Office and laboratory blood pressures as predictors of daily blood pressure level in normotensive subjects and borderline and mild hypertensive subjects (original) (raw)

Ambulatory blood pressure in normotensive and hypertensive subjects

Journal of Hypertension, 1994

Objective: To delineate more precisely an operational threshold for making clinical decisions based o n ambulatory blood pressure (ABP) measurement by studying the ABP i n subjects w h o were diagnosed as either normotensive or hypertensive by conventional blood pressure (CBP) measurement. Subjects: Twenty-four research groups recruited 7069 subjects. O f these, 4577 were normotensive (CBP 1 1 40190 mmHg), 71 9 were borderline hypertensive (systolic CBP 141-159mmHg or diastolic CBP 91-94mmHg) and 1773 were definitely hypertensive. O f the subjects in the last of these categories, 1324 had systolic

Variation of ambulatory blood pressure in healthy middle-aged men

Journal of Human Hypertension, 1997

The majority of the reference data on ambulatory blood 84.4 ± 7.7 mm Hg (95% CI 82.5, 86.4). The corresponding values for systolic and diastolic pressures during sleep pressure (ABP) monitoring is based on fixed, predefined times for waking hours and sleep. Our aim was to deter-were 101.2 ± 8.5 mm Hg (95% CI 99.1, 103.4) and 71.7 ± 7.7 mm Hg (95% CI 69.7, 73.6). The difference between mine the level of ABP according to diary entries when awake, at work, at home and during sleep in a sample day and night was 19.2 ± 7.0 mm Hg for systolic and 12.7 ± 6.0 mm Hg for diastolic pressure. The number of men of normotensive, middle-aged men. The dipping-status was also determined. All measurements were taken with whose systolic and diastolic pressure dropped less than 10% while asleep (non-dippers) was eight (13%) and 15 a non-invasive auscultatory device on a normal working day. A total of 62 clinically healthy, normotensive men (24%), respectively. If the mean ±2 standard deviation interval is considered, the range of normality averaged without a history of elevated BP were included. The mean resting BP of the group was 122/73 mm Hg. The 102-139/69-100 mm Hg when awake, 84 -118/56-87 mm Hg when asleep and 97-132/66-95 over 24 h. The 24-h systolic BP (SBP) was 114.4 ± 8.6 mm Hg (95% CI 112.3, 116.6), while the diastolic BP (DBP) was 80.4 ± 7.2 awake-sleep pressure difference did not correlate with the 24-h average. mm Hg (95% CI 78.5, 82.2). SBP when awake was 120.5 ± 9.4 mm Hg (95% CI 118.1, 122.9) and diastolic pressure Keywords: ambulatory blood pressure; healthy men; non-dippers ive, clinically healthy men without a history of

Variability of office, 24-hour ambulatory, and self-monitored blood pressure measurements

British Journal of General Practice, 2010

Background The diagnosis of hypertension is difficult when faced with several different blood pressure measurements in an individual. Using the average of several office measurements is recommended, although considerable uncertainty remains. Twenty-four-hour ambulatory monitoring is often considered the gold standard, but self-monitoring of blood pressure has been proposed as a superior method. Aim Determination of within-individual variability of blood pressure measured in the office, by ambulatory monitoring, and by a week of self-monitoring. Design of study Retrospective analysis of a clinical trial of 163 subjects. Method Within-patient variability of office and ambulatory blood pressure was determined from measurements at 0 and 6 weeks. Subjects had performed self-monitoring of blood pressure twice each morning and evening, for at least 6 weeks; variability was determined from the means of week 1 and week 6. Results The within-individual coefficients of variation (CVs) for systolic blood pressure were: office, 8.6%; ambulatory, 5.5%; self, 4.2%. Equivalent values for diastolic blood pressure were 8.6%, 4.9%, and 3.9%. CVs tended to be lower with longer self-monitoring duration, and higher with longer intervals between self-monitoring. Conclusion Office blood pressure is impractical for precise assessment, as 10-13 measurements are required to give the accuracy required for rational titration of antihypertensive drugs. Twenty-four-hour ambulatory monitoring is better than a single office measurement, but considerable uncertainty remains around the estimate. A week of self-monitoring appears to be the most accurate method of measuring blood pressure, but remains imperfect. Further research may identify superior self-monitoring schedules. Given the inherent accuracy in blood pressure measurement, the importance of considering overall cardiovascular risk is emphasised.

