Comparison of Analog and Digital Blood Pressure Results Among Military Officers. A Case Study of Nigerian Airforce Base Makurdi
CHAPTER ONE
AIMS AND OBJECTIVES
- To compare Analog And Digital Blood Pressure measurement in the adult population with reference to mercury sphygmomanometry
Secondary objectives:
- To identify any disparity in measurement by a particular instrument with respect to the complete range of both systolic and diastolic values
- To identify any disparity in measurement by a particular instrument with respect to age (Geriatric population)
CHAPTER TWO
REVIEW OF LITERATURE
Epidemiology and current trends in hypertension
Blood pressure is a normally distributed biological variable with values at the high end being termed as hypertension. Many decades ago, Geoffrey Rose realistically defined hypertension as that level of blood pressure for which investigations and management were more beneficial than harmful for the patient. Now, most national and international guidelines, barring the recent AHA 2017 hypertension guideline, choose the cut-off of 140 / 90mmHg (systolic and diastolic respectively) as the threshold to define hypertension. Hypertension is a leading factor for both disability and death including heart failure, stroke, chronic kidney disease, atherosclerosis and death from cardiovascular causes. For a period of 15 years from 1990, the estimated annual death rate associated with an SBP of 140mmHg or more increased from 97.9 to 106.3 per 1 lakh population and the number of disability related life years increased from 5.2 million to 7.8 million [8] A more alarming finding is that the prevalence of hypertension seems to be increasing in the developed population possibly owing to the multitude of lifestyle changes such as the excess intake of salt, calories and alcohol. As a result, an estimated 560 million extra people will be affected with hypertension between 2000 and 2025 [9]
Multiple lifestyle factors have been associated with an increased risk of hypertension and also an increased risk of severity of hypertension. These include high sodium intake, excess alcohol intake [10] weight gain and obesity, and the use of NSAIDs and decongestants. There has also been a genetic predisposition that is mostly likely polygenic. Overall, the prevalence of hypertension is higher in people of African origin than in those of European origin although this relation is confounded by socioeconomic status, which in turn is largely explained by differences in body-mass index.
In addition hypertension that manifests for the first time during pregnancy as the spectrum of pre eclampsia/eclampsia syndromes are associated with an increased risk of cardiovascular events and sustained hypertension in the future.
Components of blood pressure
Systolic blood pressure (SBP) and diastolic blood pressure (DBP) are the components of blood pressure. Rises in both the systolic and diastolic components of blood pressure have been attributed to an increased cardiovascular disease risk. Systolic blood pressures have a slightly higher risk comparatively especially when compared in the elderly population. Blood pressure measurements also involve other components which are generally derived from SBP and DBP. These include mid blood pressure, pulse pressure and mean arterial pressure. Mid blood pressure and mean arterial pressure help to estimate the overall blood pressure control over one cardiac cycle. Mean arterial pressure is commonly used as a target in lowering blood pressure in patients with hypertensive urgencies/emergencies. Mean arterial pressure is measured as the DBP + ⅓ Pulse pressure. Pulse pressure is measured as the difference between the systolic and diastolic blood pressure. It is considered to be a measure of pulsatile hemodynamic stress and a marker of arterial stiffness.
CHAPTER THREE
MATERIALS AND METHODS
Study Centre:
Nigerian Airforce Base Makurdi, Benue state.
Ethical Committee approval: Obtained
Study duration: Six months
Study design: Validation study
Sample size: 500 patients
CHAPTER FOUR
RESULTS
Frequency Table
CHAPTER FIVE
CONCLUSION
This study showed that the aneroid sphygmomanometer was the better device for replacement of mercury sphygmomanometers in health care, especially in patients who are in shock. For patients who are hemodynamically stable, the automated oscillometric device may still be used owing to its convenience but with caution due to its inter- manufacturer formulae variation and other pitfalls. Irrespective of the replacement device, periodic validation and calibration are mandatory to ensure proper functioning of these devices.
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