The clinical value of ambulatory blood pressure monitoring

Gibbs, C R; Murray, S; Beevers, D. G.

doi:10.1136/hrt.79.2.115

Cited by 6 publications

(10 citation statements)

References 20 publications

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“…In the present study, the systolic ABP values were about 8% higher in the PRE children and 5% higher in the non-PRE children than in the subjects with similar heights in the study of Soergel et al (23). The nocturnal fall or "dipping" of BP is a physiologic phenomenon, and its absence has been considered a predictor of cardiovascular morbidity and mortality (24). However, in our study population, the percentages of nocturnal ABP dipping were quite close to those reported by Soergel et al (23), and the decrease in nocturnal systolic and diastolic ABP did not differ between the PRE and non-PRE children.…”

Section: Discussionmentioning

confidence: 75%

Maternal Preeclampsia Predicts Elevated Blood Pressure in 12-Year-Old Children: Evaluation by Ambulatory Blood Pressure Monitoring

et al. 2006

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Ambulatory blood pressure (ABP) monitoring offers a reliable method for determining blood pressure (BP) in children. The aim of this cohort study was to examine whether maternal preeclampsia is associated with elevated BP in an offspring. The study population consisted of 57 children born to preeclamptic mothers (PRE) and their 57 age-and sex-matched control subjects born to normotensive mothers (non-PRE). We examined the 24-h ABP at 12 y of age in the PRE and non-PRE children. Within the two groups, the association of anthropometric measures, plasma catecholamine (epinephrine [E], norepinephrine [NE]) concentrations, and ABP was examined. The PRE children had significantly higher mean 24-h systolic and diastolic ABPs than the non-PRE children. The same was true for the mean daytime and nighttime systolic and diastolic ABPs. The PRE boys had higher 24-h systolic ABP than the PRE girls. In the PRE children, high plasma E concentration and being born small for gestational age (SGA) predicted high systolic 24-h ABP in logistic regression analysis. In the non-PRE children, high current body mass index (BMI) and high plasma E concentration was associated with high systolic 24-h ABP. In conclusion, systolic and diastolic ABP values were elevated in the PRE children. High plasma E concentration and being born SGA were associated with high systolic 24-h ABP in the PRE children. Presumably maternal preeclampsia affects offspring via several mechanisms, including genetic ones and metabolic consequences of restricted intrauterine growth.

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Section: Discussionmentioning

confidence: 75%

Maternal Preeclampsia Predicts Elevated Blood Pressure in 12-Year-Old Children: Evaluation by Ambulatory Blood Pressure Monitoring

et al. 2006

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“…10,12,13 Increasing the ETL from 30.48 to 182.88 cm and ensuring no air bubbles are in the system decreased the NF from 39 to 23 Hz in the radial arterial catheter. 10 One study suggested that the ETL should be limited to 121.92 cm, where it was shown that as the ETL increased, the NF decreased, and the BP was found to be reliable up to 121.92 cm ETL. 12 Conversely, this study showed that an ETL less than 275 cm could be used to reliably measure BP.…”

Section: Discussionmentioning

confidence: 99%

“…9 Although leveling, zeroing, and calibration are relatively simple and easy to achieve, the effects of the catheter tubing system are still being studied as they are affected by many variable factors. [10][11][12] The catheter tubing system, which is located just behind the catheter, transfers the pressure back to the transducer. The only way to ensure that the catheter tubing system can reproduce waveforms without distortion is to analyze the system's dynamic response characteristics.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have been performed to identify the optimal ETL of the catheter tubing system. 10,11,14,15 However, these studies were all performed with regard to human medicine, and there is a dire need to evaluate the NF, DC, and ETL of the catheter tubing system in veterinary medicine, because animal patients have relatively wide variations in size.…”

Section: Introductionmentioning

confidence: 99%

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Effect of extension tube length on the damping coefficient and natural frequency in normotensive dogs

Son

Kim

Lee

2022

J Vet Emergen Crit Care

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Objective To establish an acceptable extension tube length (ETL) to measure direct blood pressure (BP) in dogs. Design Prospective, experimental study. Setting University‐based small animal research facility. Animals Eight healthy Beagle dogs: 6 males and 2 females. Interventions Each extension tube with lengths of 25, 50, 75, 115, 145, 205, and 275 cm were connected after the catheterization with a 22‐Ga catheter in the dorsal pedal artery in sternal recumbency. A square wave from the fast‐flush test was consecutively recorded 5 times to analyze the system's dynamic response characteristics according to the ETL. After recording the square wave, the ETL was converted to a Latin square. The dynamic response was analyzed using natural frequency (NF) and the damping coefficient (DC), both of which affect the damping factor. The average values of NF and DC were plotted against a graph showing the damping factor. Linear regression was used to evaluate the between‐group changes in NF and DC. Measurements and Main Results The DC gradually increased from 0.21 to 0.29 ξ, and the NF gradually decreased from 38 to 14 Hz according to the increase in ETL (P < 0.05). The dynamic response showed adequate damping with all ETLs. Conclusion With an increase in ETL, the NF decreased significantly, while the DC demonstrated a less significant change. Therefore, NF had a greater influence on the damping factor of arterial BP measurement. There was no difference between ETLs from 25 to 275 cm lines for measuring BP. An ETL of less than 275 cm is recommended as the damping amount is adequate. Moreover, an ETL less than 275 cm does not meaningfully affect BP measurement in dogs.

