• Title/Summary/Keyword: Ambulatory blood pressure monitoring

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Optimum Electrode Selection for Measuring Abdominal Pressure using Bio-Impedance Method (생체 임피던스 방법을 이용하여 복압을 측정하기 위한 최적 전극위치 선정)

  • Kim, Keo-Sik;Lee, Sang-Ok;Seo, Jeong-Hwan;Kim, Kyeong-Seop;Song, Chul-Gyu
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.56 no.7
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    • pp.1339-1342
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    • 2007
  • In this study, we determined the optimum electrode pair for measuring the abdominal pressure using bio-impedance method and compared with conventional methods. Because impedance changes differ from a weight, a height, contractile force, volume of muscle and blood other or whatever of individuals, it was quantified using values of impedance change, correlation coefficient and SNR. Our results showed the optimum electrode pair (1, 9) which could detect impedance changes due to an increase of the intensity of the abdominal pressure. The correlation coefficient and quadratic function between the RMS values of EMG and the impedance changes were 0.87 and $y=0.0014x^2+0.0620x+0.6958$, respectively. It demonstrated that the abdominal pressure could be measured noninvasively and simply using bio-impedance method. We propose that this optimum electrode configuration would be useful for future studies involving the convenient measurement of abdominal pressure by ambulatory urodynamics monitoring study.

Radial Electrical Impedance: A Potential Indicator for Noninvasive Cuffless Blood Pressure Measurement

  • Huynh, Toan Huu;Chung, Wan-Young
    • Journal of Sensor Science and Technology
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    • v.26 no.4
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    • pp.239-244
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    • 2017
  • Noninvasive, cuffless, and continuous blood pressure (BP) monitoring is essential to prevent and control hypertension. A well-known existing method for this measurement is pulse transit time (PTT), which has been investigated by many researchers as a promising approach. However, the fundamental principle of the PTT method is based on the time interval taken by a pulse wave to propagate between the proximal and distal arterial sites. Consequently, this method needs an independent system with two devices placed at two different sites, which is a problem. Even though some studies attempted to synchronize the system, it is bulky and inconvenient by contemporary standards. To find a more sensitive method to be used in a BP measurement device, this study used radial electrical bioimpedance (REB) as a potential indicator for BP determination. Only one impedance plethysmography channel at the wrist is performed for demonstrating a ubiquitous BP wearable device. The experiment was evaluated on eight healthy subjects with the ambulatory BP monitor on the upper arm as a reference. The results demonstrated the potential of the proposed method by the correlation of estimated systolic (SBP) and diastolic (DBP) BP against the reference at $0.84{\pm}0.05$ and $0.83{\pm}0.05$, respectively. REB also tracked the DBP well with a root-mean-squared-error of $7.5{\pm}1.35mmHg$.

Clinical Usefulness of Ambulatory Blood Pressure Monitoring in Children and Adolescents (소아 및 청소년에서 24시간 활동 혈압 측정의 임상적 유용성)

  • Hwang, Young-Ju;Park, Hyo-Jung;Yang, Eun-Ae;Cho, Min-Hyun;Ko, Cheol-Woo;Yang, Dong-Heon;Hwang, Hyun-Hee
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.154-162
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    • 2011
  • Purpose: With increasing prevalence of hypertension (HTN) in children and adolescent, pediatricians have become more interested in blood pressure (BP) measurements. The ambulatory blood pressure monitoring (ABPM) is known to be useful to differentiate true HTN and white coat HTN. The object of this study is to assess the clinical usefulness of ABPM in Korean children and adolescents. Methods: A retrospective review of 51 patients in Kyungpook National University Hospital from January 2002 to February 2010 was done. All patients were 6-18 years old and underwent ABPM. We calculated the mean value of ABP, BP load, nocturnal dip and compared the results with the patients' diagnosis and characteristics. Results: The mean age of the 51 patients was $17.8{\pm}1.8$ years and 19 children were obese. 37 patients (72.5%) were truly hypertensive and 1 patient was diagnosed as masked HTN and 7 children (14%) as white coat HTN. The rest of the patients were normotensive. Among patients with white coat HTN, 5 were in a prehypertensive state. Mean systolic and diastolic BP load of patients with true HTN were significantly higher than non-hypertensive children (P<0.001). Although the nocturnal dip of all patients were below 10%, there was no statistical significance. The obese patients showed higher systolic and diastolic BP. Their systolic and diastolic BP load were significantly higher than non-obese patients (P<0.001). Conclusion: ABPM in children and adolescents seems to be a valuable tool in the assessment of white coat HTN and in the confirmation of true HTN. A considerable number of white coat HTN patients are revealed to be in a prehypertensive state and need close follow-up.

