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Ambulatory Blood Pressure Monitoring: Five Decades of More Light andLess Shadows

View Article: PubMed Central - PubMed

ABSTRACT

Casual blood pressure measurements have been extensively questioned over the lastfive decades. A significant percentage of patients have different blood pressurereadings when examined in the office or outside it. For this reason, a change inthe paradigm of the best manner to assess blood pressure has been observed. Themethod that has been most widely used is the Ambulatory Blood PressureMonitoring - ABPM. The method allows recording blood pressure measures in 24hours and evaluating various parameters such as mean BP, pressure loads, areasunder the curve, variations between daytime and nighttime, pulse pressurevariability etc. Blood pressure measurements obtained by ABPM are bettercorrelated, for example, with the risks of hypertension. The main indicationsfor ABPM are: suspected white coat hypertension and masked hypertension,evaluation of the efficacy of the antihypertensive therapy in 24 hours, andevaluation of symptoms. There is increasing evidence that the use of ABPM hascontributed to the assessment of blood pressure behaviors, establishment ofdiagnoses, prognosis and the efficacy of antihypertensive therapy. There is nodoubt that the study of 24-hour blood pressure behavior and its variations byABPM has brought more light and less darkness to the field, which justifies thetitle of this review.

No MeSH data available.


Related in: MedlinePlus

Odds ratio of patients with masked hypertension compared withnormotensive patients.34
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f4: Odds ratio of patients with masked hypertension compared withnormotensive patients.34

Mentions: Masked hypertension of white coat normotension occurs in 10-40% of patients notreceiving anti-hypertensive therapy.37,38 It is definedby the presence of normal blood pressure values obtained in the office (<140/90 mmHg) and abnormal ABPM values (> 130/85 mm Hg).22 There is a change of diagnosisfrom hypertension during daily living to normotension in the office setting.Multivariate analysis studies have identified as associated risk factors: maskedhypertension, male sex, smoking, and body mass index.39 Masked hypertension is associated withincreased risk of cardiovascular morbidity and mortality. However, since officemeasures are normal, this risk may be underestimated.40 A meta-analysis of 12 studies, involving 4,884untreated subjects - 2,467 normotensive, 1,641 hypertensive subjects, and 776with masked hypertension - showed an association between masked hypertension andincreased risk of structural changes in left ventricle. The risk observed insubjects with masked hypertension is nearly twice as high as that amongnormotensive subjects (Figure 4).34 The anti-hypertensive therapyseems to be the rational choice for these patients, although no randomizedstudies evaluating this procedure have been performed so far.37,38


Ambulatory Blood Pressure Monitoring: Five Decades of More Light andLess Shadows
Odds ratio of patients with masked hypertension compared withnormotensive patients.34
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940152&req=5

f4: Odds ratio of patients with masked hypertension compared withnormotensive patients.34
Mentions: Masked hypertension of white coat normotension occurs in 10-40% of patients notreceiving anti-hypertensive therapy.37,38 It is definedby the presence of normal blood pressure values obtained in the office (<140/90 mmHg) and abnormal ABPM values (> 130/85 mm Hg).22 There is a change of diagnosisfrom hypertension during daily living to normotension in the office setting.Multivariate analysis studies have identified as associated risk factors: maskedhypertension, male sex, smoking, and body mass index.39 Masked hypertension is associated withincreased risk of cardiovascular morbidity and mortality. However, since officemeasures are normal, this risk may be underestimated.40 A meta-analysis of 12 studies, involving 4,884untreated subjects - 2,467 normotensive, 1,641 hypertensive subjects, and 776with masked hypertension - showed an association between masked hypertension andincreased risk of structural changes in left ventricle. The risk observed insubjects with masked hypertension is nearly twice as high as that amongnormotensive subjects (Figure 4).34 The anti-hypertensive therapyseems to be the rational choice for these patients, although no randomizedstudies evaluating this procedure have been performed so far.37,38

View Article: PubMed Central - PubMed

ABSTRACT

Casual blood pressure measurements have been extensively questioned over the lastfive decades. A significant percentage of patients have different blood pressurereadings when examined in the office or outside it. For this reason, a change inthe paradigm of the best manner to assess blood pressure has been observed. Themethod that has been most widely used is the Ambulatory Blood PressureMonitoring - ABPM. The method allows recording blood pressure measures in 24hours and evaluating various parameters such as mean BP, pressure loads, areasunder the curve, variations between daytime and nighttime, pulse pressurevariability etc. Blood pressure measurements obtained by ABPM are bettercorrelated, for example, with the risks of hypertension. The main indicationsfor ABPM are: suspected white coat hypertension and masked hypertension,evaluation of the efficacy of the antihypertensive therapy in 24 hours, andevaluation of symptoms. There is increasing evidence that the use of ABPM hascontributed to the assessment of blood pressure behaviors, establishment ofdiagnoses, prognosis and the efficacy of antihypertensive therapy. There is nodoubt that the study of 24-hour blood pressure behavior and its variations byABPM has brought more light and less darkness to the field, which justifies thetitle of this review.

No MeSH data available.


Related in: MedlinePlus