Clinical utility of ambulatory blood pressure monitoring in the management of hypertension

Angeli, Fabio; Reboldi, Gianpaolo; Poltronieri, Cristina; Bartolini, Claudia; D'Ambrosio, Cinzia; Filippo, Valentina De; Verdecchia, Paolo

doi:10.1586/14779072.2014.903155

Cited by 20 publications

(9 citation statements)

References 90 publications

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“…Accurate measurement of the blood pressure (BP) is very important in the diagnosis and effective management of hypertension. Compared with conventional BP measurements, ambulatory blood pressure monitoring (ABPM) provides an insight individual BP phenotypes and it is more closely related to target organ damage and cardiovascular risk [5, 6]. In this study, we aimed to investigate the clinical and laboratory correlates of ambulatory blood pressure (ABP) phenotypes at a tertiary care hospital in Turkey.…”

Section: Introductionmentioning

confidence: 99%

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Erdogmus¹,

Kutlay²,

Celebi³

et al. 2018

Kidney Blood Press Res

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Background/Aims: Hypertension and its complications are major public health issues worldwide due to their association with high cardiovascular morbidity and mortality. Despite significant progress in health, the prevalence of hypertension is increasing. Ambulatory blood pressure monitoring (ABPM) is becoming increasingly important for the management of hypertension. In this study, we aimed to investigate the clinical and laboratory correlates of ambulatory blood pressure (ABP) phenotypes at a tertiary care hospital in Turkey. Methods: The characteristics of 1053 patients were retrospectively obtained from the hospital database. Hypertension was defined as patients with office blood pressure (BP) ≥140/90 mmHg and/or previously diagnosed hypertension and/or the use of antihypertensive medication. According to the office BP and ABPM results patients were identified namely: (1) sustained normotensive (SNT) patients (both office BP and ABPM were normal), (2) sustained hypertensive (SHT) patients (both office BP and ABPM were high), (3) masked hypertensive (MHT) patients (office BP were normal, but ABPM were high), (4) white coat hypertensive (WCHT) patients (office BP were above limits, but ABPM were normal). Results: A total of 1053 patients were included to the study (female/male: 608/445 and mean age 55 ± 15 years). The mean age of patients with hypertension was significantly higher than without hypertension (p< 0.0001). Hypertension was more frequent in females (p=0.009). The rates of history of diabetes mellitus (DM), hyperlipidemia (HL), and chronic kidney disease (CKD) were higher in patients with hypertension (p< 0.0001). Among patients with hypertension (n=853, 81%), ABPM results showed that 388 (45%) of patients had SHT, 92 (11%) had MHT, and 144 (17%) had WCHT, whereas 229 (27%) had SNT. Patients with MHT were significantly older than patients with SNT (p=0.025). The prevalence of SHT was higher in men than in women, whereas the prevalence of WCHT was higher in women than in men (p< 0.0001). There was no significant difference between 4 groups with regard to body mass index (p=0.142), a history of DM (p=0.189) and smoking status (self-reported) (p=0.306). Patients with SHT had the highest prevalence of history of hypertension, HL and CKD (p< 0.0001). Among patients without hypertension, 26 (13%) of patients had MHT and none of those patients was on antihypertensive treatment. Conclusion: Potential usages of ABPM in Turkey may include screening of high risk individuals who have traditional cardiovascular risk factors. It also provides clinicians valuable information on abnormal ABP phenotypes. Future studies are needed to clarify the risk factors of different ABP phenotypes and to evaluate the role of ABPM on detection and control of hypertension.

