ABPM screen 300/400 Risk Assessment
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1 ABPM screen 300/400 Risk Assessment
2 Highlights of custo screen400 ABPM 24 hours Synchronized ABPM and Holter ECG recordings in combination with custo guard 3 72 hours for ABPM recordings alone To our knowledge, the custo screen 400 device is the first to pass the revised ESH-IP custo med GmbH 2
3 Block diagram of the device screen 400 RF-Link SD-Card screen 300 Pressure Sensor Signal Conversion Mikrocontroller Blood Pressure Monitor Pressure Sensor Signal Conversion Pump Power Display, Button, Buzzer Mikrocontroller IrDA linear Valve Power Step Valve Power F-RAM clock custo med GmbH 3
4 Pressure signal Cuff temperature compensated resolution of 0.01 mmhg 1000 Hz 100 Hz inner tube Sensor electronics FIR-Filter kills noise of the pump Analysis Algorithm outer tube Linear Valve Valve Control: allows constant pressure drop no turbulence caused by air flowing hardly interference by valve movement or pump custo med GmbH 4
5 oszillation amplitude Envelope curve for calculation of BP pressure in mmhg custo med GmbH 5
6 Internal Validation, 318 Measurements , ,00 70,00 80,00 90,00 100,00 110,00 120,00 130,00 140,00 150,00 160,00 170,00 180,00 190,00 200, Adding new blood pressure recording with raw data and reference values to a database automatic optimizer Check the improvement optional manual correction Recalculation of the blood pressure Validation by a testing institute Systole Diastole custo med GmbH 6
7 Validation Results (ESH-IP 2010) custo med GmbH 7
8 Comparison with other ABPM devices 99 Measurements Values in: DIFFERENCE 5 MEAN DIFFERENCE STANDARD DEV. SBP DBP SBP DBP SBP DBP custo screen 300/400 (ESH-IP 2010) absolut ,4-0,4 4,1 2,7 Device 2 (ESH-IP 2002, Mallion 2005 ) absolut ,7-3 4,7 4,1 Device 3 (ESH-IP 2002, Ragazzo 2010) absolut ,7-1,1 6,9 4,3 Device 5 (ESH-IP 2002, Denchev 2007) absolut N/A N/A N/A N/A Device 6 (ESH-IP 2002, Haensel 2005) absolut ,7-0,8 4,6 4,4 Device 7 (ESH-IP 2002, Jones 2004) absolut N/A N/A N/A N/A Device 8 (ESH-IP 2002, Langewitz 2009 ) absolut ,12 1,11 3,41 3, custo med GmbH 8
9 Why ABPM? Hypertension is one of the most important preventable causes of premature morbidity and mortality in the UK [ ] If the clinical blood pressure is 140/90 mmhg or higher, offer ambulatory blood pressure monitoring to confirm the diagnosis of hypertension National Institute for Health and Clinical Excellence (NICE), clinical guideline, 127, custo med GmbH 9
10 Treatment of Hypertension Know Your Blood Pressure ABPM as a Gold Standard Know Your cardio-vascular Risks Risk Assessment: A tool to predict a person s chance of having a heart attack in the next 10 years Know how both variables are changing over time custo med GmbH 10
11 Risk Assessment Blood pressure Risk factors cardio - vascular Risk custo med GmbH 11
12 Blood Pressure Stages - DHL custo med GmbH 12
13 Blood Pressure Stages - NICE custo med GmbH 13
14 Comparison of NICE and DHL RANGE NICE -SYS NICE - DIA DHL-SYS DHL-DIA Optimum - - < 115 < 75 Normal < 135 < High-Normal Grade Grade Grade 3 > = 170 <= 110 > = 157 > = 96 Isolated Systolic Hyp. > = 135 < 85 > = 135 < custo med GmbH 14
15 Hypertension: Risk factors target organ damage cardiovascular risk factors Hypertension cardiovascular diseases Diabetes mellitus custo med GmbH 15
16 Cardio-vascular risk factors Systolic and diastolic blood pressure Smoking Dyslipidaemia Family history Abdominal obesity Glucose level Life style related factors custo med GmbH 16
17 Target Organ Damage Heart Kidney Blood vessels Retina Hypertrophy Proteinuria Arteriosclerosis Hypertensive retinopathy custo med GmbH 17
18 Diabetes mellitus (type II) Metabolic disorder Causes impairment of the kidneys, which is a central part of the blood pressure regulation Negative impact on the Renin-Angiotensin II complex, which has vasoconstructive effects mid-term to long-term effects on BP custo med GmbH 18
19 chronic diseases Cerebro-vascular impairments Stroke, TIA,. Heart related impairments Heart attack, H. insufficiency, angina pectoris Nephropathy Diabetic induced nephropathy Renal insufficiency custo med GmbH 19
20 Setting the risk factors custo med GmbH 20
21 Risk Assessment: custo diagnostic view custo med GmbH 21
22 Report Doctors view Patients view custo med GmbH 22
23 Benefits of Risk Assessment Identify patients with high risks Start with intervention asap Direct patients attention on possible risks AND options of intervention Risk Assessment could be an effective and efficient tool for making prevention real custo med GmbH 23
24 thank you for your attention Dipl. Ing. Andreas Wolf R&D Project Manager & Dr. Peter Rumm Medical Project Consultant custo med GmbH Leibnizstraße Ottobrunn Germany fon: +49 (0) fax: +49 (0) mobile: +49 (0) peter.rumm@customed.de www: custo med GmbH 24
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