Blood Pressure Monitoring最新文献

{"title":"Mean arterial pressure and mortality in patients with heart failure: a retrospective analysis of Zigong heart failure database.","authors":"Hangkun Ma, Haibo Li, Song Sheng, Longfang Quan, Zhixu Yang, Fengqin Xu, Wenying Zeng","doi":"10.1097/MBP.0000000000000674","DOIUrl":"10.1097/MBP.0000000000000674","url":null,"abstract":"<p><strong>Background: </strong>It is commonly observed that a higher target of mean arterial pressure (MAP) is in previous studies. This study assessed the association of MAP with short-term mortality in heart failure (HF) patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted by using data from Hospitalized patients with heart failure: integrating electronic healthcare records and external outcome database (v1.2 ). The characteristic of patients was described by 3 groups of MAP: below 80 mmHg, 80-100 mmHg, and above 100 mmHg. Univariate and multivariate logistic regression analyses were used to assess the relevance between MAP and all-cause mortality within 28 days and 6 months. For assessing the effect of multiple variables on patient survival time, 28-day and 6-month, Kaplan-Meier survival analysis and Forest plot were performed.</p><p><strong>Results: </strong>The overall cohort comprised 2008 patients divided by MAP into 3 groups, each group had 344 (17.1%), 938 (46.7%), and 726 (36.2%) patients. Patients in MAP < 80 mmHg group had higher mortality than MAP 80-100 mmHg and MAP ≥ 100 mmHg in 28 days(3.8% versus 1.6% versus 1.2%) and in 6 months (4.9% versus 2.5% versus 2.3%). Univariate analysis showed that MAP as a continuous variate was associated with 28-day (OR was 0.98, 95% CIs: 0.96-0.99, P  = 0.011) and 6-month mortality (OR was 0.98, 95% CIs: 0.97-1, P  = 0.021) in HF patients. Model 4 put into multivariate logistic regression analyses showed MAP 80-100 mmHg (OR was 0.13, 95% CIs: 0.02-0.8, P  = 0.027) stably associated with 28-day and 6-month mortality after adjusted covariable. Kaplan-Meier survival curves revealed a higher survival rate in the MAP ≥ 80 mmHg group than in the MAP < 80 mmHg group. The forest plot showed the stable effect of MAP ≥ 80 mmHg compared with MAP < 80 mmHg, the interaction analysis had no statistical significance effect between the two groups of MAP and multi-variable.</p><p><strong>Conclusion: </strong>It is indicated that MAP was independently associated with 28-day, 6-month all-cause mortality of HF patients, and compared with MAP < 80 mmHg, MAP ≥ 80 mmHg had a lower risk of 28-day, 6-month all-cause mortality of patients with HF.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":" ","pages":"343-350"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10222353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of chlorthalidone plus amiloride compared with amlodipine on short-term blood pressure variability in individuals with hypertension and obstructive sleep apnea: a randomized controlled trial.","authors":"Marcelo B Lucca, Juliano A Jorge, Fabio T Cichelero, Denis Martinez, Rogério B Borges, Vania N Hirakata, Flavio D Fuchs, Sandra C Fuchs","doi":"10.1097/MBP.0000000000000663","DOIUrl":"10.1097/MBP.0000000000000663","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of chlortalidone plus amiloride and amlodipine on blood pressure (BP) variability in patients with hypertension and obstructive sleep apnea syndrome (OSA).</p><p><strong>Methods: </strong>A randomized, controlled, double-blind trial enrolled men and women aged 40 years or older with a diagnosis of OSA (apnea-hypopnea index 10-40 apneas/h of sleep) confirmed by overnight laboratory polysomnography and systolic BP 140-159 mmHg or diastolic BP 90-99 mmHg. Participants were randomized to receive chlortalidone 25 mg plus amiloride 5 mg daily or amlodipine 10 mg daily for 8 weeks. BP variability was calculated from 24-hour ambulatory BP monitoring at baseline and follow-up using the following indices: SD, coefficient of variation, average real variability (ARV), time-rate index, and variability independent of the mean (VIM).</p><p><strong>Results: </strong>The study included 65 patients, with 33 assigned to the chlortalidone plus amiloride group and 32 to the amlodipine group. Participants in both groups had similar baseline characteristics. Short-term BP variability decreased within groups for SD and ARV indexes for 24-hour systolic BP and daytime systolic BP, but statistically significant time*group interactions were found for sleep systolic SD and VIM, with greater reduction in patients treated with amlodipine.