Ambulatory blood pressure monitoring

Sg, Sheps; Dubost, C; Tg, Pickering; Lr, Krakoff; Wb, White; Messerli, F. H.; Ma, Wenqiang; Perloff, D

doi:10.1016/0735-1097(94)90400-6

Cited by 45 publications

(19 citation statements)

References 25 publications

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“…There has been some research showing that mean 4-to 10-hour blood pressure was comparable to mean daytime ambulatory blood pressure. 24,25 In a recent study, Culleton et al reported on the use of a mean 25-minute (4-minute interval) oscillometric blood pressure measurement to reduce white-coat effect.26 Mean 25-minute blood pressure appeared to be 10 mm Hg lower than daytime ABPM. Differences, however, in the primary objective of the study, the study population, and the period of rest before start of measurement obstruct reasonable comparison with our results.…”

mentioning

confidence: 99%

A Novel Approach to Office Blood Pressure Measurement: 30-Minute Office Blood Pressure vs Daytime Ambulatory Blood Pressure

Wel¹,

Buunk²,

Weel³

et al. 2011

The Annals of Family Medicine

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PURPOSE Current offi ce blood pressure measurement (OBPM) is often not executed according to guidelines and cannot prevent the white-coat effect. Serial, automated, oscillometric OBPM has the potential to overcome both these problems. We therefore developed a 30-minute OBPM method that we compared with daytime ambulatory blood pressure.METHODS Patients referred to a primary care diagnostic center for 24-hour ambulatory blood pressure monitoring (ABPM) had their blood pressure measured using the same validated ABPM device for both ABPM and 30-minute OBPMs. During 30-minute OBPM, blood pressure was measured automatically every 5 minutes with the patient sitting alone in a quiet room. The mean 30-minute OBPM (based on t = 5 to t = 30 minutes) was compared with mean daytime ABPM using paired t tests and the approach described by Bland and Altman on method comparison. RESULTSWe analyzed data from 84 patients (mean age 57 years; 61% female). Systolic and diastolic blood pressures differed from 0 to 2 mm Hg (95% confidence interval, -2 to 2 mm Hg and from 0 to 3 mm Hg) between mean 30-minute OBPM and daytime ABPM, respectively. The limits of agreement were between -19 and 19 mm Hg for systolic and -10 and 13 mm Hg for diastolic blood pressures. Both 30-minute OBPM and daytime ABPM classifi ed normotension, whitecoat hypertension, masked hypertension, and sustained hypertension equally. CONCLUSIONSThe 30-minute OBPM appears to agree well with daytime ABPM and has the potential to detect white-coat and masked hypertension. This fi nding makes 30-minute OBPM a promising new method to determine blood pressure during diagnosis and follow-up of patients with elevated blood pressures. Ann Fam Med 2011;9:128-135. doi:10.1370/afm.1211. INTRODUCTIONT he Framingham and the SCORE (systematic coronary risk evaluation) risk functions, both developed to assess the risk of cardiovascular disease, are based on standardized offi ce blood pressure measurements (OBPMs).1,2 Despite guidelines that advocate the relevance of well-executed, standardized OBPM to prevent several forms of bias, 3,4 it is well known that most caregivers do not execute OBPM strictly according to these guidelines. 5,6 In addition, up to one-quarter of patients is prone to the white-coat effect (in which patients exhibit elevated blood pressure in a clinical setting but not in other settings), which infl uences cardiovascular risk profi ling as well. 7,8 This white-coat effect cannot be overcome by standardized OBPM. As a consequence, the determined cardiovascular risk will be incorrect in an estimated 25% of patients and may lead to under-or overtreatment.To enable a more precise determination of cardiovascular risk, OBPM should be free from (observer) bias and the white-coat effect. The mea- 129BLO OD PR ES SUR E ME A SUR EMENT surement should be uniform, easy to execute correctly for all types of health care personnel (doctors, practice assistants, practice nurses, research assistants, etc), and straightforward to implement in daily practice.Fortunately,...

