Detection of Atrial Fibrillation Using a Home Blood Pressure Monitor.

Purpose: Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increased risk of complications. A screening test has the potential to prevent AF-related complications. This study investigated the diagnostic accuracy of an automated device for home blood pressure (BP) monitoring, which implements an algorithm for AF detection.

Beyond the AHI-pulse wave analysis during sleep for recognition of cardiovascular risk in sleep apnea patients.

Recent evidence supports the use of pulse wave analysis during sleep for assessing functional aspects of the cardiovascular system. The current study compared the influence of pulse wave and sleep study-derived parameters on cardiovascular risk assessment. In a multi-centric study design, 358 sleep apnea patients (age 55 ± 13 years, 64% male, body mass index 30 ± 6 kg m , apnea-hypopnea index 13 [5-26] events per hr) underwent a standard overnight sleep recording.

Defining Extreme Phenotypes of OSA Across International Sleep Centers.

Background: Extreme phenotypes of OSA have not been systematically defined.

Research Question: This study developed objective definitions of extreme phenotypes of OSA by using a multivariate approach. The utility of these definitions for identifying characteristics that confer predisposition toward or protection against OSA is shown in a new prospective sample.

[Actual Standard of Blood Pressure Measurement - Statement of the German High Blood Pressure League].

Arterial hypertension is one of the most prevalent chronic diseases, and a major risk factor for cardiovascular diseases. It is essential to perform the blood pressure measurement under standardized conditions in the office/clinical setting, otherwise inaccuracy of blood pressure values may lead to poor blood pressure control or misdiagnosis. Compliance with these standards by a trained observer is of crucial importance for a reliable and accurate blood pressure measurement in clinical practice.

[Abstract - Update Arterial Hypertension 2018].

Inadequate blood pressure measurement is among the main reasons for poor blood pressure control and misclassification of patients with normal or increased blood pressure. 24-hour ambulatory blood pressure measurement has the best predictive value for cardiovascular mortality, and it could be shown that those with masked hypertension (normal office blood pressure values but hypertensive values with 24-hour measurement) are especially at risk. An increased blood pressure variability seems to be a risk factor for the development of dementia and also raises the cardiovascular risk after TIA and minor stroke.

Recognizable clinical subtypes of obstructive sleep apnea across international sleep centers: a cluster analysis.

Study Objectives: A recent study of patients with moderate-severe obstructive sleep apnea (OSA) in Iceland identified three clinical clusters based on symptoms and comorbidities. We sought to verify this finding in a new cohort in Iceland and examine the generalizability of OSA clusters in an international ethnically diverse cohort.

Methods: Using data on 972 patients with moderate-severe OSA (apnea-hypopnea index [AHI] ≥ 15 events per hour) recruited from the Sleep Apnea Global Interdisciplinary Consortium (SAGIC), we performed a latent class analysis of 18 self-reported symptom variables, hypertension, cardiovascular disease, and diabetes.

[Guidelines in Practice: The New S3 Guideline "Sleeping Disorders - Sleep-Related Abnormal Breathing"].

Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016.

REM Sleep Imposes a Vascular Load in COPD Patients Independent of Sleep Apnea.

Arterial stiffness, a marker for cardiovascular risk, is increased in patients with Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA). The specific influence of both on arterial stiffness during sleep is unknown. Nocturnal arterial stiffness (Pulse Propagation Time (PPT) of the finger pulse wave) was calculated in 142 individuals evaluated for sleep apnea: 27 COPD patients (64.

Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep.

The complexity of central breathing disturbances during sleep has become increasingly obvious. They present as central sleep apnoeas (CSAs) and hypopnoeas, periodic breathing with apnoeas, or irregular breathing in patients with cardiovascular, other internal or neurological disorders, and can emerge under positive airway pressure treatment or opioid use, or at high altitude. As yet, there is insufficient knowledge on the clinical features, pathophysiological background and consecutive algorithms for stepped-care treatment.

Vascular stiffness determined from a nocturnal digital pulse wave signal: association with sleep, sleep-disordered breathing, and hypertension.

Objectives: Reflection of the finger pulse wave form is a valid measure of arterial stiffness, which may be continuously assessed during sleep. We investigated the relationships between sleep, sleep-disordered breathing, hypertension, and pulse propagation time (PPT) in patients with suspected sleep apnea.

Methods: The digital photoplethysmographic signal derived from finger pulse oximetry was recorded during overnight sleep studies in 440 patients (64% men, age 55 ± 12 years, BMI 30 ± 6 kg/m, apnea-hypopnea index 19 ± 19 n/h).

