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Equipment to Check Blood Pressure

New Guidance For Hypertension Consultation

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The National Institute for Health and Care Excellence (NICE) has made a major change in the blood pressure guidance last published in 20111 Hypertension in adults: diagnosis and management – National Institute for Health and Care Excellence (NICE) . The draft guidelines 2 Hypertension in adults: diagnosis and management, Draft for consultation, March 2019 – National Institute for Health and Care Excellence (NICE) recommend the threshold of hypertension treatment should be reduced, which makes more than 450,000 men and 270,000 women eligible for blood pressure treatment.  This means that an increased number of individuals would be offered drugs to lower blood pressure as a means to prevent strokes and heart attacks. This guidance has been released for consultation till April, 30 and is expected to be finalized by August 2019.

Previous Guidelines and New Recommendations

According to the NICE recommended guidance from 2011, drugs for lowering blood pressure should be given to individuals under 80 years of age who are suffering from stage one hypertension and are at 20% or more risk of cardiovascular disease in the next ten years.

As per the new recommendations, NICE has recommended offering blood pressure lowering drugs to patients with 10% or more risk of cardiovascular disease.

Stage one hypertension is when there isn’t any identifiable reason behind the increase in blood pressure.  It might be associated with different factors, including genetics, physical activity, salt intake, or obesity.

According to the guideline committee chairman, Anthony Wierzbicki 3 Thousands set to benefit from blood pressure treatment under new NICE guidance – National Institute for Health and Care Excellence (NICE) , these changes in the guidelines have resulted in updating the previous recommendations for early intervention of hypertension and is expected to make major differences in the lives of patients suffering from this condition.

The Reason

The recommended new guidelines will shift the focus effectively towards early intervention with either drug treatment or lifestyle treatment.  The aim is to reduce the age-related blood pressure issues and help patients live a longer life with reduced need for consuming multiple drugs.

Hypertension is one of the leading causes of strokes and heart attacks in the country, but countless individuals are not undiagnosed.

The early diagnosis of blood pressure will result in earlier treatment and prevention as per the NICE recommended guidelines, which will save the lives of thousands while also enhancing the quality of their lives.  This is the aim of the new changes in the guidelines and to enhance the management and detection of high blood pressure in the next ten years.

Taking these steps for preventing cardiovascular disease is an important step to safeguard their long-term well-being and health.

Concerns Regarding New Recommendations

While these new guidelines will help with the early detection, many experts have raised concerns about unintended harm and over-diagnosis issues of offering prescribed medications to patients when the advantages might be restricted.

They believe that to lower the threshold of hypertension diagnosis, which is a condition that affects a major number of individuals in the country, it is essential to ensure that this decision is evidence-based and not taken lightly.

A major chunk of the population is already suffering from undiagnosed hypertension, which means they are at high risk of a deadly stroke or heart attack.  Therefore, it is essential to enhance the diagnosis around the country, but it is also important to make sure that the changes will actually improve the quality of lives of the patients and not put them at more risk.

White Salt Container and a Stethoscope

Foods to Avoid When Managing High Blood Pressure

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Diet plays a significant role in the development and management of blood pressure.  A diet which is higher in calories and fat can lead to obesity which is one of the major risk factors in high blood pressure development.  Just as there are foods that can help in controlling and managing blood pressure, there are foods that increase blood pressure. 

Hypertension is a disease that can be treated or managed by maintaining a healthy diet and an active lifestyle.  If you have hypertension or are at risk of high blood pressure, you can easily modify your diet to prevent the serious consequences of hypertension.

The Culprit

Sodium is the villain for individuals at risk of heart disease or living with hypertension.  According to World Health Organization (WHO), individuals living with hypertension should restrict their daily intake of sodium to less than 5mg.  However, an average European consumes around 7-12g of sodium every day!

About 75% of consumed salt comes from processed foods and sodium included in meals at cafes, restaurants and other food establishments.

Foods to Avoid

Here are the foods that you must avoid as they play a role in increasing your blood pressure:

1.    Canned Beans

For preservation purposes, these canned goods are loaded with sodium. It is best to opt for fresh beans.  However, if you want to use canned beans, first, place them in a colander and rinse them thoroughly with water.  This will help in washing away most of the sodium.

