scholarly journals Patient experience of home and waiting room blood pressure measurement: a qualitative study of patients with recently diagnosed hypertension

2018 ◽  
Vol 68 (677) ◽  
pp. e835-e843 ◽  
Author(s):  
Alice C Tompson ◽  
Claire L Schwartz ◽  
Susannah Fleming ◽  
Alison M Ward ◽  
Sheila M Greenfield ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Patient Experience ◽  
Blood Pressure Measurement ◽  
Lifestyle Changes ◽  
Waiting Room ◽  
Cross Sectional ◽  
Self Monitoring ◽  
The Impact ◽  
At Home

BackgroundOut-of-office blood pressure (BP) measurement is advocated to confirm hypertension diagnosis. However, little is known about how primary care patients view and use such measurement.AimTo investigate patient experience of out-of-office BP monitoring, particularly home and practice waiting room BP measurement, before, during, and after diagnosis.Design and settingA cross-sectional, qualitative study with patients from two UK GP surgeries participating in a feasibility study of waiting room BP measurement.MethodInterviewees were identified from recent additions to the practice hypertension register. Interviews were recorded, transcribed, and coded thematically.ResultsOf 29 interviewees, 9 (31%) and 22 (76%) had used the waiting room monitor and/or monitored at home respectively. Out-of-office monitoring was used by patients as evidence of control or the lack of need for medication, with the printed results slips from the waiting room monitor perceived to improve ‘trustworthiness’. The waiting room monitor enabled those experiencing uncertainty about their equipment or technique to double-check readings. Monitoring at home allowed a more intensive and/or flexible schedule to investigate BP fluctuations and the impact of medication and lifestyle changes. A minority used self-monitoring to inform drug holidays. Reduced intensity of monitoring was reported with both modalities following diagnosis as initial anxiety or patient and GP interest decreased.ConclusionHome and practice waiting room measurements have overlapping but differing roles for patients. Waiting room BP monitors may be a useful out-of-office measurement modality for patients unwilling and/or unable to measure and record their BP at home.

scholarly journals Patient use of blood pressure self-screening facilities in general practice waiting rooms: a qualitative study in the UK

2017 ◽  
Vol 67 (660) ◽  
pp. e467-e473 ◽  
Author(s):  
Alice C Tompson ◽  
Sabrina Grant ◽  
Sheila M Greenfield ◽  
Richard J McManus ◽  
Susannah Fleming ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Qualitative Study ◽  
Ease Of Use ◽  
Structured Interviews ◽  
Waiting Room ◽  
Cross Sectional ◽  
History Of ◽  
The Uk ◽  
Patient Use ◽  
At Home

BackgroundBlood pressure (BP) self-screening, whereby members of the public have access to BP monitoring equipment outside of healthcare consultations, may increase the detection and treatment of hypertension. Currently in the UK such opportunities are largely confined to GP waiting rooms.AimTo investigate the reasons why people do or do not use BP self-screening facilities.Design and settingA cross-sectional, qualitative study in Oxfordshire, UK.MethodSemi-structured interviews with members of the general public recruited using posters in GP surgeries and community locations were recorded, transcribed, and coded thematically.ResultsOf the 30 interviewees, 20% were hypertensive and almost half had self-screened. Those with no history of elevated readings had limited concern over their BP: self-screening filled the time waiting for their appointment or was done to help their doctor. Patients with hypertension self-screened to avoid the feelings they associated with ‘white coat syndrome’ and to introduce more control into the measurement process. Barriers to self-screening included a lack of awareness, uncertainty about technique, and worries over measuring BP in a public place. An unanticipated finding was that several interviewees preferred monitoring their BP in the waiting room than at home.ConclusionBP self-screening appeared acceptable to service users. Further promotion and education could increase awareness among non-users of the need for BP screening, the existence of self-screening facilities, and its ease of use. Waiting room monitors could provide an alternative for patients with hypertension who are unwilling or unable to monitor at home.

scholarly journals Hypertension and its Determinants Among School Going Adolescents: A Cross Sectional Study in Nepal

2019 ◽  
Vol 39 (2) ◽  
pp. 87-94
Author(s):  
Sujata Shakya ◽  
Shanti Bajracharya
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Cross Sectional Study ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Bivariate Analysis ◽  
Elevated Blood ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Hypertension is a chronic life threatening non- communicable disease. It increases the risk for cardiovascular diseases even leading to premature death. Almost half of the adults with hypertension had elevated blood pressure during childhood. With globalisation and lifestyle changes, adolescents are exposed to various risk factors. However, diagnosis in this population is difficult due to absence of symptoms. Thus, regular blood pressure screening is essential in these groups. This study aimed to find out the prevalence of hypertension and its determinants among the school going adolescents of Kathmandu, Nepal. Methods: This was a descriptive cross sectional study which included five private secondary schools of Kathmandu, Nepal. The adolescent students studying in classes VIII, IX and X were the study subjects. Two stage cluster random sampling technique was used to select 356 participants. Data collection was done by doing anthropometric measurements, blood pressure measurement and through self administered questionnaire. Results: The study depicted that the prevalence of elevated blood pressure was 12.4%, stage 1 hypertension 32.3% and stage 2 hypertension 9.8%. Similarly, 13.8% were overweight and 1.4% were obese. Bivariate analysis depicted significant association of prevalence of hypertension with gender, religion and obesity (p < 0.05). The multivariate analysis shows that the significant predictors of elevated blood pressure and/or hypertension were gender and obesity. Males were six times more likely to have elevated blood pressure (AOR = 6.058, CI = 2.571 - 14.274) and 2.8 times more likely to be hypertensive (AOR = 2.838, CI = 1.688 - 4.773) compared to females. Similarly, compared to obese/ overweight students, thin and normally built ones have less likelihood of having elevated blood pressure and hypertension. Conclusions: Hypertension has been prevalent among adolescents, due to various behavioural risk factors. This is really challenging and of public health significance. Regular screening of adolescents is essential for early detection and management of hypertension.