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mentioning

confidence: 99%

A Novel Approach to Office Blood Pressure Measurement: 30-Minute Office Blood Pressure vs Daytime Ambulatory Blood Pressure

Wel¹,

Buunk²,

Weel³

et al. 2011

The Annals of Family Medicine

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“…Our definition of a hypotensive episode, as with others used in the literature, 26,28 is somewhat subjective. Because of the large number of variables which can effect blood pressure, we have chosen our criteria to be relatively conservative (specific) for detecting a drop in blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, ambulatory blood pressure monitoring (ABPM) has been used to accurately and reliably diagnose and manage hypertension in the clinical setting. 28 ABPM has been reported to reduce the error associated with blood pressure measurements by taking a larger number of measurements and eliminating the "white coat" effect (the transient increase in blood pressure associated with its measurement by a health care worker). 29 ABPM of workers has also been done at industrial sites, hospital emergency departments, and offices, as a tool to evaluate the effects of various workplace factors on blood pressure.…”

Section: Blood Pressurementioning

confidence: 99%

HETA 95-0023-2531, American Azide Corporation, Cedar City, Utah.

Esswein¹,

Trout²,

Hales³

1995

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“…When we compared pa- References tients with concentric remodeling and normal geometry, alterations in diastolic function prevailed in a higher number of patients with concentric remodeling, but with no statistical significance. Analysis of blood pressure behavior on ambulatory blood pressure monitoring and the correlation of means and pressure loads with left ventricular hypertrophy have been frequent among authors [29][30][31][32][33][34][35][36] . Verdecchia et al 36 , in a recent study, showed that after adjusting for the means of 24 hours, a constant pressure overload was associated with increased left ventricular mass.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

Cunha¹,

Cunha²,

Martins³

et al. 2001

Arq. Bras. Cardiol.

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The occurrence of ventricular hypertrophy undoubtedly represents an important marker of increased risk for cardiovascular events; therefore, the importance of identifying the patterns of hypertrophy in patients with hypertension is widely justified 1,2 . A recent study by Mensah et al 3 reported that measurement of the left ventricular mass on echocardiography proved to be better for predicting the evolutional process of hypertension as compared with other variables, such as systolic blood pressure, diastolic blood pressure, and hypertension staging 4 . Left ventricular hypertrophy is no longer considered an adaptive process that compensates the pressure imposed on the heart and has been identified as an independent and significant risk factor for sudden death, acute myocardial infarction, and congestive heart failure 4,5 . In cardiac hypertrophy, anomalous collagenous proteins and other types of contractile proteins (myosin with different functional properties) are produced. These myosins show a lower activity of the ATPase enzyme and a lower velocity of power generation. Likewise the formation of anomalous collagenous proteins, changes in contractile proteins also occur. Concomitantly, sarcomeres and fibroblasts proliferate and become hyperplastic. These adaptations aim to maintain the cardiac contractile capacity to compensate the pressure load imposed on the heart 6 . The cardiac adaptive process is not always beneficial for functioning of the heart and causes alteration in myocardial fibers, in the cardiac capacity to respond to adrenergic stimuli, in the left ventricular diastolic function, in the coronary artery flow, and finally in the contractile function 6 . Left ventricular hypertrophy causes important derangements in coronary artery flow. If hypertrophy is mild, the increase in coronary circulation may proportionally accompany the increase in left ventricular mass through vascular neoformation or use of mechanisms of flow reserve. In the cases of significant increase in ventricular mass, generation of new vessels and capillaries is disproportional to the

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Ambulatory blood pressure monitoring

Cited by 45 publications

References 25 publications

A Novel Approach to Office Blood Pressure Measurement: 30-Minute Office Blood Pressure vs Daytime Ambulatory Blood Pressure

A Novel Approach to Office Blood Pressure Measurement: 30-Minute Office Blood Pressure vs Daytime Ambulatory Blood Pressure

HETA 95-0023-2531, American Azide Corporation, Cedar City, Utah.

Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

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