2.    Alcohol

Alcohol consumption has surprisingly found to decrease the risk of heart disease, but of course, there is a catch.  It must be done in moderation – one serving a day for women and two servings a day for men.  Consumption of more than the recommended servings can lead to dehydration and gradual weight gain – both of these increase blood pressure levels.

3.    Bacon

Bacon is also loaded with sodium which can increase the blood pressure.  Merely three slices of bacon have 270 mg of sodium and 4.5 grams of fat.

4.    Premade Soups

Even with nutritious veggies, premade soups include a high amount of sodium.  Unfortunately, while you can rinse off the sodium from canned beans, you can’t do that with premade soup.  It is best to make fresh soup or opt for premade soups which have ‘reduced salt’ or ‘low in sodium’ labels on their packaging.

5.    Packaged and Processed Meats

These include hot dogs, breakfast sausages and more.  Packaged and processed meats are also loaded with sodium and saturated fats, both of which play a major contributing role in hypertension.  Avoid the refrigerated section of your grocer and opt for fresh meat instead. Remember, having high blood pressure doesn’t mean you have to deprive yourself.  It is more about eating smart to keep your body healthy.  Opt for the DASH diet, one of the most effective diets in managing and reducing high blood pressure.  It includes whole grains, beans, nuts, fruits, and vegetables to ensure you are full and healthy throughout the day.

Doctor Checking Blood Pressure of an Elderly Patient

Controlled Blood Pressure Can Reduce The Risk Of Dementia

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Low blood pressure does not necessarily mean stable blood pressure.  According to a study, individuals who had suffered a stroke or a heart disease were found to have low blood pressure and were also found to have experienced changes in the brain affecting their memory and cognition.  There is a significant link between Alzheimer’s and blood pressure as studies have found that older patients with hypertension or high blood pressure are likely to experience symptoms of Alzheimer’s.  A recent study indicated that controlled blood pressure reduces the risk of dementia.

Study

The clinical trial in this study1The SPRINT MIND Investigators for the SPRINT Research Group. Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. JAMA. 2019;321(6):553–561. doi:10.1001/jama.2018.21442conducted by Wake Forest Baptist Medical Center and reported in the Jan. 28 edition of the Journal of the American Medical Association, indicated that controlling the blood pressure in individuals aged 68 and older can decrease the risk of Mild Cognitive Impairment (MCI) risk, which is a precursor of dementia.

Individuals aged 65 years and up are at increased risk of high blood pressure, which has also been identified as one of the risk factors of dementia and MCI.  The study focused on 9,400 participants around the age of 68.  These participants were randomly assigned treatments, which can help in maintaining their blood pressure at either 120mm Hg, 140 mm Hg or below.

The Results

All the participants were at risk for heart diseases. The initial aim of the study was to determine whether strict blood pressure goals can help in saving lives.  This study was planned to continue for 5 years but concluded early.

This is because within three years of trial, the participants who maintained a 120 systolic blood pressure were leading a healthier life as compared to the participants maintaining a 140 systolic blood pressure.

Moreover, the participants with a 120 systolic reading experienced a 17% decrease in the risk of dementia.  While the report stated that this result is not statistically significant, it still provides a strong base for further research.  It also indicates that controlled blood pressure can reduce this risk.

Blood Pressure and Dementia

Further research is being conducted now to understand further the link between controlled blood pressure and reduced dementia risk.

The researchers suggested that there are various ways in which the brain health can be influenced by blood pressure.  Increased blood pressure levels can cause damage to the brain’s tiny blood vessels, which can further harm the brain tissues.  This can also have an impact on the toxic substances amount, which can enter and affect the brain. While this study might not have produced significant evidence proving that controlled blood pressure can decrease the risk of dementia, it has still highlighted the importance of vascular health and cardiovascular disease and their impact on the brain.  Further research may provide enough evidence for experts to create guidelines for individuals regarding ways to control blood pressure to decrease dementia risk.

