The optimal night-time home blood pressure monitoring schedule: agreement with ambulatory blood pressure and association with organ damage.
J Hypertens
; 36(2): 243-249, 2018 02.
Article
em En
| MEDLINE
| ID: mdl-28915229
ABSTRACT
OBJECTIVE:
Night-time home blood pressure (HBP) monitoring has emerged as a feasible, reliable and low-cost alternative to ambulatory blood pressure (ABP) monitoring. This study evaluated the optimal schedule of night-time HBP monitoring in terms of agreement with night-time ABP and association with preclinical target-organ damage.METHODS:
Untreated hypertensive adults were evaluated with ABP (24-h) and HBP monitoring (daytime six days, duplicate morning and evening measurements; night-time three nights, three-hourly automated measurements/night), and determination of left ventricular mass index, common carotid intima-media thickness and urinary albumin excretion.RESULTS:
A total of 94 patients with all nine night-time HBP measurements were analysed [mean age 51.8â±â11.1 (SD) years, men 57%). By averaging an increasing number of night-time systolic HBP readings, there was a consistent trend towards stronger association of night-time HBP with night-time ABP (correlation coefficients r increased from 0.69 to 0.81), and with target-organ damage indices (for left ventricular mass index r increased from 0.13 to 0.22, carotid intima-media thickness 0.12-0.25, urinary albumin excretion 0.33-0.41). However, no further improvement in the association was observed by averaging more than four to six night-time readings. The diagnostic agreement between HBP and ABP in detecting nondippers was improved by averaging more readings, with a plateau at four readings (single reading agreement 81%, kappa 0.37; four readings 88%, 0.49; nine readings 84%, 0.40).CONCLUSION:
A two-night HBP schedule (six readings) appears to be the minimum requirement for a reliable assessment of night-time HBP, which gives reasonable agreement with ABP and association with preclinical organ damage.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ritmo Circadiano
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Monitorização Ambulatorial da Pressão Arterial
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Hipertensão
Tipo de estudo:
Evaluation_studies
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article