Method for diagnosing, monitoring and treating hypertension

• US 5,054,493 A
• Filed: 02/05/1991
• Issued: 10/08/1991
• Est. Priority Date: 01/31/1986
• Status: Expired due to Term

• Current Assignee: Regents of The University of Minnesota (University of Minnesota)
• Original Assignee: Regents of The University of Minnesota (University of Minnesota)
• Inventors: Cohn, Jay N., Finkelstein, Stanley M.
• Primary Examiner(s): JAWORSKI, FRANCIS J
• Application Number:
  US07/652,294
• Time in Patent Office: 245 Days
• Field of Search: 128/672-675, 364/413.02-413.05
• US Class Current: 600/485
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence

Abstract

A method for diagnosing, monitoring and treating hypertension uses the parameter C₂ of the modified Windkessel model as an indication of the hypertensive disease condition. Apparatus for determining the parameter C₂ (i.e. distal vascular compliance) of the modified Windkessel model includes means for obtaining a pressure pulse contour and a cardiac output value and for determining the model parameters.

Claims

1. A method for diagnosing the hypertensive disease condition in a human patient comprising the steps of:

a) determining for said patient a measure of distal compliance of the patient'"'"'s vasculature;

b) diagnosing said patient as having the hypertensive disease condition according to, at least in part, if said measured distal compliance is below a first predetermined diagnostic threshold; and

c) diagnosing said patient as not having the hypertensive disease condition according to, at least in part, if said measured distal compliance is above a second predetermined diagnostic threshold.

6. A method according to claims 1, 2, 3, 4, or 5 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model.

7. A method according to claim 1 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said first diagnostic threshold is about 0.05 mm/ml Hg.

8. A method according to claim 7 wherein said second predetermined diagnostic threshold is about 0.08 mm/ml Hg.

10. A method according to claim 1 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said first and second predetermined diagnostic thresholds are about 0.05 mm/ml Hg.

11. A method according to claim 1 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said first and second predetermined diagnostic thresholds are about 0.08 mm/ml Hg.

2. A method for treating a patient with borderline hypertension comprising the steps of:

a) determining for said patient a measure of the distal compliance of the patient'"'"'s vasculature;

b) administering medications known to raise said measured distal compliance value according to, at least in part, if said measured distal compliance is below a predetermined diagnostic threshold; and

c) identifying said patient as one not likely to benefit from administration of medication which raise distal compliance according to, at least in part, if the measured distal compliance is above said predetermined diagnostic threshold.

12. A method according to claim 2 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said predetermined diagnostic threshold is about 0.05 mm/ml Hg.

13. A method according to claim 2 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said predetermined diagnostic threshold is about 0.08 mm/ml Hg.

3. A method for diagnosing the hypertensive disease condition in a patient comprising the steps of:

a) determining for said patient a measure of distal compliance of the patient'"'"'s vasculature; and

b) diagnosing the hypertensive disease condition for said patient according to, at least in part, if said measured distal compliance is below a predetermined diagnostic threshold.

9. A method according to claim 3 wherein said measure of Windkessel model and said distal compliance is the parameter C₂ of the modified diagnostic threshold is about 0.05 mm/ml Hg.

14. A method according to claim 3 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said predetermined diagnostic threshold is about 0.08 mm/ml Hg.

4. A method for early detection of the onset of the hypertensive disease condition in a patient comprising the steps of:

a) determining for said patient a measure of the distal compliance of the patient'"'"'s vasculature;

b) repeating step a) over a period of time and charting the measured distal compliance values obtained thereby; and

c) diagnosing a movement toward the onset of the hypertensive disease condition according to, at least in part, if said charted distal compliance is trending downwardly.

5. A method for monitoring a progress of the hypertensive disease condition comprising the steps of:

a) determining for said patient a measure of the distal compliance of the patient'"'"'s vasculature;

b) repeating step a) over a period of time and charting the measured distal compliance; and

c) diagnosing the progress of the hypertensive disease condition based on said charted distal compliance, said progress being diagnosed as unchanged according to, at least in part, if said distal compliance stays substantially unchanged over time, worsening according to, at least in part, if said distal compliance decreases over time, and improving according to, at least in part, if said distal compliance increase over time.

15. A method for diagnosing and treating the hypertensive disease condition in a human patient comprising the steps of:

a) determining for said patient a measure of distal compliance of the patient'"'"'s vasculature;

b) diagnosing said patient as having the hypertensive disease condition and administering treatment for said condition, according to, at least in part, the value of said measured distal compliance; and

c) diagnosing said patient as not having the hypertensive disease condition according to, at least in part, the value of said measured distal compliance.

22. A method according to claims 15, 16, 17, 18, 19, 20 or 21 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model.

23. A method according to claim 15, 16 or 18 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said value is compared against a diagnostic threshold of about 0.05 mm/ml Hg to identify patients as having the hypertensive disease condition.

25. A method according to claims 15, 16, or 18 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said value of said measured distal compliance is compared against a diagnostic threshold of about 0.08 mm/ml Hg to identify patients as having the hypertensive disease condition.

16. A method for treating a patient with borderline hypertension comprising the steps of:

a) determining for said patient a measure of the distal compliance of the patient'"'"'s vasculature; and

b) administering a treatment program to reduce the blood pressure of said patient according to, at least in part, the value of said measure distal compliance.

17. The method according to claim 16 wherein said treatment program includes administering medications.

26. A method according to claim 16 wherein said measure of distal compliance is the parameter C₂ of the modified Windkessel model and said value of said measured distal compliance is compared against a diagnostic threshold of about 0.12 mm/ml Hg to identify the borderline patients as having the hypertensive disease condition and being a good candidate for said treatment program.

18. A method for diagnosing and treating the hypertensive disease condition in a patient comprising the steps of:

a) determining for said patient a measure of distal compliance of the patient'"'"'s vasculature;

b) diagnosing the hypertensive disease condition for said patient according to, at least in part, the value of said measured distal compliance; and

c) administering a treatment program to reduce the blood pressure of a patient diagnosed as having the hypertensive disease condition.

19. The method according to claim 18 wherein said treatment program includes administering medications.

24. A method according to claim 18 or 20 wherein said treatment program included the administration of medications to improve the distal compliance of the patient'"'"'s vasculature.

20. A method for early detection of the onset of the hypertensive disease condition in a patent and for treatment thereof comprising the steps of:

a) determining for said patient a measure of the distal compliance of the patient'"'"'s vasculature;

b) repeating step a) over a period of time and charting the measured distal compliance values obtained thereby;

c) diagnosing a movement toward the onset of the hypertensive disease condition according to if, at least in part, said charted distal compliance is trending downwardly; and

d) administering a treatment program to delay or prevent the onset of the hypertensive disease condition if a movement toward the onset of the hypertensive disease condition is diagnosed.

21. The method according to claim 20 wherein said treatment program includes administering medications.