1. Home Blood Pressure Measurements Are Not Performed According to Guidelines and Standardized Education Is Urgently Needed.
Clapham E, Picone DS, Carmichael S, Stergiou GS, Campbell NRC, Stevens J, Batt C, Schutte AE, Chapman N.
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2. Screening for Atrial Fibrillation During Routine Automated Blood Pressure Measurement in General Population Aged 65 Years and Above: EMENO National Epidemiological Survey in Greece.
Menti A, Kalpourtzi N, Kyriakoulis KG, Kollias A, Touloumi G, Stergiou GS.
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3. The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study).
Ostrowska A, Wojciechowska W, Rajzer M, Weber T, Bursztyn M, Persu A, Stergiou G, Kiełbasa G, Chrostowska M, Doumas M, Parati G, Bilo G, Grassi G, Mancia G, Januszewicz A, Kreutz R.
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4. The impact of the COVID-19 pandemic on blood pressure control in patients with treated hypertension-results of the European Society of Hypertension Study (ESH ABPM COVID-19 Study).
Wojciechowska W, Rajzer M, Kreutz R, Weber T, Bursztyn M, Persu A, Stergiou G, Parati G, Bilo G, Pac A, Grassi G, Mancia G, Januszewicz A, Chrostowska M, Narkiewicz K, Dubiela A, Doumas M, Imprialos K, Stavropoulos K, de Freminville JB, Azizi M, Cunha PG, Lewandowski J, Strzelczyk J, Wuerzner G, Gosk-Przybyłek M, Szwench-Pietrasz E, Prejbisz A, Van der Niepen P, Kahan T, Jekell A, Spaak J, Tsioufis K, Ehret G, Doroszko A, Kubalski P, Polonia J, Styczkiewicz K, Styczkiewicz M, Mazur S, Veglio F, Rabbia F, Eula E, Águila FJ, Sarzani R, Spannella F, Jarai Z, Papadopoulos D, Lopez-Sublet M, Ostrowska A, Grassos C, Kahrimanidis I, Eugenia G, Areti T, Tomasz G, Barbara W, Aleksandra S, Beata M, Angeliki N, Robles NR, Widmiski J, Zbroch E.
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5. Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension.
Kario K, Williams B, Tomitani N, McManus RJ, Schutte AE, Avolio A, Shimbo D, Wang JG, Khan NA, Picone DS, Tan I, Charlton PH, Satoh M, Mmopi KN, Lopez-Lopez JP, Bothe TL, Bianchini E, Bhandari B, Lopez-Rivera J, Charchar FJ, Tomaszewski M, Stergiou G.
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Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management. However, conventional home and ambulatory BP monitoring devices use the upper-arm cuff oscillometric method and only provide intermittent BP readings under static conditions or in a limited number of situations. New innovations include technologies for BP estimation based on processing of sensor signals supported by artificial intelligence tools, technologies for remote monitoring, reporting and storage of BP data, and technologies for BP data interpretation and patient interaction designed to improve hypertension management ("digital therapeutics"). The number and volume of data relating to new devices/technologies is increasing rapidly and will continue to grow. This International Society of Hypertension position paper describes the new devices/technologies, presents evidence relating to new BP measurement techniques and related indices, highlights standard for the validation of new devices/technologies, discusses the reliability and utility of novel BP monitoring devices, the association of these metrics with clinical outcomes, and the use of digital therapeutics. It also highlights the challenges and evidence gaps that need to be overcome before these new technologies can be considered as a user-friendly and accurate source of novel BP data to inform clinical hypertension management strategies.
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6. General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants.
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7. Age-Related Blood Pressure Gradients Are Associated With Blood Pressure Control and Global Population Outcomes.
Nolde JM, Beaney T, Carnagarin R, Stergiou GS, Poulter NR, Schutte AE, Schlaich MP.
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8. May Measurement Month 2021: results of 31 national blood pressure screening programmes.
Poulter NR, Schlaich MP, Schutte AE, Stergiou GS, Kiru G, McArdle H, Beaney T.
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9. Transforming Hypertension Diagnosis and Management in The Era of Artificial Intelligence: A 2023 National Heart, Lung, and Blood Institute (NHLBI) Workshop Report.