An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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Antihypertensive effect of Chunghyul-dan(Qingxue-dan) on stage 1 hypertensive patients with stroke (중풍환자 1기 고혈압에 청혈단(淸血丹)의 항고혈압 효과)

  • Kim, Lee-Dong;Lee, Sang-Ho;Kim, Eun-Ju;Kim, Tai-Hun;Park, Young-Min;Jung, Dong-Won;Shin, Won-Jun;Jung, Woo-Sang;Bae, Hyung-Sup;Yun, Sang-Pil
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.195-201
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    • 2004
  • Background and Purpose : Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is a primary or secondary preventative measure for stroke. This study aims to assess the efficacy of Chunghyul-dan(Qingxue-dan) in stage 1 hypertensive patients who have suffered a stroke by 24 hour ambulatory blood pressure monitoring(24ABPM). Subjects& Methods : We enrolled 40 hospitalized stroke patients with stage 1 hypertension and divided them into 2 groups by stratified randomization; group A took 1200mg of Chunghyul-dan(Qingxue-dan) at 8:00 a.m. for two weeks without changing herbal medicine, and group B was the control group. 28 patients were included in the final analysis(15 in group A. 13 in group B). Blood pressure is monitored from 8:00 am to 7:30 am every 30 minutes for 24 hours. Blood pressure was monitored two times at baseline and again two weeks later. We used 3 parameters for evaluating the efficacy of Chunghyul-dan(Qingxue-dan); The first parameter is change from baseline to two weeks later in blood pressure and pulse rate. The second parameter is the trough/peak ratio(TPR) and smoothness index(SI). The third parameter is antihypertensive rate by antihypertensive efficacy guideline. Results : There is no significant difference in the baseline assessment hetween the two groups. Systolic blood pressure $(141.37{\pm}8.96\;mmHg\;vs\;132.28{\pm}9.46\;mmHg)$ decreased after two weeks of 1200mg(P=0.03) intake of Chunghyul-dan(Qingxue-dan). Systolic TPR and SI was 0.87 and 1.04 in group A. Antihypertensive rate was higher in group A. Conclusion: These results suggest that 1200mg doses of Clunghyul-dan(Qingxue-dan) is an effective antihypertensive agent on stage 1 hypertension patients who have suffered a stroke.

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Frequency and Related Factors of Masked Hypertension at a Worksite in Korea

  • Kim, Sang-Kyu;Bae, Jun-Ho;Nah, Dung-Young;Lee, Dong-Wook;Hwang, Tae-Yoon;Lee, Kyeong-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.3
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    • pp.131-139
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    • 2011
  • Objectives: Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers. Methods: The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension. Results: The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129 /80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129/ 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139/ 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09). Conclusions: The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.

Need Assessment for Smartphone-Based Cardiac Telerehabilitation

  • Kim, Ji-Su;Yun, Doeun;Kim, Hyun Joo;Ryu, Ho-Youl;Oh, Jaewon;Kang, Seok-Min
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.283-291
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    • 2018
  • Objectives: To identify the current status of smartphone usage and to describe the needs for smartphone-based cardiac telerehabilitation of cardiac patients. Methods: In 2016, a questionnaire survey was conducted in a supervised ambulatory cardiac rehabilitation (CR) program in a university affiliated hospital with the participation of heart failure or heart transplantation patients who were smartphone users. The questionnaire included questions regarding smartphone usage, demands for smartphone-based disease education, and home health monitoring systems. Results were described and analyzed according to principal diagnosis. Results: Ninety-six patients (66% male; mean age, $5{\pm}11$ years), including 56 heart failure and 40 heart transplantation patients, completed the survey (completion rate, 95%). The median daily smartphone usage time was 120 minutes (interquartile range, 60-300), and the most frequently used smartphone function was text messaging (61.5%). Of the patients, 26% stated that they searched for health-related information using their smartphones more than 1 time per week. The major source of health-related information was Internet browsing (50.0%), and the least sought source was the hospital's website (3.1%). Patients with heart failure expressed significantly higher needs for disease education on treatment plan, home health monitoring of blood pressure, and body weight (${\chi}^2=5.79$, 6.27, 4.50, p < 0.05). Heart transplantation patients expressed a significant need for home health monitoring of body temperature (${\chi}^2=5.25$, p < 0.05). Conclusions: Heart failure and heart transplantation patients show high usage of and interest in mobile health technology. A smartphone-based cardiac telerehabilitation program should be developed based on high demand areas and modified to suit to each principal diagnosis.

