aktiia, a Swiss company based at Neuchatel and Zürich in Switzerland has achieved a breakthrough in the way the blood pressure is monitored. Backed by nearly 15 years of research, this medical startup company has patented the technology for continuous blood pressure monitor, 24/7, without interrupting the daily routine.
The technology combines information from embedded sensors in commonly worn wearables for heart rate monitoring with clinically validated software algorithms to monitor individual blood pressure. The optical sensor in the wearable picks up the signals from the pulse waveform, analyze and modulate it to be displayed as blood pressure reading.
The Optical Heart Rate Monitoring technology (OHRM), so commonly used in smartphones and bracelets was pioneered by the Swiss Research and Technology Organization (CSEM) way back in 2004. The OHRM relied on the so-called Photo-Plethysmography principle (PPG).
Image source: aktiia
The aktiia team released that the PPG technology applied at the wrist holds much more information than just measuring the heart rate. Under the able guidance of the co-founder and CTO, Josep Sola, the team identified and extracted the additional information from the pulse waveform at the wrist, resulting in the birth of the Optical Blood Pressure Monitoring (OBPM) technology.
The technology is backed by over 30 peer-reviewed publication and numerous clinical trials in acute and low-acute settings.
aktiia has recently raised CHF 4 million in seed round to commercialize its groundbreaking, cuffless, blood pressure monitoring technology. The partners include Silicon Valley-based TransLink Capital, Swiss-based Redalpine, and other international angel investors.
aktiia plans to embed the algorithms in non-medical third-party wearables for daily tracking the blood pressure trends for preventive purposes, as well as in aktiia’s medical grade wearable for the continuous monitoring of blood pressure in patients with hypertension.
Image source: aktiia
“This technology is a quantum leap in the fight against hypertension and will revolutionize the way we look at blood pressure,” stated Michael Sidler, Co-Founder, and Partner of Redalpine.
“TransLink has always been on the forefront of wearable technologies, and we are constantly on the lookout for pioneers. We are very excited to be a part of what will be a healthcare game changer,” said Eric Hsia, Managing Director of TransLink Capital.
Livongo Health, the leading consumer digital healthcare company today announced its launch of first blood pressure monitor with cellular connectivity in the U.S. at Health 2.0. It provides the simplest way to acquire, monitor and transfer the blood pressure reading to the cloud for Remote Patient Monitoring (RPM). This seamless “cuff to cloud” transfer enables the consumer to remain in the relaxed atmosphere of their home, thereby eliminating the “white coat syndrome.”
The patients also receive useful and timely insight into BP and Health Nudges TM from certified professional specially trained in the management of chronic diseases.
Just as we did with diabetes, Livongo wants to make it easier for people to stay healthy by checking their blood pressure, receiving real-time personalized feedback, sharing the information with their physician and other members of their connected care community from home, thereby avoiding a rise in blood pressure that can come with visiting a doctor," said Amar Kendale, Chief Product Officer,
Livongo.
"We are proud to introduce the first cellular-enabled blood pressure monitoring system to market in the U.S. and to add this capability to our comprehensive platform for people with all kinds of chronic conditions. This allows us to treat the whole person and the challenges they face seamlessly."
Livongo’s signature offerings include Livongo for Diabetes, Livongo for Hypertension, and Livongo Diabetes Prevention (DPP) powered by Retrofit.
Diabetes and Hypertension are the fastest growing chronic diseases in the United States and account for 458 billion dollars in healthcare costs. Improving the blood pressure control through lifestyle change and adherence to medication can bring down the chance of cardiovascular event by 50%.
Women
presenting with any subtype of hypertensive disorders of pregnancy (HDP) are at
increased risk of developing future hypertension, Ischemic Heart Disease (IHD),
stroke and renal disease reports the results of a large retrospective cohort
study epub ahead of print in journal Hypertension.
The results demonstrate
that women with any type of hypertension during pregnancy are 2.78 times the
risk of future hypertension, nearly twice the risk of IHD and stroke and 2.76
times the risk of renal disease as compared to women who were normotensive
during pregnancy.