</p><p><strong>Conclusion: </strong>In brief, our study has shown that the use of chlorthalidone in combination with amiloride and amlodipine produces comparable effects on short-term BP variability in patients with hypertension and OSA. Therefore, our findings suggest that BP variability may not be a significant factor when choosing between these medications for the treatment of hypertension and OSA.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":" ","pages":"289-294"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9831934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for orthostatic hypotension in the geriatric population in a real-world primary care setting reduces prescribed antihypertensive medications.","authors":"Matthew G Kaye, James Rutowski, Hamza Aftab, Rohan Pandey, Raheel Khan, Mohamad A Kalot, Renata Anand, Susan P Graham","doi":"10.1097/MBP.0000000000000673","DOIUrl":"10.1097/MBP.0000000000000673","url":null,"abstract":"<p><strong>Background: </strong>To determine if outpatient screening for orthostatic hypotension (OH) in the geriatric population results in fewer prescribed antihypertensive medications and if a relationship exists between OH and specific pharmacologic classes of antihypertensive medications.</p><p><strong>Materials and methods: </strong>Patients ≥ 65 years were screened for OH, defined as a decrease in systolic blood pressure (SBP) ≥ 20 mm Hg or a decrease in diastolic blood pressure (DBP) ≥ 10 mm Hg after standing for 3 minutes. Sitting blood pressure (BP) was measured after patients had been seated quietly in an exam room. Patients then stood for approximately 3 minutes at which time standing BP was recorded.</p><p><strong>Results: </strong>OH prevalence was 18%. Standing DBP was significantly different between the two groups (70 mmHg ± 18, 80 mmHg ± 13, P  = 0.007). Compared to patients without OH, patients with OH were more likely to have been previously prescribed beta-blockers (56% vs. 32%, P  = 0.056) and potassium-sparing diuretics (11% vs. 1%, P  = 0.026). Physicians discontinued an antihypertensive medication more often in patients who screened positive for OH than in to those who did not (17% vs. 4%, P  = 0.037). Calcium channel blockers were the most frequently discontinued class of medication.</p><p><strong>Conclusion: </strong>Asymptomatic OH is prevalent in geriatric patients. Screening for OH may lead to de-escalation of antihypertensive regimen and a reduction in polypharmacy. Positive screening for OH was associated with de-prescribing of antihypertensive medications. Prior use of beta-blockers and potassium-sparing diuretics was most largely associated with OH.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":" ","pages":"338-342"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10146036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement.","authors":"Musashi Yahagi, Momoko Sasaki","doi":"10.1097/MBP.0000000000000666","DOIUrl":"10.1097/MBP.0000000000000666","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the agreement between direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>A prospective observational study was conducted at Hitachi General Hospital, Japan, involving 30 patients aged 65 years and older who underwent TAVR under general anesthesia. Intra-arterial pressure and finger cuff arterial pressure measurements were recorded for 30 min after valve deployment. Bland-Altman analysis, four-quadrant plot analysis, and error grid analysis were used to assess the concordance between the two methods. Multiple regression analysis was performed to explore potential confounding factors affecting the agreement.</p><p><strong>Results: </strong>The bias and precision of ClearSight measurements were -4.88 ± 15.46 (mmHg) for SBP, 4.73 ± 8.95 (mmHg) for mean, and 9.53 ± 9.01 (mmHg) for DBP. The Bland-Altman analysis demonstrated acceptable agreement between intra-arterial pressure and finger cuff arterial pressure measurements. The four-quadrant plot analysis showed good trend-tracking ability, and the error grid analysis revealed that most of the observed values fell into the no-risk category. The mean BP match ratio and SBP match ratio were influenced by several factors such as age, BSA, ejection fraction, valve size, and gender.