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| United States Patent | 5054493 |
| Link to this page | http://www.wikipatents.com/5054493.html |
| Inventor(s) | Cohn; Jay N. (Minneapolis, MN);
Finkelstein; Stanley M. (St. Louis Park, MN) |
| Abstract | A method for diagnosing, monitoring and treating hypertension uses the
parameter C.sub.2 of the modified Windkessel model as an indication of the
hypertensive disease condition. Apparatus for determining the parameter
C.sub.2 (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. |
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Title Information  |
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Drawing from US Patent 5054493 |
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Method for diagnosing, monitoring and treating hypertension |
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| Publication Date |
October 8, 1991 |
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| Filing Date |
February 5, 1991 |
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| Parent Case |
CONTINUATION DATA
This is a continuation of application Ser. No. 07/250,315 filed Sept. 28,
1988, and now abandoned, which is a continuation-in-part of U.S.
application Ser. No. 228,820, filed Aug. 2, 1988, entitled "Method &
Apparatus for Monitoring and Diagnosing Hypertension and Congestive Heart
Failure" by Finkelstein and Cohn, now U.S. Pat. No. which is a
continuation of U.S. application Ser. No. 824,629, filed Jan. 31, 1986,
and now abandoned. The entire disclosure of Ser. No. 228,820 is hereby
incorporated by reference herein. |
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Title Information |
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Public's "Guesstimation" of Royalty Value
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Market Review |
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Technical Review |
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Claims |
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I claim:
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.
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.
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.
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.
6. A method according to claims 1, 2, 3, 4, or 5 wherein said measure of
distal compliance is the parameter C.sub.2 of the modified Windkessel
model.
7. A method according to claim 1 wherein said measure of distal compliance
is the parameter C.sub.2 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.
9. A method according to claim 3 wherein said measure of Windkessel model
and said distal compliance is the parameter C.sub.2 of the modified
diagnostic threshold is about 0.05 mm/ml Hg.
10. A method according to claim 1 wherein said measure of distal compliance
is the parameter C.sub.2 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 C.sub.2 of the modified Windkessel model and said first
and second predetermined diagnostic thresholds are about 0.08 mm/ml Hg.
12. A method according to claim 2 wherein said measure of distal compliance
is the parameter C.sub.2 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 C.sub.2 of the modified Windkessel model and said
predetermined diagnostic threshold is about 0.08 mm/ml Hg.
14. A method according to claim 3 wherein said measure of distal compliance
is the parameter C.sub.2 of the modified Windkessel model and said
predetermined diagnostic threshold is about 0.08 mm/ml Hg.
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.
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.
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.
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.
22. A method according to claims 15, 16, 17, 18, 19, 20 or 21 wherein said
measure of distal compliance is the parameter C.sub.2 of the modified
Windkessel model.
23. A method according to claim 15, 16 or 18 wherein said measure of distal
compliance is the parameter C.sub.2 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.
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.
25. A method according to claims 15, 16, or 18 wherein said measure of
distal compliance is the parameter C.sub.2 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.
26. A method according to claim 16 wherein said measure of distal
compliance is the parameter C.sub.2 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. |
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Claims |
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Description |
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TECHNICAL FIELD OF THE INVENTION
The present invention relates generally to the fields of cardiac and
circulatory medicine, and more particularly to the medical disorder of
hypertension.
BACKGROUND OF THE INVENTION
Hypertension is defined as abnormally elevated blood pressure. More
specifically, when a person under conditions of rest consistently has a
blood pressure that exceeds 145/90 (systole/diastole), the person is said
to have high blood pressure or hypertension. It is currently believed that
over fifty million people in the United States have hypertension and
fifteen to twenty percent of all deaths in people over fifty years of age
occur as a direct or indirect result of hypertension. Actuarial statistics
show that the disability and mortality rates of hypertensive persons are
higher for each age bracket than for persons with normal blood pressure.
Specific ailments attributable to hypertension include heart failure,
myocardial infarction, rupture or thrombus of the blood vessels in the
brain and kidney damage.
Despite the prevalence of hypertension and its potentially severe
consequences to health, its detection, treatment and diagnosis remains
entirely dependent on blood pressure measurements. However, the presence
of high blood pressure in a patient at any given time only establishes
that the patient's blood pressure at that moment is high; it says nothing
about the patient's underlying medical condition. Substantial transient
variations in blood pressure, for example as caused by digestion,
exercise, posture, circadian rhythms and emotional states, occur on a
regular basis in any individual. Thus, it is not possible to tell, absent
continuous measurements and periodic followup over time, whether a
hypertensive state is a function of a transient condition or is of a
chronic nature. Blood pressure measurements in and of themselves do not
reveal the presence of the hypertensive disease condition, which can be
defined as the process or presence of underlying physical changes in the
human body which result in the state of hypertension.
The inability to measure or detect the hypertensive disease condition as
opposed to merely its ultimate effects, i.e. the state of elevated blood
pressure, is a glaring and problematic deficiency in the diagnosis,
treatment and care of hypertensive individuals. This deficiency manifests
itself in various ways. For one, it can result in unnecessary and
undesirable antihypertensive treatment for individuals who are diagnosed
hypertensive due to elevated blood pressure but who may not have the
hypertensive disease condition. For instance, many healthy individuals may
exhibit blood pressures which are classified as hypertensive, or
borderline hypertensive, according to the statistical norm of 145/90.
Administering antihypertensive therapy to such healthy patients and
subjecting them to its potentially unde | | |