Contrary to
popular belief, the highest risk is faced by women with gestational
hypertension (OR, 4.08; CI,3.23–5.10) and not by women with preeclampsia during
pregnancy (OR,3.06; CI,2.18–4.29).
Women with
preeclampsia in pregnancy are nearly 5 times at risk of developing renal
disease as compared to their normotensive counterparts during pregnancy (OR, 4.74;
CI, 2.19 –10.20).
This
retrospective study was conducted at a metropolitan tertiary hospital in
Sydney, Australia, across a period of nine years. Data was extracted from
medical records. A total of 31 656 deliveries took place during the study
period out of which HDP was diagnosed in 4387 (13.8%) women, whereas 27262
(86.2%) of the women remained normotensive in their pregnancy.
The time to
develop CVD from index pregnancy varied between 3 to 29 years, the median being
20 years. Future risk of developing CVD also increased proportionately as the
severity of HDP increases. Women with preeclampsia also had more severe
hypertension as compared to women with gestational hypertension. Women with
severe HDP were older, deliver early in pregnancy and have babies that are
small for gestational age.
Women who
delivered ≤34 weeks gestation also are at increased and early risk of future
CVD and as compared to women who delivered >34 weeks gestation. Receiving
anti-hypertensive medication during pregnancy did not alter the future risk of
developing CVD, although it benefited maternal and fetal outcome.
Under-reporting
of chronic hypertension in young women might have limited some aspects of data
analysis.
Hence, these
women who have history of HDP should be explained in detail about their future
risk of CVD and renal diseases. They should be advised a lifelong close monitoring
for B.P and other modifiable risk factors for the development of CVD.
Cardiovascular
risk assessment should also include obstetric history of women.
Further
research is warranted to look into prevention of CVD after the risk is identified
early in disease course.
The use of β-Blocker
in pregnancy does not increase the risk of fetal congenital cardiac anomalies after
adjusting for maternal co-morbidities says the results of a large population basedcohort study conducted by department of research and evaluation at Kaiser
Permanente Southern California.
The study
was reported as a research letter online April 17, 2017 in JAMA Internal
Medicine.
Lewei Duan and
colleagues from Kaiser Permanente, California note, “Beta-blockers are the most
commonly used class of medication for treating cardiac conditions in pregnant
women. Despite the common use of this class of medication, data that support
its safety are limited.”
“A recent
meta-analysis reported an association between beta-blocker exposure and fetal
congenital cardiovascular defects, raising a concern regarding potential
teratogenic effects of this class of medication.”
The authors identified
379,238 women through birth records who delivered at Kaiser Permanente, Southern
California through a period of 11 years (2003-2014). Of these, 4847 women
(1.3%) received β-Blocker during pregnancy as identified by pharmacy dispensing
records.
And, 2,628 (0.7%)
were exposed during the first trimester of pregnancy.
Most common beta-blockers were labetalol (n = 3357), atenolol
(n = 638), propranolol (n = 489) and metoprolol (n = 324). The most common
indication for prescribing beta-blockers was hypertension.
Data analysis revealed that women on beta-blockers were older
and had higher body mass index(BMI). They also had higher prevalence of chronic
comorbidities like hyperlipidemia, diabetes, hypertension, heart failure, a
history of arrhythmia and pregnancy complications like preeclampsia and eclampsia.
They also delivered about a week early than those not taking beta-blockers
(mean 37.4 weeks vs. 38.9 weeks).
In unadjusted analyses, women on beta-blockers were significantly
more likely to have a baby with congenital cardiac malformation as compared to
those not taking the drug (P < 0.001).
When after taking into account the confounders like maternal
age, BMI, and comorbidities and gestational age at delivery, there was no
longer any association between the exposure and the outcome (P = 0.32).
This suggests that the association seen in unadjusted analyses
was caused by maternal demographics and other chronic co-morbidities and not
due to beta-blockers.
“The previously reported association between beta-blocker use
and fetal cardiac anomalies in other studies may be attributed to confounding,”
Duan and colleagues concluded. “While these findings do not definitively rule
out the possibility of fetal congenital defects in association with
beta-blocker use, these results do provide reassurance regarding the use of
this class of medication for the treatment of cardiac conditions in pregnant
women.”
