RU86088U1 - REMOTE MONITORING SYSTEM FOR ARTERIAL PRESSURE AND CARDIOVASCULAR ACTIVITY OF PATIENTS WITH CARDIOVASCULAR DISEASES - Google Patents

Abstract

1. A system for remote monitoring of blood pressure and cardiovascular activity of patients with cardiovascular diseases, comprising devices for measuring blood pressure and cardiovascular activity of a patient during the day, characterized in that the system comprises at least one terminal, comprising at least one wearable daily monitor for measuring blood pressure and heart rate, one daily patient monitor ECG cardiomonitor, and a personal computer, providing storage of the measured data of 24-hour monitoring of blood pressure, heart rate and ECG and risk factors, processing of measurement results, means of transmitting measured information from measuring devices to a personal computer, means of transmitting this data from the terminal computer database via the Internet to the central server database for their permanent storage, means of a working group of medical consultants, allowing to receive measured information from the database of the central server from the terminals, analyze the information received and issue recommendations from medical consultants for the treatment of a particular patient taking into account risk factors, save the results of the analysis and recommendations on personal computers, transfer recommendations to the central server database and via the Internet to the appropriate terminal for patient treatment. ! 2. The system according to claim 1, characterized in that the system comprises at least one mobile terminal of an individual patient, comprising at least one wearable daily monitor from

Description

This useful model relates to medical equipment and can be used in regional practice for the treatment of patients with cardiovascular diseases (hereinafter CVD) as a distributed medical information system based on the intellectual analysis of daily blood pressure monitoring information (hereinafter BP), heart rate abbreviations and information of daily monitoring of registration of electrocardiograms (hereinafter ECG) of the patient.

A fairly large number of medical information systems are known that are widely used in medical institutions and perform various functions, including collecting information about the patient, his illness, medications taken, etc.

For example, the Kondopoga information system is known, which was developed in the medical center of Kondopoga, which is the clinical base of the Karelian Research and Medical Center of the North-Western Department of RAMS. This information system is suitable for use in any organization and provides for the automation of patient care processes, including an electronic medical history, a database of diagnostic studies, etc. The main task of this system is to free the doctor from routine work. [one].

Also known, for example, is the medical system described in RF patent No. 2145114 “Method for storing, processing and using information in the blood service”. [2].

The essence of the invention lies in the creation of a donor base, information on blood being harvested and components. The blood preparation process is considered as a single production and technological complex. The objective of this technical solution is the creation of a medical information system aimed at improving the work of the services for the preparation and processing of blood.

Also known is the "System for the control and monitoring of blood pressure" according to the patent of the Russian Federation No. 2299008. [3].

The aim of this invention is to create, on the basis of a known blood pressure meter, a measurement system that allows you to measure blood pressure and heart rate at programmed times, the accumulation and analysis of measurement results over long time intervals with the issuance of analysis results to the patient in gradations: "normal", "excess of normal ”, As well as the transfer of accumulated information to diagnostic centers via telephone communication channels.

Achieving this task is carried out by adding to the well-known blood pressure monitor UA-767PC manufactured by the Japanese company A&D, a microcontroller unit, a digital memory unit, a clock microcircuit, a sound recording and playback unit, a microphone, a loudspeaker, a digital or graphic indicator , LED indicators, LED and ten buttons. The first and second indicators signal the first or second patient. Pressure measurement data from a pressure meter is entered into the microcontroller unit. The LED is designed to display information from the microcontroller unit. The first button - to select the first or second patient. The second button is for manually starting the meter. The third - to turn on the microphone and record sound comments of the patient. Fourth to tenth for selecting operating modes and programming parameters.

This meter expands the technical capabilities of the system. However, the use of such a meter as a daily monitor used at home creates certain inconveniences associated with its attachment to the patient and its wearing for a long time, for example, during the day due to its significant weight and dimensions. In addition, when analyzing the measurement results, a number of criteria characterizing the state of the cardiovascular system are not used, for example, such as the Kerdo vegetative index, Double product, etc., which leads to insufficiently accurate analysis of the measurement results.

