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At least 19 recordsLinked to original sources
PubMed1992

An evaluation of self-measured blood pressure in a study with a calcium-channel antagonist versus a beta-blocker.

In recent years self-measurement of blood pressure at home has gained increasing importance but there have been only a few studies comparing casual, ambulatory, and self-measured blood pressure determinations during a single clinical trial. We therefore compared treatment-induced blood pressure-reductions in a double-blind, placebo-controlled, parallel study design with a single morning dose of either 10 mg bisoprolol (n = 26) or 20 mg nitrendipine (n = 27) with casual blood pressure readings in the morning before the dose, ambulatory 24-h monitoring, and self-recorded measurements in the morning before the dose and in the evening. Mean reductions for systolic and diastolic blood pressure after 4 weeks of therapy were significantly greater for bisoprolol than for nitrendipine. The treatment-induced blood pressure reductions were most pronounced as assessed by casual readings but showed good agreement between casual, ambulatory, and self-measured blood pressure for group comparisons. In some patients, however, marked individual differences between the three methods were observed. Correlation coefficients between ambulatory and self-measured blood pressure were 0.4 for systolic blood pressure (P less than .05) and 0.6 for diastolic blood pressure (P less than .0005). Under the conditions of this parallel study design and the usual statistical risks, a difference of 5 mm Hg in diastolic blood pressure can be detected in 118 patients at the clinic, in 70 patients if ambulatory blood pressure is used, or in 56 patients if self-measured blood pressure is used. In conclusion, bisoprolol was more effective over 24 h than nitrendipine at the doses studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Comparison of casual, ambulatory and self-measured blood pressure in a study of nitrendipine vs bisoprolol.

In a double-blind, placebo-controlled study the antihypertensive efficacy and tolerability of a single morning dose of either 10 mg bisoprolol (n = 26) or 20 mg nitrendipine (n = 27) were investigated. Blood pressure was measured by three techniques: (1) Casual blood pressure 24 h after the dose; (2) ambulatory 24-h whole-day monitoring; and (3) self-recorded blood pressure in the morning 24 h after the dose (6-8 a.m.) and in the evening (6-8 p.m.). After 4 weeks of therapy bisoprolol had produced a highly significant reduction in blood pressure as assessed by causal, ambulatory day- and night-time monitoring, and self-measured morning and evening readings. Bisoprolol was significantly more effective than nitrendipine, which did not induce a significant reduction in the ambulatory night-time recordings. Whole-day ambulatory blood pressure profiles showed an antihypertensive effect of bisoprolol throughout the entire 24-h period. 24-h blood pressure curves after nitrendipine demonstrated a markedly shorter duration of action, with no reduction in early morning blood pressure. Adverse effects and tolerability of the two drugs were comparable. The average changes in systolic and diastolic blood pressure after bisoprolol and nitrendipine in 2-h periods of ambulatory monitoring (6-8 a.m. and 6-8 p.m.) and self-measured blood pressure (6-8 a.m. and 6-8 p.m.) showed a good agreement between ambulatory and self-measured blood pressure determinations with no significant difference between the methods. The results show that 24 h antihypertensive efficacy was more pronounced for bisoprolol than for nitrendipine at the doses studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1975

[Self-measurement of blood pressure in hypertensive patients. A psychological study (author's transl)].

Risks and complications of arterial hypertension can be reduced by an active and prolonged treatment. However, only a small number of hypertensive subjects is treated effectively. The co-operation of patients in the management of the disease may be useful in the treatment of hypertension. The authors report the results of a study of thirty hypertensive patients chosen at random, who checked their arterial pressure by themselves. The psychological reactions, the advantages and disadvantages of this experience and the attitude of the attending physicians were analyzed. The majority of the patients had no difficulty in the self-measurement of blood pressure and succeeded in reaching and maintaining the values of blood pressure within satisfactory levels, getting favourable psychological effects as well. Six patients (out of the ten who were indifferent or contrary to this practice) went on measuring the arteria pressure, giving in this way a contribution to a better management of the disease. The attitude of the attending physicians was on the whole indifferent or negative towards this experience.

Blood Pressure Determination↗
PubMed1992

Usefulness of self-measured blood pressure when diagnosing mild hypertension.

Blood pressure (BP) measured by the patients themselves at home and at their workplaces (self BP) and office blood pressure (office BP) were compared with ambulatory BP (amb BP) in 41 middle-aged borderline hypertensive men when diagnosing hypertension. Ambulatory BP was used as the 'gold standard'. The mean (standard deviation) value for office BP was 142/89 (14/7), self BP 143/92 (14/8), and amb BP 134/88 (12/6) mmHg. There was no difference between diastolic office BP and self BP as instruments for diagnosing hypertension. Furthermore, combining the two added little to the diagnostic value obtained from only one of them.

