Blood Pressure最新文献

{"title":"Assessment of a strategy combining ambulatory blood pressure, adherence monitoring and a standardised triple therapy in resistant hypertension.","authors":"Erietta Polychronopoulou,&nbsp;Michel Burnier,&nbsp;Georg Ehret,&nbsp;Renate Schoenenberger-Berzins,&nbsp;Maxime Berney,&nbsp;Belen Ponte,&nbsp;Paul Erne,&nbsp;Murielle Bochud,&nbsp;Antoinette Pechère-Bertschi,&nbsp;Gregoire Wuerzner","doi":"10.1080/08037051.2021.1907174","DOIUrl":"https://doi.org/10.1080/08037051.2021.1907174","url":null,"abstract":"<p><strong>Purpose: </strong>Poor adherence to drug therapy and inadequate drug regimens are two frequent factors responsible for the poor blood pressure (BP) control observed in patients with apparent resistant hypertension. We evaluated the efficacy of an antihypertensive management strategy combining a standardised therapy with three long acting drugs and electronic monitoring of drug adherence in patients with apparent resistant hypertension.</p><p><strong>Materials and methods: </strong>In this multicentric observational study, adult patients with residual hypertension on 24 h ambulatory BP monitoring (ABMP) despite the use of three or more antihypertensive drugs could be included. Olmesartan/amlodipine (40/10 mg, single pill fixed-dose combination) and chlorthalidone (25 mg) were prescribed for 3 months in two separated electronic pills boxes (EPB). The primary outcome was 24 h ambulatory systolic BP (SBP) control at 3 months, defined as mean SBP <130 mmHg.</p><p><strong>Results: </strong>We enrolled 48 patients (36.0% women) of whom 35 had complete EPB data. After 3 months, 52.1% of patients had 24 h SBP <130 mmHg. 24 h SBP decreased by respectively -9.1 ± 15.5 mmHg, -22.8 ± 30.6 mmHg and -27.7 ± 16.6 mmHg from the tertile with the lowest adherence to the tertile with the highest adherence to the single pill combination (<i>p</i> = 0.024). A similar trend was observed with tertiles of adherence to chlorthalidone. Adherence superior to 90% was associated with 24 h systolic and diastolic blood pressure control in multiple logistic regression analysis (odds ratio = 14.1 (95% confidence interval 1.1-173.3, <i>p</i> = 0.039).</p><p><strong>Conclusions: </strong>A simplified standardised antihypertensive therapy combined with electronic monitoring of adherence normalises SBP in about half of patients with apparent resistant hypertension. Such combined management strategy enables identifying patients who need complementary investigations and those who rather need a long-term support of their adherence.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"332-340"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1907174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39154566","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":"The five RADIANCE-HTN and SPYRAL-HTN randomised studies suggest that the BP lowering effect of RDN corresponds to the effect of one antihypertensive drug.","authors":"Sverre E Kjeldsen,&nbsp;Krzysztof Narkiewicz,&nbsp;Michel Burnier,&nbsp;Suzanne Oparil","doi":"10.1080/08037051.2021.1995975","DOIUrl":"https://doi.org/10.1080/08037051.2021.1995975","url":null,"abstract":"Renal denervation (RDN) may be a new treatment modality for patients with hypertension. Initially, efforts to test the efficacy of RDN in lowering blood pressure (BP) have focussed on patients with apparent treatment resistant hypertension (aTRH). The SYMPLICITY HTN2 trial [1] reported a major reduction in systolic BP with RDN in patients with aTRH using office-based BP measurement. However, using ambulatory BP, the state-ofthe art technique for measuring BP in patients with aTRH [2], BP reductions were less evident [1]. Further, since poor drug adherence, which is common in aTRH [3], was not monitored in SYMPLICITY HTN-2, interpretation of the study results could be confounded by the Hawthorne effect i.e. patients started taking their drugs as prescribed in response to the attention devoted to them [4]. SYMPLICITY HTN-3 [5] included a sham control group and ambulatory BP measurements that balanced the Hawthorne and white-coat, placebo, and regressionto-the–mean effects, resulting in a BP reduction of 2mmHg in the RDN treatment group compared to the sham control. Further, meta-analyses of the first generation of randomised controlled studies of RDN did not show BP lowering effects of RDN (Figures 1 and 2), whether or not SYMPLICITY HTN-3 was included [6], and whether or not a sham control (Figures 3 and 4) was a part of the design [7]. However, these disappointments [5–7] did not end the interest in RDN for many reasons. First, total abdominal sympathectomy resulting from surgical splanchnicectomy was highly effective in the treatment of severe hypertension in cohorts of patients reported in the 1930s [8] and 1950s [9,10]. Second, the meta-analyses showed that RDN did not lead to severe adverse events and could be considered safe [6,7]. Third, the role of the sympathetic nervous system in the pathophysiology of hypertension is strong [11,12]. Further, the procedural problems that contributed to the failure of early RDN trials to lower BP could be overcome [13,14]. Therefore, new protocols were designed to assess the antihypertensive efficacy of RDN. One new approach was to perform clinical studies in untreated hypertensive","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"327-331"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39573756","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":"Serum uric acid change in relation to antihypertensive therapy with the dihydropyridine calcium channel blockers.","authors":"Di Zhang,&nbsp;Qi-Fang Huang,&nbsp;Chang-Sheng Sheng,&nbsp;Yan Li,&nbsp;Ji-Guang Wang","doi":"10.1080/08037051.2021.1996220","DOIUrl":"https://doi.org/10.1080/08037051.2021.1996220","url":null,"abstract":"<p><strong>Purpose: </strong>We investigated serum uric acid changes in relation to the achieved clinic and ambulatory blood pressure after 8 weeks of antihypertensive therapy with two dihydropyridine calcium channel blockers.</p><p><strong>Materials and methods: </strong>The study participants were patients with clinic and ambulatory hypertension, enrolled in a randomised controlled trial that compared amlodipine (5-10 mg, <i>n</i> = 215) and nifedipine gastrointestinal therapeutic system (GITS, 30-60 mg, <i>n</i> = 203). Hyperuricaemia was defined as a serum uric acid concentration of ≥420 µmol/L in men and ≥360 µmol/L in women. Analysis of covariance and multiple regression analyses were performed to study the associations between serum uric acid changes and the achieved clinic and ambulatory blood pressure during follow-up.</p><p><strong>Results: </strong>At baseline, 67 (16.0%) of the 418 patients had hyperuricaemia. Antihypertensive treatment reduced clinic and 24-h daytime and night-time systolic/diastolic blood pressure by a mean (±standard error [SE]) change of -17.4 ± 0.6/-8.6 ± 0.4 mm Hg and -13.7 ± 0.5/-8.3 ± 0.3 mm Hg, -13.8 ± 0.6/-8.4 ± 0.4 mm Hg, and -12.7 ± 0.7/-8.0 ± 0.4 mm Hg, respectively. Antihypertensive treatment reduced serum uric acid by a mean (±SE) change of -9.3 ± 2.8 μmol/L. The serum uric acid changes differed according to the achieved clinic and ambulatory blood pressure, and were statistically significant (mean ± SE -20.6 ± 6.6 to -10.7 ± 2.9 μmol/L, <i>p</i> ≤ 0.04) at the systolic/diastolic ranges of 130-139/≥90 mm Hg in clinic pressure, and <130/75-84 mm Hg, <145/80-84 mm Hg and <120/65-69 mm Hg in 24-h, daytime and night-time ambulatory pressure.</p><p><strong>Conclusion: </strong>Our study showed that antihypertensive therapy with a dihydropyridine calcium channel blocker was associated with reduced serum uric acid, especially when 24-h ambulatory systolic blood pressure was controlled.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"395-402"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39573762","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":"Hypertension telemonitoring and home-based physical training programs.","authors":"Olívia Moraes Ruberti,&nbsp;Juan Carlos Yugar-Toledo,&nbsp;Heitor Moreno,&nbsp;Bruno Rodrigues","doi":"10.1080/08037051.2021.1996221","DOIUrl":"https://doi.org/10.1080/08037051.2021.1996221","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertensive patients with access to telemedicine can receive telemonitoring of blood pressure and cardiovascular risk factors such as sedentary lifestyle, diet, and remote supervision of treatment compliance. Faced with this challenge, electronic devices for telemonitoring of BP have gained space. They have shown to be effective in the follow-up of hypertensive patients and assist in the adherence and control of associated risk factors such as physical inactivity and obesity.</p><p><strong>Materials and methods: </strong>Narrative Review.</p><p><strong>Results: </strong>The use of advanced smartwatches, smartphone apps, and online software for monitoring physical activity is increasingly common. Electronic equipment is briefly presented here as a support for better addressing some cardiovascular variables. Using various automated feedback services with a follow-up multidisciplinary clinical team is the ideal strategy.</p><p><strong>Conclusion: </strong>Mobile health can improve risk factors and health status, particularly for hypertensive patients, improving access to cardiac rehabilitation and reducing the cost.