Comparative Study of Ambulatory Blood Pressure Monitoring and Clinic Blood Pressure Measurement in the Risk Assessment and Management of Hypertension
Journal Title: Sultan Qaboos University Medical Journal - Year 2010, Vol 10, Issue 3
Abstract
Blood pressure (BP) measurements taken in a physician’s clinic do not represent readings throughout the day. Ambulatory blood pressure monitoring (ABPM) overcomes this problem by providing multiple readings with minimal interference with the patient’s daily activities. The purpose of our study was to evaluate the value of ABPM in risk assessment and management of hypertension compared to office measurements. Methods: A total of 104 consecutive hypertensive patients were retrospectively studied from January 2007 to December 2009. Te following data were gathered: 1) clinic BP measurements; 2) routine blood test results; 3) electrocardiography, echocardiography, and 4) 24-hour ABPM. Results: Te mean age of patients was 41.1 ± 8.6 years and 51.9% of them male. Indications for ABPM were: suspected “white coat†hypertension (10.6%), de novo hypertension (18.2%), resistant hypertension (27.9%) and others (43.3%). Mean daytime and nighttime BP were 134/82 and 124/73 mmHg respectively. A non-dipping pattern was reported in 64.4%. Echocardiographic evidence of left ventricular hypertrophy (LVH) and diastolic dysfunction (LVDD) was encountered in 22.1% and 29.8% respectively. ABPM parameters were signifcantly correlated with LVDD (P = 0.043). Patients with proved “white coat†hypertension did not receive antihypertensive therapy. Conclusion: Twenty-four hour ABPM is an important yet underused tool for proper risk stratifcation of treated hypertensive patients. Te non-dipping profle is associated with a higher incidence of diastolic dysfunction. Our collective results revealed the superiority of ABPM over ofce BP measurement.
Authors and Affiliations
Hatem Farhan| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Mona Al-Hasani| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Mohamed Misbah| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Mansour Sallam| Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
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