Primary
source: Duan L, Ng
A, Chen W, Spencer HT, Nguyen J, Shen AY, Lee M. β-Blocker Exposure in
Pregnancy and Risk of Fetal Cardiac Anomalies. JAMA Intern Med.
2017;177(6):885-887. doi:10.1001/jamainternmed.2017.0608
Another interesting paper presented at
the annual meeting of the Associated Professional Sleep Societies linking
obstructive sleep apnea and preterm and early preterm delivery. Women who are
frequent, loud snorers during pregnancy and also before they were pregnant have
a definite higher risk of preterm delivery as compared to their counterpart who
sleep soundly throughout night.
It is already known that women with
Sleep disordered breathing (SDB) do not fare well in pregnancy and many particularly
have maternal hypertension and diabetes and possibly fetal growth restriction.
The study looked at 904 non-hypertensive,
non-diabetic women, pregnant women in their third trimester, attending a
prenatal clinic at a large medical center.
The women were divided into 4 groups
based on their snoring pattern: non-snorers, infrequent-quiet, frequent-quiet, or
frequent-loud snorers.
Only 6% of women were frequent
loud-snorers and about 50% did not snore at all.
About 25% of women in the pre-pregnancy
frequent, loud- snoring category had a preterm delivery.
After adjusting for all pre-pregnancy
and pregnancy confounders, those women who were frequent loud-snorers had an
81% increased risk of preterm delivery.
The mean time to delivery in frequent
loud snoring group was 37.1 weeks as compared to 38.6 weeks in controls.
Non-loud, infrequent, or
pregnancy-onset snorers did not face the risk for preterm delivery.
Galit Levi Dunietz, PhD, MPH, of the
University of Michigan said, “The fact that there is an association between
snoring and time to delivery in a cohort which is not hypertensive is alarming,
and I think that treatment for snoring earlier on in pregnancy may alleviate
some of these outcomes.”
She further added that “The
combination of snoring frequency and intensity may be a clinically useful
marker to identify otherwise low-risk women who are likely to deliver earlier.”
Michael Greger,
MD, FACLM is a
physician, New York Times bestselling author, and internationally recognized professional
speaker on a number of important public health issues. Dr. Greger has lectured
at the Conference on World Affairs, the National Institutes of Health, and the
International Bird Flu Summit, among countless other symposia
and institutions; testified before Congress; has appeared on shows such as The
Colbert Report and The Dr. Oz Show; and was invited as an expert witness in
defense of Oprah Winfrey at the infamous "meat defamation" trial.[1]
His website is NutritionFacts.org, which has got a collection of videos and articles
about healthy plant based diet.
The topic of his presentation was How
not to die: The role of diet in preventing, arresting and reversing our top 15
killers. The presentation was based upon his latest book How not to Die, which became an
instant New York Times Best Seller.
The book is available on Amazon and
other sites in kindle, audio CD, paperback and hardcover.
Photo courtesy: Amazon
The presentation begins with a
personal note about Dr.Greger’s grandmother, who was diagnosed with end stage
heart disease at age 65 and was sent home to await death as Drs. Said that
nothing could be done to improve her condition.
She was confined to wheelchair and was in a really bad shape. She was
rescued by Nathan Pritikin, one of our early lifestyle medicine pioneers.
She was put on a completely different
diet of lots of fruits and vegetables, and the outcome is a history.
Not only she defied death, but lived a
healthy life for another 31 years --- till the age of 96, and enjoyed her 6
grandchildren and great grandchildren.
This incidence inspired Dr. Greger to choose
medicine and later specialize and dedicate his life to life style changes and
prevention and cure of diseases.
He maintains his non-profit website
solely dedicated to nutrition, diet and cure of diseases through healthy plant
based diet- NutritionFacts.org.
The 15 most common cause of diseases
worldwide are Heart disease, Cancer, Hypertension, smoking and COPD, Stroke,
Diabetes, kidney failures, respiratory infection, suicide, blood septicemia,
parkinsonism.