Parameters of Overnight Pulse Wave under Treatment in Obstructive Sleep Apnea.

Background: Sleep-related breathing disorders may promote cardiovascular (CV) diseases. A novel and differentiated approach to overnight photoplethysmographic pulse wave analysis, which includes risk assessment and measurement of various pulse wave characteristics, has been evaluated in obstructive sleep apnea (OSA).

Objectives: The purpose of this study was to assess if and which of the differentiated pulse wave characteristics might be influenced by OSA treatment with positive airway pressure (PAP).

[Primary and secondary arterial hypertension - update 2016].

In patients with hypertension without diabetes and with an increased risk of cardiovascular complications a blood pressure of below 130 mmHg should be targeted. Hypertensive patients with an age above 80 years should be treated in the same way as younger hypertensive patients if they are otherwise healthy and functionally independent. On the other hand frail elderly patients could have an increased morbidity and mortality with intensive blood pressure control.

The German Hypertension League (Deutsche Hochdruckliga) Quality Seal Protocol for blood pressure-measuring devices: 15-year experience and results from 105 devices for home blood pressure control.

Objective: The German Hypertension League (Deutsche Hochdruckliga) established a program to assess the accuracy and reliability of blood pressure (BP)-measuring devices in 1999 (Quality Seal Protocol). Here, we report on the results of a testing series of 105 devices designed for BP self-measurement.

Methods: The test protocol for the validation of upper-arm, wrist, and finger devices was developed to compare device to conventional Riva-Rocci measurements based on five criteria: mean systolic and mean diastolic differences, their standard deviations, and a point score representing the correlation of systolic and diastolic errors of individual comparisons.

Detection of cardiovascular risk from a photoplethysmographic signal using a matching pursuit algorithm.

Cardiovascular disease is the main cause of death in Europe, and early detection of increased cardiovascular risk (CR) is of clinical importance. Pulse wave analysis based on pulse oximetry has proven useful for the recognition of increased CR. The current study provides a detailed description of the pulse wave analysis technology and its clinical application.

[Sleep disorders: principles, basic diagnostics and elementary measures and recommendations].

Sleep disorders are frequent. Economic costs and impairment of quality of life can be substantial. Usually, patients suffer from insomnia or hypersomnia.

[Primary arterial hypertension - update 2015].

The rate of treatment and control increased significantly in Germany during the last years. Severeal studies could demonstrate an association of sodium consumption with blood pressure. The status of renal denervation in the treatment of high blood pressure remains unclear.

The use of overnight pulse wave analysis for recognition of cardiovascular risk factors and risk: a multicentric evaluation.

Objectives: Conventional methods for cardiovascular disease risk stratification are based on quantification of recognized risk factors or assessment of biomarkers during the wake period. We evaluated an algorithm on the basis of a photoplethysmographic pulse wave recording during sleep for cardiovascular risk assessment.

Methods: Five hundred and twenty individuals (346 men, age 55.

Nasal continuous positive airway pressure: influence on digital volume pulse in obstructive sleep apnoea patients.

Obstructive sleep apnoea (OSA) is linked to increased cardiovascular risk. This risk can be reduced by nasal continuous positive airway pressure (nCPAP) treatment. As OSA is associated with an increase of several vasoconstrictive factors, we investigated whether nCPAP influences the digital volume pulse wave.

Continuous positive airway pressure treatment of mild to moderate obstructive sleep apnea reduces cardiovascular risk.

Rationale: Obstructive sleep apnea (OSA) is linked to increased cardiovascular risk, but the impact of mild forms of OSA and their treatment on cardiovascular outcomes remains controversial.

Objectives: To prospectively investigate cardiovascular outcomes in treated versus untreated patients with OSA.

Methods: Consecutive sleep laboratory patients with all degrees of OSA were included.

Risk factors and myocardial infarction in patients with obstructive sleep apnea: impact of beta2-adrenergic receptor polymorphisms.

Background: The increased sympathetic nervous activity in patients with obstructive sleep apnea (OSA) is largely responsible for the high prevalence of arterial hypertension, and it is suggested to adversely affect triglyceride and high-density lipoprotein (HDL) cholesterol levels in these patients. The functionally relevant polymorphisms of the beta2-adrenergic receptor (Arg-47Cys/Arg16Gly and Gln27Glu) have been shown to exert modifying effects on these risk factors in previous studies, but results are inconsistent.

Methods: We investigated a group of 429 patients (55 +/- 10.