Blood Pressure Being Monitored

Monitoring Blood Pressure at Home Can Be a Better Alternative Than Checking at Your Doctor

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Blood pressure monitoring is one of the most common activities in a medical practice.  Patients that have been diagnosed with peripheral vascular disease, chronic kidney disease, cerebrovascular disease, ischaemic heart disease, diabetes, and hypertension, all require continuous blood pressure monitoring.  However, high blood pressure can also be checked at home.  In fact, a recent study showed that monitoring blood pressure at home for two days can be a much better alternative to costlier methods of multiple visits to a doctor or clinician.

The Study

The study1Devereux G, Gibney D, Fadhlillah F, et al Two-day home blood pressure monitoring may offer an alternative to costlier methods BMJ Innovations 2018;4:84-90. assessed that performing 20 measurements of blood pressure in two days can offer a stable and reliable representation of the resting diastolic and systolic blood pressure of the patients. 

The researchers determined that 10 readings of blood pressure everyday are as statistically representative as 15 readings each day.  They believed that an increased frequency of blood pressure reading and decreased duration might offer a more stable and realistic representation of the resting blood pressure of the patients.

The results showed that the reading of 10 blood pressure measurements in 2 days did offer a pragmatic and stable approach towards monitoring blood pressure at home.  The results indicated that it can be a better alternative for patients rather than costlier methods of monitoring blood pressure at a clinician or surgery.

Blood Pressure Readings

In order to take the right blood pressure readings at home, it is important that you understand how it works.  The blood pressure is taken in two numbers – diastolic (bottom number) and systolic (top number).  For example, if you have a 120/80 mm Hg blood pressure, it would be read as 120 over 80.

Aside from this, there are seven classifications of BP and definitions of hypertension, as per the most recent ESH/ESC Guidelines2European Heart Journal, Volume 39, Issue 33, 01 September 2018, Pages 3021–3104, https://doi.org/10.1093/eurheartj/ehy339published in European Heart Journal, Volume 39, Issue 33, 01 September 2018.  These categories are:

Category    Systolic (mmHg)  Diastolic (mmHg) 
Optimal  <120  <80 
Normal  120–129  80–84 
High normal  130–139  85–89 
Grade 1 hypertension  140–159  90–99 
Grade 2 hypertension  160–179  100–109 
Grade 3 hypertension  ≥180  ≥110 
Isolated systolic hypertensionb  ≥140  <90 

Table: Classification of office blood pressure and definitions of hypertension grade

The condition of hypertensive crisis is extremely serious and needs medical attention.  If you have a high blood pressure and are experiencing symptoms such as speaking difficulty, vision problems, weakness, numbness, back pain, breathing difficulty, or chest pain then you must immediately call for emergency medical assistance.

The Benefits of Home Monitoring

Monitoring your blood pressure at home has numerous advantages, including enhanced reproducibility, cost effectiveness, and improved tolerance.  It is even considered to provide more accurate readings as compared to the blood pressure readings taken in doctor’s offices.

Regular home monitoring helps in reducing the risk of hypertension, and also encourages patients to take charge of their health and become more involved in their long-term care, instead of solely relying on a doctor’s visit. Moreover, it also helps patients to learn to manage their blood pressure by adapting a healthier lifestyle, thereby enhancing their overall health.

Valsartan: Blood Pressure Drug Being Recalled Across Europe After US Recall

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Over the past year, various blood pressure medicines have been recalled across the US and more recently in the UK and Europe after a cancer-causing contaminant was discovered in some of the batches.  Investigators believe that the medicines were contaminated in the manufacturing process.  Valsartan, which is one of the most commonly used blood pressure medicines, is also among those being recalled.

Valsartan

Valsartan is primarily used for the treatment of heart failure and high blood pressure.  It enhances the probability of the patient leading a longer and healthier life after suffering from a heart attack.  Valsartan is categorized under the class drugs known as Angiotensin Receptor Blockers (ARBs).  It relaxes blood vessels in order to help the blood flow easily.
There are various types of Valsartan currently available in the market and both the Medicines and Healthcare products Regulatory Agency (MHRA) and European Medicines Agency (EMA) have announced the recall of several of them.  Further details of the recall can be found on the websites of both organisations.

The Reason Behind the Recall

These recalled blood pressure medications have been found to be contaminated with either N-nitrosodiethylamine (NDEA) or N-nitrosodimethylamine (NDMA), which are cancer-causing chemicals.  Moreover, research has also indicated that NDEA may also contribute towards blood cell and liver damage.