The problem to which the claimed technical solution is directed is to create a distributed territorial medical information system that allows remote monitoring of blood pressure and cardiovascular activity of patients with cardiovascular diseases with the possibility of conducting an intellectual analysis of the genesis of cardiovascular diseases and the development of CVD with the identification of risk factors both in individual patients and in risk groups of the population of the region.

The result from the implementation of the system is:

- in improving the effectiveness of the prevention of patients with cardiovascular disease;

- in providing highly qualified care to patients with cardiovascular diseases living in the area of general practitioners;

- in obtaining objective information about the genesis and dynamics of cardiovascular diseases in individual patients and risk groups;

- in creating an electronic database of patients, including objective indicators of the incidence rate and risk factors in the region as a whole;

- replacing inpatient treatment with outpatient treatment, which significantly saves money on treatment.

The system for remote monitoring of blood pressure and cardiovascular activity of patients with cardiovascular diseases contains one or several terminals, which include at least one wearable 24-hour monitor for measuring blood pressure and heart rate, one 24-hour cardiomonitor for patient ECG recording and a personal computer (hereinafter referred to as the PC), which provides storage of the measured data of daily monitoring of blood pressure, heart rate less ECG and risk factors, as well as processing of measurement results, means of transferring measured information from measuring devices to a personal computer, means of transferring this data from the terminal computer database via the Internet to the central server database for their permanent storage, funds of a working group of doctors -consultants, allowing to receive measured and processed information from the terminals from the database of the central server, analyze the information received and give recommendations for the treatment of specific patient taking into account risk factors, save the results of the analysis and recommendations in personal computers, transfer the recommendations to the database of the central server and via the Internet to the appropriate terminal for treatment of the patient.

In addition, the system further comprises at least one mobile terminal of an individual patient, including at least one wearable daily monitor for measuring blood pressure and heart rate and one wearable daily cardiac monitor for patient ECG recording, a personal computer. The mobile terminal of an individual patient also contains means for transmitting measured information from devices for measuring blood pressure and heart rate and recording the patient's ECG into the database of a personal computer, for example, using infrared radiation via a wireless Wi-Fi connection such as Wi-Fi, as well as means for connecting to Internet and has the ability to transfer measured information through the Internet to a central server database.

The funds of the working group of doctors-consultants of the claimed system make it possible to obtain from the central server database the measured information received from the additional terminal of the mobile client, analyze the measured information and issue recommendations for the treatment of a particular patient, save the analysis results and recommendations in personal computers, transfer recommendations to the database central server data and over the Internet to the appropriate terminal of an individual patient for his treatment, as well as communicate external consultant - leading clinical centers of the country, such as the Research Institute of Neurology, Russian Academy of Sciences, KSC them. Myasnikov et al. For advice.

The terminals of the system and the means of the working group of doctors also contain means for receiving e-mail messages.

The terminals of the system can be located in regional, city and district medical institutions, as well as in the offices of general practitioners and patients at home.

The central server is located in the regional cardiology clinic.

More specifically, the essence of the claimed utility model is presented in figures 1-15.

Figure 1 presents the structural diagram of the inventive system.

Where indicated:

1 - central server

2 - terminal

3 - mobile terminal

4 - external consultant

Figure 2 presents the structural diagram of a central server. Where indicated:

1 - funds of the working group of medical consultants

2 - database server

3 - proxy server

4 - ADSL equipment

Figure 3 presents the composition of the terminal.

1 - personal computer

2 - daily monitor of blood pressure and heart rate

3 - daily cardiac monitor

Figure 4 presents the composition of the mobile terminal.

Where indicated:

1 - mobile personal computer

2 - daily monitor of blood pressure and heart rate

3 - daily cardiac monitor

Figure 5 presents the composition of the external consultant.

Where indicated:

1 - personal computer Figure 6-15 presents on-screen forms of the functioning of the inventive system.

Figure 6 presents the main menu of the program functioning of the system.

Figure 7 presents the screen form "Parameters".

On Fig presents the screen form "Plan".

Figure 9 presents the screen form "Quick programming".

Figure 10 presents the screen form "Card index".

Figure 11 presents the screen form "Card of the patient."

On Fig presents the screen form "Sheet measurements".

On Fig presents the screen form "Results".

On Fig presents the screen form "Graphics".

On Fig presents the screen form "Report".