Correlates of non-dipping blood pressure in persons with and without hypertension

Background Blood pressure (BP) is known to follow a circadian rhythm with 10% to 15% lower values during the night than daytime. Non-dipping BP refers to the absence of BP dipping and has been associated with the development of target organ damage. The general goal of this study was to determine the correlates of non-dipping BP in persons with and without hypertension. Methods This was a cross-sectional study that recruited 98 participants at Chikankata Mission General Hospital. The outcome variable of the study was non-dipping BP, with sociodemographic and clinical explanatory variables. We used SPSS version 22 to describe and make inferences. Results The median (interquartile range (IQR)) age of participants was 42 years (34.7-52) and 54.1% (53/98) had hypertension while 45.9% (45/98) were normotensive. The proportion of females was slightly higher (59.2%, n=58) than that of males (40.2%, n=40), this being similar in hypertensives but equal in normotensives. The median (IQR) age of hypertensives was higher compared to the normotensives, 46 (40-56) vs. 35 (25-41) years. The prevalence of non-dipping BP was 38.8% overall and higher among those with hypertension (54.7%) compared to the normotensive group (20%). The factors associated with non-dipping BP in the multivariate analysis were age (adjusted odds ratios (AOR) of 1.15; 95% CI: 1.05 - 1.25), spot urine sodium (AOR of 1.16; 95% CI: 0.99 - 1.36), daytime systolic blood pressure (SBP) load (AOR of 1.28; 95% CI: 1.06 - 1.55), daytime diastolic blood pressure (DBP) load (AOR of 0.77; 95% CI: 0.65 - 0.92), and nighttime DBP load (AOR of 1.10; 95% CI: 1.02, 1.18). However, this was abrogated by hypertension status albeit among normotensives only age remained significantly associated with non-dipping BP, none of the factors remained significantly associated with non-dipping BP among persons with hypertension. Conclusion The prevalence of non-dipping BP was high, among hypertensives. This provides insights into the intricate links between BP patterns, sociodemographic and clinical characteristics but further underscores the need for mechanistic researches to further advance the understanding of mechanisms of associated characteristics. Key words: BP Dipping; Ambulatory Blood Pressure Monitoring; Circadian Rhythm; Hypertension; Blood Pressure

The influence of physical activity on the variability of ambulatory blood pressure

American journal of hypertension, 2000

The aim of this study was to assess the contribution of physical activity levels to blood pressure (BP) variability, and to assess the effect age, gender, body mass index, and use of antihypertensive medications on this relationship. We simultaneously monitored 24-h ambulatory BP by automated recorder and activity by actigraphy in 431 patients. Mean activity scores for the 5, 10, 15, and 20 min preceding each BP measurement were calculated, and BP and heart rate were related to these variables using linear mixed model regression. Various patient characteristics were added to the mixed model as covariates. Patients were heterogeneous in age (48 +/- 13 years), sex (49% men), and average 24-h BP (132/81 +/- 15/10 mm Hg). Mean daytime activity level was 44 +/- 15 U. During the daytime, systolic BP (r = 0.33), diastolic BP (r = 0.29), and heart rate (r = 0.42) correlated best with the average activity for the 15 min preceding each measurement (P < .001). Variance was very high, with a...

Daily Life Blood Pressure Changes Are Steeper in Hypertensive Than in Normotensive Subjects

Hypertension, 2003

Target organ damage in hypertensive patients is related to their increased average blood pressure and greater 24-hour blood pressure variability. Whether the rate of blood pressure changes is also greater in hypertension, producing a greater stress on arterial walls, is not known, however. Our study aimed at addressing this issue by computer analysis of 24-hour ambulatory intra-arterial blood pressure recordings in 34 subjects (29 males), 13 normotensive subjects and 21 uncomplicated hypertensive subjects (mean age+/-SD, 40.4+/-11.8 years). The number, slope (mm Hg/s), and length (beats) of systolic blood pressure ramps of 3 or more consecutive beats characterized by a progressive increase (+) or reduction (-) in systolic blood pressure of at least 1 mm Hg per beat were computed for each hour and for the whole 24-hour period. Twenty-four-hour average systolic blood pressure was 112.9+/-2.1 and 159.4+/-5.7 mm Hg in normotensive and hypertensive subjects, respectively. Over the 24 hours, the number and length of systolic blood pressure ramps were similar in both groups, whereas the slope was markedly different (24-hour mean+/-SE slope, 4.80+/-0.30 in normotensives and 6.50+/-0.40 mm Hg/s in hypertensives, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Ramp slope was not influenced by age or reflex pulse interval changes, but it was greater for higher ramp initial systolic blood pressure values. Thus, in daily life, hypertensive subjects are characterized by steeper blood pressure changes than normotensives, and this, regardless of the mechanisms, may have clinical implications, because it may be associated with greater traumatic effect on the vessel walls of hypertensive patients.

The statistical analysis of treatment effects in 24-hour ambulatory blood pressure recordings

Statistics in Medicine, 1988

This paper presents a statistical analysis of treatment effects in 24-hour ambulatory blood pressure recordings. The statistical models account for circadian rhythms, subject effects, and the effects of treatment with drugs or relaxation therapy. In view of the heterogeneity of the subjects, we fit a separate linear model to the data of each subject, use robust statistical procedures to estimate the parameters of the linear models, and trim the data on a subject by subject basis. We use a meta-analytical method to combine the results of all subjects in the study. KEY WORDS 698 M. R. MARLER ET AL.