Prognostic Significance of Central Blood Pressure for Adverse Renal Outcomes Compared to 24-Hr Ambulatory Blood Pressure and Clinical Blood Pressure

Introduction Unattended automatic office blood pressure (BP) measurement has given new evidence regarding treatment goals. Aim We aimed to explore any differences between unattended and conventional office BP measurements in different groups of patients visiting a European Society of Hypertension (ESH) Excellence Centre. Methods We performed two unattended (Microlife Watch BP Home) followed by a single attended (mercury sphygmomanometer) BP measurement in 310 patients (mean age 62 ± 15 years, 151 males, 64% hypertensives and 36% normotensive individuals) visiting our ESH Centre for a scheduled follow-up. Office BP < 140 mmHg (systolic) and < 90 mmHg (diastolic) were characterized as controlled or normal in hypertensives and normotensive individuals, respectively. Results Attended BP (systolic/diastolic) was higher than unattended BP in total population (p < 0.001 and p = 0.02) and hypertensives (p < 0.001). In hypertensives, attended BP was higher than unattended BP regardless of age, smoking habit, obesity or controlled BP status but it was similar to unattended in diabetic patients. In normotensive individuals, attended BP was higher than unattended BP in older (p = 0.04), non-smoker (p = 0.002) and non-diabetic (p = 0.02) subjects. Finally, unattended BP was important for treatment decisions only in a small group of non-diabetic hypertensive patients (7%) whose unattended BP was controlled while attended BP was uncontrolled. Conclusions Unattended BP was lower than attended BP in the majority of hypertensive patients. However, it was useful only in a small percentage of non diabetic hypertensive patients in order to take appropriate treatment plan decisions.

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Are Unattended Blood Pressure Measurements Necessary in All Patients Visiting an Outpatient Cardiology Clinic?

Triantafyllidi

Voutsinos

Sioula

et al. 2020

High Blood Press Cardiovasc Prev

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Key Points of the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension

Kario

2019

Korean Circ J

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The new 2019 Japanese Society of Hypertension (JSH) guidelines for the management of hypertension are now available; these update the previous guidelines published in 2014. The primary objective of the guideline is to provide all healthcare professionals with a standard management strategy and appropriate antihypertensive treatments to prevent hypertension-related target organ damage and cardiovascular events. The major changes in the new guideline relate to the definition of normal blood pressure (BP) and target BP. The terms 'normal BP' and 'high normal BP' used in the JSH 2014 guidelines are replaced with terms 'high normal BP' and 'elevated BP,' respectively. There was no change to the office BP diagnostic threshold for hypertension (140/90 mmHg). Recommended target office and home BP values for patients with hypertension aged <75 years and/or high-risk patients are <130/80 mmHg and <125/75 mmHg, respectively. Corresponding targets for elderly patients with hypertension (age≥75 years) are 140/90 and 135/85 mmHg, respectively. The goal is that these changes will contribute to reducing cardiovascular events, especially stroke and heart failure, in Japan. The dissemination of the JSH 2019 guidelines and implementation of a home BP-based approach by all general practitioners in Japan might be facilitated by digital hypertension management using health information technology.

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Prognostic Significance of Central Blood Pressure for Adverse Renal Outcomes Compared to 24-Hr Ambulatory Blood Pressure and Clinical Blood Pressure

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Are Unattended Blood Pressure Measurements Necessary in All Patients Visiting an Outpatient Cardiology Clinic?

Are Unattended Blood Pressure Measurements Necessary in All Patients Visiting an Outpatient Cardiology Clinic?

Key Points of the 2019 Japanese Society of Hypertension Guidelines for the Management of Hypertension

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