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    How many blood pressure measurements should we take in the office?
    (Wiley, 2024) Ozkan, Gulsum; Ulusoy, Sukru; Yilmaz, Rahmi; Deger, Serpil Muge; Derici, Ulver; Arinsoy, Turgay; Erdem, Yunus
    No consensus has emerged among different guidelines concerning how many blood pressure (BP) measurements should be performed at office visits in the diagnosis of hypertension. The purpose of this study was to examine the compatibility of various multiple average office BP measurements and 24-h BP monitoring (ABPM) in patients followed up in the posthoc analysis of the Cappadocia hypertension cohort. A total 1158 office BP measurements by 207 patients were examined. The results were then classified as G1 (average of the 1st and 2nd BP), G2 (average of the 2nd and 3rd), G3 (average of the 2nd, 3rd, and 4th), G4 (average of the 2nd, 3rd, 4th, and 5th), and G5 (average of all five measurements). Compatibility between the average values in the groups and concomitant 24-h ABPM data was examined. While a significant difference was observed between daytime 24-h ABPM SBP and G1 (p = .002), no difference was found in the other groups. Office DBP approached the daytime 24-h ABPM values as the number of measurements in the five groups increased, although average office DBP data in all groups were higher than daytime 24-h ABPM DBP (p = .000 for all). In light of our study results, we recommend that three office BP measurements be performed and that the average of the 2nd and 3rd measurements be used for SBP, while in terms of DBP, we recommend that as many measurements as possible be taken without the 1st value being included in the average.
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    Serum Soluble Urokinase Plasminogen Activator Receptor Levels in Resistant Hypertension
    (Aves, 2024) Bayrakci, Nergiz; Ozkan, Gulsum; Kara, Sonat Pinar; Yilmaz, Ahsen; Celikkol, Aliye
    Background: Although the precise pathogenetic mechanisms remain incompletely elucidated, hypertension is characterized by endothelial damage and inflammation. The soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker that increases in parallel with disease activity in conditions such as systemic inflammation, infection, cancer, and atherosclerosis. The objective of this study was to assess inflammation by means of serum suPAR levels in hypertensive patients and those with resistant hypertension. Methods: Eighty-six adults, 29 newly diagnosed hypertensive patients (HT group) and 23 resistant hypertensive patients (RHT group) and 34 healthy controls, were included in this cross-sectional, observational study. Ambulatory blood pressure monitoring results were included in the analysis. Serum suPAR levels were measured using Enzyme -Linked ImmonuSorbent Assay (ELISA). Patients were divided into 2 groups as high suPAR and low suPAR. Results: The serum suPAR level was lower in the control group than that of the HT and RHT groups (P = .001). Systolic and diastolic blood pressure values were positively correlated with the serum suPAR level (r = 0.254, P = .018; r = 0.239, P = .027, respectively). Being in the high-suPAR group was found to increase the risk of RHT by 19.5 times. Other risk factors for RHT were found to be lower urinary sodium excretion and higher urinary albumin excretion [odds ratio (OR) = 0.98; OR = 1.09, respectively]. Conclusion: In our study, suPAR levels were found associated with RHT. To our best knowledge, this study is the first to evaluate the relationship between serum suPAR levels and RHT.
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    The Effect of Ambient Air Pollution on Office, Home, and 24-Hour Ambulatory Blood Pressure Measurements
    (Oxford Univ Press, 2023) Ulusoy, Sukru; Ozkan, Gulsum; Varol, Gamze; Erdem, Yunus; Derici, Ulver; Yilmaz, Rahmi; Muge Deger, Serpil
    Background Air pollution has recently been linked to a number of cardiovascular diseases, particularly hypertension (HT). In our study, we aimed to evaluate the association between air pollution and blood pressure (BP) and compare the relationship of BP measurement results obtained using different methods (office, home, and 24-hour ambulatory BP monitoring [ABPM]). Methods This retrospective nested panel study performed with prospective Cappadocia cohort data investigated the relationships between particulate matter (PM) 10 and sulfur dioxide (SO2) and concurrent home, office, and 24-hour ABPM data at each control performed over a 2-year period. Results A total of 327 patients in the Cappadocia cohort were included in this study. On the day of office blood pressure measurement, there was an increase of 1.36 mm Hg in systolic BP and 1.18 mm Hg in diastolic BP for every 10 mu m/m(3) rise in SO2 values. A mean 3-day 10 mu m/m(3) increase in SO2 was linked to an increase of 1.60 mm Hg in systolic BP and 1.33 mm Hg in diastolic BP. A 10 mu m/m(3) rise in mean SO2 on the day of 24-hour ABPM measurement was found to be associated with an increase of 1.3 mm Hg in systolic BP and 0.8 mm Hg in diastolic BP. SO2 and PM 10 had no effect on home measurements. Conclusion In conclusion, increased SO2 levels, during winter months in particular, can be associated with an elevation in office BP values. Our study findings show that air pollution in the setting in which BP is measured may be associated with the results.