13 Comments

A major flaw in the continuous ambulatory bp monitoring is the data analysis. It is about time (30 years later) to ask for help (mathematicians, engineers) and start making use of appropriate tools, like stochastic process.

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Good to hear. I think most people with paroxysmal afib should have a Kardia Kard (https://theskepticalcardiologist.com/2022/02/10/the-kardiamobile-card-review-accurate-ecg-recording-and-analysis-from-a-credit-card-sized-device/) in their wallet or an Apple Watch.

Hopefully, the cuffless wrist technology will reach that level of accuracy and validaition

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Really interesting. I've used an AliveCor Kardia since 2016 for monitoring AFIB. It has been tremendously helpful. I also have borderline hypertension that has occasionally gone beyond borderline. It would be great to have continuous monitoring, rather than just my own intermittent checks.

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If by pulse rate drop you mean heart rate recovery then I agree as it is reflective of autonomic tone. Your question has prompted me to update and import my article on heart rate recovery from my Word Press site. It should appear shortly on Substack

Variability of pulse and BP is a reflection of autonomic tone for the most part

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Wish it were available now as we are working to get my wife's BP under control.

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An infomercial from the skeptical cardiologist? Don't be absurd

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this reads sort of like an info-mercial.

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ACP does a wonderful job of presenting including diagrams, documentation, and his own thoughts. Several years ago I discussed my Journal of Clinical Hypertension 2008;10: 885 published article on the benefits of using the Omron wrist blood pressure cuff. ACP took me to task as did the authors of the original article that my letter to the editor was in response to. Seems that ACP has come around to my position now with regarding to the benefit of wrist blood pressure cuffs. Verification is essential in any case. For about $40.00 one can obtain such a cuff on the Internet. As I said in my published article, I disagree with the concept of sitting quietly for several minutes before measuring your blood pressure: that has nothing to do with the realities of normal life. I say take your BP anytime of the day. The goal is 110-115/60-70 or even a bit lower, and if on treatment, definitely not above 125/80. Bear in mind that at the 95% level, hypertension is curable. In no sense of hostility, but as an invitation to the freedom of health, the health care provider must find out what the patient is doing to make their high blood pressure occur. Mosty it is diet, salt, and animal protein. Personally, while I believe almost anything except dairy products is acceptable once in a while, being 90+% ideally organic unprocessed whole foods vegan is the right direction to go for cure of HBP as well as resulting in the simultaneous prevention of multiple diseases. Recall I just said 90%, I did not say 100%: 90% = animal protein, such as wild caught fish or cage free organic eggs or a bison hamburger or steak at about a total of 5 times in 2 weeks if one is lean and trim which is difficult to obtain. Replace salt by using substitutes or the juice of half a lemon plus half a lime at the table to give that perfect salt flavor. All of this is an invitation to consider and medication, etc. therapy is available if one is not completely successful in the above goals. There is much more to say.

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Apr 6, 2023Liked by The Skeptical Cardiologist

I’ve been a big “skeptic” about office BP measurements, and can usually coax a 10-15 point drop from the initial hurried reading the medical assistant gets at the start of the visit. Home monitoring is so much more valuable I agree, as long as accuracy is assured. This looks great. Combined with the glucose monitoring that might be on the horizon very soon with Apple Watches, engaged patients are going to be quite happy! This sort of home monitoring is good medicine, and facilitates better telemedicine as well.

Googling, it looks like the Aktiia runs about $250 (199 pounds) in the UK. I’m happy to be an early adopter if the company is looking for more primary care docs... 😉

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Super article, thank you.

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That device has nothing to do with BP measurement. Any claims to cardiac arrest prediction highly suspect.

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Sir, and perhaps this device will implement the Aktiia, it’s named the Heart Sentinel. www.movesense.com. It is still in development in Italy and alleges it has the algorithms by which cardiac arrest can be estimated. Reportedly the device does that as a function of capturing afib data. Than. You for your post. Anthony

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