NDEA is utilized to create rocket fuel and has also been discovered in small amounts in certain foods and drinking water.  This chemical can be created via some chemical reactions and as industrial processes’ byproducts.

After the US recall, both MHRA and EMA have recalled all medication containing containing four other ‘sartans’, namely candesartan, irbesartan, losartan and olmesartan.  This precautionary recall has been announced because of the potential N-nitrosodiethylamine (NDEA) contamination.

The Risk of Getting Cancer from These Medicines

According to the findings of all 3 agencies, the risk of getting cancer from using Valsartan is small since the NDMA discovered in the medicine only slightly exceeds the levels of acceptability.  According to the drug manufacturers’ records, this impurity might have been contained in Valsartan products since more than 4 years.

Investigations all over Europe have been initiated regarding this contamination.  According to the results so far, there hasn’t been any evidence indicating that any patients have been harmed and the agencies have stated that this contamination has not affected all of the sartan products.

What Should Blood Pressure Patients Relying on These Medications Do?

According to the medical experts, patients using these recalled drugs can continue taking them however, before doing so, it is highly recommended to consult your pharmacist or doctor immediately.  The threat of cancer from the contaminated batches of Valsartan and other sartans might be low as compared to the threat of not using them at all.

It is best to request your doctor to suggest an alternative.  These nationwide recalls have made it difficult to find Valsartan medicines in the market meaning that whether you want to use this drug or not, you might have no other choice but to use alternative blood pressure medications.   Therefore, ensure that you consult your doctor immediately before you switch to another medication or completely stop using it.

6 Foods That Lower Blood Pressure

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High blood pressure or hypertension is the increased amount of blood pressure against your arteries.  With time, elevated blood pressure can damage your blood vessels and lead to a stroke, kidney disease, heart disease and other health serious issues.  Hypertension is also referred as a silent killer since it doesn’t have any unique symptoms and can go untreated for years.

There are certain risk factors not under your control, including gender, family history and age; however, there are still various risk factors that you can control, including diet and exercise.  Changes in your diet can drastically decrease high blood pressure.  There are various foods that can help in lowering your blood pressure, including the following:

1.   Berries

Strawberries and blueberries include anthocyanins, which are antioxidant compounds that help to lower the blood pressure.  Studies have shown that the intake of a high amount of anthocyanins can reduce the risk of hypertension by 8% as compared to a low anthocyanin intake diet.  Eat berries as dessert, a snack, or add them in a salad, oatmeal or smoothies.

2.   Fenugreek Leaves and Seeds

Fenugreek seeds and leaves are loaded with a high amount of soluble fiber, which aids in decreasing cholesterol level.  A diet that is high in fiber has been linked to steady levels of blood pressure.  Fenugreek seeds and leaves contain low levels of sodium.
However, keep in mind that while fenugreek is efficient in lowering blood pressure, it can also reduce your blood sugar, which means it is best not to consume it every day.

3.   Beetroot

Beetroot includes a high amount of nitric oxide which helps to open up the blood vessels and lower blood pressure.  Studies have found that nitrates in beetroot juice lowered blood pressure of participants in merely 24 hours.  It is therefore best to include beets in your diet by making beet juice, cooking the whole beetroot or eating it in salads.  It also tastes delicious when added in stews or stir-fries and when roasted or baked.

4. Leafy Green Vegetables

Loaded with nitrates, leafy green vegetables also help lower blood pressure levels.  Studies have suggested that consuming two servings of nitrate-rich vegetables daily can decrease hypertension.
The leafy greens you can include in your diet are:

  • Swiss chard
  • Spinach
  • Mustard greens
  • Kale
  • Fennel
  • Lettuce
  • Collard greens
  • Cabbage

In order to consume the daily requirement of leafy greens, you can eat baked kale chips, add a side dish of sautéed Swiss chard and garlic to your main meal, add vegetables in stews and curries, or make a salad of raw leafy greens.

5. Salmon

Fresh fish is one of the best sources of omega-3 fatty acids and lean protein.  Salmon contains vitamin D, which has been reported to lower levels of blood pressure.  You can replace trans and saturated fats like fried foods and fatty beef with a serving of salmon weekly.