Each terminal (Fig. 3) is equipped with one or more wearable daily blood pressure monitors 2 (IADA-03Ul) and daily cardiomonitors 3 (SKM-01Ul) produced by the domestic industry, as well as PC 1 equipped with special software (SDO) "SDM -terminal ”, allowing you to set a monitoring plan and read into the PC memory stored in the memory of portable monitors 2 and 3 during the monitoring of medical information and analyze it. In addition, an ADSL modem connected to a personal computer (not shown in FIG. 1) provides fast communication via the Internet with a central server.

Daily monitors of blood pressure IADA-03Ul and cardiovascular activity SKM-01Ul contain uninterruptible power supply and backup electronic databases, which ensures high reliability of the security of system information.

The terminal is intended for:

- conducting daily monitoring;

- saving the results in the database (DB) of the terminal;

- monitoring data processing;

- preparation of the results for transmission (encryption of the results together with the electronic medical record (EMC) of the patient using cryptographic packets);

- data transmission via the Internet to a central server.

The terminal includes an uninterruptible power supply unit (not shown in the drawing) and an ADSL modem.

The terminal’s personal computers are equipped with software cryptographic packages of information protection against unauthorized access and malware, as well as SDM-terminal software and OS - WindowsXP;

Tasks solved by the terminal:

- Processing received data from a central server;

- Automatic adjustment of patient EMC in the terminal database;

- Consultation of a terminal doctor by specialists of the working group (if necessary);

Final diagnosis and treatment.

The mobile terminal of the system (Fig. 4) includes a mobile personal computer 1 based on a smartphone, PDA or laptop with installed cryptographic packages, SDO “SDM terminal” and a personalized access key to the central server of the system, as well as one or more wearable daily monitors blood pressure 2 (IADA-03Ul) and daily cardiac monitors 3 (SKM-01Ul),

Connecting a mobile terminal via the Internet is carried out using GPRS or EDGE, Wi Fi, Wi Max technology.

The central server (figure 2) includes the means of a working group of doctors-consultants 1 (several personal computers), a database server 2, equipped with SDO "SDM server" and providing communication with terminals and external databases, cryptographic protection of everything transmitted through " Internet ”information, its automatic analysis and compilation of electronic databases containing electronic medical records and medical history of each patient with his own personalized network number, as well as statistical and dynamic data the level and nature of the GCC region as a whole.

When analyzing the information received from the terminals, the SDM server automatically detects patients who have an excess of the calculated critical parameters and highlight them on the monitor screen of the central server as a “dangerous” group.

The central server also contains:

- uninterruptible power supply units;

- local area network (LAN);

- ADSL equipment.

- Software (software) OS - UNIX, DBMS - POSTGRESS, Sendmail, FireWall, Webserver (providing access to the database).

The service area of the central server consists of workstations of system administrators from a PC equipped with software cryptographic packages of information protection against unauthorized access and malware.

The work area includes the workstations of medical consultants with PCs equipped with SDM-SDO software, Analytical Cubes software and WindowsXP OS.

Tasks solved by the central server:

- receiving data from terminals;

- data processing;

- decryption of data by cryptographic packets;

- saving the results in the server database;

- processing of results by medical consultants (diagnosis and treatment recommendations);

- saving the processing results in the electronic medical record (EMC) of the patient and sending them to the terminal.

The terminals, the mobile terminal and the central server are also equipped with video conferencing devices for remote dialogue:

experienced specialist - general practitioner - patient.

System communication channels:

- central server - Internet: two channels using ADSL technology;

- terminal - Internet: one channel using ADSL technology.

If necessary, an external consultant 4 (Fig. 1) can access the system database, on whose computer cryptographic packages and SDM-terminal SPO are installed, as well as a personalized access key to the central server of the system.

An external consultant can be located in the leading clinical centers of the country and provide advisory assistance to specialists of the central server working group and to the attending physicians of the terminals.

The system can be expanded by connecting external servers and workgroups with installed cryptographic packages and SDO “SDM server”.

The system operates as follows.

Before starting work, the system installs the operating program and carries out its configuration.

