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  1. Fulltext The influence of self-owned home blood pressure monitoring (HBPM) on primary care patients with hypertension: a qualitative study
    Abdullah A, Othman S
    BMC Fam Pract, 2011;12:143.
    PMID: 22208768 DOI: 10.1186/1471-2296-12-143
    BACKGROUND:
    Home blood pressure monitoring (HBPM) is gaining popularity among hypertensive patients. This study aimed to explore the influence of self-initiated HBPM on primary care patients with hypertension.
    METHODS:
    Six in-depth interviews and two focus group discussions were conducted, taking into consideration the experiences of 24 primary care patients with hypertension. These patients had been using HBPM as part of their hypertension management. The overriding influences were grouped under themes which emerged from analyzing the data using the grounded theory approach.
    RESULTS:
    There are both positive and negative influences of self-initiated HBPM. Patients used the readings of their HBPM to decide on many aspects of their hypertension management. The HBPM readings both influenced their adherence to diet and exercise and provided certain reassurance when they experienced symptoms. In addition, the act of discussing their HBPM readings with their health care providers resulted in an enhanced doctor-patient therapeutic relationship. Nevertheless, HBPM created confusion at times in some patients, particularly with regard to the target blood pressure level and the need for medication. This led to some patients making their own medical decisions based on their own standards.
    CONCLUSIONS:
    HBPM is becoming an integral part of hypertension management. Primary care patients who self-initiated HBPM reported being more self-efficacious, but lack of participation and guidance from their doctors created confusion, and hindered the true benefit of HBPM.

    Study site: urban primary care clinic, located within the University Malaya Medical Centre
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory*
  2. Guidelines adherence and hypertension control at a tertiary hospital in Malaysia
    Ahmad N, Hassan Y, Tangiisuran B, Meng OL, Abd Aziz N, Ahmad FU, et al.
    J Eval Clin Pract, 2013 Oct;19(5):798-804.
    PMID: 22583820 DOI: 10.1111/j.1365-2753.2012.01852.x
    RATIONALE, AIMS AND OBJECTIVES: Existing literature suggests that doctors' poor adherence with guidelines is one of the major contributing factors to suboptimal control of hypertension. This study aims to evaluate doctors' adherence with Malaysian clinical practice guideline (CPG 2008) in a tertiary care hospital, and factors associated with guideline adherence and hypertension control.
    METHODS: This was a cross-sectional study conducted at Hospital Pulau Pinang, Penang, Malaysia. Prescriptions written by 26 enrolled doctors to 650 established hypertensive outpatients (25 prescriptions per enrolled doctor) were noted on visit 1 along with patients' demographic and clinical data. The noted prescriptions were classified either as compliant or non-compliant to CPG (2008). Five hundred twenty (80%) of the enrolled patients (20 patients per enrolled doctor) were followed for one more visit. Blood pressure (BP) noted on visit 2 was related to the prescription written on visit 1. SPSS 16 (SPSS Inc., Chicago, IL, USA) was used for data analysis.
    RESULTS: Three hundred forty-nine (67.1%) patients received guidelines compliant pharmacotherapy. In multivariate analysis, hypertension clinic had significant negative association with guidelines adherence. Two hundred sixty-five patients (51%) were at goal BP on visit 2. In multivariate analysis, angiotensin-converting enzyme inhibitors and guidelines adherence had significant positive, while renal disease, diabetes mellitus and diabetic clinic had significant negative association with hypertension control.
    CONCLUSIONS: An overall fair level of adherence with guidelines and better control of hypertension was observed. Guidelines compliant practices resulted in better control of hypertension. The gaps between what guidelines recommend and clinical practice were especially seen in the pharmacotherapy of uncomplicated hypertension and hypertension with diabetes mellitus and renal disease.