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"428-438"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39826339","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":"Resistant hypertension after renal infarction in a man with fibromuscular dysplasia.","authors":"Nikolina Bukal,&nbsp;Dražen Pekov,&nbsp;Luka Penezić,&nbsp;Bojan Jelaković,&nbsp;Živka Dika","doi":"10.1080/08037051.2021.2003180","DOIUrl":"https://doi.org/10.1080/08037051.2021.2003180","url":null,"abstract":"<p><p>We report the case of 39-year-old Caucasian man presenting in emergency department with new onset of severe hypertension with hypokalaemia eight weeks after renal colic. Patient was referred to a hypertension unit for further investigation. Hormonal analysis confirmed secondary aldosteronism and slightly impaired kidney function. Imaging revealed smaller right kidney, 'string of beads appearance' of distal part of right renal artery, a short zone of dissection and renal infarction. Renal scintigraphy showed significant blood flow reduction and severe functional damage of the right kidney. Despite multidrug antihypertensive treatment patient's hypertension was resistant and target organ damage evolved. After initial patient's refusal, he was later successfully treated with laparoscopic simple nephrectomy. Histopathological analysis confirmed renal artery dissection and medial fibroplasia. Thereafter, hypertension was controlled with trandalopril monotherapy. This is a first case report of the patient with renovascular multifocal fibromuscular dysplasia, dissection and renal infarction whose diagnosis of the disease was confirmed by angiography and histopathologic analysis. Resistant hypertension was successfully treated with nephrectomy.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"421-427"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634971","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":"Intraoperative hypotension and its organ-related consequences in hypertensive subjects undergoing abdominal surgery: a cohort study.","authors":"Szymon Czajka,&nbsp;Zbigniew Putowski,&nbsp;Łukasz J Krzych","doi":"10.1080/08037051.2021.1947777","DOIUrl":"https://doi.org/10.1080/08037051.2021.1947777","url":null,"abstract":"<p><p><b>Purpose</b>. Intraoperative hypotension is associated with organ hypoperfusion, which is deleterious to vital organs. Little is known about the prevalence and consequences of intraoperative hypotension in subjects with arterial hypertension (AH). The primary goal of this study was to investigate the prevalence and determinants of hypoperfusion-related clinical consequences of intraoperative hypotension, taking into account the role of AH, in a homogeneous cohort of patients undergoing abdominal surgery.<b>Materials and methods.</b> We enrolled 508 patients (219 males, median age 62 years). Intraoperative hypotension was defined as systolic blood pressure (SBP) <90 mmHg for at least 10 min or mean arterial pressure (MAP) <65 mmHg for at least 10 min or a need for noradrenaline infusion of at least 0.05 μg/kg/min for ≥10 min or intraoperative MAP drop of at least 30% from the baseline value for at least 10 min, regardless of the time of surgery. Acute kidney injury, stroke or transient ischaemic attack, delirium, and myocardial infarction were considered as the outcome.<b>Results.</b> AH concerned 234 (46%) individuals. The prevalence of intraoperative hypotension varied from 19.9 to 59.4%. Patients with AH were more likely to experience MAP drop of >30% than non-hypertensive patients (OR = 1.53; 95%CI 1.07-2.19; <i>p</i> = 0.02). The outcome was diagnosed in 38 (7.5%) patients. AH was a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied (logOR 2.80 ÷ 3.22; <i>p</i> < 0.05 for all). Only intraoperative hypotension defined as 'MAP < 65mmHg' was found to be a determinant of negative outcome (logOR = 2.85; 95%CI 1.35-5.98; <i>p</i> < 0.01), with AUROC = 0.83 (95%CI 0.0-0.86); <i>p</i> < 0.01.<b>Conclusion</b>. AH is a significant predictor of hypoperfusion-related events, regardless of the intraoperative hypotension definition applied. In hypertensive patients, hypoperfusion-related clinical consequences are more frequent in high-risk and long-lasting procedures. MAP < 65 mmHg lasting for >10 min during surgery was identified as most associated with the negative outcome.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"348-358"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39256824","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":"Renal nerve stimulation: complete versus incomplete renal sympathetic denervation.","authors":"Annemiek F Hoogerwaard,&nbsp;Ahmet Adiyaman,&nbsp;Mark R de Jong,&nbsp;Jaap-Jan J Smit,&nbsp;Jan-Evert Heeg,&nbsp;Boudewijn A A M van Hasselt,&nbsp;Arif Elvan","doi":"10.1080/08037051.2021.1982376","DOIUrl":"https://doi.org/10.1080/08037051.2021.1982376","url":null,"abstract":"<p><strong>Purpose: </strong>Blood pressure (BP) reduction after renal sympathetic denervation (RDN) is highly variable. Renal nerve stimulation (RNS) can localize sympathetic nerves. The RNS trial aimed to investigate the medium-term BP-lowering effects of the use of RNS during RDN, and explore if RNS can check the completeness of the denervation.