Ambulatory blood pressure monitoring: Is it mandatory for blood pressure control in treated hypertensive patients? Prospective observational study
Twenty-four hour ambulatory blood pressure (ABP) is superior to office blood pressure (BP) in predicting cardiovascular events. However, its use to optimise BP control in treated hypertensive patients is less well examined. In this observational study conducted in 899 general practitioners' off...
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| Veröffentlicht in: | International journal of cardiology 2013-10, Vol.168 (3), p.2255-2263 |
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| container_title | International journal of cardiology |
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| creator | LEHMANN, M. V ZEYMER, U DECHEND, R KAISER, E HAGEDORN, I DEEG, E SENGES, J SCHMIEDER, R. E |
| description | Twenty-four hour ambulatory blood pressure (ABP) is superior to office blood pressure (BP) in predicting cardiovascular events. However, its use to optimise BP control in treated hypertensive patients is less well examined.
In this observational study conducted in 899 general practitioners' offices, 4078 hypertensive patients with uncontrolled office BP were included. Antihypertensive therapy was intensified and after 1 year office BP and 24-hour ABP were measured to categorise patients according to the ESC/ESH 2007 guidelines.
In this cohort (mean office BP 156/90 mmHg, mean ABP 146/85 mmHg), 2059 out of 4078 patients (50.5%) had controlled office BP ( |
| doi_str_mv | 10.1016/j.ijcard.2013.01.209 |
| format | Article |
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In this observational study conducted in 899 general practitioners' offices, 4078 hypertensive patients with uncontrolled office BP were included. Antihypertensive therapy was intensified and after 1 year office BP and 24-hour ABP were measured to categorise patients according to the ESC/ESH 2007 guidelines.
In this cohort (mean office BP 156/90 mmHg, mean ABP 146/85 mmHg), 2059 out of 4078 patients (50.5%) had controlled office BP (<140/90 mmHg) at 1 year examination. Of these apparently controlled patients (N=2059), 1339 (65.8%) had 24-hour ABP ≥ 130/80 mmHg, indicating masked hypertension (32.9% of all treated patients). In the prespecified subgroups the prevalence of masked hypertension was the following: diabetes 28.2%, CVD 29.1%, and CKD 32.1%. White coat hypertension (24h-ABP<130/80 mmHg and office BP ≥ 140/90 mmHg) was found in 12.4% (N=233) of patients with elevated office BP (6.1% of all treated patients), and in 5.7% of the diabetic subgroup, 5.6% CVD and 7.1% CKD. Discrepancies in BP categorisation between office BP and 24-hour ABP were high; all subjects 52.8%, diabetes 50.0%, CVD 49.0% and CKD 50.4%.
In hypertensive patients on therapy, 2 out of 3 with apparently controlled office BP had masked hypertension, suggesting a more aggressive therapy, and 1 out of 8 with elevated office BP had white coat hypertension potentially falsely forcing physicians to intensify therapy. The 3A Registry is listed under clinicaltrials.gov, NCT01454583.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2013.01.209</identifier><identifier>PMID: 23474245</identifier><identifier>CODEN: IJCDD5</identifier><language>eng</language><publisher>Shannon: Elsevier</publisher><subject>Aged ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Blood Pressure Monitoring, Ambulatory ; Cardiology. Vascular system ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - physiopathology ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Time Factors</subject><ispartof>International journal of cardiology, 2013-10, Vol.168 (3), p.2255-2263</ispartof><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27889138$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23474245$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEHMANN, M. V</creatorcontrib><creatorcontrib>ZEYMER, U</creatorcontrib><creatorcontrib>DECHEND, R</creatorcontrib><creatorcontrib>KAISER, E</creatorcontrib><creatorcontrib>HAGEDORN, I</creatorcontrib><creatorcontrib>DEEG, E</creatorcontrib><creatorcontrib>SENGES, J</creatorcontrib><creatorcontrib>SCHMIEDER, R. E</creatorcontrib><title>Ambulatory blood pressure monitoring: Is it mandatory for blood pressure control in treated hypertensive patients? Prospective observational study</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>Twenty-four hour ambulatory blood pressure (ABP) is superior to office blood pressure (BP) in predicting cardiovascular events. However, its use to optimise BP control in treated hypertensive patients is less well examined.
In this observational study conducted in 899 general practitioners' offices, 4078 hypertensive patients with uncontrolled office BP were included. Antihypertensive therapy was intensified and after 1 year office BP and 24-hour ABP were measured to categorise patients according to the ESC/ESH 2007 guidelines.
In this cohort (mean office BP 156/90 mmHg, mean ABP 146/85 mmHg), 2059 out of 4078 patients (50.5%) had controlled office BP (<140/90 mmHg) at 1 year examination. Of these apparently controlled patients (N=2059), 1339 (65.8%) had 24-hour ABP ≥ 130/80 mmHg, indicating masked hypertension (32.9% of all treated patients). In the prespecified subgroups the prevalence of masked hypertension was the following: diabetes 28.2%, CVD 29.1%, and CKD 32.1%. White coat hypertension (24h-ABP<130/80 mmHg and office BP ≥ 140/90 mmHg) was found in 12.4% (N=233) of patients with elevated office BP (6.1% of all treated patients), and in 5.7% of the diabetic subgroup, 5.6% CVD and 7.1% CKD. Discrepancies in BP categorisation between office BP and 24-hour ABP were high; all subjects 52.8%, diabetes 50.0%, CVD 49.0% and CKD 50.4%.
