scholarly journals Long Working Hours and the Prevalence of Masked and Sustained Hypertension

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 532-538 ◽  
Author(s):  
Xavier Trudel ◽  
Chantal Brisson ◽  
Mahée Gilbert-Ouimet ◽  
Michel Vézina ◽  
Denis Talbot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Measurement ◽  
Prevalence Ratio ◽  
Working Hours ◽  
Masked Hypertension ◽  
Clinic Blood Pressure ◽  
Long Working Hours ◽  
Sustained Hypertension ◽  
The Mean

Previous studies on the effect of long working hours on blood pressure have shown inconsistent results. Mixed findings could be attributable to limitations related to blood pressure measurement and the lack of consideration of masked hypertension. The objective was to determine whether individuals who work long hours have a higher prevalence of masked and sustained hypertension. Data were collected at 3-time points over 5 years from 3547 white-collar workers. Long working hours were self-reported, and blood pressure was measured using Spacelabs 90207. Workplace clinic blood pressure was defined as the mean of the first 3readings taken at rest at the workplace. Ambulatory blood pressure was defined as the mean of the next readings recorded every 15 minutes during daytime working hours. Masked hypertension was defined as clinic blood pressure < 140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg. Sustained hypertension was defined as clinic blood pressure ≥140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg or being treated hypertension. Long working hours were associated with the prevalence of masked hypertension (prevalence ratio 49+ =1.70 [95% CI, 1.09–2.64]), after adjustment for sociodemographics, lifestyle-related risk factors, diabetes mellitus, family history of cardiovascular disease, and job strain. The association with sustained hypertension was of a comparable magnitude (prevalence ratio 49+ =1.66 [95% CI, 1.15–2.50]). Results suggest that long working hours are an independent risk factor for masked and sustained hypertension. Workplace strategies targeting long working hours could be effective in reducing the clinical and public health burden of hypertension.

scholarly journals Persistence and Progression of Masked Hypertension: A 5-Year Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Xavier Trudel ◽  
Alain Milot ◽  
Chantal Brisson
Keyword(s):  
Blood Pressure ◽  
Prospective Study ◽  
Working Hours ◽  
White Collar ◽  
Public Organizations ◽  
Diagnosis And Treatment ◽  
Masked Hypertension ◽  
Sustained Hypertension ◽  
White Collar Workers ◽  
The Mean

Objectives. To examine masked hypertension persistence over 5 years.Methods. White-collar workers were recruited from three public organizations. Blood pressure (BP) was measured using Spacelabs 90207. Manually operated BP was defined as the mean of the first three readings taken at rest. Ambulatory BP was defined as the mean of the next readings taken every 15 minutes and recorded during working hours. BP was assessed three times over 5 years. Masked hypertension was defined as manually operated BP less than 140 and less than 90 mmHg and ambulatory BP at least 135 or at least 85 mmHg. Sustained hypertension was defined as manually operated BP at least 140 or at least 90 mmHg and ambulatory BP at least 135 or at least 85 mmHg or being treated for hypertension.Results. BP measurements were obtained from 1669 participants from whom 232 had masked hypertension at baseline. Persistence of masked hypertension was 38% and 18.5%, after 3 and 5 years, respectively. Progression to sustained hypertension was 26% and 37%, after 3 and 5 years, respectively.Conclusion. Among baseline masked hypertensives, one-third progressed to sustained hypertension and about one out of five remained masked after 5 years, potentially delaying diagnosis and treatment.

scholarly journals Renal hypertension and cardiovascular disorder in children with chronic kidney disease

2014 ◽  
Vol 142 (1-2) ◽  
pp. 113-117 ◽  
Author(s):  
Amira Peco-Antic ◽  
Dusan Paripovic
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Children And Adolescents ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Renal Hypertension ◽  
Masked Hypertension ◽  
Ambulatory Blood Pressure Measurement