scholarly journals Self-Monitoring of Blood Pressure among Adults with Hypertension

2021 ◽  
Vol 4 (1) ◽  
pp. 55-60
Author(s):  
JO Edah ◽  
G Odoh ◽  
GA Amusa ◽  
MJ Duguru
Keyword(s):  
Blood Pressure ◽  
Medical Condition ◽  
Demographic Data ◽  
University Teaching ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Self Monitoring ◽  
Female Ratio ◽  
Study Population ◽  
At Home

Hypertension is a serious medical condition associated with complications and premature death. Self- measurement of blood pressure (BP) which is a way of monitoring BP is recommended and encouraged and is effective at lowering BP. This was a hospital based descriptive cross-sectional study conducted at the Jos University Teaching Hospital (JUTH). Consenting adults with hypertension who regularly attend the Medical Out Patient Department (MOPD) clinics were recruited consecutively for the study over a six-week period. A questionnaire was used to obtain socio-demographic data from the participants. Information including the presence of complications of hypertension and comorbidities, antihypertensive medications used and three blood pressure (BP) readings in the last twelve months were gotten from the patients' folders with the average taken to determine BP control. Three hundred and fifty patients were recruited for the study among whom 230 (65.71%) were females giving a male to female ratio of 1:1.9. The mean age ± SD of the study population was 59±12 years. Less than half 156 (44.57%) of the study population practiced self-monitoring of blood pressure (SMBP) at home. Higher level of education (OR: 6.76, 95% CI 3.87-11.81), use of ≥ 3 antihypertensive medications (OR: 3.18, 95% CI 1.84-5.48) and good diastolic BP (OR: 0.54, 95% CI 0.30-0.98) were found to be correlates of SMBP at home. The practice of SMBP at home among our patients is low. This highlights the importance of regular patients' education on the need for SMBP at home.

scholarly journals Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

2021 ◽  
Vol 10 (9) ◽  
pp. 1913
Author(s):  
Tomonori Kimura ◽  
Emi Ushigome ◽  
Yoshitaka Hashimoto ◽  
Naoko Nakanishi ◽  
Masahide Hamaguchi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Pulse Pressure ◽  
Handgrip Strength ◽  
Cross Sectional Study ◽  
Home Blood Pressure ◽  
Cross Sectional ◽  
The Relationship ◽  
At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

scholarly journals Improved agreement and diagnostic accuracy of a cuffless 24-h blood pressure measurement device in clinical practice

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thenral Socrates ◽  
Philipp Krisai ◽  
Annina S. Vischer ◽  
Andrea Meienberg ◽  
Michael Mayr ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Area Under The Curve ◽  
Pulse Transit Time ◽  
Hypertension Detection ◽  
Software Update ◽  
Reference Device ◽  
Cuffless Blood Pressure ◽  
The Impact ◽  
Blood Pressure Measurement Device

AbstractA cuffless blood pressure (BP) device (TestBP) using pulse transit time is in clinical use, but leads to higher BP values compared to a cuff-based 24 h-BP reference device (RefBP). We evaluated the impact of a recent software update on BP results and TestBP’s ability to differentiate between normo- and hypertension. 71 individuals had TestBP (Somnotouch-NIBP) and RefBP measurements simultaneously performed on either arm. TestBP results with software version V1.5 were compared to V1.4 and RefBP. Mean 24 h (± SD) BP for the RefBP, TestBP-V1.4 and TestBP-V1.5 were systolic 134.0 (± 17.3), 140.8 (± 20) and 139.1 (± 20) mmHg, and diastolic 79.3 (± 11.7), 85.8 (± 14.1) and 83.5 (± 13.0) mmHg, respectively (p-values < 0.001). TestBP-V1.5 area under the curve (95% confidence interval) versus RefBP for hypertension detection was 0.92 (0.86; 0.99), 0.94 (0.88; 0.99) and 0.77 (0.66; 0.88) for systolic and 0.92 (0.86; 0.99), 0.92 (0.85; 0.99) and 0.84 (0.74; 0.94) for diastolic 24 h, awake and asleep BP respectively. TestBP-V1.5 detected elevated systolic/diastolic mean 24 h-BP with a 95%/90% sensitivity and 65%/70% specificity. Highest Youden’s Index was systolic 133 (sensitivity 95%/specificity 80%) and diastolic 87 mmHg (sensitivity 81%/specificity 98%). The update improved the agreement to RefBP. TestBP was excellent for detecting 24 h and awake hypertensive BP values but not for asleep BP values.