</p><p><strong>Conclusion: </strong>The ClearSight finger cuff arterial pressure measurement showed good agreement with direct intra-arterial pressure in elderly patients undergoing TAVR. However, factors such as age, BSA, ejection fraction, valve size, and gender may influence the agreement between the two methods.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":" ","pages":"309-315"},"PeriodicalIF":1.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54227540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glyceryl trinitrate-induced blood pressure variability decrease during head-up tilt test predicts vasovagal response.","authors":"Bernard Meglič, Aljoša Danieli","doi":"10.1097/MBP.0000000000000653","DOIUrl":"10.1097/MBP.0000000000000653","url":null,"abstract":"<p><strong>Purpose: </strong>Glyceryl trinitrate (GTN) provoked cardioinhibitory syncope during the head-up tilt test is preceded by a period of disrupted blood pressure variability (BPV). Endogenous nitric oxide (NO) attenuates BPV independently of blood pressure (BP). We hypothesized that exogenous NO donor GTN might decrease BPV during the presyncope period. A decrease in BPV may predict the tilt outcome.</p><p><strong>Methods: </strong>We analyzed 29 tilt test recordings of subjects with GTN-induced cardioinhibitory syncope and 30 recordings of negative subjects. A recursive autoregressive model of BPV after GTN was performed; powers of the respiratory (0.15-0.45 Hz) and nonrespiratory frequency (0.01-0.15 Hz) bands were calculated for each of the 20 normalized time periods. The post-GTN relative changes in heart rate, BP, and BPV were calculated.</p><p><strong>Results: </strong>In the syncope group, spectral power of nonrespiratory frequency systolic and diastolic BPV progressively felt for 30% after GTN application and stabilized after 180 s. BP started to fall 240 s after the GTN application. Decrease in nonrespiratory frequency power of diastolic BPV 20 s after GTN administration predicted cardioinhibitory syncope (area under the curve 0.811; 77% sensitivity; 70% specificity; cutoff value > 7%).</p><p><strong>Conclusion: </strong>GTN application during the tilt test attenuates systolic and diastolic nonrespiratory frequency BPV during the presyncope period, independent of BP. A decrease in nonrespiratory frequency diastolic BPV 20 s after GTN application predicts cardioinhibitory syncope with good sensitivity and moderate specificity.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"236-243"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different time points, different blood pressures: complexity of blood pressure measurement in hemodialysis patients.","authors":"Shan Lan, Yazhen Zhang, Jing Wang, Zhibin Wu, Shanying Chen","doi":"10.1097/MBP.0000000000000661","DOIUrl":"10.1097/MBP.0000000000000661","url":null,"abstract":"<p><strong>Objective: </strong>We used our established database to investigate predialysis blood pressure (BP) measurements at different time points.</p><p><strong>Methods: </strong>Our study period spanned from 1 January 2019 to 31 December 2019. The different time points included: the long interdialytic interval versus the short interdialytic interval; different hemodialysis shifts. Multiple linear regression was used to explore the association between BP measurements and different time points.</p><p><strong>Results: </strong>A total of 37 081 cases of hemodialysis therapies were included. After a long interdialytic interval, predialysis SBP and DBP were significantly elevated. Predialysis BP was 147.72/86.73 mmHg on Monday and 148.26/86.52 mmHg on Tuesday, respectively. Both predialysis SBP and DBP were higher in the a.m. shift. The mean BP in the a.m. and p.m. shifts were 147.56/87 mmHg and 144.83/84.64 mmHg, respectively. In both diabetic nephropathy and non-diabetic nephropathy patients, higher SBP measurements after a long interdialytic interval were observed; however, in diabetic nephropathy patients, we did not find significant differences in DBP among different dates. In diabetic nephropathy and non-diabetic nephropathy patients, we observed that the effect of different shifts on BP was similar. In Monday, Wednesday and Friday subgroups, the long interdialytic interval was also associated with BP; however, in Tuesday, Thursday and Saturday subgroups, different shifts but not the long interdialytic interval was associated with BP.