How to measure office blood pressure?

peer reviewedaudience: professional, studentLa mesure de la pression artérielle de façon classique repose toujours sur l’auscultation des bruits de Korotkoff. Devenue un geste banal, elle est souvent mal pratiquée et, donc, source d’erreurs dans l’estimation du niveau réel de pression d’un patient. Elle exige rigueur et précision pour être utile en pratique médicale quotidienne. Cette vignette à destination des étudiants veut rappeler les grands principes de la mesure de la pression artérielle au cabinet de consultation, mais aussi au domicile du patient.Routinely measuring blood pressure is still performed according to the auscultatory method using recognition of Korotkoff sounds. This usual technique is, however, often mishandled and is thus a source of error in the estimation of the true blood pressure level. Accuracy of such measure is, however, of paramount importance to be useful in daily medical practice. This methodology paper more specifically written for medical students recalls the essential principles of blood pressure measurement at the medical office, but also at home

Reference values of central blood pressure and pulse wave velocity in relations with 24 hours ambulatory blood pressure monitoring in Belgian normotensive young subjects

The present study aimed to define reference values of central blood pressure (cBP) and Pulse Wave Velocity (PWV) together with 24H APPM in healththy normotensive young adults before starting a follow-up of their CV profile modifications over time

Optimal Blood Pressure Level and Best Measurement Procedure in Hemodialysis Patients

Hypertension occurs frequently among hemodialysis (HD) patients and can be due to many factors, such as salt intake, elevated sympathetic tone, and uremic toxins. It is responsible for the high cardiovascular risk associated with renal disease. Generally, in HD patients, while there is an elevation of systolic blood pressure (BP), diastolic BP seems to decrease, and the resultant effect is high pulse pressure, which can have a deleterious effect on the cardiovascular system. Although controversial, in the HD population the relationship between BP and risk of death seems to be U shaped, probably because of pre-existing cardiac disease in patients with the lowest BP. In chronic kidney disease, BP lower than 130/80 mmHg is recommended, but an appropriate target for BP in the HD population remains to be established. Moreover, there is no consensus regarding which routine peridialysis BP (pre- or post-dialysis BP, or both) can ensure the diagnosis of hypertension in this population. Ambulatory BP monitoring remains the gold standard to quantify the integrated BP load applied to the cardiovascular system. As well, home BP assessment could contribute to improve the definition of an optimal BP in the HD population. An ideal goal for post-dialysis systolic BP seems to be a value higher than 110 mmHg and lower than 150 mmHg. However, HD patients are generally old and often have cardiac complications, so a reasonable pre-dialysis target systolic BP could be 150 mmHg. It is prudent to suggest that an improvement in BP control is necessary in the HD population, first by slow and smooth removal of extracellular volume (dry weight) and thereafter by the use of appropriate antihypertensive medication

Blood Pressure Variability

peer reviewedBlood pressure variability is a physiological phenomenon influenced by many internal and external factors. This variability could be also influenced by pathological conditions such as arterial hypertension. Two forms must be mainly distinguished: the blood pressure variability at long but also short-term. The latter could only be studied by continuous recordings. From the initial invasive intraarterial approach, it can nowadays be explored by a non invasive system of beat to beat recordings using the infrared photo plethysmography (the FINAPRES system). In this paper, some important questions will be treated such as the interest of measuring blood pressure variability, its cardiovascular prognosis and how therapeutic tools can be applied when it is increased?La variabilité de la pression artérielle (PA) est un phénomène physiologique influencé par de nombreux facteurs intrinsèques et extrinsèques. Cette variabilité se voit cependant modifiée dans plusieurs conditions pathologiques dont l'hypertension artérielle. On distingue principalement la variabilité de PA à long terme et celle à court terme. Cette dernière ne peut être étudiée que par des enregistrements continus de la pression artérielle. De la localisation invasive intra-artérielle, on est passé actuellement à un mode non-invasif d'enregistrement grâce à la photopléthysmographie infrarouge (FINAPRES® ...). Dans cet article, nous abordons certaines questions cruciales à savoir quel est l'intérêt de la mesure de la variabilité tensionnelle. Son influence sur le pronostic cardio-vasculaire apparaît évident. Comment peut-elle influencer la prise en charge thérapeutique lorsqu'elle est accrue

Does nocturnal decrease of blood pressure predict left ventricular hypertrophy?

Peer reviewe

HOME BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS (Ktr)-VALIDITY OF DIFFERENT SCHEDULES OF SELF-MONITORING

Office blood pressure (OBP) coupled with 24-h ambulatory monitoring (24-h ABPM) or home self-monitoring (HBPM) allow a more accurate assessment of BP control in treated hypertensive patients and identification of different phenotypes of BP. ESH/ESC guidelines (2013) recommended 7 days of home measurements (3 days at least) but that duration is questioned. The present study examined if we can reduce, and to what extent, the 7-days schedule for home measurements in treated hypertensive kidney transplant recipients (ktr) while keeping a reliable assessment of their BP status

Fractures osseuses et ostéodensitométrie chez l'hémodialysé

peer reviewedaudience: professiona