BLOOD PRESSURE VARIATION IN CHILDREN AT 5 MINUTE INTERVAL FOR IDENTIFICATION OF WHITE COAT HYPERTENSION

White-coat hypertension is a condition when a person’s blood pressure tends to increase only when they are at the doctor's office. In children, blood pressure between the 90th and 95th percentile is labelled as pre-hypertension and above the 95thcentile it is classified as hypertension. The difference between 90th and 95th centiles for both systolic and diastolic blood pressure is only 4 mm of Hg. Methods: Children between ages 5 to 10 years admitted in the children ward of Shri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India from February to April 2020 included in the study. We record blood pressure by oscillometer 4 times a day, over 4 days of hospital stay and each time two readings were taken at 5 minute intervals. Results: During 4 days of hospital stay blood pressure varied widely. In addition second reading of BP were always less than the first reading BP, but second readings data also varied widely just as first readings. Conclusion: White coat’ hypertension is the phenomenon where BP is exaggerated by act of measuring BP. This is initiated by anxiety. Children are particularly susceptible and distressed by the circumstances of hospitalization, stranger anxiety and fear to painful intervention. We should take multiple readings before reach a conclusion of hypertension. Key words: Blood pressure, White-coat Hypertension, Ambulatory BP, Hypertension

Monitoring the Cardiovascular Changes of a Rabbit Caused by Phenylephrine via a Microfluidic-Based Tactile Sensor

In this work, a microfluidic-based tactile sensor was investigated for monitoring changes in the cardiovascular (CV) system of a rabbit caused by phenylephrine. The sensor was fixed on the front right leg of an anesthetized rabbit to measure the arterial pulse signal. Phenylephrine, as a vasoconstrictor, was used to introduce CV changes of the rabbit. Two sensors, one with high sensitivity and the other with low sensitivity, were tested on their suitability for measuring the pulse signals of the rabbit. The sensor with low sensitivity generated clear pulse signals and was further used to monitor the CV changes of the rabbit caused by phenylephrine. An automated sphygmomanometer and an ECG were used to record blood pressure and heart rate for comparison. Three low-dose injections of phenylephrine were sequentially performed on the rabbit. Through model-based analysis of the measured pulse signals, arterial elastic modulus, arterial radius and pulse wave velocity (PWV) were obtained. As compared with the baseline values measured before injection, injections of phenylephrine caused an increase in mean blood pressure (MAP) recorded by the medical instruments, and a decrease in arterial radius (increase in peripheral vascular resistance (PVR)) and an increase in arterial elastic modulus and PWV captured by the tactile sensor. Thus, the tactile sensor was proven to be feasible for monitoring the changes in the CV system caused by phenylephrine.

History of vascular reactivity models and their involvement in hypertension pathogenesis

Hypertension is a silent and multifactorial disease. Over two centuries ago, the first device to record blood pressure was developed, making it possible to determine normotension and to establish criteria for hypertension. Since then, several studies have contributed to advance knowledge in this area, promoting significant advances in pharmacological treatments and, as a result, increasing survival of hypertensive people. The main models developed for the study of hypertension and the main findings in the vascular area are included in this review. We considered aspects related to vascular reactivity, changes in the population, and action of beta adrenergic receptors in the pathogenesis of hypertension.

Blood Pressure Assessment Practices of Dental Hygienists

An estimated 50 million Americans have high blood pressure (HBP), with 30% of them unaware of their condition. Both the American Dental Association (ADA) and the American Dental Hygienists’ Association (ADHA) have advocated including recording blood pressure during the dental appointment. Recording blood pressure is also a standard procedure in patient care. This study surveyed 236 dental hygienists attending a continuing education program to document their blood pressure assessment practices. The majority (55%) of participants indicated they rarely or never record blood pressure. The primary reason cited by 51% of the participants was a lack of time in the appointment. Based on these findings, a recommendation was made for dental offices to modify their patient check-in procedures to include recording blood pressure. Citation Hughes CT, Thompson AL, Collins MA. Blood Pressure Assessment Practices of Dental Hygienists. J Contemp Dent Pract 2006 May;(7)2:055-062.