Shimbo D, Shah RU, Abdalla M, Agarwal R, Ahmad FS, Anaya G, Attia ZI, Bull S, Chang AR, Commodore-Mensah Y, Ferdinand K, Kawamoto K, Khera R, Leopold J, Luo J, Makhni S, Mortazavi BJ, Oh YS, Savage LC, Spatz ES, Stergiou G, Turakhia MP, Whelton PK, Yancy CW, Iturriaga E.
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Hypertension is among the most important risk factors for cardiovascular disease, chronic kidney disease, and dementia. The artificial intelligence (AI) field is advancing quickly, and there has been little discussion on how AI could be leveraged for improving the diagnosis and management of hypertension. AI technologies, including machine learning tools, could alter the way we diagnose and manage hypertension, with potential impacts for improving individual and population health. The development of successful AI tools in public health and health care systems requires diverse types of expertise with collaborative relationships between clinicians, engineers, and data scientists. Unbiased data sources, management, and analyses remain a foundational challenge. From a diagnostic standpoint, machine learning tools may improve the measurement of blood pressure and be useful in the prediction of incident hypertension. To advance the management of hypertension, machine learning tools may be useful to find personalized treatments for patients using analytics to predict response to antihypertension medications and the risk for hypertension-related complications. However, there are real-world implementation challenges to using AI tools in hypertension. Herein, we summarize key findings from a diverse group of stakeholders who participated in a workshop held by the National Heart, Lung, and Blood Institute in March 2023. Workshop participants presented information on communication gaps between clinical medicine, data science, and engineering in health care; novel approaches to estimating BP, hypertension risk, and BP control; and real-world implementation challenges and issues.
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10. Estimated impact of guidelines-based initiation of dual antihypertensive therapy on long-term cardiovascular outcomes in 1.1 million individuals.
Coca A, Borghi C, Stergiou GS, Khan I, Koumas A, Blacher J, Abdel-Moneim M.
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11. Validation of a novel professional automated auscultatory upper-arm cuff blood pressure monitor in a general population according to the AAMI/ESH/ISO Universal Standard: KOROT V2 Doctor (InBody BPBIO280KV).
Theodosiadi A, Ntousopoulos V, Ntineri A, Stathopoulou P, Menti A, Kyriakoulis KG, Kollias A, Stergiou GS.
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12. 2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension.
Kreutz R, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, Tsioufis K, de Pinho RM, Albini FL, Boivin JM, Doumas M, Nemcsik J, Rodilla E, Agabiti-Rosei E, Algharably EAE, Agnelli G, Benetos A, Hitij JB, Cífková R, Cornelissen V, Danser AHJ, Delles C, Huelgas RG, Járai Z, Palatini P, Pathak A, Persu A, Polonia J, Sarafidis P, Stergiou G, Thomopoulos C, Wanner C, Weber T, Williams B, Kjeldsen SE, Mancia G.
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13. Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney.
Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Jaén Águila F, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg F, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre I, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, der Niepen PV, Veglio F, Venzin R, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, Vogt L.
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Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70-95%]) than MRA (20% [10-30%]), SGLT2i (30% [20-50%]) or (GLP1-RA (10% [5-15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15-40%) vs 18% [10%-25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5-5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers' dosage reduction was the usual management.
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14. Blood pressure measurement and assessment of arterial structure and function: an expert group position paper.
Asmar R, Stergiou G, de la Sierra A, Jelaković B, Millasseau S, Topouchian J, Shirai K, Blacher J, Avolio A, Jankowski P, Parati G, Bilo G, Rewiuk K, Mintale I, Rajzer M, Agabiti-Rosei E, Ince C, Postadzhiyan A, Zimlichman R, Struijker-Boudier H, Benetos A, Bäck M, Tasic N, Sirenko Y, Zelveian P, Wang H, Fantin F, Kotovskaya Y, Ezhov M, Kotsis V.
