Clinical accuracy of the Omron M3 Comfort and the Omron Evolv for self-blood pressure measurements in pregnancy and pre-eclampsia - validation according to the Universal Standard Protocol.

Background: Electronic devices for blood pressure (BP) measurements need to go through independent clinical validation as recommended by different authorities, both in general and in special populations such as pregnancy.

Objective: To evaluate the accuracy of the Omron Evolv (HEM-7600T-E) and the Omron M3 Comfort (HEM-7134-E) devices in pregnancy and pre-eclampsia according to the Universal Standard Validation Protocol.

Methods: Both devices, the Evolv and the M3 Comfort, measure BP at the brachial level using the oscillometric method.

[Arterial hypertension in metabolic syndrome: pathophysiological aspects].

Arterial hypertension (AH) is one of the basic components of metabolic syndrome that is caused by four factors: autonomic sympathetic dysfunction; activation of the hypothalamic-pituitary-adrenal axis; that of the renin-angiotensin-aldosterone system; and endothelial dysfunction (ED). AH is a slowly progressive hemodynamic disease, the natural course of which is characterized by not only elevated blood pressure (BP), but also by left ventricular hypertrophy, arterial remodeling, and a progressive increase in total peripheral resistance. ED and arterial remodeling play a key role in the pathogenesis of AH in metabolic syndrome.

[Psychosomatic correlations in patients with hypertension and renal arterial hypertension].

Psychosomatic status was investigated in 104 patients with essential hypertension (EH) and 111 patients with secondary arterial hypertension (AH) of renal origin in the presence of chronic pyelonephritis. A significant heterogeneity of psychological characteristics was established in patients with these two clinical forms of AH. In EH patients psychological deviations were detected since very early stages of the disease, but they did not become more profound with stabilisation of blood pressure.

[The nature of the changes in the repolarization complex of the ECG in patients with arterial hypertension and left ventricular hypertrophy].

Altogether 58 patients suffering from arterial hypertension (AH) were examined. The patients with left ventricular hypertrophy (LVH) and changes in the ST-T demonstrated a high correlation between an increase of the end systolic tension (EST) and interval elongation and the minimal size of the left ventricle before mitral valve opening. These data point to the development of "high-stressful LVH" which is accompanied by a non-proportional increase of EST, subendocardial ischemia of the myocardium (changes in the ST-T) and derangement of diastolic heart function.

The influence of the haemodynamic factor on the development of left ventricular hypertrophy in patients with arterial hypertension.

One hundred and forty-seven patients with essential hypertension (EH) and 126 patients with secondary arterial hypertension (AH) on the basis of chronic pyelonephritis were studied by means of radiocardiography with 131I-albumin and M-mode echocardiography. The importance of the haemodynamic type of circulation for the development of left ventricular hypertrophy (LVH) was established. Correlative analysis revealed that the influence of arterial pressure (AP) on LVH is increased by stabilization of AH, especially in patients with the normo- and hypokinetic types of circulation; interestingly, the relation between LVH and systolic pressure was closer than that between LVH and diastolic pressure, especially in patients with secondary AH.

[State of hemodynamics, function and perfusion of the myocardium in patients with arterial hypertension with different degree of left ventricular hypertrophy].

Seventy eight patients with arterial hypertension were examined by echo-, radiocardiography and scintigraphy of the myocardium, using 99mTc pyrophosphate and 201Tl. A relationship was found between the development of hypertrophy of the left ventricle and the impairment of it perfusion and function. At the same time there was a correlation between the decrease in cardiac output and the deterioration of myocardial blood supply.

Efficacy of intravenous verapamil in arterial hypertension refractory to three-step antihypertensive therapy.

Intravenous verapamil infusion reduced the arterial pressure (AP) in 13 out of 71 (76.5%) patients with severe arterial hypertension (AH) refractory to a two-week, three-step oral antihypertensive medication. Investigations including echo- and radio-cardiography were performed: in the control period before starting the three-step treatment; after two weeks before intravenous verapamil infusions; 10 days after stopping the verapamil administration, and before leaving the hospital during continued 3-4 weeks three-step therapy.

[Status of central hemodynamics in patients with hypertension and secondary arterial hypertension].

