Comparative Assessment of Four Blood Pressure Measurement Methods in Hypertensives

Lamarre-Cliché, Maxime; Cheong, Nathalie Ng; Larochelle, Pierre

doi:10.1016/j.cjca.2011.05.001

Cited by 42 publications

(32 citation statements)

References 31 publications

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“…Despite an excellent agreement between r-HBPM and ABPM (either 24 h or daytime), the difference between r-HBPM and ABPM was larger than published previously [29,31], especially for SBP. However, our study was carried out in very elderly patients with cognitive impairment, two conditions that have been associated with increased WCH and BP variability [5,32,33].…”

Section: Discussioncontrasting

confidence: 78%

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Home blood pressure measurement in elderly patients with cognitive impairment

Plichart

Seux²,

Caillard³

et al. 2013

Blood Pressure Monitoring

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Section: Discussioncontrasting

confidence: 78%

“…However, our study was carried out in very elderly patients with cognitive impairment, two conditions that have been associated with increased WCH and BP variability [5,32,33]. This may explain the observed difference from previous studies carried out in younger and healthier patients [29,31].…”

Section: Discussioncontrasting

confidence: 64%

Home blood pressure measurement in elderly patients with cognitive impairment

Plichart

Seux²,

Caillard³

et al. 2013

Blood Pressure Monitoring

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“…Moreover, mean AOBP without rest correlates well with daytime ambulatory BP values, 14 whereas AOBP with 5 minutes leads to mean values below ambulatory daytime readings. 3,15,16 More specifically, in the SPRINT ambulatory BP study, daytime ambulatory SBP was ~7 higher than clinic SBP with intensive treatment and ~3 than SPRINT standard treatment. Daytime ambulatory SBP is typically ~5 lower than usual clinic SBP.…”

Section: Discussionmentioning

confidence: 99%

Controlling Systolic Blood Pressure below 140 mm Hg in Most Hypertensive Patients matches Systolic Blood Pressure Intervention Trial Intensive Treatment: Practical Implications for Patient Care

Egan¹,

Li²,

Wagner³

et al. 2017

Hypertension Journal

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The Systolic Blood Pressure Intervention Trial (SPRINT) investigators concluded that most hypertensive patients would benefit from treating systolic blood pressure (SBP, mm Hg) to a target below 140 benchmark, as intensive treatment (SBP, 121.5) led to 25% fewer cardiovascular endpoints than standard treatment (SBP, 134.6) in high-risk patients. This conclusion reflects at least three assumptions addressed in this report. First, SBP with SPRINT standard was similar to or lower than SBP of treated adults in usual care. Second, SBP with SPRINT intensive treatment was lower than in adults with treated hypertension controlled to <140 with usual care. Third, SPRINTs rigorous blood pressure (BP) measurement methods translate to most care settings. Systolic blood pressure in a representative sample of US adults [National Health and Nutrition Examination Survey ≥18 years with treated hypertension fell from 137.1 in 1999-2002 to 130.1 in 2009-2012 as control to SBP <140 rose from 60 to 72%. Over the time, SBP in treated adults controlled to <140 fell from 123.0 to 120.9 as percentages with SBP <130 rose from 66.1 to 74.7%. The SPRINT BP measurement protocol led to SBP ~3 and ~7 below daytime ambulatory SBP for standard and intensive treatment respectively, whereas usual clinic SBP is ~5 above daytime ambulatory SBP. Thus, SBP 134.6 and 121.5 with SPRINT standard and intensive treatment are comparable to usual clinic SBP of 142.6 and 133.5 respectively. Systolic blood pressure intervention trial Intensive Treatment standard and intensive treatment fall short of SBP with usual care, especially when measurement methodologies are considered. Systolic blood pressure intervention trial supports the current SBP goal <140 based on usual clinic measurement methods.