Launch the program by double-clicking the left mouse button on the IADA-03Ul monitoring program shortcut. When the program starts, a blank window appears on the PC monitor screen with a horizontal menu bar at the top. The menu includes a number of items, when selected, the corresponding windows of the screen forms are called up. The menu consists of the following items (Fig.6):

“Exit”, “File cabinet”, “Plan”, “Options”, “Hint”.

When you first start the program, you need to configure the program, select the "Parameters" item.

The following items are located on the “Parameters” screen (Fig. 7):

- step to set the start time;

- communication port;

Parameters of the interval between plan points:

- the minimum value of the interval between points in the plan;

- the maximum value of the interval between the points of the plan;

- value of the interval change step;

Parameters necessary for analyzing the results:

- start time of the active period;

- the end time of the active period;

- the upper limit of normal blood pressure (active period);

- the upper limit of normal blood pressure (passive period);

- the lower limit of normal blood pressure (active period);

- the lower limit of normal blood pressure (passive period);

- the start time of the special period;

- the end time of the special period;

- button "Standard";

- “Cancel” button;

- "Exit" button.

To set the default values of the parameters, click the Standard button, then the Exit button to exit the screen with saving the parameters.

Next, carry out the formation of a monitoring plan. To form a monitoring plan, select the item "Plan" (Fig.6.).

The screen form "Monitoring program" (Fig. 8.) allows the user to draw up a measurement plan for the patient, write the plan to the memory of the wearable monitor and run it. In this case, the monitor will automatically turn on at the set time, take measurements of the patient’s blood pressure and heart rate.

The procedure for the formation of the plan.

To automatically create a plan, click "Quick program." In the window that appears (Fig. 9), you must enter the monitoring parameters.

To manually create a plan, click the "Clear" button, set the start time for monitoring. Click the "Add" button, thereby adding a measurement point to the table of the monitoring plan, which indicates:

- numbers of plan points,

- date and time the monitor was turned on at a given measurement point. Repeat pressing the required number of times. Using the “Delete” button, delete the last point in the table.

If during the formation process it is necessary to change the measurement step (for example, during the day the step is 15 minutes, at night - 30 minutes), change the step and click the "Add" button.

If it is necessary to change the standard parameters for pumping air into the cuff (default: the first threshold is 170 mmHg, step 30 mmHg, upper limit is 290 mmHg), check the box “non-standard pressure pumping” and enter the necessary parameters.

The panel “Automatic Day / Night Switching” determines whether the monitor’s audible alarm is turned off in night mode:

- if the switch is set - the monitor turns off the alarm automatically during the passive mode,

- if switching is not installed, then switching occurs by double-clicking on the "Event" button on the monitor.

The “Result Indication” panel determines the display of measurement results on the LCD monitor. Install the USB port to which the monitor will be connected via the USB interface.

Insert charged batteries into the battery compartment of the monitor and close the battery compartment. Then a sound signal sounds and the LCD displays PLS 000, then press the "Program" button. A beep sounds. The PC indication appears on the LCD. The message “Programming completed” appears on the PC screen and, when asked “Start monitoring mode?”, Click the “Yes” button. After that, the indication PC AAA appears on the monitor, where AAA is the digital time count information from 005 to 000 seconds. At the end of the programming process, the monitor indicator turns off. The monitor goes into monitoring mode. Click the "Exit" button.

Reading information from the monitor.

Select from the program menu (Fig.6) item "Card index". The on-screen form “Card index” (Fig. 10) allows keeping records of patients who have undergone a course of examination using a portable monitor. The list of patients is displayed in tabular form on the screen and there are a number of buttons that allow you to operate the list:

- “Editor” button - brings up the “Patient Card” screen form (Fig. 11) for editing patient information;

- “New” button - starts a new empty account in the file cabinet and calls up the “Patient card” screen form for editing information about the new patient (the card number is assigned automatically);

- “Delete” button - deletes the patient account from the Card File. Moreover, if the patient has information about the examinations, then a request will be issued to confirm the deletion of information and, in the case of an affirmative answer, all information and the account in the file cabinet will be deleted. In the case of a negative answer, the information and account in the File Cabinet will not be deleted;

- the button “Find Name” - sets the order of the location of the accounts in the file cabinet by the name and calls the request window for the search for the patient in the file cabinet by the name of “Search Card”;

- the button “Find Card No.” - sets the order of the accounts in the file cabinet in ascending order of card numbers and brings up a request window to search for a patient in the card file by the card number “Go to card number”;

- “Contents” button - the button calls up the “Measurement sheet” screen form for viewing;

- “Comment.” button - the button calls up the “Comment” screen form for viewing, where you can specify additional information about the patient;

- “OK” button - the button allows you to save the entered data and exit the “Card File” screen form.

