II Consenso Brasileiro para o uso da monitorização ambulatorial da pressão arterial

Abstract

Face ao desenvolvimento científico ocorrido desde o I Consenso Brasileiro para o uso da Monitorização Ambulatorial da Pressão Arterial (MAPA) 1-3 e a ampla utilização do método em nosso país, as Sociedades Brasileira de Cardiologia e Nefrologia, através de seus Departamentos de Hipertensão Arterial, e a Sociedade Brasileira de Hipertensão, reuniram, em São Roque (SP), 20 especialistas com larga experiência em MAPA, para, à luz de suas experiências pessoais e de profunda e completa revisão da atual e abrangente literatura, revisarem o documento anterior e redigirem o documento que ora apresentamos.Os conceitos emanados dessa reunião de consenso estão contidos nesta publicação, que se almeja possa nortear a prática da MAPA em nosso país, consoante com o que se faz, atualmente, em todo o mundo.

Avaliação da pressão arterial em bombeiros militares filhos de hipertensos através da monitorização ambulatorial da pressão arterial

“…Many authors have detected higher plasma noradrenaline levels in subjects with hypertensive parents [34][35][36] , although others did not confirm an elevation in plasma or urinary noradrenaline; in addition, microneurography shows no differences in sympathetic activity among subjects with hypertensive parents and subjects with normotensive parents [37][38][39][40][41] . Mean SPL and DPL of group 1 are within borderline values 16 (between 25% and 50%), while other authors 17 classify mean normal SPL (>30%) and borderline DPL (between 15% and 30%). Mean SPL and DPL of group 2, on the other hand, are normal 16,17 (<25%).…”

“…Mean SPL and DPL of group 1 are within borderline values 16 (between 25% and 50%), while other authors 17 classify mean normal SPL (>30%) and borderline DPL (between 15% and 30%). Mean SPL and DPL of group 2, on the other hand, are normal 16,17 (<25%). The importance of these findings lays in the fact that subjects in group 1, with mean SPL and DPL ranging from 20% to 40%, will develop hypertension in the future, despite the low correlation with left ventricular (LV) anatomical and functional changes 42 .…”

“…Although mean SBP and DBP of group 1 are higher than those of group 2, both are considered normal for the awake period (SBP < 135 mmHg and DBP < 85 mmHg) [16][17][18][19] . Countless ABPM studies comparing subjects with hypertensive parents with subjects with normotensive parents have found higher values in the former, although still within normal limits 20,21 .…”

“…The device was set to obtain automatic readings every 10 minutes, with a cuff deflation rate of 8 mmHg/second. Measurement rejection followed criteria ser forth by the II Brazilian Consensus for Ambulatory Blood Pressure Monitoring (II Consenso Brasileiro para o Uso da Monitorização Ambulatorial da Pressão Arterial) 16 (HR > 125 bpm or < 40 bpm, SBP > 240 mmHg or < 50 mmHg, and DBP > 140 mmHg or < 40 mmHg). Examinations were considered valid when a minimum of 48 readings at least every two hours were valid.…”

“…Examinations with mean SBP > 140 mmHg and/or DBP > 90 mmHg were repeated 36 hours after baseline monitoring, but this time for 24 hours during the subject's day off. The concept of systolic pressure load (SPL) and diastolic pressure load (DPL) were those described in the II Brazilian Consensus for Ambulatory Blood Pressure Monitoring 16 (% of readings > 140 mmHg for SBP and > 90 mmHg for DBP).…”