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“…14 The automated office BP protocol with 5 minutes of rest leads to SBP 6.9 mm Hg lower than daytime ambulatory values, 15,16 which matches the difference between automated office SBP and daytime ambulatory SBP with SPRINT intensive treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, BP values in NHANES participants likely would have been significantly lower if measured using SPRINT methods. [14][15][16][17]27,28 Third, unlike SPRINT, our NHANES analysis did not include individuals with untreated SBP 130 to 139, because the Seventh Joint National Committee defined hypertension in untreated adults as an SBP ≥140 during 2003-2013, 29 which includes the time period of our NHANES analysis. Adults with diabetes mellitus comprised the largest group of patients with an SBP <140 (goal <130), 29 and they were excluded from SPRINT.…”

mentioning

confidence: 99%

Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines

Egan

Wagner

2016

Hypertension

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The Systolic Blood Pressure (SBP) Intervention Trial (SPRINT) Research Group concluded that among patients at high risk for cardiovascular events but without diabetes mellitus, an SBP (mm Hg) target <120 rather than <140 reduced major cardiovascular events 25% and cardiovascular mortality 43%. 1 The investigators stated that "SPRINT now provides evidence of benefits for an even lower SBP target than that currently recommended in most patients with hypertension." This statement suggests that future guidelines should consider lowering the SBP goal to a value below <140 currently recommended for most hypertensives, for example, <130 or <120.SPRINT's impact on future hypertension guidelines reflects 2 implicit assumptions. The first assumption is that SPRINT standard treatment produced SBP values as low or lower than the SBP of US adults with treated hypertension. If SPRINT standard treatment did not attain SBP values as low as in US adults with treated hypertension, then the benefit of intensive treatment in the population could be overestimated. The second assumption is that SPRINT intensive treatment produced a lower mean SBP than in US adults with treated hypertension and SBP <140. If this is not the case, then the rationale for lowering the SBP target would be less compelling, whereas the basis for raising the percentage of treated adults with SBP <140 mm Hg would be enhanced. 2Our study addressed these 2 implicit assumptions using National Health and Nutrition Examination Survey (NHANES) data. First, mean SBP in 3 groups of NHANES adults with treated hypertension was compared to mean SBP achieved with SPRINT standard treatment. The 3 groups with treated hypertension included (1) a SPRINT-like group, (2) all adults ≥18 years, and (3) adults ≥18 years excluding the SPRINT-like group and others with SPRINT-like exclusions. Second, mean SBP in the same 3 groups of NHANES adults with treated hypertension and SBP <140 was compared to mean SBP with SPRINT intensive treatment. MethodsThe NHANES are repeated cross-sectional assessments over time of the health and nutritional status in a representative sample of the US civilian population. All adults provided written consent approved by the National Center for Health Statistics. Since 1960, National Health Examination Surveys have been used to assess hypertension prevalence, awareness, treatment, and control in the United States 3,4 Participants for this analysis included adults meeting SPRINT-like inclusion-exclusion criteria in NHANES 1999 to 2012. Inclusion Abstract-The Systolic Blood Pressure (SBP, mm Hg) Intervention Trial (SPRINT) showed that targeting SBP <120 mm Hg (intensive treatment, mean SBP: 121.5 mm Hg) versus <140 (standard treatment, mean SBP: 134.6 mm Hg) reduced cardiovascular events 25%. SPRINT has 2 implicit assumptions that could impact future US hypertension guidelines: (1) standard therapy controlled SBP similarly to that in adults with treated hypertension and (2) intensive therapy produced a lower mean SBP than in adults with treated hypertensio...

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Comparative Assessment of Four Blood Pressure Measurement Methods in Hypertensives

Cited by 42 publications

References 31 publications

Home blood pressure measurement in elderly patients with cognitive impairment

Home blood pressure measurement in elderly patients with cognitive impairment

Controlling Systolic Blood Pressure below 140 mm Hg in Most Hypertensive Patients matches Systolic Blood Pressure Intervention Trial Intensive Treatment: Practical Implications for Patient Care

Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines

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