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Measuring blood pressure (BP) and investigating arterial hemodynamics are essential in understanding cardiovascular disease and assessing cardiovascular risk. Several methods are used to measure BP in the doctor's office, at home, or over 24 h under ambulatory conditions. Similarly, several noninvasive methods have been introduced for assessing arterial structure and function; these methods differ for the large arteries, the small ones, and the capillaries. Consequently, when studying arterial hemodynamics, the clinician is faced with a multitude of assessment methods whose technical details, advantages, and limitations are sometimes unclear. Moreover, the conditions and procedures for their optimal implementation, and/or the reference normality values for the parameters they yield are not always taken into sufficient consideration. Therefore, a practice guideline summarizing the main methods and their use in clinical practice is needed. This expert group position paper was developed by an international group of scientists after a two-day meeting during which each of the most used methods and techniques for blood pressure measurement and arterial function and structure evaluation were presented and discussed, focusing on their advantages, limitations, indications, normal values, and their pragmatic clinical application.
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15. Prevalence, awareness, and control of hypertension in Greece before and after the COVID-19 pandemic: May Measurement Month survey 2019-2022.
Menti A, Kollias A, Papadakis JA, Kalaitzidis RG, Milionis H, Krokidis X, Nikitas G, Maragkoudakis S, Makaris E, Papachristou E, Sarakis V, Lanaras L, Gkaliagkousi E, Goumenos D, Grassos C, Kallistratos MS, Katsi V, Konstantinidis D, Kotsis V, Kyriakoulis KG, Makris T, Manios E, Manolis A, Marketou M, Papadopoulos D, Pikilidou MI, Protogerou A, Sarafidis P, Theodorakopoulou M, Tsioufis K, Zebekakis P, Doumas M, Stergiou GS.
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16. Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire.
Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Águila FJ, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg FP, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre IM, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, Van der Niepen P, Veglio F, Venzin RM, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, Vogt L.
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17. Blood pressure variability assessed by office, home, and ambulatory measurements before and during antihypertensive drug treatment: a sub-analysis of the REVERENT randomized trial.
Kyriakoulis KG, Kollias A, Bilo G, Soranna D, Liu CY, Pengo MF, Zambon A, Zhang W, Destounis A, Wang JG, Stergiou GS, Parati G.
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18. Visual assessment of Korotkoff sounds improves the accuracy of a validated professional automated auscultatory blood pressure monitor KOROT P3 Accurate.
Menti A, Ntineri A, Kyriakoulis KG, Theodosiadi A, Ntousopoulos V, Stathopoulou P, Kollias A, Stergiou GS.
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19. Assessment and management of exaggerated blood pressure response to standing and orthostatic hypertension: consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability.
Palatini P, Kollias A, Saladini F, Asmar R, Bilo G, Kyriakoulis KG, Parati G, Stergiou GS, Grassi G, Kreutz R, Mancia G, Jordan J, Biaggioni I, de la Sierra A.
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Recent evidence suggests that an exaggerated blood pressure (BP) response to standing (ERTS) is associated with an increased risk of adverse outcomes, both in young and old individuals. In addition, ERTS has been shown to be an independent predictor of masked hypertension. In the vast majority of studies reporting on the prognostic value of orthostatic hypertension (OHT), the definition was based only on systolic office BP measurements. This consensus statement provides recommendations on the assessment and management of individuals with ERTS and/or OHT. ERTS is defined as an orthostatic increase in SBP at least 20 mmHg and OHT as an ERTS with standing SBP at least 140 mmHg. This statement recommends a standardized methodology to assess ERTS, by considering body and arm position, and the number and timing of BP measurements. ERTS/OHT should be confirmed in a second visit, to account for its limited reproducibility. The second assessment should evaluate BP changes from the supine to the standing posture. Ambulatory BP monitoring is recommended in most individuals with ERTS/OHT, especially if they have high-normal seated office BP. Implementation of lifestyle changes and close follow-up are recommended in individuals with ERTS/OHT and normotensive seated office BP. Whether antihypertensive treatment should be administered in the latter is unknown. Hypertensive patients with ERTS/OHT should be managed as any other hypertensive patient. Standardized standing BP measurement should be implemented in future epidemiological and interventional studies.
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20. Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis.
Kyriakoulis KG, Kollias A, Menti A, Chardouvelis P, Stergiou GS.
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