    KEYWORDS: Malaysia; adherence; guidelines; hypertension
    Study site: Cardiology, nephrology, diabetic and hypertension clinics, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory/statistics & numerical data
  3. Fulltext The capability of fiber Bragg grating sensors to measure amputees' trans-tibial stump/socket interface pressures
    Al-Fakih EA, Osman NA, Eshraghi A, Adikan FR
    Sensors (Basel), 2013 Aug 12;13(8):10348-57.
    PMID: 23941909 DOI: 10.3390/s130810348
    This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.
    Matched MeSH terms: Monitoring, Ambulatory/instrumentation*
  4. Mobile Patient Monitoring Systems from a Benchmarking Aspect: Challenges, Open Issues and Recommended Solutions
    Almahdi EM, Zaidan AA, Zaidan BB, Alsalem MA, Albahri OS, Albahri AS
    J Med Syst, 2019 May 29;43(7):207.
    PMID: 31144129 DOI: 10.1007/s10916-019-1336-z
    This paper presents comprehensive insights into mobile patient monitoring systems (MPMSs) from evaluation and benchmarking aspects on the basis of two critical directions. The current evaluation criteria of MPMSs based on the architectural components of MPMSs and possible solutions are discussed. This review highlights four serious issues, namely, multiple evaluation criteria, criterion importance, unmeasurable criteria and data variation, in MPMS benchmarking. Multicriteria decision-making (MCDM) analysis techniques are proposed as effective solutions to solve these issues from a methodological aspect. This methodological aspect involves a framework for benchmarking MPMSs on the basis of MCDM to rank available MPMSs and select a suitable one. The benchmarking framework is discussed in four steps. Firstly, pre-processing and identification procedures are presented. Secondly, the procedure of weight calculation based on the best-worst method (BWM) is described. Thirdly, the development of a benchmark framework by using the VIKOR method is introduced. Lastly, the proposed framework is validated.
    Matched MeSH terms: Monitoring, Ambulatory/instrumentation; Monitoring, Ambulatory/methods*
  5. Fulltext Improvement of nutritional intake for the low-income urban dwellers with hypertension in Malaysia
    Azizan NA, Majid HA, Nahar Mohamed A, Su TT
    SAGE Open Med, 2020;8:2050312120960563.
    PMID: 33014371 DOI: 10.1177/2050312120960563
    Objective: To ascertain the effect of dietary practice modification and a peer-support home blood pressure monitoring program on the nutritional intake (macronutrients and micronutrients), blood pressure and biochemical profiles of hypertension patients in a low-income community setting.

    Methods: This is a pre- and post-measurement intervention study conducted in low-income community housing projects in Kuala Lumpur, Malaysia. A total of 90 participants aged 18 years and above with hypertension received intervention. The participants were divided into small groups and received instructions on the use of home blood pressure measurement. They also attended a series of talks on dietary intake modification and exercise demonstration for the first six months (active phase). In another 6 months (maintenance phase), they received only pamphlet and SMS reminders. Their anthropometry, blood pressure, dietary, and biochemical parameter changes were measured at baseline, 6 months, and 12 months of intervention.

    Results: Macronutrients and micronutrients showed a significant improvement at the end of 12-month dietary intervention. The energy, carbohydrate, protein, total fat, sodium, and potassium are showing significant reduction from baseline to end of the 12-month intervention. There is no significant reduction in blood pressure. Fasting blood glucose, renal sodium, triglyceride, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol showed a significant improvement, after controlling for age and reported physical activity.

    Conclusion: The intervention improved the nutritional intake and biochemical profiles of the low-income urban population with hypertension. This promising result should be replicated in a larger scale study.

    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  6. Data-Centric Routing for Intra Wireless Body Sensor Networks
    Bangash JI, Khan AW, Abdullah AH
    J Med Syst, 2015 Sep;39(9):91.
