High Blood Pressure - Basic facts
High blood pressure or hypertension occurs when blood vessels have persistently raised pressure. If the pressure is high in the vessels, the heart has to work harder in order to pump blood into them. If left untreated, high blood pressure may cause heart attack, heart enlargement, heart failure or even stroke. But hypertension can also lead to kidney failure or blindness.
Definition of High Blood Pressure
Blood pressure is measured in mmHg (millimetres of mercury) and it is indicated by two numbers. The systolic blood pressure is the upper number and recorded when the heart beats. The diastolic blood pressure is the lower number and recorded when the heart is at rest. Clinic and ambulatory (Holter) hypertension values are defined differently.
Stage 1 Hypertension
When clinic blood pressure is > 140/90 mmHg and ambulatory (Holter) blood pressure daytime average is > 135/85 mmHg.
Stage 2 Hypertension
When clinic blood pressure is > 160/100 mmHg and ambulatory (Holter) blood pressure daytime average is > 150/95 mmHg.
Severe Hypertension
When clinic blood pressure is > 180/110 mmHg.
Causes of High Blood Pressure
There are socioeconomic, behavioural and metabolic risk factors that should be considered when assessing the causes of high blood pressure.
Socioeconomic Factors
Socioeconomic factors such as income, education or housing may have an effect on the ability of developing high blood pressure. For example, unemployment or bad living or working conditions cause stress, which results in high blood pressure. On the other hand, the risk of hypertension increases with age due to stiffening of blood vessels.
Behavioural Factors
Unhealthy diet, tobacco use, physical inactivity, excess use of alcohol may all lead to high blood pressure.
Metabolic Factors
In some cases genetic factors may also play a role and sometimes it is imporatnt to rule out secondary cause of hypertension, especially when it develops in people under 40. Secondary hypertension may be caused by kidney disease, malfunction of blood vessels or pregnancy. Hypertension occurs in women during pregnancy is called preeclampsia. Finally, when blood pressure is measured in clinic environment, due to anxiety of visiting a doctor, it may be higher than it usually is. This is the white-coat syndrome.
White-Coat Hypertension
Around 15-30% of people who show elevated blood pressure measured in the doctor's office have white coat hypertension. White-coat hypertension is one of the most important reasons for ambulatory (Holter) blood pressure monitoring.
In case of white-coat hypertension, the clinic blood pressure is above 140/90 mmHg, while the average daytime ambulatory (Holter) blood pressure is normal, that is it is below 135/85 mmHg.
Further Indications of Ambulatory (Holter) Blood Pressure Monitoring 
- resistant hypertension
- masked hypertension
- childhood hypertension
- assessing the efficacy of anti-hypertensive drug therapy on a 24-hour basis
- nocturnal hypertension
- episodic hypertension and/or anxiety disoredrs
- hypotensive symptoms
- changes in diet and daily routine designed to reduce hypertension
- hypertension in pregnancy
Meditech is a reliable, EU-based supplier of quality ambulatory (Holter) blood pressure monitors with excellent cost-benefit ratio. Delivery can be guarrantied usually within a week. Send your inquiry today!
Holter ABPM - Financial Considerations
High blood pressure is a global public health issue, which contributes to the burden of heart disease, stroke and other cardiovascular risk factors. A Holter ABPM monitor is a more effective, yet a bit more expensive tool in the diagnoses and control of hypertension in comparision to a conventional blood pressure monitor. But the patient benefits will justify additional expense.
There are significant health and economic gains attached to early detection and good control of hypertension. Several years of unnecessary and costly hypertension treatment and expensive interventions such as cardiac bypass surgery or dialysis can be spared. The Holter ABPM technique has a significant role in early and proper diagnosis, as it can take repetative measurements away from medical environment, over a 24-hour period, including nighttime. The latter feature is very important, as there is evidence that nighttime blood pressure values are superior to daytime values in predicting cardiovascular risks.
According to a WHO study almost 80% of deaths due to cardiovascular disease occur in low- and middle-income countries, where many people do not look for treatment for hypertension because it is expensive. However, both the households and the government spend a substantial share of their income on hospitalization and care, including heart attack, stroke and kidney failure. Research shows that in certain low- and middle income countries, current health expenditure on cardiovascular diseases accounts for 20% of total health expenditure. The below table shows the economic burden of noncommunicable diseases, 2011-2025 (US$ Trillion in 2008), source: WHO.
Holter ABPM - Health & Economic Gains
A Holter ABPM is more expensive than a conventional blood pressure monitor but the adventages to patients justify the additional expense. People with white-coat hypertension are often misdiagnosed with hypertension, however, their blood pressure is elevated only in medical setting. In this case, applying a Holter ABPM may save several years of unnecessary and expensive drug treatment. Likewise, there is compelling evidence that when a Holter ABPM is used as the basis for prescribing medications rather than conventional blood pressure monitor, significantly less antihypertensive medication is prescribed.
Meditech Holter ABPM
Meditech ABPM-05 Holter ambulatory blood pressure monitor is a simple, easy-to-use Holter for diagnosis and control of hypertension. Unique features 
include:
1. Dual-valve technology for extra patient safety
2. Stepwise deflation for quick and accurate results
3. Manual device programming for eliminating PC-use
4. Small size
5. Extra low noise and quite operation compared to competitor products
If you want to know more, please contact Meditech - significant discount available for your first order!
