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J Clin Hypertens (Greenwich). 2017 Dec;19(12):1240-1245. doi: 10.1111/jch.13086. Epub 2017 Aug 22.

Role of ambulatory blood pressure monitoring for the management of hypertension in Asian populations.

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Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
The Shanghai Institute of Hypertension & Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, South Korea.
Division of Cardiology, College of Medicine, Korea University, Seoul, South Korea.


Out-of-clinic blood pressure (BP) measurement, eg, ambulatory BP monitoring, has a strong association with target organ damage and is a powerful predictor of cardiovascular events compared with clinic BP measurement. Ambulatory BP monitoring can detect masked hypertension or various BP parameters in addition to average 24-hour BP level. Short-term BP variability assessed by standard deviation or average real variability, diminished nocturnal BP fall, nocturnal hypertension, and morning BP surge assessed by ambulatory BP monitoring have all been associated with target organ damage and cardiovascular prognosis. Recently, the authors compared the degree of sleep-trough morning BP surge between a group of Japanese and a group of Western European untreated patients with hypertension and found that sleep-trough morning BP surge in Japanese persons was significantly higher than that in Europeans. Although Asian persons have been known to have a higher incidence of stroke than heart disease, the difference in characteristics of BP indices assessed by ambulatory BP monitoring might be the cause of racial differences in stroke incidence between Asian and Western populations. This review focuses on Asian characteristics for the management of hypertension using ambulatory BP monitoring.


ABPM; Asian population; racial difference

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