Renal hypertension is one of the earliest and the most prevalent complications of pediatric chronic kidney disease (CKD). Among renal patients, hypertension is frequently underdiagnosed and undertreated. For casual blood pressure measurement, the best method is auscultatory, while for ambulatory blood pressure measurement, oscillometric method is the most commonly used. Both casual and ambulatory blood pressure measurement provide more powerful means of diagnosing hypertension. Masked hypertension is a condition in which casual blood pressure is normal but ambulatory blood pressure is elevated. The risk of cardiovascular morbidity and mortality is higher with masked hypertension as compared to the controls. Children and adolescents with CKD are at high risk of cardiovascular disease that has been established as the leading cause of death in patients with end stage renal disease. Left ventricular hypertrophy remains the most thoroughly documented form of end-organ damage caused by hypertension in children and adolescents with CKD. Based on clear evidence on the correlation between blood pressure and cardiovascular morbidity, mortality, and renal function, renal hypertension must be aggressively treated. Target blood pressure for patients with renal hypertension should be at low normal values: <75 percentile for patients without proteinuria and <50 percentile for patients with proteinuria. Renin-angiotensin system antagonists are considered the first choice pharmacological option in hypertensive CKD 2-4 patients while the management of volume overload is the most important in dialysis patients. Successful transplantation can eliminate or significantly improve uremia-related cardiovascular risk factors and increase predicted life expectancy.

Ambulatory versus clinic blood pressure measurement - more evidence

2018 ◽  
Vol 56 (10) ◽  
pp. 116-116
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Clinic Blood Pressure ◽  
Ambulatory Blood Pressure Measurements

Review of: Banegas J et al. Relationship between clinic and ambulatory blood pressure measurements and mortality. New Engl J Med 2018; 378: 1509–20.

scholarly journals Non-Clinic Blood Pressure Measurement – More Light, Less Darkness

2018 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Vinay Kapur
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Target Organ Damage ◽  
Early Morning ◽  
Morbidity And Mortality ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Clinic Blood Pressure ◽  
Night Time ◽  
Nocturnal Hypertension

Non-clinic blood pressure measurements are very important in confirming diagnosis of hypertension and they give us an idea of associated cardiovascular risk more precisely than clinic BP measurements. It can detect masked hypertension and white coat hypertension & ABPM especially can monitor night-time BP diagnosing individuals with nocturnal hypertension.  Masked hypertension and nocturnal hypertension are strongly related with target organ damage along with enhanced morbidity and mortality due to cardiovascular causes. ABPM can also measure early morning rise of BP, mean 24 hour BP, diurnal variation as well as average real variability. Home BP monitoring by patients themselves leads to their greater involvement in maintaining BP records and in achieving treatment goals. The purpose of this review is to preferentially discuss role of non-clinic BP monitoring in making accurate diagnosis and deciding treatment of hypertension that might help a great deal in reducing morbidity and mortality associated with it.        Asian Journal of Medical Sciences Vol.10(1) 2019 13-18 

scholarly journals Office and Ambulatory Arterial Hypertension in Highlanders

Hypertension ◽  
2020 ◽  
Vol 76 (6) ◽  
pp. 1962-1970
Author(s):  
Grzegorz Bilo ◽  
Lorenzo Acone ◽  
Cecilia Anza-Ramírez ◽  
José Luis Macarlupú ◽  
Davide Soranna ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Blood Oxygen Saturation ◽  
Chronic Mountain Sickness ◽  
Nocturnal Hypertension ◽  
Mountain Sickness

Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%) participants, while ambulatory hypertension was found in 58 (20%) participants. Masked hypertension was common (15%), and white coat hypertension was rare (2%). Among participants with ambulatory hypertension, the most prevalent phenotypes included isolated nocturnal hypertension, isolated diastolic hypertension, and systodiastolic hypertension. Ambulatory hypertension was associated with male gender, age, overweight/obesity, 24-hour heart rate, and excessive erythrocytosis. Prevalence of hypertension among Andean highlanders may be significantly underestimated when based on conventional blood pressure measurements, due to the high prevalence of masked hypertension. In highlanders, ambulatory hypertension may be independently associated with excessive erythrocytosis.

