Ambulatory Blood Pressure Monitoring in Hypertensive Patients with High Cardiovascular Risk: a Cross-sectional Analysis of a 20,000-patient Database in Spain.
From: Hospital San Agustín, Avilés, Asturias, Spain. manuel.gorostidi@sespa.princast.es
Journal of hypertension
- Publish Date: May 2007
- ISSN: 0263-6352
- Volume: 25
- Issue: 5
- Pages: 977-84
- Medium: Print
- Language: English
- Citation (JAMA): Gorostidi Manuel, Sobrino Javier, Segura Julián, et al. Ambulatory Blood Pressure Monitoring in Hypertensive Patients with High Cardiovascular Risk: a Cross-sectional Analysis of a 20,000-patient Database in Spain.. J. Hypertens. May 2007;25:977-84
Abstract
OBJECTIVE: To evaluate ambulatory blood pressure monitoring (ABPM) parameters in a broad sample of high-risk hypertensive patients. METHODS: The Spanish Society of Hypertension is developing a nationwide project in which more than 900 physicians send ABPM registries and corresponding clinical records to a central database via www.cardiorisc.com. Between June 2004 and July 2005 a 20 000-patient database was obtained; 17 219 were valid for analysis. RESULTS: We identified 6534 patients with high cardiovascular risk according to the 2003 European Society of Hypertension/European Society of Cardiology guidelines stratification score. Office blood pressure (BP) was 158.8/89.9 mmHg and 24-h BP was 135.8/77.0 mmHg. Patients with grade 3 BP in the office showed ambulatory systolic BP values less than 160 mmHg in more than 80%. A non-dipping pattern was observed in 3836 cases (58.7%), whereas this abnormality was present in 47.9% of patients with low-to-moderate risk [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.45-1.64]. The prevalence of non-dippers was higher as ambulatory BP increased ( approximately 70% when 24-h systolic BP > 155 mmHg) and was similar in both groups. At the lowest levels of BP (24-h systolic BP < 135 mmHg) a non-dipping pattern was more prevalent in high-risk cases (56.6 versus 45.7%; OR 1.51; 95% CI 1.40-1.64). CONCLUSION: There was a remarkable discrepancy between office and ambulatory BP in high-risk hypertensive patients. The prevalence of a non-dipper BP pattern was almost 60%. In the lowest levels of ambulatory BP, high-risk patients showed a higher prevalence of non-dipping BP than lower-risk cases. These observations support the recommendation of a wider use of ABPM in high-risk hypertensive patients.
Mesh Headings (Keywords): Aged, Blood Pressure, Blood Pressure Monitoring, Ambulatory, Cardiovascular Diseases, Circadian Rhythm, Cross-Sectional Studies, Female, Humans, Hypertension, Male, Middle Aged, Prognosis, Risk Factors
Check for Full Text / PubMed Unique Identifier (PMID): 17414661
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