In the presence of a new patient, click on the "New" button (Fig. 10) and enter into a new empty patient account in the opened screen form "Patient card" (Fig. 11). The screen form "Patient Card" (11) allows you to edit information about the patient.

The form has the following panels and buttons:

- panel “Card No.” - the patient card number is not edited, it is generated automatically by the program;

- panel "Last name";

- panel "Name";

- panel "Middle name";

- panel "Date of birth";

- panel "floor";

- panel "Weight";

- panel "Growth";

- panel "Waist circumference";

- panel “Hip circumference”;

- “OK” button - closes the form with saving the editing results;

- “Cancel” button - closes the form without saving results

editing (leaves the patient card unchanged). After entering the patient information, press the OK button.

Reading data from the monitor.

On the screen form "Card index" (Fig. 10), the mouse cursor is placed on the newly created record and the "Content" button is pressed, after which the "Measurement sheet" form appears (Fig. 12).

The screen form “Measurement sheet” contains a table with information about the examinations carried out for a given patient using the monitor:

measurement number, monitor number, examination date, examination start time.

On the screen form “Measurement sheet” are also located:

- a panel with the number of the patient selected to view the examination;

- button “View” - calls the window “Results” to view the results of the examination;

- “Download” button - calls the program for transferring data from a portable monitor to a computer;

- button “Delete” - deletes the results of the examination from the computer memory;

- button "Upload to file" - allows you to save the measurement results in a file to copy the monitoring results to another computer;

- button “Download from file” - allows you to download the measurement results from a file to copy the monitoring results from another computer;

- button “Comment” - allows you to add a text comment to the measurement results;

- button "Send by mail" - allows you to send the results of measurements and comments to them by e-mail;

- button “Download mail” - allows you to download the measurement results and commentary received by e-mail;

- “Exit” button - allows you to exit the “Measurement sheet” screen form.

In order to transfer data from the monitor to the PC, click on the EVENT button on the monitor. A beep is heard and the indication “FFF EEE” appears on the monitor indicator, after which the “Download” button is pressed on the screen form. While data is being transferred to the PC, “PC” appears on the monitor indicator.

After the transfer of data from the monitor to the PC is completed, it is disconnected from the computer, the batteries are removed from the battery compartment and installed in the charger for charging.

Viewing and analysis of monitoring results.

In the table of the screen form “Measurement sheet”, position the cursor on the last measurement and press the “View” button.

On the screen form “Results” (Fig. 13), a table with the measurement results, the “Sampling” panel with statistics for the selected measurement points and a number of buttons will appear:

- “Select All” button - marks all points in the results table as selected reporting points;

- “Cancel all” button - removes from all points of the table of measurement results the mark “selected reporting point”;

- button “Special. period ”- marks the points in the results table related to the special period;

- button “Select. period ”- marks the points in the results table related to the selected period;

- button “Active. period ”- marks the points in the table of results related to the active period;

- button “Passive. period ”- marks the points in the table of results related to the passive period;

- “Report” button - causes the construction of the reporting form for the selected measurement points and displays it on the screen in the “Report” window;

- “Chart” button - calls the construction of a chart for the selected reporting points and displays it on the screen in the “Charts” window;

- “Exit” button - closes the “Results” window.

The table of measurement results contains a number of columns:

- No. - number of the point of the measurement plan;

- Date - date of measurement;

- Time - measurement time;

- DD - diastolic pressure (mmHg);

- SD - systolic pressure (mmHg);

- PE - heart rate (beat / min.);

- C - label "Event" (the patient presses the "EVENT" button stored in the memory of the wearable monitor);

- A - tag artifact (the tag is set automatically or by the user of the program to exclude doubtful or objectionable data from the analysis; the tag is placed (removed) by double-clicking the left mouse button in column “A” of the selected row of the table);

- Sample - number in order in the list of measurement results selected for analysis.

