Comparative Study of Ambulatory Blood Pressure Monitoring and Clinic Blood Pressure Measurement in the Risk Assessment and Management of Hypertension (original) (raw)
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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...
AMBULATORY BLOOD PRESSURE MONITORING IN INTREATED HYPERTENSIVES: WHAT ARE THE TARGET PARAMETERS
2017
Ambulatory blood pressure monitoring (ABPM) as out-of-office method of evaluation blood pressure (BP) is recommended in guidelines for the practical clinical use of the diagnosis and management of hypertension. However, there is poor information about the algorithm of ABPM analysis strategy in treated cohort individuals. To this purpose, we analyzed 150 ABPM records in hypertensive individuals with essential hypertension. We have selected ABPM data in 150 patients conducted ABPM with a bifunctional recorder (Incart, S.-P., RF) using an oscillometric method. For analyzing matter, we defined awake and asleep periods as the fixed periods of time (from 9:00 AM to 9:00 PM as day time and from 01:00 to 06:00 AM as a nighttime period). We have also calculated BP averages for systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) for 24-h, day and nighttime periods. Moreover, we calculated sleep-through morning surge as the average morning SBP minus moving lowest nocturnal SBP [5], a dipping status and SBPnight variability. Results. The age of participants was 61 (10,4) yrs, 54 % was male. We found average SBPday < 135 mmHg and/or average DBPday< 85 mmHg in 53 cases. In that subgroup SBPnight variability < 12.2 mmHg, average PBP24 < 53 mmHg, sleep-through morning surge < 37mmHg and a dipping status was found in 11 cases. Conclusion. In this retrospective study 35 % of hypertensive subjects achieve target level of ABPM component basis on a day-time BP and only 7 % of subjects in the same hypertensive population reach target level of five ambulatory BP parameters as pulse presse, morning surge, dipping status and SBP variability in night period.
Guidance on ambulatory blood pressure monitoring: A statement from the HOPE Asia Network
The Journal of Clinical Hypertension, 2020
Hypertension is an important public health issue due to its association with a number of serious diseases, including cardiovascular disease and stroke. The importance of evaluating hypertension taking into account different blood pressure (BP) profiles and BP variability (BPV) is increasingly being recognized, and is particularly relevant in Asian populations given the specific features of hypertension in the region (including greater salt sensitivity and a high rate of nocturnal hypertension). Ambulatory BP monitoring (ABPM) is the gold standard for diagnosing hypertension and assessing 24‐hour BP and provides data on several important parameters that cannot be obtained using any other form of BP measurement. In addition, ABPM parameters provide better information on cardio‐ and cerebrovascular risk than office BP. ABPM should be used in all patients with elevated BP, particularly those with unstable office or home BP, or who are suspected to have white‐coat or masked hypertension....
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
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.
2012
Results: The mean age of the subjects was 50.5 ± 16.1 years and 74.7% were males. Of the 158 subjects, 62 (39.2%) had “controlled office BP” (BP <140/90 mmHg) and the remaining 96 (60.8%) had “uncontrolled office BP” (BP > 140/90 mmHg). Overall, ABP monitoring was performed for an average of 25.7 ± 7.3 h, which included 15.7 ± 4.5 h of day-time recording and 9.9 ± 3.1 h of night-time recording. As compared to the patients with uncontrolled office BP, those with controlled office BP had lower 24-h BP, day-time BP, night-time BP, and the overall BP load. However, despite apparently controlled office BP, a significant proportion of these patients (24.2%) had increased 24-h average ABP and 58.1% patients had at least 40% day-time BP values above the normal range. Similarly, 10.4% patients with uncontrolled office BP actually had normal 24-h average BP and normal BP load (<40% day-time BP values above the normal range). In addition, patients with controlled office BP had less ma...
Hypertension is a very common disease, and office measurements of blood pressure are frequently inaccurate. Ambulatory Blood Pressure Monitoring (ABPM) offers a more accurate diagnosis, more detailed readings of average blood pressures, better blood pressure measurement during sleep, fewer false positives by detecting more white-coat hypertension, and fewer false negatives by detecting more masked hypertension. ABPM offers better management of clinical outcomes. For example, based on more accurate measurements of blood pressure variability, ABPM demonstrates that taking anti-hypertensive medication at night leads to better controlled nocturnal blood pressure, which translates into less end organ damage and fewer clinical complications of hyper-tension. For these reasons, albeit some shortcomings which were discussed, ABPM should be considered as a first-line tool for diagnosing and managing hypertension.