Hypertension Secondary to Ingestion of Licorice Root Tea

2011 ◽  
Vol 27 (6) ◽  
pp. 266-268 ◽  
Author(s):  
Tony Joseph Eid ◽  
Amanda A Morris ◽  
Sachin A Shah
Keyword(s):  
Blood Pressure ◽  
Dietary Supplements ◽  
Blood Pressure Measurement ◽  
Plasma Renin ◽  
Licorice Root ◽  
African American Female ◽  
Lifestyle Modifications ◽  
Plasma Aldosterone Concentration ◽  
Serum Potassium Concentration ◽  
The Impact

Objective: To report a case of hypertension secondary to ingestion of licorice root tea. Case Summary: A 46-year-old African American female with newly diagnosed stage 1 hypertension presented with a blood pressure measurement of 144/81 mm Hg and a reduced plasma potassium level of 3.2 mEq/L. The patient attempted lifestyle modifications prior to initiating an antihypertensive agent, but at a follow-up appointment, her blood pressure remained elevated. A current laboratory panel revealed a depressed morning plasma aldosterone concentration (PAC) of 5 ng/dL and low morning plasma renin activity (PRA) of 0.13 ng/mL/h. Later it was revealed that the patient regularly (1–2 cups/day) consumed “Yogi Calming” tea, a blend of herbs, including licorice root. The patient was advised to discontinue consumption of the herbal tea, and at a subsequent appointment, her blood pressure was 128/73 mm Hg and her laboratory panel had improved, including serum potassium concentration of 4.1 mEq/L, PAC of 6 ng/dL, and PRA of 0.19 ng/mL/h. Discussion: Excessive consumption of licorice has been well documented to cause pseudohyperaldosteronism, characterized by hypertension, hypokalemia, and suppressed plasma renin and aldosterone levels. Glycyrrhizin, the active ingredient in licorice, inhibits 11β-hydroxysteroid dehydrogenase type 2, an oxidase responsible for the conversion and inactivation of cortisol to cortisone. Chronic ingestion of licorice-containing foods has been demonstrated to cause pseudohyperaldosteronism. These include soft candies, lozenges, and dietary supplements, but licorice-containing teas have been infrequently described. Based on the Naranjo probability score, our patient's hypertension appears to have been a probable licorice-induced reaction secondary to a licorice-containing tea. Conclusions: Herbal and dietary supplements are frequently consumed by patients without full knowledge of the contents of the products or the impact on their health. In clinical practice, when hypertension is accompanied by hypokalemia and reduced PRA and PAC, licorice consumption should be investigated and causal hypertension ruled out.

Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Elderly Population ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Pressure Measurements ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Blood Pressures

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

Self blood pressure measurement at home

2004 ◽  
Vol 22 (6) ◽  
pp. 1075-1079 ◽  
Author(s):  
Gianfranco Parati ◽  
George Stergiou
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
At Home

scholarly journals Use of physical activity and cardiorespiratory fitness in identifying cardiovascular risk factors in male brazilian adolescents

2016 ◽  
Vol 18 (6) ◽  
pp. 678
Author(s):  
Lilian Messias Sampaio Brito ◽  
Luis Paulo Gomes Mascarenhas ◽  
Deise Cristiane Moser ◽  
Ana Cláudia Kapp Titski ◽  
Monica Nunes Lima Cat ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass ◽  
Cardiorespiratory Fitness ◽  
High Blood Pressure ◽  
Abdominal Obesity ◽  
Age Groups ◽  
Cross Sectional ◽  
The Impact

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n6p678 The aim of this study was to investigate the impact of physical activity (PA) and cardiorespiratory fitness (CRF) levels on the prevalence of overweight and high blood pressure levels in adolescents. In this observational, cross-sectional study, 614 boys aged 10-14 years were assessed for height, body mass, body mass index (BMI), waist circumference (WC) and blood pressure (BP). CRF was assessed using a run test (Léger Test) and subjects were then grouped according to their CRF level. PA level was assessed through a questionnaire (The Three Day Physical Activity Recall) and classified into two groups, namely > 300 minutes of PA/week and < 300 minutes of PA/week. Maturational stage was evaluated according to the development of pubic hair (self-assessment) as proposed by Tanner. We used statistical descriptive analysis, univariate and multivariate analyses in the total participants and subjects were divided by age. Fifty percent of the sample performed < 300 minutes of PA/week and 67.6% had unsatisfactory CRF levels. There was a higher prevalence of unsatisfactory CRF levels among subjects with altered BMI (overweight), WC (abdominal obesity) or BP (high blood pressure) for all age groups. PA history, however, did not show any significance. A total of 31% of participants were overweight, 24.8% had abdominal obesity and 15.4% had increased BP. Unsatisfactory CRF levels were found to be a better predictor for the diagnosis of cardiovascular diseases (CV) risk factors than PA history, regardless of age group. 

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