Ambulatory blood pressure measurement in a patient with pheochromocytoma by means of finger volume-oscillometric device.

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.

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Role of Ambulatory Blood Pressure Measurement in Diagnosis and Control of Hypertension

Medical Journal Armed Forces India ◽

10.1016/s0377-1237(02)80084-3 ◽

2002 ◽

Vol 58 (4) ◽

pp. 307-309

Author(s):

MSN Murty ◽

AS Narula ◽

GD Choudhury

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Ambulatory Blood Pressure Measurement ◽

And Control

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Ambulatory Blood Pressure Measurement and Home Blood Pressure Measurement

Preeclampsia - Comprehensive Gynecology and Obstetrics ◽

10.1007/978-981-10-5891-2_12 ◽

2018 ◽

pp. 199-208

Author(s):

Hirohito Metoki

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Ambulatory Blood Pressure Measurement

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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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