The “Sampling” panel contains statistical information on the list of measurement results selected for analysis. You can select either all points in the results table (by clicking the "Select All" button) or a fragment from consecutive points in the results table.

The “Report” and “Chart” buttons are functional only if there are measurement points selected for analysis.

On the screen form “Charts” (Fig. 14.) graphs of the dependence of the heart rate and blood pressure on time at selected points marked “Event” are displayed.

On the screen form "Report" (Fig. 15) presents a reporting form for the selected measurement points.

Blood pressure monitoring is carried out for 24 hours in a free motor mode with intervals between recordings of 15 minutes during wakefulness and 30 minutes during sleep.

Monitoring under stationary conditions allows the use of a fixed sleep time (passive period from 22 to 6 hours) and a wakeful period (active period from 6 to 22 hours) in the calculation.

The period (from 4 to 10 hours) is especially distinguished, since it is known that people with arterial hypertension most often develop myocardial infarction, strokes and sudden coronary death in the early morning hours.

During SMAD, the averaged indicators of systolic, diastolic, average blood pressure and heart rate are analyzed: for 24 hours or shorter periods of time (active period, passive period and special period). The maximum and minimum values of blood pressure at different periods of the day are determined.

During the ABPM, the following are calculated:

- Standard deviation (Standart deviation, SD), characterizing the variability of blood pressure and heart rate in different periods of the day

SD - standard deviation,

a is the average measurement,

and _i is the value of each dimension,

n is the total number of measurements.

- Hypertension time index (RTU - percentage of measurements that exceed normal values separately for each time of day); 140/90 mm Hg during the day, 120/80 mm at night. mercury column [6].

Where:

n is the total number of measurements;

n _ex - the number of measurements in excess of normal values;

t1 _i ; t2 _i - measurement time;

norm - normal indicators

- Hypotensive PTE time index - the percentage of blood pressure measurements that are below the border of normal blood pressure.

- Hypertension area index (LOAD, area under the curve) - the area bounded above by a graph of pressure versus time, and below - by a line of threshold blood pressure values.

Where:

n _eх is the number of measurements in excess of normal values;

t1 _i , t2 _i , is the measurement time;

norm - normal indicators

and _i , is the value of each dimension

In the daily profile of blood pressure, its increase is considered, which is characterized by magnitude and speed. The magnitude of the morning increase in blood pressure is determined in the period from 4 to 10 hours by the difference between the maximum and minimum values of blood pressure.

- The rate of morning increase in blood pressure

HELL max - HELL min (mmHg) / t1 max - 1 min,

Where:

t max - t HELL max,

t min - t HELL min.

All indicators are evaluated separately for systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean (ADS) blood pressure.

Another main indicator characterizing the variability of blood pressure during the day is the daily index (SI, DI). SI reflects the degree of nighttime decrease in blood pressure.

Where:

a _active - active (daily) average blood pressure;

a _passive - passive (night) average blood pressure.

Depending on the daily index, the following groups of patients are distinguished:

- "Dipper" - patients with a normal decrease in blood pressure at night, in which SI is 10-22%;

- "Non-dipper" - patients with insufficient drop in blood pressure, with SI less than 10%;

- "Over-dipper" - patients with an excessive drop in blood pressure at night, with SI over 22%;

- "Night-peaker" - persons with nocturnal hypertension, whose nightly rates are higher than daytime and SI has a negative value.

- Double product (load index, double product) - reflects the load on the cardiovascular system at different periods of the day, calculated by the formula

(GARDEN * HR) / 100.

Along with the absolute value of systolic and especially diastolic pressure, as well as pulse pressure calculated by their difference, the level of blood pressure and the severity of hypertension are characterized to a certain extent by the ratio of these values. The higher the level of blood pressure, the more unfavorable the small gap between DBP and SBP - the so-called "headless" hypertension. Mathematically, this side of the pulse drops in blood pressure reflects the criterion S, calculated by the formula

S = (GARDEN × DBP) :( GARDEN-DBP) mm. Hg

The higher it is, the less favorable the hemodynamic characteristic of hypertension:

- normal blood pressure 120/80, criterion S = 240;

- HELL 160/100 meets the criterion S = 267,

-AD 120/100-S = 600,

-AD 140/120-S = 840.