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“…ABPM and mean daytime BP provided an accurate assessment of patients' hypertension (28), and enabled clinicians to exclude subjects with white coat hypertension (29,30).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Increasing the doses of both diuretics and angiotensin receptor blockers is beneficial in subjects with uncontrolled systolic hypertension

Lacourcière

Poirier

Lefèbvre

et al. 2010

Canadian Journal of Cardiology

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A ccording to two recent Canadian studies (1,2), control rates of hypertension are markedly increasing in middle-aged (61%) and elderly (67.7%) hypertensive patients, but are more difficult to achieve in patients with predominant systolic hypertension (3). In this regard, most patients may require multiple-drug therapy including a diuretic to achieve their blood pressure (BP) target. Two-drug therapy consisting of an angiotensin receptor blocker (ARB) and a thiazide diuretic provides additive efficacy through the different actions of the two drugs on the renin-angiotensin-aldosterone system (RAAS) (4). Current practice usually limits the daily dose of hydrochlorothiazide (HCTZ) to 25 mg because of the belief that efficacy can be obtained and that deleterious metabolic effects are not frequent with such a dose.In a previous study (5), combinations of losartan (LOS) 50 mg with HCTZ 12.5 mg (LOS50/HCTZ12.5) and LOS 100 mg with HCTZ 25 mg (LOS100/HCTZ25) provided a significant systolic and diastolic ambulatory BP ( BACKGROUND: Blood pressure (BP) control is frequently difficult to achieve in patients with predominantly elevated systolic BP. Consequently, these patients frequently require combination therapy including a thiazide diuretic such as hydrochlorothiazide (HCTZ) and an agent blocking the renin-angiotensin-aldosterone system. Current clinical practice usually limits the daily dose of HCTZ to 25 mg. This often leads to the necessity of using additional antihypertensive agents to control BP in a high proportion of patients. OBJECTIVES: To compare the efficacy of two doses of losartan (LOS)/ HCTZ combinations in patients with uncontrolled ambulatory systolic hypertension after six weeks of treatment with LOS 100 mg/HCTZ 25 mg (LOS100/HCTZ25). METHODS: Following a two-to four-week washout period, subjects with a mean clinic sitting systolic BP of 160 mmHg or higher and a mean ambulatory daytime systolic BP (MDSBP) of 135 mmHg or higher on LOS100/HCTZ25 (n=105; 33 women and 72 men) were randomly assigned to receive LOS 150 mg/HCTZ 25 mg (group 1; n=53) or LOS 150 mg/HCTZ 37.5 mg (LOS150/HCTZ37.5, group 2; n=52). The primary end point was the difference in MDSBP reductions. RESULTS: At the end of the six-week treatment period, the respective additional decreases in MDSBP were 1.2 mmHg (P=0.335) on LOS 150 mg/HCTZ 25 mg and 5.6 mmHg (P<0.0001) on LOS150/HCTZ37.5 (difference of 4.4 mmHg; P=0.011). Daytime systolic ambulatory BP goal (lower than 130 mmHg) achievement tended to be higher (25% versus 17%; P=0.313) with LOS150/HCTZ37.5, while it was significantly higher (65% versus 43%; P=0.024) for mean daytime diastolic BP (lower than 80 mmHg). No deleterious metabolic changes were observed. CONCLUSIONS: In patients with uncontrolled systolic ambulatory hypertension receiving LOS100/HCTZ25, increasing both HCTZ and LOS dosages simultaneously to LOS150/HCTZ37.5 may be an effective strategy that does not affect metabolic parameters.

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The clinical value of ambulatory blood pressure monitoring

Cited by 6 publications

References 20 publications

Maternal Preeclampsia Predicts Elevated Blood Pressure in 12-Year-Old Children: Evaluation by Ambulatory Blood Pressure Monitoring

Maternal Preeclampsia Predicts Elevated Blood Pressure in 12-Year-Old Children: Evaluation by Ambulatory Blood Pressure Monitoring

Effect of extension tube length on the damping coefficient and natural frequency in normotensive dogs

Increasing the doses of both diuretics and angiotensin receptor blockers is beneficial in subjects with uncontrolled systolic hypertension

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