Effect of Intensive and Standard Clinic‐Based Hypertension Management on the Concordance Between Clinic and Ambulatory Blood Pressure and Blood Pressure Variability in SPRINT

ObjectivesRecent studies reported that 24-hour ambulatory blood pressure variability (ABPV) was associated with lacunar infarction and white matter hyperintensities (WMH). However, the relationship between ABPV and enlarged perivascular spaces (EPVS) has not been investigated. Thus, our study aimed to investigate whether ABPV is associated with EPVS by 24-hour ambulatory blood pressure monitoring (ABPM).DesignWe conducted this study as a cross-sectional study.SettingsThe study was based on patients who presented for physical examinations in our hospital from May 2013 to June 2016.ParticipantsPatients with both brain MRI scans and 24-hour ABPM were included and patients with acute stroke, a history of severe stroke and some other severe diseases were excluded. A total of 573 Chinese patients were prospectively enrolled in this study.Primary and secondary outcome measuresEPVS in basal ganglia (BG) and white matter (WM) were identified on MRI and classified into three categories by the severity. WMH were scored by the Fazekas scale. Coefficient of variation (CV) and SD were considered as metrics of ABPV. Spearman correlation analysis and ordinal logistic regression analysis were used to assess the relationship between ABPV and EPVS.ResultsThere were statistical differences among the subgroups stratified by the severity of EPVS in BG in the following ABPV metrics: SD and CV of systolic blood pressure (SBP), CV of diastolic blood pressure (DBP) in 24 hours, daytime and nighttime and SD of DBP in nighttime. The above ABPV metrics were positively associated with the degree of EPVS. The association was unchanged after adjusting for confounders. Spearman correlation analysis showed ABPV was not related to the degree of EPVS in the WM.ConclusionABPV was independently associated with EPVS in BG after controlling for blood pressure, but not in the WM. Pathogenesis of EPVS in BG and WM might be different.

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USEFULNESS OF BLOOD PRESSURE VARIABILITY MARKERS DERIVED FROM AMBULATORY BLOOD PRESSURE MONITORING IN DETECTING AUTONOMIC FAILURE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)32357-x ◽

2018 ◽

Vol 71 (11) ◽

pp. A1816

Author(s):

Hamza Lodhi ◽

Peri-Okonny Poghni ◽

Kevin Schesing ◽

Kamal Phelps ◽

Christian Ngo ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Autonomic Failure ◽

Blood Pressure Monitoring ◽

Pressure Monitoring

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Comparison of valsartan and amlodipine on ambulatory blood pressure variability in hypertensive patients

Clinical and Experimental Hypertension ◽

10.1080/10641963.2016.1200609 ◽

2016 ◽

Vol 38 (8) ◽

pp. 721-724 ◽

Cited By ~ 6

Author(s):

Kazuo Eguchi ◽

Yuki Imaizumi ◽

Toshiki Kaihara ◽

Satoshi Hoshide ◽

Kazuomi Kario

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Hypertensive Patients

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MASked-unconTrolled hypERtension management based on office BP or on ambulatory blood pressure measurement (MASTER) Study: a randomised controlled trial protocol

BMJ Open ◽

10.1136/bmjopen-2017-021038 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021038 ◽

Cited By ~ 17

Author(s):

Gianfranco Parati ◽

Enrico Agabiti-Rosei ◽

George L Bakris ◽

Grzegorz Bilo ◽

Giovanna Branzi ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Management Strategy ◽