    PMID: 26242749 DOI: 10.1007/s10916-015-0268-5
    A significant proportion of the worldwide population is of the elderly people living with chronic diseases that result in high health-care cost. To provide continuous health monitoring with minimal health-care cost, Wireless Body Sensor Networks (WBSNs) has been recently emerged as a promising technology. Depending on nature of sensory data, WBSNs might require a high level of Quality of Service (QoS) both in terms of delay and reliability during data reporting phase. In this paper, we propose a data-centric routing for intra WBSNs that adapts the routing strategy in accordance with the nature of data, temperature rise issue of the implanted bio-medical sensors due to electromagnetic wave absorption, and high and dynamic path loss caused by postural movement of human body and in-body wireless communication. We consider the network models both with and without relay nodes in our simulations. Due to the multi-facet routing strategy, the proposed data-centric routing achieves better performance in terms of delay, reliability, temperature rise, and energy consumption when compared with other state-of-the-art.
    Matched MeSH terms: Monitoring, Ambulatory/instrumentation*
  7. Fulltext A study to assess the knowledge on self-blood pressure monitoring (SBPM) among hypertensive patients in selected wards of Hospital Lam Wah Ee, Malaysia
    Beth, Mini Rani Mary, Shin, Yan Low, Poh, Yoke Chung
    International e-Journal of Science, Medicine & Education, 2012;6(2):43-45.
    MyJurnal
    Self-blood pressure monitoring (SBPM) at home creates greater awareness and patient participation in their treatment prevents hypertensive complications and helps facilitate doctors to make decisions on treatment. A study was conducted to assess the knowledge on self-blood pressure monitoring (SBPM) among hypertensive patients in selected wards of Hospital Lam Wah Ee, Malaysia. The results showed only 21 (32.3%) respondents monitored their blood pressure and 44 (67.7%) did not monitor their blood pressure at home. A total of 12 (18.4%) respondents reported that they monitored their blood pressure at home because they were aware of complications of hypertension. From those respondents who did not monitor blood pressure at home, only 13 (29.5%) respondents planned to carry out SBPM at home in the future. The overall knowledge score results for self-blood pressure monitoring showed that 6 (9.2%) subjects scored 8 and above, 42 (64.6%) scored 5-7, and 17 (26.1%) scored less than 4. The findings from the study will help the nurses understand the level of knowledge on SBPM among hypertensive patients, and include training and health education during hospitalisation reinforcing the importance and the technique of performing SBPM at home. It also helps to identify patients with poor control of blood pressure so that they can be referred to the physician for further treatment.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  8. Fulltext The Evaluation of Physical Stillness with Wearable Chest and Arm Accelerometer during Chan Ding Practice
    Chang KM, Chun YT, Chen SH, Lu L, Su HT, Liang HM, et al.
    Sensors (Basel), 2016 Jul 20;16(7).
    PMID: 27447641 DOI: 10.3390/s16071126
    Chan Ding training is beneficial to health and emotional wellbeing. More and more people have taken up this practice over the past few years. A major training method of Chan Ding is to focus on the ten Mailuns, i.e., energy points, and to maintain physical stillness. In this article, wireless wearable accelerometers were used to detect physical stillness, and the created physical stillness index (PSI) was also shown. Ninety college students participated in this study. Primarily, accelerometers used on the arms and chest were examined. The results showed that the PSI values on the arms were higher than that of the chest, when participants moved their bodies in three different ways, left-right, anterior-posterior, and hand, movements with natural breathing. Then, they were divided into three groups to practice Chan Ding for approximately thirty minutes. Participants without any Chan Ding experience were in Group I. Participants with one year of Chan Ding experience were in Group II, and participants with over three year of experience were in Group III. The Chinese Happiness Inventory (CHI) was also conducted. Results showed that the PSI of the three groups measured during 20-30 min were 0.123 ± 0.155, 0.012 ± 0.013, and 0.001 ± 0.0003, respectively (p < 0.001 ***). The averaged CHI scores of the three groups were 10.13, 17.17, and 25.53, respectively (p < 0.001 ***). Correlation coefficients between PSI and CHI of the three groups were -0.440, -0.369, and -0.537, respectively (p < 0.01 **). PSI value and the wearable accelerometer that are presently available on the market could be used to evaluate the quality of the physical stillness of the participants during Chan Ding practice.
