Hypertension is one of the most powerful modifiable risk factors for cardiovascular disease. It is usually asymptomatic and therefore essential to measure blood pressure regularly for the detection of hypertension. Home blood pressure monitoring (HBPM) is recognized as a valuable tool to monitor blood pressure and facilitate effective diagnosis of hypertension. It is useful to identify the masked or white-coat hypertension. There is also increasing evidence that supports the role of HBPM in guiding antihypertensive treatment, and improving treatment compliance and hypertension control. In addition, HBPM has also shown prognostic value in predicting cardiovascular events. Despite these benefits, the use of HBPM in many parts of Asia has been reported to be low. An expert panel comprising 12 leading experts from 10 Asian countries/regions convened to share their perspectives on the realities of HBPM. This article provides an expert summary of the current status of HBPM and the key factors hindering its use. It also describes HBPM-related initiatives in the respective countries/regions and presents strategies that could be implemented to better support the use of HBPM in the management of hypertension.
Uncontrolled hypertension is a significant problem in many parts of Asia. Effective management is essential to reduce the burden of hypertension. Home blood pressure monitoring (HBPM) is a promising tool that can aid in the diagnosis and management of hypertension. Experts from 11 countries/regions in Asia conceptualized a large-scale survey to examine the current realities of HBPM. A cross-sectional survey was conducted among health care professionals from China, India, Indonesia, Japan, Malaysia, the Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam between November 2019 and June 2021. Physicians' responses were summarized using descriptive statistics. A total of 7945 physicians participated in the survey. Among all respondents, 50.3% and 33.5% viewed HBPM as highly recognized by physicians and patients in their country/region, respectively. Lack of understanding of HBPM and concern with the accuracy and reliability of HBPM devices were identified as key barriers to HBPM recognition. Nearly all physicians (95.9%) reported recommending HBPM to their patients; however, they reported less than 50% of their patients measured home blood pressure (HBP). Among physicians who recommended HBPM, only 22.4% and 54.1% cited HBP diagnostic threshold values and timing of taking antihypertensive drugs that were consistent with available guidelines, respectively. The survey reveals that the recognition of HBPM as a valuable tool to diagnose and manage hypertension is suboptimal in most parts of Asia. Despite high recommendation of HBPM to hypertensive patients by physicians, there are considerable discrepancies between guidelines recommendations and practice realities. The recognition of HBPM as a valuable tool for the diagnosis and management of hypertension is suboptimal among both physicians and patients in Asia. A clear and consistent guidance for proper HBPM practice and use of validated and calibrated HBP monitors are among the top priorities to support the integration of HBPM into daily patient care. HBPM: home blood pressure monitoring, HBP: home blood pressure.
Conference abstracts: Malaysia in affiliation
(1). PO-211. AGE-SPECIFIC STRESS-MODULATED
CHANGES OF SPLENIC IMMUNOARCHITECTURE
IN THE GROWING BODY. Marina Yurievna Kapitonova, Syed Baharom Syed Ahmad Fuad, Flossie Jayakaran; Faculty of Medicine, Universiti Teknologi MARA, Shah Alam, Malaysia
syedbaharom@salam.uitm.edu.my
(2). PO-213. A DETAILED OSTEOLOGICAL STUDY OF THE ANOMALOUS GROOVES NEAR THE
MASTOID NOTCH OF THE SKULL. ISrijit Das, 2Normadiah Kassim, lAzian Latiff, IFarihah Suhaimi, INorzana Ghafar, lKhin Pa Pa Hlaing, lIsraa Maatoq, IFaizah Othman; I Department of Anatomy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 2 Department of Anatomy, Universiti Malaya, Kuala Lumpur, Malaysia. das_sri jit23@rediffmail.com
(3). PO-21S. FIRST LUMBRICAL MUSCLE OF THE
PALM: A DETAILED ANATOMICAL STUDY WITH
CLINICAL IMPLICATIONS. Srijit Das, Azian Latiff, Parihah Suhaimi, Norzana Ghafar, Khin Pa Pa Hlaing, Israa Maatoq, Paizah Othman; Department of Anatomy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. das_srijit23@rediffmail.com
(4). PO-336. IMPROVEMENT IN EXPERIMENTALLY
INDUCED INFRACTED CARDIAC FUNCTION
FOLLOWING TRANSPLANTATION OF HUMAN
UMBILICAL CORD MATRIX-DERIVED
MESENCHYMAL CELLS. lSeyed Noureddin Nematollahi-Mahani, lMastafa Latifpour, 2Masood Deilami, 3Behzad Soroure-Azimzadeh, lSeyed
Hasan Eftekharvaghefi, 4Fatemeh Nabipour, 5Hamid
Najafipour, 6Nouzar Nakhaee, 7Mohammad Yaghoobi, 8Rana Eftekharvaghefi, 9Parvin Salehinejad, IOHasan Azizi; 1 Department of Anatomy, Kerman University of Medical Sciences, Kerman, Iran; 2 Department of Cardiosurgery, Hazrat-e Zahra Hospital, Kerman, Iran; 3 Department of Cardiology, Kerman University of Medical Sciences, Kerman, Iran; 4 Department of Pathology, Kerman University of Medical Sciences, Kerman, Iran; 5 Department of Physiology, Kerman University of Medical Sciences, Kerman, Iran; 6 Department of Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran; 7 Department
of Biotechnology, Research Institute of Environmental Science, International Center for Science, High Technology & Environmental Science, Kerman, Iran; 8 Students Research Center, Kerman University of Medical Sciences, Kerman, Iran; 9 Institute of Bioscience, University Putra Malaysia,
Kuala Lumpur, Malaysia; 10 Department of Stem Cell, Cell Science Research Center, Royan Institute, ACECR, Tehran, Iran. nnematollahi@kmu.ac.ir
(5).
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.