White-Coat Hypertension vs White-Coat Effect
ABPM (ambulatory blood pressure monitoring) is being used increasingly in clinical practices and it is indicated for:
a) the exclusion or confirmation of suspected white-coat hypertension;
b) the confirmation of a diagnosis of hypotension;
c) identifying patients with resistant hypertension
d) assessing drug efficacy
e) identifying masked hypertension.
In clinical practice, the most important indication for ambulatory blood pressure monitoring is to identify white-coat hypertension.
What is White-Coat Hypertension?
White-coat hypertension can be identified in untreated patients who have high blood pressure readings in the office but normal readings during usual daily activities outside clinical environment. White-coat hypertensive patients have elevated office blood pressure > 140 mmHg systolic and/or > 90 mmHg diastolic with a normal blood pressure during the day (active) period. However, nocturnal (night-time or passive) blood pressure is superior to daytime blood pressure in predicting cardiovascular risks. Therefore, night-time blood pressure measurements have to be also considered. So patients with office readings above than or equal to 140/90 mmHg and a mean ambulatory blood pressure below 130/80 mmHg have to be included as well.
The prevalence of white-coat hypertension in the community is around 20-25 percent.
What is White-Coat Effect?
The white-coat effect is defined as the increase in blood pressure during the office visit regardless of the daytime ambulatory blood pressure monitoring level or whether the patient receives or not antyhypertensive treatment. White-coat effect is present if the patient's office blood pressure is considerable higher than his or her daytime ambulatory blood pressure level.
So, while in case of white-coat hypertension the office blood pressure is high, but normal daytime ambulatory blood pressure levels are normal, patients with white-coat effect has high office blood pressure regardless of their daytime ambulatory blood pressure levels, which can also be raised above normal.
Ambulatory blood pressure monitoring can make a difference between the two phenomena, while an office blood pressure meter can only see patients with severe hypertension, even if the patients do not have hypertension at all, or if they develop only moderate hypertension at home.
Source: Eoin O'Brien, Gianfranco Prati, George Stergiou: Ambulatory Blood Pressure Measurement - What is the International Consensus? Click here for the review.
24-hour Blood Pressure Monitors for OEM at MEDICA 2013
Meditech exhibits at MEDICA, one of the world's largest medical equipment fairs between 20 - 23 November in Dusseldorf, Germany. Visitors, who are welcome in hall 9/B78, can view the Meditech 24-hour blood pressure monitor OEM package, which includes not only a simple blood pressure module, but also the freely customizable main unit with accessories and the software.
The risk associated with elevated blood pressure is rather high, as each 2 mmHg rise
in systolic blood pressure is associated with a 7% increased risk of mortality from coronary heart disease and a 10% increased risk of mortality from stroke. Many studies confirmed that blood pressure measured over a 24-hour period is superior to clinic blood pressure in predicting cardiovascular morbidity.
24-hour (ambulatory) blood pressure monitors are increasingly being used in clinical practices, as they provide information over and above conventional blood pressure monitors. Ambulatory blood pressure monitors show blood pressure profile over a 24-hour period, therefore they make it possible to record more measurements, even at night-time, while the patient is away from medical environment. As a result, not only real blood pressure values are reflected more accurately, but patients with white coat hypertension and patients whose blood pressure does not decrease at night-time - the non-dippers - can also be identified.
Meditech has more than 20 years of experience in manufacturing PC-based non-invasive ambulatory blood pressure monitors and related software solutions, which are suitable both for busy general practices and clinical research purposes. The small, EU-based company combines the latest advanced technologies with ease-of-use and simplicity. The company provides CE marked products with FDA market clearance and an ISO certified quality management system. Whether you encounter the original Meditech brand or the unmistakable quality in an OEM product, you will always be satisfied with Meditech 24-hour blood pressure monitors.
For more information visit Meditech at MEDICA in 9/B78 or contact us via mail!
Increased Urine Protein is Associated with White Coat Hypertension
According to a recent study elevated levels of protein in the urine can be linked to an increased risk of white coat hypertension.
Protein in urine may often be the earliest sign of diabetic kidney damage. Several diseases and conditions can cause increased levels of protein in urine, included chronic kidney failure, diabetes, heart disease, heart failure, high blood pressure (hypertension) or pregnancy.
White coat hypertension – elevated blood pressure in the physician's office - occurs approximately 25-30 percent of people. In case of white coat hypertension the blood pressure recorded in the physician's office is above 140/90 mmHg, while the average daytime blood pressure is below 135/85 mmHg, which is considered to be normal.
Why ambulatory blood pressure monitoring is indispensable tool to diagnose white coat hypertension?
Failing to identify white coat hypertension may result in inappropriate medical treatment for elevated blood pressure. However, according to the National Institute for Health and Care Excellence (NICE) the risk associated with increased blood pressure is continuous, with each 2 mmHg rise in systolic blood pressure linked to a 7 percent increased risk of mortality from ischaemic heart disease and a 10 percent increased risk of mortality from stroke.
Ambulatory blood pressure monitoring makes it possible to obtain blood pressure readings over 24 hours, whilst the patient is outside clinical environment. In this way his blood pressure readings reflects 'true' blood pressure values.
Generally, ambulatory blood pressure monitors are programmed and used for 24 hours, but in certain cases, the ambulatory blood pressure monitor itself can be programmed for 27 hours. This extension in time makes it possible to identify white coat hypertension, as the first hours of the examination can easily be filtered and analysed.
Meditech is an EU-based developer of quality ambulatory blood pressure monitors and related software solutions. If you need more information on ambulatory blood pressure monitoring in general or on Meditech ABPM-05 ambulatory blood pressure monitor specifically, click here to contact the manufacturer.