</p><p><strong>Material and methods: </strong>Forty-four treatment-resistant hypertensive patients were included in the prospective, single-center RNS trial. The primary study endpoint was change in 24-h BP at 6- to 12-month follow-up after RDN. The secondary study endpoints were the acute procedural RNS-induced BP response before and after RDN; number of antihypertensive drugs at follow-up; and the correlation between the RNS-induced BP increase before versus after RDN (delta [Δ] RNS-induced BP).</p><p><strong>Results: </strong>Before RDN, the RNS-induced systolic BP rise was 43(±21) mmHg, and decreased to 9(±12) mmHg after RDN (<i>p</i> < 0.001). Mean 24-h systolic/diastolic BP decreased from 147(±12)/82(±11) mmHg at baseline to 135(±11)/76(±10) mmHg (<i>p</i> < 0.001/<0.001) at follow-up (10 [6-12] months), with 1 antihypertensive drug less compared to baseline. The Δ RNS-induced BP and the 24-h BP decrease at follow-up were correlated for systolic (<i>R</i> = 0.44, <i>p</i> = 0.004) and diastolic (<i>R</i> = 0.48, <i>p</i> = 0.003) BP. Patients with ≤0 mmHg residual RNS-induced BP response after RDN had a significant lower mean 24-h systolic BP at follow-up compared to the patients with >0 mmHg residual RNS-induced BP response (126 ± 4 mmHg versus 135 ± 10 mmHg, <i>p</i> = 0.04). 83% of the patients with ≤0 mmHg residual RNS-induced BP response had normal 24-h BP at follow-up, compared to 33% in the patients with >0 mmHg residual RNS-induced BP response (<i>p</i> = 0.023).</p><p><strong>Conclusion: </strong>The use of RNS during RDN leads to clinically significant and sustained lowering of 24-h BP with fewer antihypertensive drugs at follow-up. RNS-induced BP changes were correlated with 24-h BP changes at follow-up. Moreover, patients with complete denervation had significant lower BP compared to the patients with incomplete denervation.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"376-385"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39516557","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":"Impact of a screening protocol for blood pressure level for hypertension in the Korean community health survey.","authors":"Jinho Shin,&nbsp;Ju-Han Kim,&nbsp;Jeong Hun Shin,&nbsp;Mi Hyang Jung,&nbsp;Jung-Woo Son,&nbsp;Eun Mi Lee,&nbsp;Yu Mi Kim,&nbsp;Jung Sun Cho,&nbsp;Jung Hyun Choi,&nbsp;Hack-Lyoung Kim,&nbsp;Seon Kui Lee,&nbsp;Sun Hye Choi,&nbsp;Sang Hyun Ihm","doi":"10.1080/08037051.2021.1997094","DOIUrl":"https://doi.org/10.1080/08037051.2021.1997094","url":null,"abstract":"<p><strong>Purpose: </strong>A community program is an efficient model for improving the management of chronic diseases such as hypertension, diabetes, and dyslipidemia. A specific blood pressure (BP) measurement protocol was developed for community settings in which BP was measured by the interviewer at the interviewee's home.</p><p><strong>Materials and methods: </strong>In the 2018 Korean Community Health Survey, BP was measured twice at a five-minute interval after a five-minute resting period at the beginning of the survey. In 2019, BP was measured at the end of the survey after a two-minute rest and was obtained as three measurements at one-minute intervals. As factors related to BP level, stressful stimuli within 30 min before BP measurement such as smoking, caffeine, and/or exercise; duration of rest; and survey year were analysed.</p><p><strong>Results: </strong>The mean age of participants was 55.2 years, and females accounted for 55.4% of the participants (<i>n</i> = 399,838). Stressful stimuli were observed in 21.9% of the participants in 2018 (<i>n</i> = 188,440) and 11.3% in 2019 (<i>n</i> = 211,398). Duration of rest was 0 min (2.1%), two minutes (55.0%), and five minutes (47.9%). When adjusted for age, sex, body mass index, antihypertensive medication, the arm of measurement, survey year (beta= -4.092), stressful stimuli (beta = 0.834), and resting time (beta = -1.296 per one minute of rest) were significant factors for mean systolic BP. A two-minute rest was not a significant factor in mean BP. The differences in adjusted mean systolic BPs were significant for rest times of five minutes vs. two minutes (3.1 mmHg, <i>p</i> < 0.0001), for stressful stimuli (0.8 mmHg, <i>p</i> < 0.0001), and for survey year (127.8 ± 0.2 mmHg vs. 122.2 ± 0.3 mmHg for 2018 vs. 2019, <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>For the community-based home visit survey, avoidance of stressful stimuli, five-minute rest, and allocation of BP measurement in the last part of the survey was useful for obtaining a stable BP level.