    Matched MeSH terms: Monitoring, Ambulatory/methods*
  9. Real-life safety and effectiveness of amlodipine/valsartan combination in the treatment of hypertension
    Chazova IE, Dongre N, Vigdorchik AV
    Adv Ther, 2011 Feb;28(2):134-49.
    PMID: 21240661 DOI: 10.1007/s12325-010-0099-1
    The aim of our study was to evaluate the safety and effectiveness of the free combination of amlodipine/valsartan in patients with arterial hypertension in a real-life setting.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  10. Fulltext Asian management of hypertension: Current status, home blood pressure, and specific concerns in Malaysia
    Chia YC, Kario K
    J Clin Hypertens (Greenwich), 2020 03;22(3):497-500.
    PMID: 31693281 DOI: 10.1111/jch.13721
    Cardiovascular disease (CVD) accounts for a third of all deaths in Malaysia. The background CV risk of Malaysia is much higher than that of developed countries in the west and in Asia. This high CV mortality is contributed by the high prevalence of CV risk factors especially hypertension which is very prevalent, coupled with low awareness and low control rates. This highlights the importance of home blood pressure measurements (HBPM). HBPM is an important adjunct in the management of hypertension, particularly to identify those unaware as well as white-coat hypertension which is high in treated hypertensive patients in Malaysia. Ownership of HBPM devices in Malaysia is high, and this is an opportunity as well as timely to encourage more use of HBPM. The Malaysian national guidelines do not require HBPM for the diagnosis of hypertension but do recommend HBPM for specific situations. The most commonly prescribed anti-hypertensives are calcium channel blockers, followed by renin-angiotensin system blockers. Despite the wide availability of anti-hypertensive agents, BP control rates remain low. It is important that strategies are in place to ensure that individuals are aware of the need to have their BP monitored regularly and this can be facilitated by the use of HBPM. Hence, there is a plan to develop a local HBPM consensus document. Strategies to reduce salt intake would also be beneficial. In summary, identification of those unaware and better control of BP with the help of HBPM would help reduce the burden of CV mortality and morbidity in Malaysia.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  11. Fulltext Target blood pressure and control status in Asia
    Chia YC, Kario K, Turana Y, Nailes J, Tay JC, Siddique S, et al.
    J Clin Hypertens (Greenwich), 2020 Mar;22(3):344-350.
    PMID: 31742891 DOI: 10.1111/jch.13714
    It is widely accepted that hypertension constitutes a significant cardiovascular risk factor and that treating high blood pressure (BP) effectively reduces cardiovascular risk. An important issue in Asia is not just the high prevalence of hypertension, particularly in some countries, but also the low level of awareness and treatment rates in many regions. The 2017 update of the American College of Cardiology/American Heart Association hypertension guidelines raised the question about which BP threshold should be used to diagnose and treat hypertension. Although there is a theoretical rationale for a stricter BP criterion in Asia given the ethnic-specific features of hypertension in the region, the majority of countries in Asia have retained a diagnostic BP threshold of ≥140/90 mm Hg. Although lowering thresholds might make theoretical sense, this would increase the prevalence of hypertension and also markedly reduce BP control rates. In addition, there are currently no data from robust randomized clinical trials of the benefits of the lower targets in preventing cardiovascular disease and reducing cardiovascular risk, particularly in high-risk patients and especially for Asian populations. There is also no defined home BP treatment target level for an office BP treatment target of 130/80 mm Hg. However, in this regard, in the interim, lifestyle modifications, including reducing body weight and salt intake, should form an important part of hypertension management strategies in Asia, while studies on treating at lower BP threshold level in Asians and getting to lower BP targets will be helpful to inform and optimize the management of hypertension in the region.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory*
  12. Fulltext Comparison of day-to-day blood pressure variability in hypertensive patients with type 2 diabetes mellitus to those without diabetes: Asia BP@Home Study
    Chia YC, Kario K, Tomitani N, Park S, Shin J, Turana Y, et al.
