约瑟夫
#63
There is more than one instrument.
Do not know the cost
Review
The Vicorder device compared with SphygmoCor in the assessment of carotid–femoral pulse wave velocity in patients with peripheral arterial disease
https://www.nature.com/articles/hr2012144
AnUser
#64
They should stay focused and stick to one thing right now, blood pressure. The other things can be measured with other devices. If they do blood pressure right they will become extremely rich, rightfully so. HBP is a terrible killer.
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Sun exposure to skin reduces blood pressure - “Whole body UVA irradiation caused a rapid, significant decrease, lasting up to 60 minutes, in systolic and diastolic blood pressure of healthy volunteers by 11±2% at 30 minutes after UVA exposure”
Opländer, C., et al (2009). Whole body UVA irradiation lowers systemic blood pressure by release of nitric oxide from intracutaneous photolabile nitric oxide derivates. Circulation Research , 105 (10), 1031-1040. https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.109.207019
Summer is your friend as a natural factor lowering blood pressure. I think the nitric oxide expression due to sunshine on skin is the main factor. As well as other means such as eating more veggies with nitrates (beets, arugula, lettuce) from summer gardens. Other sunlight factors include higher vit d levels. Temperature is also aligned with higher or lower blood levels. Cold temperatures cause constricted blood vessels and hence higher blood pressure in winter. People are also more active and exercising in the summer which improves blood pressure.
Nice to think that simple lifestyle factors could eliminate or reduce the need to medicate away this risk factor.
I have been monitoring my BP for a week now, I measured every day 3x, morning, midday and evening. The average seems fine at 115/75. Systolic pressure seems quite constant (113-118) but my diastolic pressure seems to go up and down, from 60-89… quite some measurements above 80. How dangerous is diastolic hypertension? My husband (MD) thinks I am ridiculous about that, that my average is great and MAP as well. He said less salt. But I would not be me if I were not obsess for at least a while 
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Rather than less salt, I have found that the first line of action that works best for me is to increase potassium. This in effect alters the sodium/potassium ratio and basically does the same thing, but you seem like a pretty active guy and so I feel increasing potassium is number one, active people I feel need sodium. Just my two cents
5 Likes
When it comes to Sodium supplementation I think it is always important to make sure that there is sufficient Potassium. Hence if you are taking NaCl also take at least 1/3 of the quantitiy of KCl. I don’t know of the limitations. It may be better to have similar quantities of NaCl and KCl, but I don’t know.
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LaraPo
#70
It talks about exposure to daily high dose for up to 3 years. What is high dose? If I’m not mistaken, Lasartan was recalled sometime in the past due to contamination. I started taking telmisartan, 20mg/day.
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CTStan
#71
In general, a “high dose” of telmisartan is considered to be a dose that exceeds the maximum recommended dose of 80 mg per day.
Telmisartan is available in several different doses. The most common doses of telmisartan are:
- 20 mg tablets
- 40 mg tablets
- 80 mg tablets
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I have been monitoring my blood pressure recently and it fluctuates so much based on time of day, activity level, perceived stress level, etc. I was listening to an episode of The Drive recently and Attia was talking about the challenges of monitoring blood pressure. I noted that he gets patients to check it 5x per day for 2 weeks. Makes me think about the best BP measuring protocol.
The bottom line is that in one day, I can see readings as high as 127/87 (lunch time) and as low as 107/74 (bed time). That’s a big swing. The truth is that in only happy with one of these numbers.
Curious to understand how other people approach monitoring BP and which results they choose to follow.
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Neo
#73
Finally a good, simple continuous blood pressure monitoring bracelet?
Approved in UK and EU:
FDA approval expected to follow.
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I think that measuring twice daily for a week or two and calculating average and MAP would be sufficient (reavaluating maybe every 6 months or so). If any of single measurements would be in hypertension territory (systolic over 135 and diastolic over 85) one would need to look more into it. But remember measuring BP you need to be seated down for few minutes before and not doing it soon after exercise or when stressed. If stressed is your way of being then you have a problem. 
约瑟夫
#75
FWIW
As of 04/07/2023
Aktiia Cost $268 / £199.99 / AU$366
Since October, 2022
I use/have been using the E500 watch. I calibrate the watch software to an independent OMRON BPM Model BP760N, BP reading is + or - 3%. Measuring 24/7 every 5 minutes.
I spent a total of less than $100.00 usd for the watch new and the BPM which was used.
And I do have a mercury sphygmomanometer and several {more than three] other BP measurement devices.
3 Likes
Neo
#76
Interesting. I thought others had accuracy issues with the E500, but that was perhaps more is CGM estimates?
Do you know if there are any clinical data on the E500s BP accuracy?
What I like with Aktiia is that it has a lot of clinical validation and approval by regulatory agencies and also that Eric Topol is very credible in this space and it got as close of an enforcement that you ever see him give something.
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Neo
#77
Hi there, Personally, not going for sufficient, but for optimal 
As with for instance glucose, averages of just select point in time measurements do not contain as much information as patterns, including variability and peaks.
See eg the conversation between Peter Attia and Ethan Weiss, a leading preventative cardiologist at UCSF linked below
Especially this part:
Blood pressure variability, how to best measure it, and data suggesting the enormous impact of keeping blood pressure down [1:21:00]
Peter also explicitly discusses why it would be valuable to have continuous blood pressure measurement.
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Would you accept that Peter Attia might have a personality trait (would not go that far to characterize it as PD) and things he says must be taken trough this optics? If you measure your blood pressure twice daily for two weeks you notice if you have any problems and if you have any problems with BP, than this is something that needs more looking into and this is where continuous monitoring makes sense, but wearing it all the time what good would that cause? BP like every parameter fluctuates and small deviations are not a concern. If exercise is beneficial for example and we know it acts as blood pressure lowering strategy it will cause you BP to go up during and up to several hours after exercising one could argue that fluctuations are not only normal but desired that occasional stress makes us stronger in the long run. Something that is repeatedly concerning and showing a trend must be looked more into…
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RPS
#79
I think it’s best to get the highest measurement of the day (any testing after 15 minutes of sitting and not straight after drinking or eating) at or below the 120/80.
My highest of the day appears to be first thing in the morning so I rarely test at any other time (and when I do it is always lower).
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I am also very hopeful to see this device approved for the US. I’ve signed up to be notified when its available.
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I use an Omron (which I tested against the E500 and posted about) I have records since 2016 morning and evening in bed for something over 99% of potential readings.