In hypertensive patients on therapy, 2 out of 3 with apparently controlled office BP had masked hypertension, suggesting a more aggressive therapy, and 1 out of 8 with elevated office BP had white coat hypertension potentially falsely forcing physicians to intensify therapy. The 3A Registry is listed under clinicaltrials.gov, NCT01454583.</description><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Blood Pressure - physiology</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>Cardiology. Vascular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Time Factors</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0MtKxDAUBuAgio6XNxDJRnDTMddJ6kYG8TIwoAtdD2lzqhnapCapMK_hE1txRHD1w38-_sVB6JSSKSV0drmeunVtop0yQvmU0DHLHTShWomCKil20WRkqpBM8QN0mNKaECLKUu-jA8aFEkzICfqcd9XQmhziBldtCBb3EVIaIuAueDf2zr9e4UXCLuPOePtDmxD_8zr4HEOLncc5gslg8dumh5jBJ_cBuDfZgc_pGj_FkHqo83cbqgTxYzwFb1qc8mA3x2ivMW2Ck20eoZe72-ebh2L5eL-4mS-LngmaCwVKGmi4ZLKUurFqJjRIzQ2ptGoapivCq7GglWV0RoAwWYMFKbmERnPKj9DFz24fw_sAKa86l2poW-MhDGlFheC8ZIR807MtHaoO7KqPrjNxs_r94wjOt8Ck2rRNNL526c8prUvKNf8C-uiH9Q</recordid><startdate>20131003</startdate><enddate>20131003</enddate><creator>LEHMANN, M. V</creator><creator>ZEYMER, U</creator><creator>DECHEND, R</creator><creator>KAISER, E</creator><creator>HAGEDORN, I</creator><creator>DEEG, E</creator><creator>SENGES, J</creator><creator>SCHMIEDER, R. E</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20131003</creationdate><title>Ambulatory blood pressure monitoring: Is it mandatory for blood pressure control in treated hypertensive patients? Prospective observational study</title><author>LEHMANN, M. V ; ZEYMER, U ; DECHEND, R ; KAISER, E ; HAGEDORN, I ; DEEG, E ; SENGES, J ; SCHMIEDER, R. 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Vascular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEHMANN, M. V</creatorcontrib><creatorcontrib>ZEYMER, U</creatorcontrib><creatorcontrib>DECHEND, R</creatorcontrib><creatorcontrib>KAISER, E</creatorcontrib><creatorcontrib>HAGEDORN, I</creatorcontrib><creatorcontrib>DEEG, E</creatorcontrib><creatorcontrib>SENGES, J</creatorcontrib><creatorcontrib>SCHMIEDER, R. 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Prospective observational study</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2013-10-03</date><risdate>2013</risdate><volume>168</volume><issue>3</issue><spage>2255</spage><epage>2263</epage><pages>2255-2263</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><coden>IJCDD5</coden><abstract>Twenty-four hour ambulatory blood pressure (ABP) is superior to office blood pressure (BP) in predicting cardiovascular events. However, its use to optimise BP control in treated hypertensive patients is less well examined.
In this observational study conducted in 899 general practitioners' offices, 4078 hypertensive patients with uncontrolled office BP were included. Antihypertensive therapy was intensified and after 1 year office BP and 24-hour ABP were measured to categorise patients according to the ESC/ESH 2007 guidelines.
In this cohort (mean office BP 156/90 mmHg, mean ABP 146/85 mmHg), 2059 out of 4078 patients (50.5%) had controlled office BP (<140/90 mmHg) at 1 year examination. Of these apparently controlled patients (N=2059), 1339 (65.8%) had 24-hour ABP ≥ 130/80 mmHg, indicating masked hypertension (32.9% of all treated patients). In the prespecified subgroups the prevalence of masked hypertension was the following: diabetes 28.2%, CVD 29.1%, and CKD 32.1%. White coat hypertension (24h-ABP<130/80 mmHg and office BP ≥ 140/90 mmHg) was found in 12.4% (N=233) of patients with elevated office BP (6.1% of all treated patients), and in 5.7% of the diabetic subgroup, 5.6% CVD and 7.1% CKD. Discrepancies in BP categorisation between office BP and 24-hour ABP were high; all subjects 52.8%, diabetes 50.0%, CVD 49.0% and CKD 50.4%.
In hypertensive patients on therapy, 2 out of 3 with apparently controlled office BP had masked hypertension, suggesting a more aggressive therapy, and 1 out of 8 with elevated office BP had white coat hypertension potentially falsely forcing physicians to intensify therapy. The 3A Registry is listed under clinicaltrials.gov, NCT01454583.</abstract><cop>Shannon</cop><pub>Elsevier</pub><pmid>23474245</pmid><doi>10.1016/j.ijcard.2013.01.209</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged Antihypertensive Agents - therapeutic use Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood Pressure - physiology Blood Pressure Monitoring, Ambulatory Cardiology. Vascular system Female Follow-Up Studies Heart Humans Hypertension - diagnosis Hypertension - drug therapy Hypertension - physiopathology Male Medical sciences Middle Aged Prospective Studies Reproducibility of Results Time Factors |
| title | Ambulatory blood pressure monitoring: Is it mandatory for blood pressure control in treated hypertensive patients? Prospective observational study |
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