Just this simple swap once a week helps to reduce inflammation, lower arterial plaque buildup, and decrease triglycerides – all of these being the biggest contributors to heart disease.

6. Dark Chocolate

A piece of dark chocolate is effective in lowering high blood pressure.  Studies have suggested that chocolate rich in cocoa can help to reduce high levels of blood pressure in individuals with prehypertension or hypertension.

Make sure you select high quality chocolate, which includes at least 70% cocoa.  Eat one square or a 1oz piece every day.

A healthy diet and regular exercise can drastically decrease the risk of high blood pressure.  Start including these six foods that help in lowering blood pressure to maintain a stable blood pressure.  Other foods that lower blood pressure include various spices, herbs, lentils, nuts, oats and other vegetables and fruits.  Make sure you consult your doctor in case of any doubts or for more health tips in reducing your blood pressure.

Causes of High Blood Pressure

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High blood pressure is a serious health issue and is now becoming more common and a growing concern in the United Kingdom.

This is clearly evident from the following facts and statistics published by Public Health England:

  • High blood pressure affects nearly 1 in 4 individuals,
  • It is the third-biggest risk factor for premature deaths and disability, after smoking, in England,
  • At least ½ of all the cardiac arrests and strokes are linked with high blood pressure,
  • It is also among the major risk factors for developing chronic kidney diseases and dementia, Over 5.5 million individuals in England have undiagnosed high BP and remain untreated, thereby putting their lives at serious risk.

High blood pressure is estimated to affect over 1.5 billion individuals worldwide by the year 2025.

What is High Blood Pressure?

High blood pressure, occurs when the pressure of your blood is persistently higher than the pressure that is considered normal. The optimal blood pressure rate is under 120/80mmHg.  Readings above this range (for example, 130-139/80-89) are considered as stage 1 high blood pressure, while stage 2 is 140 and above/90 and above.

Blood Pressure Chart

Blood Pressure Chart

High blood pressure can be dangerous because the heart has to work harder to pump blood to the body and further leads to hardening of the arteries, thereby increasing the risk of developing a stroke and heart failure.  Although the exact causes of high blood pressure are still unknown, there are many factors linked to it.  These factors are believed to have a strong influence on blood pressure, thereby increasing the likelihood of developing the condition.

Age

It is estimated that approximately 1 in 2 individuals over 65 have high blood pressure.  This indicates that you may be exposed to the risk of high blood pressure as you age.

Family History

Studies also show that family history also increases the risk of high blood pressure.  So, if high blood pressure tends to run in your family then it’s important that you closely monitor yours and manage it proactively to reduce the chances of developing it in the future.

Obesity

It is believed that people who are overweight or obese can develop high blood pressure.  This is backed by the fact that as your weight increases, more blood is needed by your body to supply nutrients and oxygen to the tissues. So, when the volume of blood circulation through the vessels shoots up, so does the pressure on the walls of your arteries.

A Diet Rich in Sodium and Poor in Potassium

Your diet also influences your blood pressure level. If your diet is rich in sodium and has very little potassium, it can increase your likelihood of developing high blood pressure.  This is because sodium causes the body to retain fluid, while potassium helps balance the amount of salt in the cells.  So, if your diet has too much salt and little potassium, you will retain and accumulate salt in the blood, thereby putting you at risk of high blood pressure.

Other potential causes include:

  • High alcohol intake,
  • Stress,
  • Minimal physical activity, and
  • Frequent use of tobacco.

To lower the risk of developing high blood pressure, monitor and manage your blood pressure at home yourself. Consider investing in a high quality home blood pressure monitoring machine, such as A&D’s UA-651BLE Upper Arm Blood Pressure Monitor with Smart Bluetooth Low Energy Connectivity to check your blood pressure daily.  It is easy to use, and offers reliable and accurate reading.  Also, seek proper treatment and adopt a healthy lifestyle to minimize your risk.

A&D UA-651BLE Upper Arm Blood Pressure Monitor with Bluetooth® Smart Bluetooth® Low Energy Connectivity

The UA-651BLE is the 4th generation of the range of A&D telehealth blood pressure monitors, and is designed for the home user as part of the ‘wellness connected™’ family of products and free app, A&D Connect.