</p><p><strong>Conclusion: </strong>The long interdialytic interval and different hemodialysis shifts have a significant effect on predialysis BP in patients with hemodialysis. When interpreting BP in patients with hemodialysis, different time points is a confounder.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"268-275"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the JOYTECH DBP-6279B blood pressure monitor in adults and adolescents according to the AAMI/ESH/ISO universal standard(ISO 81060-2:2018 + Amd.1:2020).","authors":"Baojing Duan, Le He, Jianling Zhang, Lixiu Fang, Gang Li","doi":"10.1097/MBP.0000000000000662","DOIUrl":"10.1097/MBP.0000000000000662","url":null,"abstract":"<p><p>This study aimed to validate the accuracy of DBP-6279B, an automated inflationary oscillometric upper-arm blood pressure (BP) monitor, in the sitting position according to the AAMI/ESH/ISO (81060-2 : 2018 + Amd.1 : 2020) universal standard protocol. SBPs and DBPs were measured simultaneously on the same arm in 88 adults (female : male = 47 : 41) with a mean age of 56.85 years using a mercury sphygmomanometer (two observers) and a DBP-6279B device (one supervisor). The AAMI/ESH/ISO 81060-2 : 2018 and Amd.1 : 2020 universal standards for the validation of BP-measuring devices in adults and adolescents were followed. A total of 259 valid pairs of data were used in the analysis. According to Criterion 1, the mean difference of SBP between the test device (DBP-6279B) and the reference device (the mercury sphygmomanometer) was 0.75 mmHg, with a SD of 7.66 mmHg. The mean difference in DBP was 1.13 mmHg, with a SD of 6.14 mmHg. The mean difference of both SBP and DBP was less than 5 mmHg, and the SD was less than 8 mmHg, which met the requirements. According to Criterion 2, the mean difference of SBP between the test device and the reference device was 0.85 mmHg, and the SD was 6.56 mmHg, which was less than 6.88 mmHg and met the requirements. The mean difference in DBP was 1.27 mmHg, and the SD was 5.42 mmHg, which was less than 6.82 mmHg and met the requirements. DBP-6279B fulfilled the requirements of the AAMI/ESH/ISO universal standard (ISO 81060-2 : 2018 + Amd.1 : 2020); hence, it can be recommended for both clinical and self/home BP measurement in adults and adolescents.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"284-288"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/62/bpmj-28-284.PMC10484188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10545634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of hypertension control among hemodialysis patients in Pakistan: a prospective follow-up study.","authors":"Kiran Hameed, Sampath Chinnam, Khanzada Sheraz Khan, Saima Mushtaq, Nafees Ahmad, Ammar Ali Saleh Jaber, Zeeshan Anwar, Inayat Ur-Rehman, Amjad Khan","doi":"10.1097/MBP.0000000000000656","DOIUrl":"10.1097/MBP.0000000000000656","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is highly prevalent and uncontrolled among hemodialysis patients. In Pakistan published data does not provide enough information about the management and factors associated with uncontrolled hypertension in hemodialysis patients.</p><p><strong>Objective: </strong>This study was conducted to evaluate the factors influencing the pharmacotherapeutic management and control of hypertension in hemodialysis patients.</p><p><strong>Methods: </strong>A prospective follow-up study was conducted on hemodialysis patients who were enrolled at study sites between 1 June 2020 and 31 December 2020. The predialysis blood pressure (BP) readings were recorded as mean SBP and DBP at baseline and for each of 6 months. Multivariate analyses were applied to analyze the factors associated with uncontrolled hypertension in hemodialysis patients.</p><p><strong>Results: </strong>The average predialysis BP (SBP and DBP) of study participants at baseline visit was 158.41 and 87.22 mmHg respectively. After 6 months the study participants have 150.27 mmHg and 80.03 mmHg average predialysis SBP and DBP respectively. Only 28.1% of hemodialysis patients were on target BP after 6 months. Results of multivariate analysis have shown that the use of beta-blockers and calcium channel blockers (CCBs) were significantly associated with hypertension control at baseline [odds ratio (OR) = 1.432, P value = 0.034] (OR = 1.499, P value = 0.045) and at after 6 months (OR = 2.824, P value = 0.015) (OR = 1.883, P value = 0.032).