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Am J Hypertens. 2017 May 1;30(5):453-463. doi: 10.1093/ajh/hpw148.

Blood Pressure Measurement Anno 2016.

Author information

1
Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
2
R&D Group VitaK, Maastricht University, Maastricht, The Netherlands.
3
Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
4
Department of Social Pharmacy and Public Health, Showa Pharmaceutical University, Tokyo, Japan.
5
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
6
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
7
Eamon Dolan, Stroke and Hypertension Unit, Connolly Hospital, Blanchardstown, Co, Dublin, Ireland.
8
Conway Institute, University College Dublin, Dublin, Ireland.

Abstract

The rational management of hypertension (HT) inevitably starts with accurate measurement of blood pressure (BP). The recently published Systolic Blood Pressure Intervention Trial implemented automated office BP measurement. However, event-driven studies have overwhelmingly indicated that out-of-the-office BP monitoring is a prerequisite for risk stratification and for identifying the need of initiating or adjusting antihypertensive drug treatment. 24-Hour ambulatory BP monitoring is the preferred method of BP measurement and addresses major issues not covered by conventional or automated office BP measurement or home BP monitoring, such as reliably diagnosing nocturnal HT (the time window of the day during which BP is most predictive of adverse cardiovascular outcome), hypotension, or masked HT, a condition that affects 15% of the general populations and carries a risk equal to that of HT on both office and out-of-the-office BP measurement. Moreover, 24-hour ambulatory BP monitoring is cost-effective. Outcome-driven criteria support single BP thresholds that can be applied in both sexes and across the age range. In conclusion, the overall evidence now overwhelmingly shows that ambulatory BP monitoring is mandatory for the proper management of HT. Health care providers should therefore facilitate access to this technique in both primary and specialized care.

KEYWORDS:

ambulatory blood pressure monitoring; blood pressure; home blood pressure recording; hypertension; office blood pressure measurement.

PMID:
28052877
DOI:
10.1093/ajh/hpw148
[Indexed for MEDLINE]

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