Features:

  • 4th gen. blood pressure monitor telehealth range
  • Bluetooth® Version 4.0LE/ Bluetooth® Smart communication
  • Continua™ Certified – to ensure interoperability
  • Compatible with UC-352BLE scales and UT-201BLE thermometer
  • A&D’s Slimfit™ Cuff 22-32cm
  • 2nd gen. IHB Indicator
  • WHO Blood Pressure Class.Indicator
  • Internal 30-memory + Average Reading
  • ESH Clinical Validation

The Holiday Season is almost here!

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Don’t forget to place your orders as soon as possible, so that we can guarantee a delivery before Christmas!

Our European offices will be closed from December 22nd, 2018 until January 2nd, 2019, for the holiday season.

In order to guarantee despatch before the holidays, please send any final orders before 2pm on Friday, 21st December to:

If you have any questions on our products or services, don’t hesitate to check out our website: www.adi-corporate-staging.z4pby1v9-liquidwebsites.com.

You will find lots of helpful information such as:

We would like to take this oppotunity to thank you all for your great support during this year.

The team at A&D Instruments wish you and your family a Merry Christmas and a Happy New Year!

Saving time with the Wellpoint Kiosk

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The consulting time of medical specialists at the University Hospital Antwerp has been fundamentally improved over the past two years. The screening of blood pressure, heart rate, height, weight, BMI and temperature is no longer done by a doctor, nurse or clinician but by the patient himself.  This has been possible thanks to the WellPoint Kiosk featuring the A&D TM-2657P Waiting Room Monitor.  Professor Dr. Guy Hans, medical director of the University Hospital talks more about it.

The WellPoint Kiosk is a collection of devices with which the patient can independently measure his/her vital parameters, such as blood pressure, heart rate, weight and temperature.  In addition, the patient can provide the healthcare professional with other clinically desired information by completing personal validated questionnaires for pre-screening and risk assessment.  The results are immediately passed to the Electronic Medical Record (EMR) and therefore do not have to be entered manually, saving time and reducing data entry errors.  Healthcare professionals can immediately discuss the results with the patient during consultation hours.

At UZA, there are six of these kiosks embedded in the hospital flow.  Plans for further expansion contain the integration of this kiosk to keep the patient flow within the hospital as efficient as possible.

“The decision to work with this kiosk stems from the accreditation requirements set by JCI” says Professor Hans. “When we were working on accreditation to comply with the JCI quality standard for safe and quality care1, it became clear that we had a problem: we did not have the minimal clinical data of patients required”

This is a problem that is not unique to UZA. According to Professor Hans, many hospitals do not have this minimal set of patient data.

“In order to meet the quality standards for accreditation of JCI, UZA went in search of a solution to gather this patient data on a wide scale. We found this in the WellPoint Kiosk.”

Working with the kiosk has several advantages according Professor Hans.

“Thanks to the kiosk, we receive the results of the vital parameters from every patient who comes here during consultation hours. In this way, the physician has an up-to-date and accurate ‘snapshot’ of the patient’s physical condition during the consultation. Another important advantage is time saving; care providers do not have to take measurements manually anymore. That saves about 6 minutes per patient. Multiplied by the tens of thousands of patients who visit the UZA every year … that time saving is therefore enormous”.

Professor Hans emphasizes that UZA uses the time gained to optimize and improve the quality of care rather than to reduce costs.

Professor Hans commented that the quality of the consultation hours has greatly improved thanks to the kiosk.

“As soon as the patient enters my office, I have the vital parameters needed to start the conversation.  In addition, the kiosk is a great tool for working on primary prevention. We often see patients who have no symptoms but with this standard screening process, an increased blood pressure or a deviation in, for example the heart rate, is noticed.  If the doctor suspects abnormal / concerning results, he can immediately take action, consider referral to a specialist or back to the GP.  In particular, from a preventive point of view, the Kiosk is a particularly valuable addition to the care we provide as UZA.  Its something we couldn’t do without!”

1 https://www.jointcommissioninternational.org/

TM-2657P Waiting Room Blood Pressure Monitor

The TM-2657P is the latest model in the range of A&D freestanding fully automatic blood pressure monitors. Designed for high foot fall areas to save time and money offering a Return on Investment (ROI) normally within 6 months.