Blood Pressure Determination↗
PubMed2026

Validation of the LD-526 brachial blood pressure monitor according to the International Organization for Standardization protocol (ISO 81060-2:2018/AMD 1:2020/AMD 2:2024).

OBJECTIVE: The LD-526 oscillometric upper-arm blood pressure (BP) monitor is intended for self-measurement of BP in adults. The aim of this study was to evaluate the accuracy of LD-526 oscillometric upper-arm BP monitor in the general population according to the International Organization for Standardization (ISO) universal standard (ISO 81060-2 : 2018/AMD 1 : 2020/AMD 2 : 2024). METHOD: Subjects were recruited to fulfill the age, gender, BP, and cuff distributions of the ISO universal standard in the general population using the same-arm sequential BP measurement method. The test device was used with one universal cuff for arm circumferences of 22-42 cm. Reference BP measurements were obtained using a calibrated mercury sphygmomanometer, with two cuffs (inflatable bladder sizes of 12 × 24 and 16 × 32 cm, respectively). RESULTS: Of the 98 recruited subjects, 85 [women/men: 46/39; mean (±SD) age: 52.2 ± 17.4 years] were analyzed, and 13 were excluded from the final analysis: 10 because of reference BP variability and three because of cardiac arrhythmias. For validation of criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 1.34 ± 5.56/-0.31 ± 4.36 mmHg (systolic/diastolic). For criterion 2, the SD of the average BP differences between the test device and reference BP per subject was 4.51/3.77 mmHg (systolic/diastolic). CONCLUSION: The LD-526 BP monitor fulfilled all the requirements of the ISO universal standard (ISO 81060-2 : 2018/AMD 1 : 2020/AMD 2 : 2024) in the general population and can be recommended for self-measurement.

blood pressure monitor↗
PubMedDate not supplied

Chronobiology in the diagnosis and treatment of mesor-hypertension.

An elevation of systolic and diastolic bloodpressure to values regarded as abnormal ones on the basis of conventional criteria was recognized by self-measurement. For both systolic and diastolic blood pressure, the overall means adjusted for rhythms, the so-called mesors, also were elevated in the light of their response to treatment: these mesors were found to be lowered with statistical significance when values during treatment were compared by an objective test with values measured before treatment. Individualized rhythmometry quantitatively characterizes a predictalbe portion of the variability in human blood pressure and tests for the statistical significance of changes in blood pressure as a function of the treatment and also as a function of the circadian timing of such treatment. The case report thus illustrates an individualized chronotherapy of systolic and diastolic mesor-hypertension, diagnosed retrospectively from the tested effect of hydrochlorothiazide. In the case reported, and perhaps routinely, computer-analyzed self-measurements can serve 1) to prescribe the right kind and amount with the right timing, for a given therapy, and 2) for diagnosis and prevention as well (Meyer et al.; Halberg et al.).

Blood Pressure↗
PubMedDate not supplied

Chronobiology in 1975.

UNLABELLED: A spectrum of rhythms with several frequencies importantly characterizes not only the central nervous system but also the neuroendocrines and endocrines, other structures and organs, beyond the level of the cell to subcellular structures; it has a wide bearing since chronobiologic methods and facts relate to both basic research and its bearing on major problems of our day. Perhaps most important, computer analysis of data series allows study of temporal structure, progressive and rhythmic variations in life processes and in their responses to environment and drugs. By such methods coupled to modern data collection and/or self-measurement, chronobiology is particularly promising in the following areas, cited as illustrative rather than comprehensive examples: 1. Work hygiene: optimization of work schedules by adjustment of regular schedules and in particular of shift-work to the individuals' physical and mental rhythms. Experimentally, differences in manner of schedule change can account for the difference between the life span shortening and lengthening. 2. Population control: improved methods for detecting the neural as well as neurohormonal regulation of ovulatory cycles should aid efficient family planning by the recognition of a spectrum of rhythms and its synchronization with socio-ecologic factors acting, perhaps, via olfactory and/or other sensory modalities; 3. Nutrition: optimizing the utilization of ever scarcer food supplies and also the benefit from both oral and parenteral medications by meal timing; 4. Education: providing a do-it-yourself system for monitoring individual health in the context of secondary and adult education and as the basis for preventive health care; and, in another context, taking individual mental rhythms as well as morningness-eveningness into account in teaching and learning; 5. Health care: Any risk, e.g., from blood pressure rhythm alteration (perhaps preceding by years intermittent labile elevation) will be detected earlier and more efficiently by multiple measurements readily obtained by autorhythmometry. Results of such an endeavor provide at any one time indices that can be compared with an individualized rhythmometric reference standard as well as peer group rhythm parameters. The rhythm-determined average is more reliable than the single measurement. Other individualized characteristics of a rhythm, such as measures of extent of change or timing of change, may constitute an early warning signal and could be monitored by self-measured or preferably automatically-collected data. Timely and timed treatment can then be sought to prevent, in the case of blood pressure, elevation and consequent debilitating disease such as coronary infarction and stroke. 6. THERAPY: One can strive toward the more specific correction of any pathogenic rhythm alteration when such can be recognized by modern methods of data collection and data analysis...

