Ambulatory Blood Pressure Monitoring in the Elderly

García, Juan Diego Mediavilla; Águila, Fernando Jaén; Torres, C. Fernández; Extremera, Blas Gil; Alonso, Juan Francisco Jiménez

doi:10.1155/2012/548286

Cited by 10 publications

(9 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study we investigated the accuracy and the agreement of currently available measurement methods in very old (> 80 years) hypertensive patients admitted in an internal medicine service of a teaching hospital. Data from previous studies suggest that ambulatory blood pressure monitoring and home self-blood pressure measurements are likely to be the most accurate BP assessment strategies for elderly subjects [29, 30].…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Giorno

Heiniger

Balestra

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Background. The reliability of blood pressure (BP) measurement in hospitalized patients is a topic of debate and the therapeutic implication of the routinely collected BP profiles is probably overestimated. When measurements are performed in elderly patients, further potential sources of misinterpretation occur. Methods. We conducted a subanalysis of a previous study including 79 over 80-year-old hypertensive patients, hospitalized in an internal medicine ward. Five modalities of BP evaluations (measurement by physicians and nurses, self-measurement by patients, Finometer® beat-to-beat finger monitoring, and 24h monitoring) were analyzed, considering agreement and accuracy. Results. The mean (SD) age of the patients was 86.9±4.9 years (50% women). Patients’ self-measurements of both systolic and diastolic BP (SBP and DBP) did not differ significantly from daytime 24-hour monitoring (D24hBPM) (mean difference -1.52, SE 1.71; p: ns and -0.58, SE 1.19 mmHg; p: ns). Conversely, SBP and DBP registered by nurses did significantly differ (mean difference -7.34, SE 1.42; p=0.007 and -4.7, SE 1.05 mmHg; p=0.003). SBP and DBP measured by patients also showed the better concordance, with lowest biases, and narrowest limits of agreements (LoA) and for SBP higher Kappa statistic values (bias 1.5, LoA -28.9 to 31.9; κ 0.563 and bias 0.6, LoA -20.4 to 21.5 mmHg; κ 0.412). The patients’ sensitivity and specificity in predicting hypertensive systolic D24hBPM were 84.8% and 69.7%, respectively. Conclusions. In elderly hospitalized patients an alternative to 24hBPM, self-measurements by patients offer the better agreement and reliability in detecting hypertensive values.

show abstract

Section: Discussionmentioning

confidence: 99%

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Giorno

Heiniger

Balestra

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Aging may reduce cardiac output and heart rate (a response mediated by β receptors) as well as increase arterial stiffness, reduce arterial compliance, elevate pulse pressure, and increase peripheral vascular resistance . Thus, in the elderly, hypertension usually manifests as ISH.…”

Section: Discussionmentioning

confidence: 99%

“…Nondipping is more common in the elderly. In the general population, nondippers account for 25% to 35% . However, one study of hypertensive patients found a prevalence of nondipping of 41% in treated patients and 53% in untreated patients .…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Variability and Morning Blood Pressure Surge in Elderly Chinese Hypertensive Patients

Qin

Zhang

Yang

et al. 2014

J of Clinical Hypertension

View full text Add to dashboard Cite

2This retrospective study aimed to investigate blood pressure variability (BPV), morning systolic blood pressure surge (MBPS), and the associated factors in 513 elderly (65 years and older) and 188 younger (younger than 65 years) hypertensive Chinese patients who had ambulatory blood pressure monitoring (ABPM) at our hospital from January 1, 2002, to December 31, 2010. The MBPS was lower in the younger patients compared with the elderly patients, and it was highest in the 75 years and older and younger than 80 group (29.0AE13.4 mm Hg). Compared with other groups, the 80 years and older group had a significant increase in BPV (P<.05). Multiple linear regression analysis showed that body mass index (BMI; P<.01), up to 50 years of smoking (P≤.03), and circadian blood pressure variation (P<.01) were factors associated with MPBS. In summary, systolic BPV and MBPS were increased in elderly Chinese hypertensive patients, and the MBPS was associated with BMI, years of smoking, and circadian blood pressure variation. J Clin Hypertens (Greenwich). 2014;16:511-517. ª2014 Wiley Periodicals, Inc.The overall prevalence of hypertension ranges from 30% to 45% in the general population, and the prevalence increases in the elderly.1 Most studies providing these data have been conducted in industrialized, Western countries. However, similar findings were reported in a recently published study of Chinese adults: 26.6% of the study group had hypertension, but the hypertension prevalence for patients 65 years and older was 56.5%. 2In recent years, data from ambulatory blood pressure monitoring (ABPM) rather than office blood pressure (BP) has been shown to more closely correlate with target organ damage in hypertensive patients. Furthermore, the average 24-hour BP more strongly correlates with morbidity and mortality than does office BP. 1 Additionally, BP variability (BPV), reflecting the extent of BP fluctuation within a specific interval, can serve as a potential indicator of damage to target organs and prognosis in hypertensive patients.3 Dynamic BP has been used to document the phenomenon of the morning BP surge (MBPS): the nocturnal BP decreases during sleep (the lowest at 2 AM-3 AM), then increases rapidly to the highest level within several hours after waking. In the general population, an abrupt increase in morning BP above the 90th percentile is an important independent risk factor for mortality and cardiovascular events, especially in smokers. 4 However, little is known about BPV and circadian rhythm in elderly hypertensive patients in China.In the present retrospective study, the aim was to review ABPM performed in Chinese hypertensive patients aged 65 years and older compared with younger patients and to investigate the factors associated with the MBPS. METHODSThis was a retrospective study conducted at the Department of Cardiovascular Medicine of the Affiliated First Hospital of Sun Yat-sun in Guangdong Province, China, and the People's Hospital of Guangxi Zhuang Autonomous Region, China. Since the study was retrospecti...

show abstract

“…Another important consideration in the management of hypertension in older individuals is to use ambulatory BP monitoring instead of relying on single office measurements. The development of isolated systolic hypertension (and thus wide pulse pressure), white coat effect, different measurements between ambulatory and clinical BP, prevalence of orthostatic hypotension, and medication interactions are among the reasons that necessitate ambulatory BP monitoring 45 .…”

Section: What Are the Pharmacologic Options For Hypertension Managemementioning

confidence: 99%

Hypertension management in older adults

Bilen

Wenger²

2020

F1000Res

View full text Add to dashboard Cite

Vascular aging leads to arterial hypertension, which is the leading cause of cardiovascular mortality and morbidity in older adults. Blood pressure reduction is effective in reducing the cardiovascular risk and is safe in ambulatory older adults. It is important to note that blood pressure control in this group of patients is challenging because of comorbidities, polypharmacy, and frailty. Choice of pharmacotherapy is not simple and should be individualized.

show abstract

Ambulatory Blood Pressure Monitoring in the Elderly

Cited by 10 publications

References 64 publications

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Blood Pressure Variability and Morning Blood Pressure Surge in Elderly Chinese Hypertensive Patients

Hypertension management in older adults

Contact Info

Product

Resources

About