</p><p><strong>Conclusion: </strong>This study revealed that among the antihypertensive drugs, CCBs and beta-blockers provided better management in controlling hypertension among hemodialysis patients.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"253-259"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the U60EH Wrist Electronic Blood Pressure Monitor in general population according to the ISO 81060-2:2018/AMD 1:2020 Protocol.","authors":"Sicong Mu, Min Zhu, Liping Ma, Lixiu Fang","doi":"10.1097/MBP.0000000000000659","DOIUrl":"10.1097/MBP.0000000000000659","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of the U60EH Wrist Electronic Blood Pressure Monitor in general population according to the Universal Standard (ISO 81060-2:2018/AMD 1:2020).</p><p><strong>Methods: </strong>Subjects were recruited to fulfill the age, gender, blood pressure (BP) and cuff distribution criteria of the Universal Standard in a general population using the same arm sequential BP measurement method. A single cuff for wrist sizes 13.5-21.5 cm was used on this test device.</p><p><strong>Results: </strong>According to Criterion 1, the mean difference of SBP between the test device and the reference device was 1.51 mmHg, with an SD of 6.48 mmHg. The mean difference of DBP was -0.44 mmHg, with an SD of 5.98 mmHg. The mean difference of both SBP and DBP was less than 5 mmHg, and the SD was less than 8 mmHg, which met the requirements. According to Criterion 2, the mean difference of SBP between the test device and the reference device was 1.51 mmHg, and the SD was 5.88 mmHg, which was less than 6.78 mmHg and met the requirements. The mean difference of DBP was -0.44 mmHg, and the SD was 5.22 mmHg, which was less than 6.93 mmHg and met the requirements.</p><p><strong>Conclusion: </strong>All results passed the Standard (ISO 81060-2:2018/AMD 1:2020) requirements. The U60EH Wrist Electronic Blood Pressure Monitor can be recommended for home and clinical use.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"280-283"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/13/bpmj-28-280.PMC10484183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10545632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-utility analysis of diagnostic methods for arterial hypertension in primary care for Brazil: ABPM vs. OBPM vs. HBPM.","authors":"Rosana Lima Garcia, Marcus Tolentino Silva, Amaury Zatorre Amaral, Giovanio Vieira Silva","doi":"10.1097/MBP.0000000000000654","DOIUrl":"10.1097/MBP.0000000000000654","url":null,"abstract":"<p><strong>Introduction: </strong>Arterial hypertension (AH) is diagnosed using three methods: office blood pressure measurement (OBPM), home blood pressure monitoring (HBPM), and ambulatory blood pressure monitoring (ABPM). No economic studies have evaluated the impact of incorporating these strategies for AH diagnosis into the Brazilian public health system.</p><p><strong>Methods: </strong>A Markov model was created to evaluate the costs associated with AH diagnosis using the ABPM, HBPM, and OBPM. Patients were entered into the model with SBP ≥ 130 mmHg or DBP ≥ 85 mmHg obtained using OBPM. The model was based on cost, quality adjusted life-years (QALYs), and incremental costs per QALY. In the economic analysis, the costs were calculated from the perspective of the payer of the Brazilian public health system.</p><p><strong>Results: </strong>In the cost-utility analysis of the three methods, ABPM was the most cost-effective strategy compared to HBPM and OBPM in all groups over 35 years of age. Compared with OBPM, ABPM was a cost-effective strategy, as it presented higher costs in all scenarios, but with better QALYs. Compared to HBPM, ABPM was the dominant strategy for all age groups, presenting lower costs and higher QALYs. When comparing HBPM with OBPM, the results were similar to those described for ABPM (i.e. it was a cost-effective strategy).</p><p><strong>Conclusion: </strong>With a willingness-to-pay threshold of R$35 000 per QALY gained, both ABPM and HBPM are cost-effective methods compared with OBPM in all scenarios. In Brazilian healthcare facilities that currently diagnose AH using OBPM, both ABPM and HBPM may be more cost-effective choices.</p>","PeriodicalId":8950,"journal":{"name":"Blood Pressure Monitoring","volume":"28 5","pages":"260-267"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10564328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}