Reproducibility of ambulatory blood pressure monitoring in daily practice

Steen, Michael; Lenders, J. W. M.; Graafsma, S.J.; Arend, Jörg; Thien, Th.

doi:10.1038/sj.jhh.1000808

Cited by 57 publications

(29 citation statements)

References 25 publications

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“…Previously, similar data have been reported in healthy normotensive adults as well as in untreated and treated patients with arterial hypertension [32,[35][36][37][38][39][40][41][42]. In accordance with our results, many studies have shown that ambulatory BP values are more reproducible than office BP values [13,[43][44][45][46].…”

Section: Discussionsupporting

confidence: 81%

Reproducibility of ambulatory blood pressure measurement in patients with coronary heart disease

2014

Cardiovasc Med

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SummaryAmbulatory blood pressure monitoring (ABPM) is a useful tool to establish the diagnosis of hypertension as well as for the monitoring of the response to antihypertensive therapy. We aimed to assess the reproducibility of the circadian blood pressure (BP) pattern (24 h, daytime and night-time BP and heart rate HR), the categorisation of individuals as dippers and non-dippers and the morning BP peak in three consecutive ABPM recordings obtained in patients with coronary artery disease.Methods: We performed a retrospective analysis of the reproducibility of 3 repeated ABPM obtained in 49 patients with coronary artery disease (age: 61.4 ± 7.9 years, 41 males, 36 hypertensives) enrolled in two previous studies using Tracker NIBP2 devices (Delmar, Del Mar Reynolds Medical, Hertford, UK). The standard interval of measurement was 20 minutes during the day and 45 minutes at night. The patients underwent ABPM on three separate days at intervals two to six weeks apart, on a typical week day with normal daily activity. All patients had a history of coronary artery disease and stable cardiovascular medication during the period of the three measurements.Results: Using analysis of variance for repeated measurement (ANOVA, Pillai's trace test) and by Pearson's correlation coefficient there was no significant variance in 24-hour, day and night BP and HR as well as morning BP peak. The categorisation of the subjects as dippers and non-dippers was also highly reproducible (p = 0.852; ns).Conclusions: Our data confirm that in patients with coronary artery disease the 24-hour recording of the circadian blood pressure patterns using Tracker NIBP2 devices is highly reproducible.

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Section: Discussionsupporting

confidence: 81%

Reproducibility of ambulatory blood pressure measurement in patients with coronary heart disease

2014

Cardiovasc Med

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“…Although this could mean that antihypertensive treatment based on SBPM leads to worse BP control as compared with OBPM-based treatment, we must realize that the reproducibility of ABPM is limited. 30 Although differences in mean ABPM and OBPM values between both groups are small and perhaps not relevant for a patient as an individual, these results cannot be ignored, because even small differences can have serious consequences with respect to cardiovascular complications in the population at large. Indeed, a meta-analysis of individual data for 1 million adults in 61 prospective studies showed that a 2-mm Hg-lower systolic BP value would eventually lead to a 10% lower stroke mortality and Ϸ7% lower mortality from ischemic heart diseases or other vascular causes in middleage patients.…”

Section: Discussionmentioning

confidence: 99%

Self-Measurement of Blood Pressure at Home Reduces the Need for Antihypertensive Drugs

et al. 2007

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Abstract-It is still uncertain whether one can safely base treatment decisions on self-measurement of blood pressure. In the present study, we investigated whether antihypertensive treatment based on self-measurement of blood pressure leads to the use of less medication without the loss of blood pressure control. We randomly assigned 430 hypertensive patients to receive treatment either on the basis of self-measured pressures (nϭ216) or office pressures (OPs; nϭ214). During 1-year follow-up, blood pressure was measured by office measurement (10 visits), ambulatory monitoring (start and end), and self-measurement (8 times, self-pressure group only). In addition, drug use, associated costs, and degree of target organ damage (echocardiography and microalbuminuria) were assessed. Key Words: blood pressure Ⅲ hypertension Ⅲ self-measurements Ⅲ home monitoring Ⅲ ambulatory blood pressure measurement Ⅲ treatment A s indications for lowering blood pressure (BP) become increasingly stringent, the associated medication use and costs rise markedly. 1 This calls for proper diagnosis and careful selection of patients in whom treatment is really indicated. In this respect, conventional office BP measurements (OBPMs) have disadvantages, because they can easily elicit a white-coat effect, overestimation of a patient's BP, 2 and unnecessary drug prescription. Self-BP measurements (SBPMs) are less liable to the white-coat effect 3 and may provide a more reliable estimate of a patient's "true" BP. In addition, SBPM correlates better with the development of target organ damage (TOD) than OBPM 4 -6 and for the occurrence of cardiovascular complications. 7,8 Therefore, SBPM has the potential to identify subjects that may not need treatment. This could reduce drug use and lead to considerable costs savings. The Home versus Office Measurement, Reduction of Unnecessary treatment Study (HOMERUS) was designed to determine whether treatment based on SBPM leads to a decreased drug prescription without an impaired BP control and TOD as compared with treatment based on OBPM. MethodsThe design of the HOMERUS has been described in detail elsewhere. 9 Briefly, HOMERUS is a multicenter, prospective, randomContinuing medical education (CME) credit is available for this article. Go to http://cme.ahajournals.org to take the quiz.

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“…However, recent studies specifically directed to reproducibility of the presentation of blood pressure drop during sleep showed no statistical differences after 4 examinations of ambulatory blood pressure monitoring in the same patient, performed on the same weekday at 30-day intervals 36 . The possible factors involved in the reproducibility of ambulatory blood pressure monitoring could be the following: different daily activities on different days of examination, a reduction in accuracy due to very high levels of blood pressure, differences in the quality of sleep, and limitation of the examination in conditions of ambulatory measurements 37 . Noninclusion of patients with diagnosed or suspected secondary hypertension according to medical requisitions aimed to exclude patients with previous alterations in blood pressure drop during sleep, which do not depend on the quality of sleep 23 .…”

Section: Discussionmentioning

confidence: 99%

Influence of Quality of Sleep on the Nocturnal Decline in Blood Pressure During Ambulatory Blood Pressure Monitoring

Alessi¹,

Alessi²,

Piana³

et al. 2002

Arq. Bras. Cardiol.

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Reproducibility of ambulatory blood pressure monitoring in daily practice

Cited by 57 publications

References 25 publications

Reproducibility of ambulatory blood pressure measurement in patients with coronary heart disease

Reproducibility of ambulatory blood pressure measurement in patients with coronary heart disease

Self-Measurement of Blood Pressure at Home Reduces the Need for Antihypertensive Drugs

Influence of Quality of Sleep on the Nocturnal Decline in Blood Pressure During Ambulatory Blood Pressure Monitoring

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