Office vs. Ambulatory Blood Pressure

December 23rd, 2008 | Sources: Archives Int. Medicine, Medical News Today

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It’s a shame that blood pressure recordings from the doctor’s office aren’t great predictors of future cardiovascular events due to white-coat hypertension, but it is what it is.

The long-recognized phenomenon is characterized by office-based BP readings that are higher and more labile than those taken during the course of normal everyday life.

Thankfully, scientists have shown that ambulatory blood pressure recording devices provide useful predictive information, particularly in those having severe hypertension, a cardiac history, multiple cardiovascular risk factors, pregnancy and elderly folks.

Now Gil Salles and co-investigators at University Hospital Clementino Fraga Filho in Rio de Janeiro, Brazil have shown that ambulatory blood pressure recordings can predict CV risk in another subset of patients, the ones with resistant hypertension.

Sales’ was a prospective study of 556 patients with resistant hypertension, defined as persistently elevated blood pressure despite treatment with 3 anti-hypertensive agents.

After median follow-up of 4.8 years, the scientists found that 109 patients (19.6%) either died or incurred a cardiovascular event.

After controlling for age, gender, prior cardiac events and other CV risk factors, Salas’ group confirmed that office-derived blood pressure recordings were not predictive of future events, but higher mean ambulatory BPs did predict these events.

Ambulatory systolic and diastolic blood pressure recordings were both effective predictors, and nighttime recordings were superior to those obtained during the day.


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