    J Clin Hypertens (Greenwich), 2020 03;22(3):407-414.
    PMID: 31891447 DOI: 10.1111/jch.13731
    Blood pressure variability (BPV) has been shown to be independently associated with cardiovascular (CV) mortality and morbidity. Patients with type 2 diabetes mellitus (T2DM) have also been shown to have increased BPV. We aimed to compare BPV in hypertensive patients with diabetes with those without diabetes. A total of 1443 hypertensive patients measured their blood pressure (BP) twice in the morning and twice before bed at home for a week. Demographic data, history of T2DM, and anti-hypertensive use were captured. Clinic BP was measured twice in the clinic. Control of BP was defined as clinic systolic BP (SBP) <140 mm Hg and home SBP 
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  13. The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore
    Enkelmann HC, Bishop GD, Tong EM, Diong SM, Why YP, Khader M, et al.
    Int J Psychophysiol, 2005 May;56(2):185-97.
    PMID: 15804452
    This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  14. [FEATURES MANIFESTATIONS COMORBID CURRENTS OF GASTROESOPHAGEAL REFLUX DISEASE AND ARTERIAL HYPERTENSION DEPENDING ON THE DEGREE OF ARTERIAL HYPERTENSION]
    Fadieienko G, Gridniev O
    Georgian Med News, 2015 Nov.
    PMID: 26656546
    The purpose of research - to study the features of circadian profile of blood pressure (BP), the data of echocardiography, pH-monitoring, lipid spectrum, level of apelin and the state of the system "lipid peroxidation-antioxidant protection" in patients with a combination of arterial hypertension (AH) and gastroesophageal reflux disease (GERD) depending on the level of AH. It was examined 126 patients with combination of AH II stage, 2-3 degrees, and GERD, 70 (55.56%) men and 56 (44.44%) women, mean age 56.84 ± 1.17. The anthropometric indicators, a condition of "lipid peroxidation- antioxidant protection", the level of apelin, ambulatory blood pressure monitoring (ABPM), echocardiography, esophageal pH-monitoring were evaluated. Analysis of the results was performed using a computer program IBM SPSS Statistics 21.0 for Windows XP. According to the daily averages ABPM systolic BP/diastolic BP in the I group were 141.2 ± 0.8/90.4 ± 0.4 mm Hg., in II group - 163.3 ± 0.9/101.0 ± 0.5 mm Hg., in III group - 185.6 ± 0.8/112.1 ± 0.5 mm Hg., p = 0.001. There are only 25.39% of patients had normal indicators of the variability of BP among individuals with comorbidity. Transformation from mild AH to moderate was accompanied by a significant increase in the severity of left ventricular remodeling by type of concentric hypertrophy. The data of esophageal pH-monitoring allow us to classify the disorders as severe gastroesophageal reflux in patients with a combination of AH and GERD (DeMeester, 1993). In the group with first degree of AH the average rate of circulating apelin was 930.58 ± 56.27 pg/mL, for the patients with 2nd degree of AH - 880.56 ± 17.97 pg/ml, p>0.05, in patients with third degree of AH - 650.91 ± 12.87 pg/ml (p = 0.001). Assessment of lipid profile has allowed to establish the worse dyslipidemia in patients with 3rd degree of AH combined with GERD (atherogenic ratio - 3.11 ± 0.09). The deterioration of degree of AH combined with GERD accompanied by an increase of oxidative stress with increase of nitrites plasma and malondialdehyde concentration, and decrease of glutathione peroxidase and of SH-groups concentration. Increased degree of AH in patients with severe GERD accompanied by worsening of left ventricular remodeling, reduction of apelin levels, progression of dyslipidemia, and imbalances in the system of "lipid peroxidation-antioxidant protection."