Talking about heart disease Dr. Greger
said “Heart disease is a choice like dental cavities.”Coronary
heart disease; atherosclerosis; hardening of the arteries, begins in childhood. By
age 10, the arteries of nearly all kids raised on the standard American diet
already have fatty streaks—the first stage of the disease.[2]
When
researchers took people with heart disease and put them on the kind of
plant-based diet followed by those populations that didn’t suffer from heart
disease, their hope was to slow the disease process down—maybe even stop it.
But instead, something miraculous happened.
The disease
started to reverse, to get better. As soon as patients stopped eating an
artery-clogging diet, their arteries started opening up. Their bodies
were able to start dissolving some of the plaque away. Even in some cases of
severe triple vessel heart disease, arteries opened up without drugs, without
surgery—suggesting their bodies wanted to heal all along, but were just never
given the chance. This improvement in blood flow to the heart is after just
three weeks of eating healthy.
Similarly,
he has put out reasons and evidence for each of the 15 diseases he described
that can be prevented, or reversed with diet.
The complete lecture can be heard
here.
He has a famous list of daily dozen
that should be consumed daily to add years to your life.
This is the list by Dr.Michael Greger as told to Daily Mail, UK.[3]
1Cruciferous
vegetables, such as broccoli, brussels sprouts, cabbage, cauliflower, kale,
spring greens, radishes, turnip tops, watercress
One serving a day: A serving is half a
cup chopped or quarter of a cup of broccoli or brussels sprouts.
2 Greens
including spring greens, kale, young salad greens, sorrel, spinach, swiss chard
Two servings a day: A serving is
one cup raw or half a cup cooked.
Two servings a
day: A serving is one cup raw leafy vegetables; half a cup raw or cooked
non-leafy vegetables; half a cup vegetable juice; a quarter of a cup dried
mushrooms
Three servings a
day: That's a quarter of a cup of hummus or bean dip; half a cup of cooked
beans, split peas, lentils or tofu; or a full cup of fresh peas or sprouted
lentils.
5 Berries: Any
small edible fruit, including grapes, raisins, blackberries, cherries,
raspberries and strawberries
One serving a
day: A serving is half a cup of fresh or frozen, or quarter of a cup of dried.
The average sodium
intake in USA is 3,400 mg per day against the recommended 2,300 mg of sodium per day. The
2015-2020 Dietary Guidelines for Americans and Healthy People 2020 advise
people to consume less than or equal to 2,300 mg of sodium per day.
Approximately
75% of dietary sodium is consumed by eating processed and commercially prepared
(e.g., restaurant) foods. So FDA is targeting the food industry namely food
manufacturers, restaurants, and food service operations to reduce sodium in
foods.
According to
FDA the new guidelines focus on amount of sodium content in given food and
supports the food industry voluntary efforts to reduce sodium in packaged food.
It does not recommend any specific method to achieve the final goal, nor does
it addresses the sodium in naturally occurring food or salt used in household
food.
FDA further
stressed the fact that reduction in sodium should not affect the safety or
shelf life of the finished product, nor any other ingredient like sugar or fat
be added to compensate the lower sodium.
It is
estimated that a decrease in sodium intake by as little as 400 mg/d or 12% could prevent 32 000 myocardial infarctions
and 20 000 strokes annually according to an editorial in JAMAby
Thomas Frieden, director of the Centers for Disease Control and Prevention.
More than 1,000 Americans die each day from high blood pressure.
In addition,
sodium reduction is the most achievable strategy to reduce blood pressure; no other
intervention would have such large public health implication.
A robust
body of evidence supports the health benefits of sodium reduction.
A recent
study used three epidemiological datasets to estimate the separate public
health benefits of reducing the population’s average sodium intake to 2,200
mg/day over 10 years. The researchers estimated that this pattern of reduction
would prevent between 280,000 and 500,000 premature deaths over 10 years and
that sustained sodium reduction would prevent additional premature deaths.
U.S.
Department of Health and Human Services and U.S. Department of Agriculture.
2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015.
Available athttp://health.gov/dietaryguidelines/2015/guidelines/.