Animals↗
PubMed1992

Ambulatory blood pressure monitoring: an historical perspective.

Since blood pressure was first measured more than 250 years ago, it has been assumed to be a fluctuating phenomenon, but always it has been determined by static measurements in the physician's office. In the 1940s, self-measurement at home was attempted, and two decades later the first ambulatory blood pressure recording devices were developed. These have since been improved, made more convenient, rendered automatic, and are now available for 24-h measurement during a patient's normal day. It is now increasingly recognized that such measurement is more physiologically valid and more accurate in diagnosing hypertension than clinic measurement. In addition, such monitoring may have special utility in assessing response to treatment.

Ambulatory Care↗
PubMed1992

The impact of home monitoring and daily diary recording on patient status in cystic fibrosis.

An experimental home monitoring system for assessing the progress and planning changes in the care of patients with cystic fibrosis (CF) has been implemented at the University of Minnesota Cystic Fibrosis Center. One group of patients and families did daily recording of physical measurements and symptoms, and sent the diary to the data coordinating center weekly for analysis. The remaining patients were not part of the home monitoring program. Twenty-five patients were randomly selected from the home monitoring group. They were compared to an age- and sex-matched control group not doing home monitoring to ascertain if home self-measurement and daily diary recording, in the absence of any therapeutic intervention, produced any change in physical or psychological status, pulmonary function, or growth over a 4-year study period. Subjects ranged in age from 6 to 43 years. Clinical status was measured by the National Institutes of Health cystic fibrosis scoring system. Pulmonary function was assessed as percent of predicted forced vital capacity and percent of predicted forced expiratory volume in 1 sec (FEV1). Growth was analyzed as percent of predicted weight based on age-, sex-, and height-dependent equations. Psychological status was determined by self-assessment and referral for conseling. Only percent predicted FEV1 in the control group declined significantly. There were no statistically significant changes in any other measures either within or between diary and nondiary groups over the 4-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

The Pulsair-Keeler non-contact tonometer in self-tonometry: preliminary results.

The authors considered the possibility of using the Pulsair-Keeler non-contact tonometer in self-tonometry. For this reason, 45 patients have been trained to use the instrument and, after a reasonable trial period, were able to self-measure their IOP. The results have been compared to the tonometric values measured with Goldmann tonometer to evaluate statistically the limits and the dependability of this method of measurement. The results shows that self-tonometry with the Pulsair-Keeler tonometer can be used in monitoring glaucomatous patients at home.

Adult↗
PubMed1976

Triamcinolone acetonide aerosols for asthma. I. Effective replacement of systemic corticosteroid therapy.

Triamcinolone acetonide, a water-insoluble corticosteroid preparation in a Freon-propelled metered-dose aerosol, was administered via a specially designed nebulizer to 22 adult patients with severe, chronic asthma. All patients had required oral corticosteroid therapy, daily, for several years, in order to control their incapacitating obstructive airways disease. During 4 wk of treatment with triamcinolone acetonide, taken in 4 daily doses totaling 8 to 28 inhalations (400-1,400 mcg) per day: (1) asthma remained under satisfactory control; (2) oral corticosteroids were stopped in 19 patients and reduced in 2, and 1 patient withdrew from the study; (3) adrenal cortical function returned to normal or near normal levels; (4) spirometric and plethysmographic measurements improved significantly; (5) daily self-measurements of peak expiratory flow showed a marked improvement in median weekly levels, as well as a reduction in daily variability. No immediate undesirable side effects were noted. These observations indicated that more extensive applications of topical corticosteroid therapy are justified as an effective, convenient, and relatively safe method for the preventive management of severe, persistent asthma.

Administration, Intranasal↗
PubMed1977

Twenty-four-hour rhythm in the bronchial hyperreactivity to house dust in asthmatics.