Systolic hypertension occurs at low values of the criterion S (<200), diastolic - at significantly elevated (> 350).

For an integrative assessment of the vegetative status of patients with GE, the vegetative Kerdo index is used. Vegetative Index (VI) Kerdo is calculated by the formula:

VI = (1-DBP / HR) * 100,

Where:

- DBP - the value of diastolic pressure;

- Heart rate - heart rate in 1 min.

With complete autonomic equilibrium (eutonia) in the cardiovascular system, VI = 0. If the VI coefficient is positive, then sympathetic influences predominate; if the value of VI with a minus sign, then increased parasympathetic tone.

VI takes into account the level of DBP and heart rate. Heart rate fluctuations provide a sensitive indicator of the function of the responsive sympathetic, parasympathetic and renin-angiotensin system.

- The body mass index is calculated as the quotient of dividing body weight in kilograms by the square of growth in meters (normal 20-24.9).

- The index "waist-hip" is the quotient of dividing the size of the waist circumference by the circumference of the hips (norm 0.8-0.9).

Upon completion of the examination procedure of the patient by the attending physician - the user of the terminal, a card for dynamic monitoring of the patient with arterial hypertension is filled.

DYNAMIC MONITORING CARD FOR PATIENTS WITH ARTERIAL HYPERTENSION

I. GENERAL INFORMATION

Date of initial examination _______________________

1. Surname _________ First name _________ Middle name _______

2. Insurance policy ______________________________

3. Gender: Male - 1 Female - 2

4. Resident: cities - 1 village - 2

5. Date of birth: _______________________________

6. Marital status __________________________

7. Age at registration (number of full years) _________

8. Home address: st. __________________________

House __________ building ___________ quarter .___________

Office phone __________ home ___________

9. Place of work ________________________________

10. Education ______________________________

11. Profession ________________________________

12. Position ________________________________

13. Social category __________________________

14. Full name student (family) physician ______________________

15. N plot __________________________________

II. PRIMARY SURVEY DATA

1.ADP ______________________________________

2. Growth ____________________________________ (cm)

3. Weight ___________________________________ (kg)

4. Body mass index _________________ (weight in kg / height in sq. M)

5. T / B Index __________________________________

6. Taking antihypertensive drugs the last two weeks

Yes - 1 No - 2

if "yes", then enter the name of the drugs ________________

7. Complaints (availability to underline, missing to enter):

headache - 1, dizziness - 2, flickering of "flies" in front of the eyes - 3, pain in the heart (angina pectoris, rest angina, atypical for angina pectoris) - 4, palpitations - 5: shortness of breath - 6, swelling on the legs - 7, pain in legs when walking (intermittent claudication) - 8, other - 9 (enter) ___________________________________

8. Risk factors:

1. the presence of myocardial infarction in parents - 1,

2. cerebral stroke (up to 55 years) - 2,

3. Smoking:

3.1. smokes

3.2. smoked in the past 4. alcohol consumption

4.1. several times a week or daily

4.2. 1-2 times a month

4.3. several times a year

4.4. not at all

5. everyday physical activity: low - 1, moderate - 2, high - 3

6. psycho-emotional stress (stress level): low - 1, medium - 2, high - 3

7. total cholesterol ____ mg / dl ____ mmol / l (norm _______)

9. Diabetes mellitus (underline): Yes - 1 No - 2 if there is, then type of diabetes mellitus:

insulin-dependent - 3, non-insulin-dependent - 4 (emphasize).