Reliability of single office blood pressure measurements

Heart ◽  
2018 ◽  
Vol 104 (14) ◽  
pp. 1173-1179 ◽  
Author(s):  
Thilo Burkard ◽  
Michael Mayr ◽  
Clemens Winterhalder ◽  
Licia Leonardi ◽  
Jens Eckstein ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Measurement ◽  
Office Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Short Term ◽  
Cross Sectional ◽  
Registration Number ◽  
The Mean ◽  
The Difference

ObjectivesStandard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH).Design and settingIn this cross-sectional, single-centre trial, 1000 adult subjects were enrolled. After 5 min of rest, four sequential standard OBPMs were performed at 2 min intervals in a quiet room in sitting position. We compared the first (fBPM) to the mean of the second to fourth measurement (mBPM). STMH was defined as fBPM <140 mm Hg systolic and <90 mm Hg diastolic and mBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg. STWCH was defined as fBPM systolic ≥140 mm Hg or diastolic ≥90 mm Hg and mBPM <140 mm Hg systolic and <90 mm Hg diastolic.ResultsComplete measurements were available in 802 subjects. Between fBPM and mBPM, 662 (82.5%), 441 (55%) and 208 (25.9%) subjects showed a difference in systolic and 531 (66.2%), 247 (30.8%) and 51 (6.4%) in diastolic blood pressure (BP) values of >2 mm Hg, >5 mm Hg and >10 mm Hg, respectively. In 3.4% of initially normotensives STMH and in 34.3% of initially hypertensives, STWCH was apparent.ConclusionsThere are significant differences between a single OBPM and the mean of consecutive BP measurements. Our study provides evidence that a single OBPM should not be the preferred method and should be discouraged in future guidelines.Trial registration numberNCT02552030;Results.

scholarly journals Normal Variations in Blood Pressure in Ambulatory Blood Pressure Measurements

2021 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Selcuk Mistik ◽  
Kevser Goktas ◽  
Demet Unalan ◽  
Abdurrahman Oguzhan ◽  
Bulent Tokgöz
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Pressure Measurements ◽  
Mean Values ◽  
Blood Pressures ◽  
The Mean ◽  
Ambulatory Blood Pressure Measurements

Aim: Hypertension is very common in primary care patients. The diagnosis of hypertension is made by office measurements and home blood pressure measurements. The aim of this study was to define the normal variation levels of blood pressure in individuals in primary care by using ambulatory blood pressure measurement. Methods: This study was performed in primary care. Individuals who had no hypertension history were included in the study. Subjects were evaluated by using three office measurements, seven days home blood pressure measurements and 24 hours ambulatory blood pressure measurement. The ambulatory blood pressure gave us the variations in blood pressure values. Results: The study started in January 2018 and ended in May 2018. Of the 47 subjects, 70.2% were women and 29.8% were men. The mean age was 41.63±12.00. The most common educational level was elementary school graduates. The most common occupation was housewives. Of the participants, 84.2% were married. At ambulatory blood pressure measurements, 34.0% of the subjects had mean systolic blood pressures 24 hours between 120-129 mmHg. Of the diastolic blood pressure 24 hours mean values, 15.3% had values between 80-89, where 51.0% were between the 71-79 mmHg groups. The mean value of 24 hours variation in systolic blood pressure was 15.75±18.59 (median=11.40, min=8.80, max=106.00). The 24 hours variation in the mean values of diastolic blood pressures was 12.12±10.90 (median=9.70, min=6.80, max=64.00). Conclusion: The results of this study demonstrated that there were high levels of variations in normal blood pressures, which could show candidates for hypertension. Keywords: ambulatory monitoring, blood pressure, variability, primary care

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