scholarly journals OPTIMAL THRESHOLDS FOR AMBULATORY BLOOD PRESSURE IN PATIENTS WITH HIGH CARDIOVASCULAR RISK

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e53
Author(s):  
Ha Jaehyung ◽  
Lee Chanjoo ◽  
Kim Hyoeun ◽  
Chun Kyeong-Hyeon ◽  
Oh Jaewon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Ambulatory Blood Pressure ◽  
High Cardiovascular Risk ◽  
Optimal Thresholds

Abstract 113: Ambulatory Blood Pressure in Hypertensive Patients with Inclusion Criteria for the SPRINT Trial

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Alejandro De La Sierra ◽  
Jose R Banegas ◽  
Juan A Divison ◽  
Manuel Gorostidi ◽  
Ernest Vinyoles ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Antihypertensive Therapy ◽  
Ambulatory Blood Pressure ◽  
Normal Values ◽  
Inclusion Criteria ◽  
High Cardiovascular Risk ◽  
Exclusion Criteria ◽  
Hypertensive Patients ◽  
Mean Values

The SPRINT trial has demonstrated the benefit of intensive BP reduction in hypertensive patients at high cardiovascular risk. Values of ABPM are of potential interest in such patients to better select those who will benefit of a lower BP target. We aimed to evaluate ABPM values in a large cohort of patients potentially candidates (meeting inclusion criteria) for the SPRINT trial. Moreover, in patients on antihypertensive therapy who also fulfill SPRINT criteria, except for clinic SBP ≥ 130 mmHg, we evaluated 24-hour SBP values among those who had clinic SBP < 120; between 120 and 139, or ≥ 140. From the database of the Spanish ABPM Registry containing 115708 patients, we identified 39132 (34%, 51% women, mean age 65 years) who fulfill both inclusion and exclusion criteria of the SPRINT trial. Mean values of clinic SBP were 151±11 mmHg, whereas corresponding values for 24-h SBP were 130±13 mmHg. Overall, 52% of patients had 24-h SBP below 130 mmHg. The proportion varied from 69% in those with clinic BP 130-139 to 34% in those with clinic BP ≥ 170 mmHg. Among 34328 treated patients who fulfilled SPRINT inclusion criteria (except for clinic BP ≥ 130), 1014 (3%) had clinic SBP < 120 mmHg, and 5330 (16%) values between 120 and 139 mmHg. The remaining 27984 patients were not controlled and had clinic SBP ≥ 140 mmHg. Values of 24 h SBP below 130 mmHg were seen in 88% of those with clinic BP < 120, in 74% of those with clinic BP 120-139, and in 47% of those with clinic BP ≥ 140 mmHg. The corresponding proportion of patients having 24-h SBP < 100 mmHg were 7.7%, 1.1%, and 0.6%. We conclude that ABPM assessment could be necessary in the evaluation of hypertensive patients at high CV risk before targeting the BP goal, as roughly half of them may have normal values of 24-h SBP (< 130 mmHg). In addition, targeting clinic BP below 120 mmHg is accompanied by 8% of patients with 24-h SBP below 100 mmHg.

Abstract 14799: Home Blood Pressure Range and 24-hr Ambulatory Blood Pressure Control: The Japan Morning Surge Home Blood Pressure (J-HOP) Study-ABPM Substudy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mizuri Taki ◽  
Satoshi Hoshide ◽  
Kazuo Eguchi ◽  
Yuichiro Yano ◽  
Kazuomi Kario
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Control ◽  
Home Blood Pressure ◽  
High Cardiovascular Risk ◽  
Antihypertensive Medications ◽  
Data Memory ◽  
Blood Pressure Range

Background: Measures of home and ambulatory blood pressure monitoring (HBPM and ABPM) are crucial to evaluate BP control status in hypertensive patients. HBPM is widely used in clinical practice, but ABPM is used less frequently. Few studies have examined the threshold of home BP, suggesting well controlled BP in 24-hour BP, daytime BP, and nighttime BP . Methods: We analyzed data from the Japan Morning Surge Home Blood Pressure (J-HOP) Study, which included 1,439 patients with at least one cardiovascular risk factor (mean age 64.6 years, 47.8% men, 82.3% used antihypertensive medications). Both HBPM (three measures each in the morning and evening over 14 days, using the same semiautomatic HBP device with data memory and 24-hr ABPM were performed in all patients). Results: Of 355 patients with home systolic BP (HSBP) <125mmHg, 78.9%, 76.9%, and 81.4% were classified as having well-controlled 24-hr SBP (<130mmHg), daytime SBP (<135mmHg), and nighttime SBP (<120mmHg), respectively). In contrast, of 656 subjects with HSBP ≥135 mmHg, 67.5% were classified as having uncontrolled 24-hr SBP (≥130mm Hg). Of 428 patients with HSBP between 125mmHg and 134mmHg, only 54.9% were classified as having well-controlled 24-hr SBP. Conclusions: Among patients with high cardiovascular risk, nearly 80% of those with home systolic BP <125mmHg were well-controlled for 24-hr SBP including nighttime systolic BP, whereas nearly 70% of those with >135mmHg were uncontrolled for 24-hr systolic BP. The patients with HBP at 125-134mmHg require ABPM for the evaluation of their 24-hr BP control status.

Management of high blood pressure in patients with high cardiovascular risk

Medic ro ◽  
2018 ◽  
Vol 4 (124) ◽  
pp. 48
Author(s):  
Svetlana Moșteoru ◽  
Roxana Pleavă ◽  
Claudia Hudrea ◽  
Laura Gaiţă ◽  
Dan Gaiţă
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
High Blood Pressure ◽  
High Cardiovascular Risk

Therapieziele bei der Hypertoniebehandlung

2017 ◽  
Vol 142 (19) ◽  
pp. 1420-1429 ◽  
Author(s):  
Rainer Düsing
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Systolic Blood Pressure ◽  
Measurement Procedure ◽  
Treatment Goals ◽  
High Cardiovascular Risk ◽  
Hypertensive Patients ◽  
Optimal Target ◽  
Elderly Hypertensive ◽  
Intervention Trials

AbstractThe optimal target blood pressure (BP) in the treatment of hypertensive patients remains controversial. Recently, the systolic blood pressure trial (SPRINT) has proposed that a target systolic blood pressure of < 120 mmHg provides prognostic benefit in elderly hypertensive patients at high cardiovascular risk. The results of SPRINT contrast with several other intervention trials which have investigated the effect of intense BP lowering (Secondary Prevention of Small Subcortical Strokes [SPS3], Action to Control Cardiovascular Risk in Diabetes [ACCORD], Heart Outcomes Prevention Evaluation [HOPE]-3). The differences in outcomes in SPRINT vs. other intervention trials are, to a large extend, due to an "unobserved" BP measurement procedure utilized in the SPRINT trial. Thus, a BP goal of < 120 mmHg, at least by conventional BP measurement, remains unproven. Independent of SPRINT the controversial evidence with respect to BP targets calls for further studies and, possibly, for more individualized treatment goals.

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