Blood Pressure Measurement ◽

Uncontrolled Hypertension ◽

Hypertension Management ◽

Ambulatory Blood Pressure Measurement ◽

Group 2 ◽

Group 1

IntroductionMasked uncontrolled hypertension (MUCH) carries an increased risk of cardiovascular (CV) complications and can be identified through combined use of office (O) and ambulatory (A) blood pressure (BP) monitoring (M) in treated patients. However, it is still debated whether the information carried by ABPM should be considered for MUCH management. Aim of the MASked-unconTrolled hypERtension management based on OBP or on ambulatory blood pressure measurement (MASTER) Study is to assess the impact on outcome of MUCH management based on OBPM or ABPM.Methods and analysisMASTER is a 4-year prospective, randomised, open-label, blinded-endpoint investigation. A total of 1240 treated hypertensive patients from about 40 secondary care clinical centres worldwide will be included -upon confirming presence of MUCH (repeated on treatment OBP <140/90 mm Hg, and at least one of the following: daytime ABP ≥135/85 mm Hg; night-time ABP ≥120/70 mm Hg; 24 hour ABP ≥130/80 mm Hg), and will be randomised to a management strategy based on OBPM (group 1) or on ABPM (group 2). Patients in group 1 will have OBP measured at 0, 3, 6, 12, 18, 24, 30, 36, 42 and 48 months and taken as a guide for treatment; ABPM will be performed at randomisation and at 12, 24, 36 and 48 months but will not be used to take treatment decisions. Patients randomised to group 2 will have ABPM performed at randomisation and all scheduled visits as a guide to antihypertensive treatment. The effects of MUCH management strategy based on ABPM or on OBPM on CV and renal intermediate outcomes (changing left ventricular mass and microalbuminuria, coprimary outcomes) at 1 year and on CV events at 4 years and on changes in BP-related variables will be assessed.Ethics and disseminationMASTER study protocol has received approval by the ethical review board of Istituto Auxologico Italiano. The procedures set out in this protocol are in accordance with principles of Declaration of Helsinki and Good Clinical Practice guidelines. Results will be published in accordance with the CONSORT statement in a peer-reviewed scientific journal.Trial registration numberNCT02804074; Pre-results.

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Higher Blood Pressure Variability in White Coat Hypertension; from the Korean Ambulatory Blood Pressure Monitoring Registry

Korean Circulation Journal ◽

10.4070/kcj.2016.46.3.365 ◽

2016 ◽

Vol 46 (3) ◽

pp. 365 ◽

Cited By ~ 5

Author(s):

In Sook Kang ◽

Wook Bum Pyun ◽

Jinho Shin ◽

Sang-Hyun Ihm ◽

Ju Han Kim ◽

...

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure Monitoring ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Blood Pressure Monitoring ◽

White Coat ◽

White Coat Hypertension ◽

Pressure Monitoring

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The Importance of Home Versus 24-Hour Ambulatory Blood Pressure Monitoring and Assessment of Blood Pressure Variability in Hypertension

Acta Medica Marisiensis ◽

10.1515/amma-2016-0020 ◽

2016 ◽

Vol 62 (2) ◽

pp. 239-242

Author(s):

Annamária Magdás ◽

Boglárka Belényi ◽

Adina Gaburoi ◽

Alexandru Incze

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Blood Pressure Variability ◽

Blood Pressure Monitoring ◽

Home Blood Pressure ◽

Home Blood Pressure Monitoring ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

Variability Index

AbstractBackground: A number of studies reveal that home blood pressure variability is associated with cardiovascular risk factors. However, we do not have a consensus regarding the variability index and the frequency of measurements.Objective: The aim of the study was to assess home blood pressure variability for a period of 7 consecutive days and 24-hour ambulatory blood pressure variability using the average real variability index and to test whether home blood pressure variability represents a suitable parameter for long-term monitoring of the hypertensive patients.Material and methods: A number of 31 hypertensive patients were included in the study, 8 male, 23 female, mean age 60.19±7.35 years. At the inclusion ambulatory blood pressure monitoring was performed, home blood pressure monitoring was carried out for 7 consecutive days with 2 measurements daily. We compared ambulatory blood pressure values, variability using paired t-test. We were looking for correlations between HBP values and cardiovascular risk factors.Results: Ambulatory versus home blood pressure derived mean blood pressure was 131.38±15.2 versus 131.93±8.25, p=0.81. Ambulatory derived variability was 10.65±2.05 versus home variability 10.56±4.83, p=0.91. Home versus ambulatory pulse pressure was 51.8± 9.06 mmHg vs. 54.9±11.9 mmHg, p=0.046. We found positive correlation between HBPV and home BP values, p=0.027, r2=0.1577, (CI: 0.04967 to 0.6588). Home, as well as ambulatory derived variability were positively correlated to age p=0.043, r2=0.1377 (CI: 0.01234 to 0.6451) versus p<0.0001, CI: 0.3870 to 0.8220, r2=0.4302.Conclusion: Assessment of home blood pressure monitoring and variability could represent a well-tolerated alternative for long-term follow-up of hypertension management.

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