Ambulatory Blood Pressure Monitoring and Risk of Cardiovascular Disease: A Population Based Study

Abstract Traditionally, blood pressure has been measured by the sphygmomanometer in the medical office. There is growing evidence, however, that office blood pressures may not be typical of values throughout the day. Between 20% and 30% of patients diagnosed with hypertension in the office actually are normotensive at other times. Ambulatory blood pressure monitoring with small, portable devices that automatically measure blood pressure every few minutes throughout the day appears to be an appropriate tool when "white-coat" hypertension is suspected--i.e., for individuals whose hypertension in the physician's office is not associated with other physical or historical evidence for cardiovascular disease or with other risk factors. Used prudently, ambulatory monitoring is a cost-effective technique that potentially can prevent unnecessary treatment of patients. Moreover, whole-day measurements may correlate more closely than office measurements may correlate more closely than office measurements do with findings of cardiovascular disease. This new approach also has highlighted the circadian pattern of blood pressure, especially the sharp early to mid-morning increase that coincides with an increased tendency to major cardiovascular events. This has focused attention on directing antihypertensive therapy towards the morning hours. Ambulatory monitoring is now used routinely in studies of antihypertensive drugs. This technique has no placebo effect and takes fewer patients to assess drug efficacy than do conventional methods.

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Ambulatory blood pressure monitoring and risk of cardiovascular disease

American Journal of Hypertension ◽

10.1016/j.amjhyper.2005.03.083 ◽

2005 ◽

Vol 18 (5) ◽

pp. A31-A32

Author(s):

T HANSEN ◽

J JEPPESEN ◽

S RASMUSSEN ◽

H IBSEN ◽

C TORPPEDERSEN

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring

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Disruption in Circadian Rhythm Increases Cardiovascular Disease Risk Factors in Shift Working Nurses

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0041-1732508 ◽

2021 ◽

Vol 06 (02) ◽

pp. 079-085

Author(s):

Ghizal Fatima ◽

Ashish Jha ◽

Mohsin Ali Khan

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Circadian Rhythm ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Significant Difference ◽

Hs Crp

Abstract Background Shift work is associated with behavioral, psychosocial, and physiological consequences in the body that may cause cardiovascular disease (CVD) risk. Therefore, in this study we tried to demonstrate the disruption in circadian rhythm of blood pressure by ambulatory blood pressure monitor in shift working nurses. Methods A total of 50 nurses, 25 night shift working nurses (NSWN), and 25 day shift working nurses (DSWN) underwent ambulatory blood pressure monitoring (ABPM) for a period of 24 hours. Along with measurements of inflammatory markers (hs-CRP and IL-6) the risk factors for cardiovascular disease between NSWN and DSWN and their possible relationship with disrupted circadian rhythm were measured by circadian rhythm questionnaire. Results The mean systolic and diastolic pressure for a period of 24 hours and mean diastolic blood pressure analysis throughout the sleep time was found greater in the NSWN than the DSWN (118 mm Hg vs. 112 mm Hg, p < 0.05: 72 mm Hg vs. 68 mm Hg, p < 0.05: 62 mm Hg vs. 59 mm Hg, p < 0.05). High mean blood pressure readings were found to be more frequent in the NSWN (p < 0.05) than in DSWN. No significant differences were found in IL-6 and hs-CRP levels. However, a significant difference in circadian rhythm abnormality was found in NSWN than in DSWN. Conclusion The 7 day/24 hours ambulatory blood pressure monitoring (ABPM) in NSWN showed a reduced circadian rhythm variation in blood pressure along with abnormality in circadian rhythm itself as compared with DSWN. Work schedules and the consequent rest–activity schedules affect circadian rhythms, with likely long-term impact on health. Therefore, working in critical care unit during night hours leads to abnormal blood pressure in NSWN, suggesting that this type of work, in which sleep is disturbed, leading to mental stress, could be a direct risk factor in cardiovascular diseases.

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Ambulatory Blood Pressure Monitoring in Diabetes and Obesity—A Review

International Journal of Hypertension ◽

10.4061/2011/954757 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Kazuo Eguchi

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Monitoring ◽

Masked Hypertension ◽

Pressure Monitoring ◽

Increased Risk ◽

Patients With Diabetes ◽

Diabetes And Obesity

Diabetes mellitus and obesity are both related to the risk of cardiovascular disease and sudden death. In hypertensive guidelines, diabetes and obesity, especially abdominal obesity, are regarded as high-risk factors. Ambulatory blood pressure monitoring (ABPM) is an established method for the management of hypertension. However, ABPM is not a standard tool for the management of hypertension in diabetes and obesity. In this paper, recent data on the use of ABPM in diabetes and obesity will be discussed. In patients with diabetes, the ambulatory BP level has been shown to be better than clinic BP in predicting cardiovascular events. A riser pattern has been associated with increased risk of cardiovascular disease. White-coat hypertension and masked hypertension in diabetics constitute a moderate risk. A nondipping pattern is very common in obese hypertensive patients. In this paper, we will summarize the findings on the use of ABPM in patients with diabetes and obesity.

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Comparison of 3 Devices for 24-Hour Ambulatory Blood Pressure Monitoring in a Nonclinical Environment Through a Randomized Trial

American Journal of Hypertension ◽

10.1093/ajh/hpaa117 ◽

2020 ◽

Vol 33 (11) ◽

pp. 1021-1029

Author(s):

Tatiana Nwankwo ◽

Sallyann M Coleman King ◽

Yechiam Ostchega ◽

Guangyu Zhang ◽

Fleetwood Loustalot ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Task Force ◽

Blood Pressure Monitoring ◽

Population Based ◽

Pressure Monitoring ◽

Convenience Sample ◽

The Difference ◽

Mean Differences

Abstract Background The U.S. Preventive Services Task Force recommends the use of 24-hour ambulatory blood pressure monitoring (ABPM) as part of screening and diagnosis of hypertension. The optimal ABPM device for population-based surveys is unknown. Methods We compared the proportion of valid blood pressure (BP) readings, mean awake and asleep BP readings, differences between awake ABPM readings and initial standardized BP readings, and sleep experience among three ABPM devices. We randomized a convenience sample of 365 adults to 1 of 3 ABPM devices: Welch Allyn Mobil-O-Graph (WA), Sun Tech Classic Oscar2 (STO) and Spacelabs 90227 (SL). Participants completed sleep quality questionnaires on the nights before and during ABPM testing. Results The proportions of valid BP readings were not different among the 3 devices (P > 0.45). Mean awake and asleep systolic BP were significantly higher for STO device (WA vs. STO vs. SL: 126.65, 138.09, 127.44 mm Hg; 114.34, 120.34, 113.13 mm Hg; P < 0.0001 for both). The difference between the initial average standardized mercury systolic BP readings and the ABPM mean awake systolic BP was larger for STO device (WA vs. STO. vs. SL: –5.26, –16.24, –5.36 mm Hg; P < 0.0001); diastolic BP mean differences were ~ –6 mm Hg for all 3 devices (P = 0.6). Approximately 55% of participants reported that the devices interfered with sleep; however, there were no sleep differences across the devices (P > 0.4 for all). Conclusion Most of the participants met the threshold of 70% valid readings over 24 hours. Sleep disturbance was common but did not interfere with completion of measurement in most of the participants.

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