Clinical value of ambulatory blood pressure: Is it time to recommend for all patients with hypertension (original) (raw)
Related papers
Ambulatory Blood Pressure Monitoring: How Reproducible Is It
American Journal of Hypertension, 1997
We tested the reproducibility of ambulatory blood pressure monitoring (ABPM) by the use of agreement plots. Thirty-two normotensive volunteers underwent ABPM on four separate days (interval 28 days), on the same typical weekday. Sleeping time was restricted to the ABPM nighttime subperiod from 11:00 PM to 7:00 AM. Twenty-four-hour average values-both systolic and diastolic-daytime average values, and nighttime average values, as well as standard deviation (SD) values, were analyzed for differences (analysis of variance). Adaptation occurred from the first to the fourth ABPM, ie, average 24 h, daytime, and nighttime values were lower (؊1 to ؊3 mm Hg) during the fourth recording than the first (P < .05 to P < .01). The agreement analysis showed a surprisingly high agreement among the four data sets (ie, differences from ؎2.54 to ؎5.92 mm Hg; ؎2 SD of the distribution). We concluded that reproducibility of ABPM seems excellent, but adaptation may occur, even in normotensive volunteers under research conditions. Caution must be paid before labeling a patient as hypertensive, because initial ABPM may yield higher values than later monitorings. Am J Hypertens 1997;10:936 -939
Ambulatory Blood Pressure Monitoring – Clinical Practice Recommendations
Acta Medica Marisiensis, 2016
Ambulatory blood pressure monitoring (ABPM) became a subject of considerable scientific interest. Due to the increasing use of the ABPM in everyday clinical practice it is important that all the users have a correct knowledge on the clinical indications, the methodology of using the device including some technical issues and the interpretation of results. In the last years several guidelines and position papers have been published with recommendations for the monitoring process, reference values, for clinical practice and research. This paper represents a summary of the most important aspects related to the use of ABPM in daily practice, being a synthesis of recommendations from the recent published guidelines and position papers. This reference article presents the practical and technical issues of ABPM, the use of this method in special situations, the clinical interpretation of measured values including the presentation of different ABPM patterns, derived parameters, the prognost...
Ambulatory blood pressure monitoring: from old concepts to novel insights
International Urology and Nephrology, 2012
Ambulatory blood pressure monitoring (ABPM) is an out-of-office technique for the assessment of 24-h blood pressure measurements. ABPM is indicated to diagnose many conditions, including white-coat hypertension, resistant hypertension, episodic hypertension, nocturnal hypertension, autonomic dysfunction, hypotension secondary to excessive usage of antihypertensive medication, and masked hypertension. ABPM gives a better prediction of clinical outcomes in patients with hypertension and cardiovascular diseases when compared to office blood pressure measurements. Recently, several new indices have been introduced with the aim of predicting various clinical end-points in several patient populations. In this review, we aimed to determine the clinical utility of 24-h ABPM and its potential implications for the management of hypertension in patients with a high risk of cardiovascular mortality and morbidity, as well as various novel indices that can predict clinical end-points in different patient populations.
European Society of Hypertension position paper on ambulatory blood pressure monitoring
Journal of Hypertension, 2013
Ambulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM. This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of devices, the additional information and indices that ABPM devices may provide, and the software requirements. At a practical level, the paper details the requirements for using ABPM in clinical practice, editing considerations, the number of measurements required, and the circumstances, such as obesity and arrhythmias, when particular care needs to be taken when using ABPM. The clinical indications for ABPM, among which white-coat phenomena, masked hypertension, and nocturnal hypertension appear to be prominent, are outlined in detail along with special considerations that apply in certain clinical circumstances, such as childhood, the elderly and pregnancy, and in cardiovascular illness, examples being stroke and chronic renal disease, and the place of home measurement of blood pressure in relation to ABPM is appraised. The role of ABPM in research circumstances, such as pharmacological trials and in the prediction of outcome in epidemiological studies is examined and finally the implementation of ABPM in practice is considered in relation to the issue of reimbursement in different countries, the provision of the technique by primary care practices, hospital clinics and pharmacies, and the growing role of registries of ABPM in many countries.
Sultan Qaboos University medical journal, 2010
Blood pressure (BP) measurements taken in a physician's clinic do not represent readings throughout the day. Ambulatory blood pressure monitoring (ABPM) overcomes this problem by providing multiple readings with minimal interference with the patient's daily activities. The purpose of our study was to evaluate the value of ABPM in risk assessment and management of hypertension compared to office measurements. A total of 104 consecutive hypertensive patients were retrospectively studied from January 2007 to December 2009. The following data were gathered: 1) clinic BP measurements; 2) routine blood test results; 3) electrocardiography, echocardiography, and 4) 24-hour ABPM. The mean age of patients was 41.1 ± 8.6 years and 51.9% of them male. Indications for ABPM were: suspected "white coat" hypertension (10.6%), de novo hypertension (18.2%), resistant hypertension (27.9%) and others (43.3%). Mean daytime and nighttime BP were 134/82 and 124/73 mmHg respectively. A n...
Role of ambulatory blood pressure measurement in diagnosis and control of hypertension
Medical Journal Armed Forces India, 2002
Oftice blood pressure (BP) measurements by sphygmomanometer are not necessarUy representative of patient's usual blood pressure. In contrast, ambulatory blood pressure measurements (ABPM) represent a large number of readJngs and may reOeet the actual BP status of an iadivtduaJ. ID this study, ISO individuals were studied in 2 groups. 110 patients (group A) bad stage I & n, hypertensJon based on casual BP readings. 26 (23.6%) of them were found to be normootens.ive~per existing ABPM standard. There were 40 patients with poorly controlled hypertension on multiple drugs (group B). The trougb/peak ratio of >50% was seen in 12.5% of these patients at start of study. Thk increased to 84.8% after modification of drugs~per the profile on ABPM, thus indicating usefuloess in acl1ievlng a smoother co.trot MJAFI2002; 58 : 307-309
Ambulatory blood pressure measurement in the diagnosis and management of hypertension
Journal of human hypertension, 1991
Before the diagnostic potential of 24-hour non-invasive BP measurement can be assessed, the accuracy of ambulatory recorders must be established, and normal reference values determined. The accuracy criteria of four ambulatory BP measuring systems (the SpaceLabs 90207, the Novecor DIASYS 200, the Takeda TM-2420 and the Del Mar Avionics Pressurometer IV) have been assessed according to the British Hypertension Society (BHS) protocol, and the Medilog, Suntech Accutracker II and the SpaceLabs 90202 according to the standard of the Association for the Advancement of Medical Instrumentation (AAMI). The SpaceLabs 90202 and 90207, the DIASYS 200 and the Medilog fulfilled the AAMI criteria. The best devices with the BHS grading system are the SpaceLabs 90207 and the DIASYS 200. Normal reference values for daytime, night-time and 24-hour ambulatory BP have been provided by the Allied Irish Bank study of 815 healthy individuals, which showed clear age and sex differences. The mean 24-hour amb...