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  15. Fulltext Clinical significance of nocturnal home blood pressure monitoring and nocturnal hypertension in Asia
    Fujiwara T, Hoshide S, Tomitani N, Cheng HM, Soenarta AA, Turana Y, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):457-466.
    PMID: 33591641 DOI: 10.1111/jch.14218
    Nocturnal home blood pressure (BP) monitoring has been used in clinical practice for ~20 years. The authors recently showed that nocturnal systolic BP (SBP) measured by a home BP monitoring (HBPM) device in a Japanese general practice population was a significant predictor of incident cardiovascular disease (CVD) events, independent of office and morning home SBP levels, and that masked nocturnal hypertension obtained by HBPM (defined as nocturnal home BP ≥ 120/70 mmHg and average morning and evening BP 
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  16. Fulltext Standing beat-to-beat blood pressure variability is reduced among fallers in the Malaysian Elders Longitudinal Study
    Goh CH, Ng SC, Kamaruzzaman SB, Chin AV, Tan MP
    Medicine (Baltimore), 2017 Oct;96(42):e8193.
    PMID: 29049203 DOI: 10.1097/MD.0000000000008193
    The aim of this study was to determine the relationship between falls and beat-to-beat blood pressure (BP) variability.Continuous noninvasive BP measurement is as accurate as invasive techniques. We evaluated beat-to-beat supine and standing BP variability (BPV) using time and frequency domain analysis from noninvasive continuous BP recordings.A total of 1218 older adults were selected. Continuous BP recordings obtained were analyzed to determine standard deviation (SD) and root mean square of real variability (RMSRV) for time domain BPV and fast-Fourier transform low frequency (LF), high frequency (HF), total power spectral density (PSD), and LF:HF ratio for frequency domain BPV.Comparisons were performed between 256 (21%) individuals with at least 1 fall in the past 12 months and nonfallers. Fallers were significantly older (P = .007), more likely to be female (P = .006), and required a longer time to complete the Timed-Up and Go test (TUG) and frailty walk test (P ≤ .001). Standing systolic BPV (SBPV) was significantly lower in fallers compared to nonfallers (SBPV-SD, P = .016; SBPV-RMSRV, P = .033; SBPV-LF, P = .003; SBPV-total PSD, P = .012). Nonfallers had significantly higher supine to standing ratio (SSR) for SBPV-SD, SBPV-RMSRV, and SBPV-total PSD (P = .017, P = .013, and P = .009). In multivariate analyses, standing BPV remained significantly lower in fallers compared to nonfallers after adjustment for age, sex, diabetes, frailty walk, and supine systolic BP. The reduction in frequency-domain SSR among fallers was attenuated by supine systolic BP, TUG, and frailty walk.In conclusion, reduced beat-to-beat BPV while standing is independently associated with increased risk of falls. Changes between supine and standing BPV are confounded by supine BP and walking speed.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory/methods*
  17. Determining level of postural control in young adults using force-sensing resistors
    Gopalai AA, Senanayake SM, Gouwanda D
    IEEE Trans Inf Technol Biomed, 2011 Jul;15(4):608-14.
    PMID: 21478080 DOI: 10.1109/TITB.2011.2140378
    A force-sensing platform (FSP), sensitive to changes of the postural control system was designed. The platform measured effects of postural perturbations in static and dynamic conditions. This paper describes the implementation of an FSP using force-sensing resistors as sensing elements. Real-time qualitative assessment utilized a rainbow color scale to identify areas with high force concentration. Postprocessing of the logged data provided end-users with quantitative measures of postural control. The objective of this research was to establish the feasibility of using an FSP to test and gauge human postural control. Tests were conducted in eye open and eye close states. Readings obtained were tested for repeatability using a one-way analysis of variance test. The platform gauged postural sway by measuring the area of distribution for the weighted center of applied pressure at the foot. A fuzzy clustering algorithm was applied to identify regions of the foot with repetitive pressure concentration. Potential application of the platform in a clinical setting includes monitoring rehabilitation progress of stability dysfunction. The platform functions as a qualitative tool for initial, on-the-spot assessment, and quantitative measure for postacquisition assessment on balance abilities.