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Section: Introductionmentioning

confidence: 99%

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Erdogmus¹,

Kutlay²,

Celebi³

et al. 2018

Kidney Blood Press Res

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“…At the same time, there is substantial evidence showing many advantages of ambulatory blood pressure monitoring (ABPM) beyond office BP measurement, for example, a large number of BP readings, a superior prognostic value, absence of observer bias, digit preference, and 'white coat' effect (WCE), among many others [3,4]. However, there is no consensus in the scientific community on whether ABPM is ready to replace clinic BP [5,6].…”

Section: Introductionmentioning

confidence: 99%

Successive blood pressure measurements to evaluate suspected and treated hypertension

Silva

Giorgi

et al. 2016

Blood Pressure Monitoring

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“…Subjects were also divided into three dipper status categories for nocturnal BP: dippers, nondippers, and reverse dippers, defined as a difference in mean BP between daytime and nighttime hours greater than 10%, 0%-10%, and less than 0%, respectively [36,37]. Separately, nighttime sBP variability and 24-hour pulse pressure could be divided into two categories as follows: low (≤10.8 mmHg) and high (>10.8 mmHg) sBP variability and low (≤53 mmHg) and high (>53 mmHg) pulse pressure, respectively [9,38]. Among ABPM profiles, use of "Ambulatory Does Prediction Valid" parameters has been suggested from a practical standpoint and include average ambulatory BP, nocturnal dipping pattern, 24-hour pulse pressure, and variability of nighttime sBP [9].…”

Section: Ambulatory Bp Monitoringmentioning

confidence: 99%

“…Traditionally, 24-hour ambulatory blood pressure (BP) monitoring (ABPM) has been used to study BP under normal living conditions as it offers a reliable estimate of habitual diurnal BP rhythm, which may be used to independently predict hypertension-related complications [8]. Although average 24-hour, daytime (awake), and nighttime (asleep) BP have been the principal components of the ambulatory BP profile investigated as prognostic determinants, other summary measures exist for describing varying aspects of ambulatory readings, including nocturnal dipping, BP variability, and pulse pressure [9][10][11]. In normal subjects, the mean nocturnal systolic BP (sBP) is 10-20% lower than the mean daytime sBP, a phenomenon known as dipping [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of the ambulatory blood pressure monitoring profile on cognitive and imaging findings of cerebral small-vessel disease in older adults with cognitive complaints

Shim

Shin

2021

J Hum Hypertens

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We investigated ambulatory blood pressure (BP) monitoring (ABPM) profiles and magnetic resonance imaging (MRI) findings of cerebral small-vessel disease (cSVD) in older adults with cognitive complaints who were grouped as follows: subjective cognitive decline, mild cognitive impairment, and dementia of Alzheimer’s type. Group comparisons and correlation analyses among demographic characteristics, cognitive and MRI findings, and ABPM profiles were performed. Furthermore, multivariate logistic regression analyses for dependent variables of (1) dementia or not and (2) MRI criteria of subcortical vascular dementia (SVaD) or not were conducted with independent variables of dichotomized ABPM profiles. A total of 174 subjects (55 males and 119 females) were included: mean age 75.36 ± 7.13 years; Mini-Mental State Examination (MMSE) score 20.51 ± 6.23. No MRI and ABPM findings except medial temporal atrophy were different between three groups. Twenty-four-hour systolic BP (sBP) was correlated with MMSE score (r = –0.182; p = 0.022) and the severity of white matter hyperintensity (WMH) (r = 0.157; p = 0.048). A higher daytime sBP was associated with dementia (odds ratio (OR): 3.734; 95% confidence interval (CI): 1.041–13.390; p = 0.043) and MRI finding of SVaD (OR: 10.543; 95% CI: 1.161–95.740; p = 0.036). Although there were no differences in ABPM profiles between three groups, a higher BP—especially a higher sBP—correlated with cognitive dysfunction and severity of WMH in older adults. Only higher daytime sBP was an independent predictor for dementia and MRI findings of SVaD. Among various ABPM profiles in this study, a higher BP, especially a higher sBP, may be considered the most important for clinical and MRI findings of cSVD.

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Clinical utility of ambulatory blood pressure monitoring in the management of hypertension

Cited by 20 publications

References 90 publications

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Clinical Correlates of Ambulatory Blood Pressure Phenotypes at a Tertiary Care Hospital in Turkey

Successive blood pressure measurements to evaluate suspected and treated hypertension

Impact of the ambulatory blood pressure monitoring profile on cognitive and imaging findings of cerebral small-vessel disease in older adults with cognitive complaints

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