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"403-410"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39578366","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":"Adherence to antihypertensive drug treatment in kidney transplant recipients.","authors":"Coralie M G Georges,&nbsp;Arnaud Devresse,&nbsp;Sabrina Ritscher,&nbsp;Pierre Wallemacq,&nbsp;Stefan W Toennes,&nbsp;Nada Kanaan,&nbsp;Alexandre Persu","doi":"10.1080/08037051.2021.2004087","DOIUrl":"https://doi.org/10.1080/08037051.2021.2004087","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension is a common cardiovascular co-morbidity after kidney transplantation and contributes to shortened graft and patient survival outcomes. However, by contrast with adherence to immunosuppressive drugs, adherence to antihypertensive treatment in kidney transplant recipients has been seldom explored. The aim of the current study was to assess adherence to antihypertensive drugs in kidney transplant recipients from the Cliniques Universitaires Saint-Luc and to look for demographic and clinical characteristics associated with drug adherence.</p><p><strong>Methods: </strong>Demographic and clinical data were collected from medical files in a standardised case report form. Blood pressure was measured in the sitting position after 5 min rest, using validated oscillometric devices. Drug adherence was assessed by drug dosage in urine using liquid chromatography coupled with tandem mass spectrometry.</p><p><strong>Results: </strong>Our analysis included 53 kidney transplants recipients (75% of men, mean age: 57.2 ± 12.6 years, time since kidney transplantation: 9.5 ± 7.3 years, blood pressure: 130 ± 16/78 ± 11 mmHg on 2.1 ± 1.1 antihypertensive drugs). The proportion of patients showing full drug adherence, partial drug adherence, and total non-adherence to antihypertensive drugs was 79% (<i>N</i> = 42), 15% (<i>N</i> = 8), and 6% (<i>N</i> = 3), respectively. Adherent patients did not differ from less or non- adherers in any of the analysed characteristics.</p><p><strong>Conclusion: </strong>The proportion of patients adhering to antihypertensive drug treatment among kidney transplant recipients appears similar to that reported for immunosuppressive drugs in renal transplanted patients (∼70%), but much higher than that observed in patients with drug-resistant hypertension (30-40%). Our results need further confirmation in a large, multicenter, prospective cohort.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"411-415"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634562","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":"Ambulatory blood pressure using 60 rather than 20-min intervals may better reflect the resting blood pressure.","authors":"Karol M Dabrowski,&nbsp;Jakob Nyvad,&nbsp;Martin B Thomsen,&nbsp;Jannik B Bertelsen,&nbsp;Kent L Christensen","doi":"10.1080/08037051.2021.1953372","DOIUrl":"https://doi.org/10.1080/08037051.2021.1953372","url":null,"abstract":"<p><strong>Purpose: </strong>Twenty-four hours of ambulatory blood pressure monitoring (ABPM) is recommended in several guidelines as the best method for diagnosing hypertension. In general, the prognostic value of ABPM is superior to single office blood pressure (BP) measurements. Unfortunately, some patients experience considerable discomfort during frequently repeated forceful cuff inflations.</p><p><strong>Materials and methods: </strong>In this study we investigated the difference in mean daytime systolic BP (SBP) between low-frequency ABPM (LF-ABPM), measuring once every hour, and high-frequency ABPM (HF-ABPM), measuring three times an hour during daytime, and two times an hour during night-time.</p><p><strong>Results: </strong>Seventy-one patients were included in the analysis. All included patients had an HF-ABPM performed first and within a few weeks they underwent an LF-ABPM. The average day time difference in SBP between the two frequencies was 3.8 mmHg (<i>p</i>-value = 0.07) for mild, 8.2 mmHg (<i>p</i>-value < 0.01) for moderate and 15 mmHg (<i>p</i>-value < 0.001) for severe hypertension. A similar pattern was seen for night-time SBP. This study suggests that mean BP is similar between the two measuring frequencies for normotensive and mild hypertensive patients, while HF-ABPM results in a higher 24-h mean BP for moderate- and severe hypertensive patients.</p><p><strong>Conclusion: </strong>LF-ABPM may more correctly reflect the resting blood pressure in patients with moderate and severe hypertension.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"341-347"},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1953372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39185306","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}