure. RESULTS: Median (interquartile range, IQR) systolic blood pressure for the group was 120.6 (110.4–132.4) mmHg. Factors significantly associated with higher systolic blood pressure in a general linear model were increased age, increased nervousness, male sex, neutering, or history of being a stray. The model explained 29.2% of the variation in systolic blood pressure. CONCLUSIONS AND CLINICAL IMPORTANCE: The age, demeanor, sex, neuter status and history of being a stray should be taken into account when assessing systolic blood pressure in apparently healthy cats

Development of a PC interfaced blood pressure meter (E-BPMS)

Blood pressure is one of the fundamental vital signs, and its measurement is of great importance to medical professionals and the general public alike. Nowadays, there are several types of blood pressure meter available manufactured from various companies. In order to meet the demand on telemedicine and technology advancement, a new form of blood pressure meter is desirable. This prototype of blood pressure meter is interfaced with a personal computer (PC) which able to simulate the measurement process in real time. The proposed system was named e-BPMS (Electronic Blood Pressure Measurement System) suggests the usage of both hardware and software in determining blood pressure reading. Hardware elements operate on oscillometric principle which gives the results in terms of systolic, diastolic and MAP (Mean Arterial Pressure). Furthermore, these results will be presented and simulated on the software. The e-BPMS interface was developed by using Visual Basic 6.0 language which highlights the user friendly attributes. Moreover, the simulated waveform will evaluate the blood pressure and gives the blood pressure value. This application shows significant improvement on the overall performance and gives reliable results. The framework used to design e-BPMS is easy to understand and it can be extended further to endorse new application area