Features:

  • Can be integrated into Electronic Patient Record solution (EPR)
  • User-friendly small footprint & barrier-free design
  • Simple to use, one-touch measurement
  • Network connectivity options using Bluetooth or RS-232
  • Reliable high speed printer with easy paper replacement
  • Irregular Heart Beat (IHB) indicator
  • BHS A/A Clinically Validated

What is Atrial Fibrillation?

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Atrial fibrillation (AF) is a type of irregular heartbeat. It occurs when your heart is not pumping as well as it should, resulting from a disturbance in the electrical conduction pathways in the heart.  A condition more common with advancing age, if left untreated can lead to serious complications such as heart failure and stroke.

Being the most common sustained heart rhythm disturbance (arrhythmia)1 and affecting 1 in 4 middle-aged adults at some point in their life2, people with AF are three to five times more likely to suffer a devastating, debilitating, disabling and often fatal stroke than people without AF.

Resulting from a disturbance in the electrical conduction pathways in the heart leading to an irregular pulse which can often be quite rapid, AF often contributes to symptoms of palpitations, shortness of breath, chest discomfort, light headedness, fainting and fatigue.

The Scale of the Problem

AF-related strokes cause unacceptably high levels of death and disability, and the scale of the problem across Europe is increasing as our populations age.

By 2035 the number of strokes is projected to rise by 34%, to over 800,000 events.3  At the same time, the number of people with AF is increasing and, by 2060, it is estimated that nearly 18 million adults over the age of 55 will have AF.4

Screening for Atrial Fibrillation

No country has yet established a national screening programme (NSP) for AF, including the UK.  However, there is an increasing body of evidence suggesting screening may be beneficial, prompting recommendations from prominent expert bodies to screen for AF.5  The British Cardiovascular Society issued a statement suggesting that it would be in the public interest to initial such a screening programme.6

Several factors have led to an increased interest in AF screening.8

The prevalence of AF is increasing due to a combination of population ageing, changing patterns of risk factors, and improved survival rates in other, contributory forms of cardiovascular disease.

Newer treatments are available in the form of novel oral anticoagulants (NOACS), which are safer, at least as effective as the existing treatment mainstay of vitamin K antagonists, and simpler to use (as they do not require regular blood tests).

A number of relatively inexpensive screening devices for detecting AF in the community have been developed and the field may evolve rapidly as new technologies and algorithms emerge.

Ambulatory Blood Pressure Monitors

Ambulatory Blood Pressure Monitors (ABPMs) provide testing to determine the presence of hypertension by taking measurements during normal daily activities, over a span of 24 (or more) hours. They help to diagnose as well as monitor high blood pressure (hypertension), usually defined as a systolic pressure of 140 mm Hg or more and a diastolic pressure of 90 mm Hg or more.

ABPMs are portable blood pressure devices worn on a belt, with the cuff being attached around the upper arm. All types of daily activities, including sleep, may be normally carried out while wearing this device.

Benefits of ABPM

By giving an accurate picture of a patient’s blood pressure throughout the day and during sleep, it can prevent unnecessary prescribing of hypertension-reducing drugs for white coat hypertension. It also helps patients with masked hypertension to receive required treatment. It reduces the risk of stroke, heart disease, and organ damage caused by hypertension, and also shows how well a person responds to a long-acting antihypertensive drug.

Footnotes

  1. Camm AJ, Kirchhof P, Lip GY, et al. 2010. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 31(19): 2369-429
  2. Kirchhof P, Benussi S, Kotecha D, et al. 2016. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Europace 18(11): 1609-78
  3. Stroke Alliance for Europe. 2017. The burden of stroke in Europe. London: Stroke Alliance for Europe
  4. Krijthe BP, Kunst A, Benjamin EJ, et al. 2013. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J 34(35): 2746-51
  5. Kirchhof P, Benussi S,Kotecha D,et al. (2016) 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37(38):2893–2962
  6. British Cardiovascular Society (2014) BCS statement on screening for atrial fibrillation to prevent stroke (BCS), http://www.bcs.com/pages/news_full.asp?NewsID=19792297 (accessed 22 May 2017).