10. The defeat of the "target organs":

10.1 Left ventricular hypertrophy (ECHO-KG) Yes - 1 No - 2

10.2. Proteinuria and / or hypercreatininemia (1.2-2 mg / dl) Yes - 1 No - 2

10.3. Atherosclerosis of large vessels (ultrasound or radiological) Yes - 1 No - 2

10.4. Retinal vasoconstriction Yes-1 No - 2

eleven. Concomitant diseases affecting the prognosis Yes 1 No - 2 11.1. Cerebrovascular disease Yes 1 No - 2 11.2. Heart disease Yes 1 No - 2 11.3. Kidney disease Yes 1 No - 2 11.4. Vascular disease Yes 1 No - 2 11.5. Severe hypertensive retinopathy Yes 1 No - 2 12. The degree of arterial hypertension (GFCF 2001 recommendations) ADS ADD 12.1. Normal Below 140 Below 90 12.2. Soft 140-159 90-99 12.3. Moderate 160-179 100-109 12.4. Heavy 180 and above 100 and above

13. Risk level (underline): low - 1, medium - 2, high - 3, very high - 4

14. Clinical diagnosis: ______________________

ICD-10 code _______

15. The dispensary registration group ______________

16. Recommended observation (underline):

local (family) doctor, cardiologist, doctor of the medical prevention cabinet

The introduction of a remote monitoring system for blood pressure and cardiovascular activity of patients with cardiovascular diseases will significantly increase the effectiveness of CVD prevention and reduce the level of demographic and socio-economic losses in the region.

The advantage of the claimed monitoring system is that it allows you to:

- Introduce in the regional medical institutions the procedures of BPM for population at risk;

- create and save in electronic databases all the necessary medical information about the health status and CVD dynamics of the studied patients, depending on the treatment prescribed for each, as well as systematize and save statistical information on the incidence rate for the region as a whole;

- to equip general practitioners with a new effective method for the treatment of hypertension and CVD, which allows them to quickly and collectively, with the participation of experienced specialists, make the right decisions on the diagnosis and treatment of patients.

Currently, work is underway in the region to introduce the inventive system for monitoring blood pressure and SSD.

1. Inna Laprun. Informatization as the basis for the organization of the healing process. Newspaper PCWEEK, February 6-12, 2007 No. 3 (561), Moscow.

2. RF patent No. 2145114 for the invention "A method for storing, processing and using information in the blood service", G06F 17/40, 2000.

3. RF patent No. 2299008 for the invention "System for monitoring and monitoring blood pressure", AB 5/022, 2007.

Claims (5)

1. A system for remote monitoring of blood pressure and cardiovascular activity of patients with cardiovascular diseases, comprising devices for measuring blood pressure and cardiovascular activity of a patient during the day, characterized in that the system comprises at least one terminal, comprising at least one wearable daily monitor for measuring blood pressure and heart rate, one daily patient monitor ECG cardiomonitor, and a personal computer, providing storage of the measured data of 24-hour monitoring of blood pressure, heart rate and ECG and risk factors, processing of measurement results, means of transmitting measured information from measuring devices to a personal computer, means of transmitting this data from the terminal computer database via the Internet to the central server database for their permanent storage, means of a working group of medical consultants, allowing to receive measured information from the database of the central server from the terminals, analyze the information received and issue recommendations from medical consultants for the treatment of a particular patient taking into account risk factors, save the results of the analysis and recommendations on personal computers, transfer recommendations to the central server database and via the Internet to the appropriate terminal for patient treatment. 2. The system according to claim 1, characterized in that the system comprises at least one mobile terminal of an individual patient, comprising at least one wearable daily monitor for measuring blood pressure and heart rate, one wearable daily cardiomonitor for ECG recording of a patient and a personal computer, means for transmitting measured information from devices for measuring blood pressure and heart rate and registering an ECG of a patient in the base of a personal computer, for example, using infrared waist radiation, as well as connectivity to the Internet and is able to transmit the measured data via the Internet to a central server database. 3. The system according to claim 1 or 2, characterized in that the system comprises means for receiving mail messages. 4. The system according to claim 2, characterized in that the means of the working group of medical consultants make it possible to obtain measured information from the database of the central server from the mobile terminal of an individual patient, analyze the information and issue recommendations from medical consultants regarding the treatment of the patient, taking into account risk factors, save the results of the analysis and recommendations in personal computers, transfer recommendations to the database of the central server and via the Internet to the appropriate mobile terminal of the individual patient that for its treatment. 5. The system according to claim 1 or 2, characterized in that the system contains means for communicating with the equipment of an external consultant, allowing the external consultant to receive measured information from a central server database on a specific patient, recommendations of medical consultants for his treatment, and also transmit to the central server database its recommendations for treatment.