scholarly journals Ambulatory blood pressure monitoring in young adults with different levels of office blood pressure

2018 ◽  
Vol 24 (4) ◽  
pp. 427-434
Author(s):  
N. T. Vatutin ◽  
E. V. Sklyannaya
Keyword(s):  
Blood Pressure ◽  
Young People ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Office Blood Pressure ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
Group 2

Objectiveof our study was to assess the ambulatory blood pressure monitoring (ABPM) in young people with different office blood pressure (BP).Design and methods. We included 981 students of a medical university at the age of 20–29 years (536 men, 445 women). ABPM was performed using the device “Kardiotekhnika 4000” (Inkart, Russia), the data were processed using the program “KT Result2” (Inkart, Russia).Results. The optimal BP during office measurement was recorded in 220 patients (22,4 %, group 1), normal — in 488 (49,8 %, group 2), high normal — in 134 (13,6 %, group 3), hypertension (HTN) 139 (14,2 %, group 4). The proportion of males was significantly higher in groups 3 and 4 (96,6 % and 85,6 %) compared with groups 1 and 2 (47,7 % and 40,2 %, respectively, p < 0,001). The median systolic BP (SBP) was 123 (110; 126) mm Hg, diastolic BP (DBP) — 85 (84; 87) mm Hg. According to the ABPM, the parameters of SBP and DBP correlated with the corresponding office BP parameters. A strong direct correlation was found for both SBP (rs= 0,87) and DBP (rs= 0,85). Daytime variability of SBP was significantly higher in individuals with high normal BP and HTN (15,9 ± 2,6 and 17,2 ± 4,2 mm Hg) compared to groups 1 and 2 (9,2 ± 4,4 and 9,9 ± 3,0, respectively, p < 0,05). The majority of young people had normal BP decrease at night (dipper), non-dipper profile was also frequent. Over-dipper and night-peaker profiles were rarely recorded. In the groups 3 and 4, a larger number of non-dipper patients were observed compared with groups 1 and 2 (23,9 % and 34,6 %, compared with 10,0 % and 11,1 %, respectively, p < 0,001). The prevalence of white-coat hypertension (WCH) among the young people was 0,31 % (95 % CI 0,06–0,75 %), among subjects with office HTN 2,2 % (95 % CI 0,4–5,3 %). The prevalence of masked hypertension (MHTN) in the studied population was 1,4 % (95 % CI 0,8–2,3 %), among normotensive subjects — 1,7 % (95 % CI 0,9–2,6 %), among subjects with high normal BP — 10,4 % (95 % CI 5,8–16,2 %).Conclusions. ABPM in young hypertensive patients is characterized by higher variability of daytime SBP. The majority (56,1 %)of HTN subjects had normal BP decrease at night. The prevalence of WCH among young people is 0,31 % (95 % CI 0,06–0,75 %). The prevalence of MHTN among young people is 1,4 % (95 % CI 0,8–2,3 %).

Abstract P206: Ambulatory Blood Pressure Monitoring Phenotypes Among Individuals With and Without Diabetes: The Jackson Heart Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Samantha G Bromfield ◽  
Daichi Shimbo ◽  
Alain Bertoni ◽  
Mario Sims ◽  
April P Carson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Prevalence Ratio ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Monitoring ◽  
Heart Study

Several ambulatory blood pressure monitoring (ABPM) phenotypes including masked hypertension are associated with an increased risk for cardiovascular disease (CVD). Diabetes is associated with CVD risk as well as a higher prevalence of hypertension. However, little is known about whether ABPM phenotypes differ between individuals with versus without diabetes. We evaluated the association between diabetes and ABPM phenotypes including clinic hypertension, awake hypertension, sustained hypertension, nocturnal hypertension, non-dipping pattern, white coat hypertension, and masked hypertension in the Jackson Heart Study (JHS). Baseline data collection included two clinic blood pressure measurements using standardized protocols. ABPM measurements were taken in the 24 hours following the baseline visit. Diabetes was defined as fasting glucose ≥126 mg/dL, hemoglobin A1c ≥6.5%, or use of diabetes medications. Of the 1,032 JHS participants with valid ABPM data (67.7% female, mean age 59.2 years), 253 (24.5%) had diabetes. The prevalence of clinic hypertension was similar for participants with and without diabetes (Table 1). After multivariable adjustment, diabetes was associated with an increased prevalence ratio of awake, sustained, and masked hypertension and a lower prevalence ratio of white coat hypertension compared with individuals without diabetes. In summary, there was an increased prevalence of adverse blood pressure phenotypes among individuals with versus those without diabetes that was not captured in the clinic setting alone. The role of ABPM for identifying high risk individuals with diabetes should be further investigated.

scholarly journals The Key Role of Ambulatory Blood Pressure Monitoring in the Detection of Masked Hypertension and Other Phenomena in Frail Geriatric Patients

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1221
Author(s):  
Marek Koudelka ◽  
Eliška Sovová
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Geriatric Patients ◽  
Blood Pressure Monitoring ◽  
Target Range ◽  
Masked Hypertension ◽  
Pressure Monitoring

Background and Objectives: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients’ prognoses might worsen due to inadequate therapy (never-detected MUH). Materials and Methods: 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. Results: Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. Conclusions: ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.

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