Four subjects, 2 males (17 and 35 yr of age) and 2 females (24 and 47 yr of age) suffering from allergic asthma were studied for 10 days in allergen-shielded rooms and without medication. Synchronization of subjects to activity was by light on at 7 A.M. and sleep by light off at midnight. A single bronchial challenge to the threshold concentration of house dust, predetermined for each subject, was presented every other day at designated clock hours such that during a 10-day study span tests were presented at the following times: 8 A.M., 3 P.M., 7 P.M., and 11 P.M. The effect upon bronchial patency determined by FEV 1.0 15 min after house dust inhalation resulted in greatest effect at 11 P.M., while that at 8 A.M. resulted in least effect. The differences were statistically significant (p less than 0.025). Peak expiratory flow (PEF), self-measured at 3-hr intervals throughout the 10-day span, revealed practically no persistence of effect for inhalation of the house dust preparations at 8 A.M.; on the other hand, considerable persistence of effect on airway patency occurred from tests carried out at 11 P.M. The differences between the 24-hr rhythm-adjusted means (mesors) in the PEF for the (24-hr) spans following house dust inhalation at 8 A.M. and 11 P.M. were statistically significant (p less than 0.025) as well.

Adolescent↗
PubMed1992

Exposures of older adults with chronic respiratory illness to nitrogen dioxide. A combined laboratory and field study.

We combined field and laboratory experimentation to evaluate the effects of nitrogen dioxide in a panel of Los Angeles area residents with chronic respiratory illness, 15 men and 11 women aged 47 to 69. All had heavy smoking history, chronic symptoms, and low FEV1; some also had low FVC. During the fall-winter high-NO2 season, they monitored themselves for 2-wk periods using spirometers in the home, passive NO2 sampling badges, and diaries to record time and activity patterns and clinical status. In the middle of each self-monitoring week they were exposed in a chamber, once to clean air and once to 0.3 ppm NO2. Chamber exposures were double blind, lasted 4 h, and included four 7-min exercise sessions with average ventilation rates near 25 L/min. Symptom reports and hourly forced expiratory function tests showed no statistically significant differences between clean air and NO2 chamber exposures, although peak flow showed a approximately 3% loss with NO2 relative to clean air during the first 2 h of exposure only (p = 0.056). No significant overall differences were found between field self-measurements and measurements of lung function in the chamber or between field measurements in clean air and NO2 exposure weeks. Field data showed that group average lung function and symptom levels were worse in the morning than later in the day (p < 0.005) but otherwise were stable over 2 wk. Even though most subjects smoked and stayed indoors 80 to 90% of the time, personal NO2 exposures correlated significantly with outdoor NO2 concentrations as reported by local monitoring stations.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1976

Bio-behavioral monitoring: a method for remote health measurement.

The treatment of chronic disease has been severely limited by the failure to develop a technology of self-measurement. To examine and validate remotely acquired data from ambulatory patients, 13 cirrhotic subjects were asked to make daily measurements of medically and behaviorally significant variables. Subjects transmitted data for six months on variables such as weight, alcohol consumption, medications, hours worked, liquid consumed and general activity, complying with 90.4% (10,078) of the requests for data. Highly significant relationships were found between patients' reports and criterion measures of weight data and alcohol consumption. Significant negative relationships between hours worked and alcohol consumption were found for several patients (P less than 0.001). The results suggest that ambulatory patients can systematically measure and communicate medically and behaviorally significant information.

Absenteeism↗
PubMed1992

Ambulatory blood pressure monitoring. A tool for more comprehensive assessment.

AIMS: To investigate the usefulness of more comprehensive blood pressure measurements, made during daily life, in the diagnosis and treatment of hypertension. METHODS: A blood pressure screening was carried out in middle-aged men and women in Kävlinge, a municipality in southern Sweden. Subjects were classified according to Swedish standard criteria. Ambulatory blood pressure (amb-BP) was recorded in a random sample of normotensives and borderline hypertensives as well as in all the untreated hypertensives identified at screening and willing to participate. A subgroup of borderline hypertensives also carried out self-measurements of blood pressure (self-BP) both at work and at home. The blood pressure lowering efficacy of atenolol 50 mg o.d. and enalapril 20 mg o.d. was compared in hypertensives at rest, during 24 hours, and during dynamic and isometric exercise. The efficacy of enalapril and lisinopril (two ACE inhibitors with different durations of action) were also compared, with special focus on the early morning hours. RESULTS: Men and women classified as normotensives clearly differed from those with hypertension, also when blood pressure was recorded with ambulatory technique. The number of correctly classified subjects did not differ between self-BP and office-BP; combining the two added little. Atenolol reduced blood pressure better during dynamic exercise than did enalapril, while there was no significant difference in effect between enalapril and lisinopril, not even 18-24 hours post-dose. CONCLUSION: More comprehensive blood pressure measurements should be considered in the evaluation of hypertension treatment. Office BP, however, seems a reasonably good tool for diagnosing hypertension.

Adult↗
PubMed1992

[Application for medical field of enzyme sensor].

Various portable glucose sensors have been developed and used for self-measurement of blood glucose levels for diabetes. Enzyme sensors will become one of a useful technology for assay of various substances and be applied to analysis for clinical chemistry.

Artificial Organs↗