    Matched MeSH terms: Monitoring, Ambulatory/instrumentation; Monitoring, Ambulatory/methods*
  18. Fulltext Characteristics of hypertension in obstructive sleep apnea: An Asian experience
    Hoshide S, Kario K, Chia YC, Siddique S, Buranakitjaroen P, Tsoi K, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):489-495.
    PMID: 33705599 DOI: 10.1111/jch.14184
    Obstructive sleep apnea (OSA) is a risk of hypertension and is associated with cardiovascular disease (CVD) incidence. In Asian countries, the prevalence of OSA is high, as in Western countries. When blood pressure (BP) is evaluated in OSA individuals using ambulatory BP monitoring (ABPM), the BP phenotype often indicates abnormal BP variability, such as increased nighttime BP or abnormal diurnal BP variation, that is, non-dipper pattern, riser pattern, and morning BP surge, and all these conditions have been associated with increased CVD events. Asians have a higher prevalence of increased nighttime BP or morning BP surge than Westerners. Therefore, this review paper focused on OSA and hypertension from an Asian perspective to investigate the importance of the association between OSA and hypertension in the Asian population. Such abnormal BP variability has been shown to be associated with progression of arterial stiffness, and this association could provoke a vicious cycle between abnormal BP phenotypes and arterial stiffness, a phenomenon recognized as systemic hemodynamic atherothrombotic syndrome (SHATS). OSA may be one of the background factors that augment SHATS. An oxygen-triggered nocturnal oscillometric BP measurement device combined with a pulse oximeter for continuous SpO2 monitoring could detect BP variability caused by OSA. In addition to treating the OSA, accurate and reliable detection and treatment of any residual BP elevation and BP variability caused by OSA would be necessary to prevent CVD events. However, more detailed detection of BP variability, such as beat-by-beat BP monitoring, would further help to reduce CV events.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  19. Fulltext Characteristics and control of the 24-hour ambulatory blood pressure in patients with metabolic syndrome
    Huang JF, Li Y, Shin J, Chia YC, Sukonthasarn A, Turana Y, et al.
    J Clin Hypertens (Greenwich), 2021 03;23(3):450-456.
    PMID: 33629806 DOI: 10.1111/jch.14229
    Asian countries are facing an increasing prevalence of metabolic syndrome (MetS), which may aggravate the burden of cardiovascular diseases in this region. MetS is closely associated with ambulatory blood pressure (BP). Patients with MetS, compared to those without, had a twofold higher risk of new-onset office, home, or ambulatory hypertension. Furthermore, the risk of new-onset MetS in patients with white-coat, masked and sustained hypertension was also doubled compared to normotensives. High-risk masked hypertension and blunted nighttime BP dipping are common in patients with MetS, suggesting perfect 24-hour BP control with long-acting antihypertensive drugs and early initiation of combination therapy might be especially important for patients with MetS.
    Matched MeSH terms: Blood Pressure Monitoring, Ambulatory
  20. Fulltext Cost effectiveness analysis of using multiple neuromodalities in treating severe traumatic brain injury in a developing country like Malaysia
    Ibrahim MI, Abdullah M, Naing L, Abdullah JM, Idris Z, Aljunid SM
    Asian J Surg, 2007 Oct;30(4):261-6.
    PMID: 17962129
    The aim of this study was to determine the cost-effectiveness of using baseline neuromonitoring (BNM) compared with multimodality monitoring (M3) for severe traumatic brain injury (TBI).
    Matched MeSH terms: Monitoring, Ambulatory/economics*
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