NICaS Hypertension Event Monitoring, UK
Physiology of Hypertension (and Hypotension):
Pressure is determined by two factors: flow and resistance. In physiological terms, blood pressure is determined by cardiac output (flow) and total peripheral resistance (resistance). This relationship is illustrated in Figure 1 below.
Figure 1. Determinants of blood pressure and medicines that affect these determinants.1
A typical "hemodynamic profile" of a patient with high blood pressure is shown in Figure 1. Either or both Total Peripheral Resistance and Cardiac Output may be high. Heart Rate, Stroke Volume, Preload, and Contractility may be high.
Objective data can lead to better outcomes and decreased cost of care.
NICaS provides data that directly or indirectly relate to blood pressure and each of its determinants. When physicians have access to these objective data, they can make more accurate diagnoses,2 utilize these data to guide therapy,3 achieve better outcomes,3 decrease cost of care,4 and identify heart failure patients at high risk of hospital readmission5,6.
NICaS Status Report:
An example of a NICaS Status report from a patient with mild hypertension (145/80) is shown in Figure 2. The NICaS data reveal that this patient has very low stroke volume and cardiac output, very high total peripheral resistance, and normal body water. These objective data certainly have therapeutic implications.
Figure 2. NICaS Status Report
Studies by Taler and associates at the Mayo Clinic7 and Smith, et al.3, in a primary care setting demonstrated that when physicians utilized a device similar to NICaS (BioZ by CardioDynamics), they were much more likely to achieve targeted blood pressure reductions than when they followed standard treatment guidelines.
Related Clinical Studies:
Risk Managment: Hypertension In Pregnancy
Hypertension 06 Value Of NI Hemodynamics To Achieve Blood Pressure Control In Hypertensive Subjects
Outcomes of Pregnancies at Risk for Hypertensive Complications Managed Using Impedance Cardiography
- Adapted from: Chobanian, A, et al. JAMA, 2003; 289L13)2560-2572 and Houston, MC. Primary Care 1991; 18:713-753.
- Springfield, CL, et al. CHF, 10(2 suppl2):14-16.
- Smith, RD, et al. Hypertension. 2006; 47:769-775.
- Ferrario, CM, et al. Am Heart Hosp J. 2006; 4:279-289.
- Packer, M, et al. J Am Coll Cardiol, 2006; 47:2245-52.
- Tanino, Y et al. Circulation Journal, 2009; 73: 1074 - 1079
- Taler, SJ, et al. Hypertension. 2002; 39:982-988.