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Ambulatory blood pressure monitoring: recorders, applications and analyses

  • Gregory A. Harshfield
  • Thomas G. Pickering
  • Seymour Blank
  • Cherie Lindahl
  • Lisa Stroud
  • John H. Laragh

Summary

We have had considerable experience with ambulatory monitoring of blood pressure and heart rate over the past five years. We have used three different systems to monitor over 800 patients: the Del Mar Avionics Ambulatory Pressurometer II and ECG Recorder (P2), the Del Mar Avionics Ambulatory Pressurometer III (P3), and the Instruments for Cardiac Research system (ICR). We have found that all of these systems provide accurate readings on approximately 80% of the patients tested. The ICR unit has the advantage of being smaller, quieter, and cheaper than either the P2 or P3. The current major problem with all of the systems, however, is a breakdown rate of over 30%. We have also developed our own software to evaluate the 24 hour records and have taken a decidedly behavioral approach to analysis. Specifically we code each blood pressure determination for location, position, activity and mood. We have been able to link these pressures to both target organ damages and personality traits. Finally, we have begun to use the technique of ambulatory monitoring in the evaluation of patients with psychiatric disorders.

Keywords

Diastolic Pressure Panic Disorder Ambulatory Blood Pressure Monitoring Target Organ Damage Breakdown Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Harshfield GA, Pickering TG, Laragh JH: A validation study of the Del Mar Avionics Ambulatory Blood Pressure System. Ambulatory Electrocardio 1: 7–12 (1979).Google Scholar
  2. 2.
    West JE, Busch-Visniac IJ, Harshfield GA, Pickering TG: Foil electret transducer for blood pressure monitoring. J Acoust Soc Am 74: 680–686 (1983).PubMedCrossRefGoogle Scholar
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    Marion RM, Sullivan PA, Harshfield GA, Kleinert HD, Pickering TG, Laragh JH: The value of home blood pressure vs. physician office blood pressure. Circulation 68: III - 37 (1983).Google Scholar
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    Harshfield GA, Pickering TG, Kleinert HD, Blank S, Laragh JH: Situational variations of blood pressure in ambulatory hypertensive patients. Psychosometric Med 44 (3): 237–245 (1982).Google Scholar
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    Harshfield GA, Pickering TG, Kleinert HD, Denby L, Kleiner B, Kaplan PM, Tucker LW, Laragh JH: The situational reactivity of blood pressure in essential hypertensive patients during normal activities. Psychophysiology 18: 163 (1981) (Abstract).Google Scholar
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    Pickering TG, Harshfield GA, Kleinert HD, Blank S, Laragh, JH: Comparisons of blood pressure during normal daily activities, sleep, and exercise in normal and hypertensive subjects. JAMA 247: 992–996 (1982).PubMedCrossRefGoogle Scholar
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    Devereux RB, Pickering TG, Harshfield GA, Kleinert HD, Denby L, Clark L, Pregibon D, Jason M, Sachs I, Borer JS, Laragh JH: Left ventricular hypertrophy in patients with hypertension: Importance of blood pressure response to regularly recurring stress. Circulation 68 (3): 470–476 (1983).PubMedCrossRefGoogle Scholar
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    Jason M, Devereux RB, Borer JS, Pickering T, Fisher J, Harshfield G, Berkowitz A, Laragh J: 24-Hour arterial pressure measurement: Improved prediction of left ventricular dysfunction in essential hypertension. Am J Cardiol 1 (2): 599 (1983).Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

Authors and Affiliations

  • Gregory A. Harshfield
    • 1
  • Thomas G. Pickering
    • 1
  • Seymour Blank
    • 1
  • Cherie Lindahl
    • 1
  • Lisa Stroud
    • 1
  • John H. Laragh
    • 1
  1. 1.Cardiovascular CenterThe New York Hospital-Cornell Medical CenterUSA

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