A study was undertaken to examine 285 patients with hypertensive disease and 187 with secondary arterial hypertension. Their hemodynamic parameters were assessed by a radionuclide method. It was found that there were various blood circulatory types at each stage, no matter what the clinical type of the disease.

[Cardiac adaptation in hypertension].

As many as 75 patients with essential hypertension were examined by echocardiography and radiocardiography. The development of hypertrophy was accompanied by the rise of the diastolic dimensions of the left ventricle regardless of the type of the heart overload (by volume or pressure). As left ventricle hypertrophy developed, the myocardial contractility declined and normal hemodynamic function of the heart was maintained due to the Frank-Starling mechanism.

[Effect of hypertrophy of the left ventricle on myocardial perfusion in patients with arterial hypertension].

A study of 32 patients with arterial hypertension using echocardiography, electrocardiography and myocardial 99mTc-pyrophosphate scintigraphy, demonstrated that developing left-ventricular hypertrophy may interfere with myocardial perfusion. Regression of left-ventricular hypertrophy and recovery of myocardial perfusion is shown to be possible under the effect of antihypertensive treatment.

[Hemodynamics of pulmonary circulation in hypertension based on data from radionuclide studies].

The authors presented the results of a combined radionuclide study of the state of pulmonary hemodynamics in patients with essential hypertension. Altogether 132 patients were investigated. Radiocardiography, perfusion scintigraphy and a study of the regional pulmonary blood flow using radioactive Xe were conducted.

[Effectiveness of long-term treatment of patients with hypertension].

Dispensary care was provided to 122 patients with essential hypertension. During a 3-year follow-up period BP decrease in regularly treated patients (44) was accompanied by the restoration of hemodynamic cardiac function and regression of myocardial hypertrophy and ischemia. BP stabilization, transformation of the blood circulation of hemodynamic type, an increased degree of myocardial hypertrophy and ischemia were noted in irregularly treated patients.

[Diastolic relaxation and left ventricular blood filling in patients with hypertension].

Disorders of left-ventricular diastolic relaxation and blood filling in patients with first- and second-stage essential hypertension are shown, by means of echo-, radio- and apexcardiography, to be due to the effects of arterial blood pressure, hemodynamic changes, heart rate and the magnitude of left-ventricular hypertrophy. Antihypertensive treatment, affecting major parameters of disease, brings about the recovery of the heart's diastolic function.

[Possible reverse development of myocardial hypertrophy and ischemia in patients with hypertension after short-term antihypertensive therapy].

The effects of short-term antihypertensive therapy were assessed using echo- and electrocardiography, in patients with first- or second-stage essential hypertension, with respect to possible reverse development of left-ventricular hypertrophy and myocardial ischemia. A reduction of left-ventricular hypertrophy was found to be possible, with regard to the hemodynamic type, in patients with mild or moderate essential hypertension provided their blood pressure was controlled effectively. Reverse development of electrocardiographic signs of myocardial ischemia (ST segment and T wave reaching their normal values) is possible through a decrease of arterial BP and a reduction of adrenergic effects on the heart.

[Treatment of arterial hypertension with calcium antagonists].

The antihypertensive effect of finoptin (verapamil) and corinfar (nifedipin) and their impact on the hemodynamics and the repolarization complex of the ECG were studied in 52 patients with essential hypertension and 48 patients with secondary arterial hypertension. The calcium antagonists were found to effectively decrease the blood pressure by reducing the peripheral resistance. Verapamil may be recommended for the monotherapy of mild and moderate forms of arterial hypertension, whereas corinfar should be used in cases of marked hypertension and at the third stage of therapy.

[Development of heart hypertrophy in hypertension].

A total of 120 patients with essential hypertension, stage I and II, were examined, using radio- and electrocardiography, before and after a hypotensive treatment. Two mechanisms: excessive volume (in patients with hyperkinetic circulation) and excessive pressure (in those with normo- and hypokinetic circulation) were found to form the basis of the formation of left-ventricular muscular hypertrophy. Antihypertensive effect of treatment reducing electrocardiographic signs of left-ventricular muscular hypertrophy was shown to be related to improved arterial pressure control and lesser adrenergic influence on the heart.