Hypertension staging through ambulatory blood pressure monitoring.
TLDR
This issue of Hypertension includes an article by Bur et al that focuses on the comparison between clinic and ambulatory blood pressure (ABP) values in patients with moderate to severe hypertension, and adds interesting information to the existing database on the clinical value of ABP.Abstract:
This issue of Hypertension includes an article by Bur et al1 that focuses on the comparison between clinic and ambulatory blood pressure (ABP) values in patients with moderate to severe hypertension. The primary goal of the Bur study was to obtain a classification of hypertensive patients, based on the ABP values corresponding to the clinic blood pressure (BP) values that have been used to stage hypertension by the World Health Organization–International Society of Hypertension (WHO-ISH) and the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC) VI guidelines.2,3 An additional goal was to evaluate whether this ABP-based classification has prognostic value, as shown for the prognostic value of the clinic BP staging. Both clinic BP and ABP were measured in 736 hypertensive patients (557 of whom were under treatment) at the time of their first admission to the local Hypertension Unit. All patients then entered a follow-up period with an average duration of 52 months (range, 6 to 96 months), during which only clinic BP was obtained. During the observation time, 82 patients had nonfatal cardiovascular events and 9 patients died of cardiovascular causes.
The article adds interesting information to the existing database on the clinical value of ABP. In particular, it contributes to the available knowledge on the prognostic importance of ABP as well as on its relation to clinic BP in the context of treating patients in a hypertension center.4
Stratifying patients into different risk categories on the basis of ABP values requires studies that (1) establish in populations or in large groups of hypertensive patients the relation of cardiovascular morbidity and mortality with the different 24-hour ABP values selected5,6 and (2) evaluate how prognosis of patients is modified when ABP is reduced by treatment, leading to a change in …read more
Citations
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Journal ArticleDOI
Predictors of All-Cause Mortality in Clinical Ambulatory Monitoring. Unique Aspects of Blood Pressure During Sleep
Iddo Z. Ben-Dov,Jeremy D. Kark,Drori Ben-Ishay,Judith Mekler,Liora Ben-Arie,Michael Bursztyn +5 more
TL;DR: In practice, ambulatory blood pressure predicts mortality significantly better than clinic blood pressure and the availability of blood pressure measures during sleep and, in particular, the pattern of dipping add clinically predictive information and provide further justification for the use of ambulatory monitoring in patient management.
Journal ArticleDOI
Clinical and research aspects of ambulatory blood pressure monitoring in children.
Journal ArticleDOI
Guiding antihypertensive treatment decisions using ambulatory blood pressure monitoring.
TL;DR: The usefulness of ABPM in pharmacologic studies aimed at evaluating the 24-hour antihypertensive efficacy of different drugs and drug combinations is acknowledged and the ABPM-derived smoothness index provides a superior measure of the homogeneity of BP control compared with trough:peak ratios.
Journal ArticleDOI
Home blood pressure monitoring in general practice: expectations and concerns.
TL;DR: Department of Clinical Medicine, Prevention and Applied Biotechnology, University of Milano-Bicocca, Milan, Italy, II Cardiology Unit, San Luca Hospital, IRCCS, Istituto Auxologico Italiano and Clinical Pharmacology Unit and Hypertension Clinic are cited.
References
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Journal ArticleDOI
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
Effects of an angiotensin-converting -enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients
TL;DR: Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure.
Journal Article
The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure
Journal ArticleDOI
Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.
Björn Dahlöf,Richard B. Devereux,Sverre E. Kjeldsen,Stevo Julius,Gareth Beevers,Ulf de Faire,Frej Fyhrquist,Hans Ibsen,Krister Kristiansson,Ole Lederballe-Pedersen,Lars H Lindholm,Markku S. Nieminen,Per Omvik,Suzanne Oparil,Hans Wedel +14 more
TL;DR: Losartan prevents more cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and is better tolerated, while new-onset diabetes was less frequent with losartan.
Journal Article
1999 world health organization-international society of hypertension guidelines for the management of hypertension
Michael H. Alderman,K. Arakawa,L. Beilin,John Chalmers,S. Erdine,M. Fujishima,P. Hamet,L. Hannson,Lewis Landsberg,F. Leenen,L. Lindholm,L. Lisheng,A. F B Mabadeje,S. MacMahon,G. Mancia,I. Martin,A. Mimran,K. H. Rahn,A. Ribeiro,P. Sleight,J. Whitworth,Alberto Zanchetti,Bruce Neal,Anthony Rodgers,C. N. Mhurchu,T. Clark +25 more
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