Ambulatory blood pressure monitoring: clinical characteristics of 31,530 patients.

Med Clin (Barc). 2007 Jun 2;129(1):1-5.
Sierra C, De la Sierra A, Sobrino J, Segura J, Banegas JR, Gorostidi M, Ruilope LM; en representación de los Investigadores del Registro Nacional de MAPA. Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA).
Unidad de Hipertensión. Servicio de Medicina Interna. Hospital Clínic. Barcelona. España.

BACKGROUND AND OBJECTIVE: Ambulatory blood pressure monitoring (ABPM) is a useful diagnostic and therapeutic tool in hypertensive patients. This study reports the clinical characteristics of 31,530 patients included in the Spanish Registry of ABPM.

PATIENTS AND METHOD: A total number of 767 investigators recruited patients with suspected or confirmed hypertension to whom an ABPM was indicated with a validated device and included them in the study. Mean blood pressures from daytime, nighttime, and the whole 24-hour period were all measured. Circadian patterns were defined depending on nocturnal systolic blood pressure fall: extreme dipper (> 20%), dipper (10%-20%), non-dipper (< 10%) and riser (nocturnal blood pressure increase).

RESULTS: 24-hour, daytime, and nighttime blood pressure values were lower than those obtained at the office. Twenty percent of patients exhibited elevated office blood pressure with normal values on ABPM (<> hypertensives or false resistant) whereas 9% showed increased values on ABPM, but normal at the office (masked hypertension). The non-dipper or riser circadian patterns were present in more than half of the patients (40.2% and 13.4%, respectively) and were associated with an increased cardiovascular risk.

CONCLUSIONS: Almost one third of hypertensive patients exhibit blood pressure values that are not concordant between office and ABPM. More than a half of patients, especially those at higher risk, present a circadian pattern with an inadequate nocturnal blood pressure fall.




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