Effects of Sahyangsohap-won on Cerebral Hemodynamics in Healthy Subjects (사향소합원(麝香蘇合元)이 정상인의 뇌혈류역학에 미치는 영향)

  • Koo, Bon-Soo;Kim, Sung-Hwan;Moon, Sang-Kwan;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Lee, Kyung-Sup;Ryu, Soon-Hyun
    • The Journal of Internal Korean Medicine
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    • v.22 no.2
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    • pp.199-205
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    • 2001
  • Background and Purpose : Transcranial doppler ultrasonography(TCD) is a noninvasive and nonradioactive technique for evaluation of the hemodynamics in large cerebral vessels. Sahyangsohap-won(SS) has been considered to be effective for the treatment of various disease, especially cerebrovascular, cardiovascular, and psychosomatoform disorders. But, there is no study about the effect of SS on the cerebral hemodynamics in humans. The aim of this study was to assess the effect of SS on the changes in cerebral hemodynamics and the dose-dependant effect by using TCD. Subjects and Methods : 30 healthy subjects were randomly divided into three group: group 1 took no drug, group 2 took SS one pill, and group 3 took SS 2 pills. Changes in the mean blood flow velocity(MBFV) and pulsatility index(PI) in the middle cerebral artery were evaluated by means of TCD. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with the breath-holding index(BHI). Systolic blood pressure(SBP), diastolic blood pressure(DBP), and heart rate(HR) were measured by means of ambulatory blood pressure monitoring. In group 2 and group 3, the evaluations were performed during the baseline and were repeated at 20, 40, and 60 minutes after SS administration. In group 1, the evaluation was performed at corresponding time intervals. Results : In mean values of MSFV, PI, SSP, DBP, and HR, no stastically significant differences were found between the 3 groups. However, BHI values were significantly lower in groups 2 and 3 than in group 1 at 40 minutes after SS administration(P<0.05, group 1 vs group 2, group 1 vs group 3 by post-hoc analysis: Scheffe's test) but in dose-dependant effect, there was no difference between group 2 and group 3. Conclusion : These results suggest that SS can decrease vascular resistance in cerebral small arteries or arterioles and enhance their distensibility. Further studies on larger numbers of subjects are needed to confirm these effects and the dose-dependant effects.

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Postprandial Blood Pressure in Hypertensive and Normotensive Elderly and Young Adult Subjects (고혈압노인과 정상혈압노인 및 청년의 식후혈압 변화 비교)

  • Son, Jung Tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.12
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    • pp.5849-5859
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    • 2012
  • The aim of this study was to find out the impact of age and hypertensive status on postprandial hypotension(PPH). Twenty-six hypertensive elderly ($77.7{\pm}7.2$ years old), twenty-five normotensive elderly ($80.2{\pm}6.8$ years old) and twenty-six young adults ($20.0{\pm}1.5$ years old) took part in the study. The blood pressure (BP) and heart rates (HR) were measured every 15 minutes, from 30 minutes before a meal to 90 minute after a meal in sitting position, using an ambulatory blood pressure monitor. In the hypertensive group, postprandial reduction in systolic BP continued from 30minutes to 90minutes. The reductuion rate of systolic BP of hypertensive elderly group was significantly greater than other groups (p<.05). However, there were no significant differences in trend of HR change between the groups (p=.082). The incidence of PPH was significantly higher in the hypertensives than other groups (73.1% vs 24% vs 0%, respectively, p=.001). In conclusion, age and hypertensive status had a significant impact on PPH. Elderly persons require more intensive BP monitoring and nursing intervention.

The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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