Home Blood Pressure Monitoring as an Alternative to Confirm Diagnoses of Hypertension in Adolescents with Elevated Office Blood Pressure from a Brazilian State Capital

Abstract

BackgroundRegional differences of using home blood pressure monitoring (HBPM) as an alternative to ambulatory blood pressure monitoring (ABPM) in hypertensive adolescents are unknown.ObjectivesDefine if HBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian capital with elevated office blood pressure (BP).MethodsAdolescents (12-18years) from public and private schools with BP > 90th percentile were studied to compare and evaluate the agreement among office BP measurements, HBPM and ambulatory BP monitoring. Office BP measurements, HBPM and ABPM were performed according to guidelines recommendations. Semi-automatic devices were used for BP measurements. Values of p < 0.05 were considered significant.ResultsWe included 133 predominantly males (63.2%) adolescents with a mean age of 15±1.6 years. HBPM systolic blood pressure and diastolic blood pressure mean values were similar to the daytime ABPM values (120.3 ± 12.6 mmHg x 121.5 ± 9.8 mmHg - p = 0.111 and 69.4 ± 7.7 mmHg x 70.2 ± 6.6 mmHg - p = 0.139) and lower than the office measurement values (127.3 ± 13.8 mmHg over 74.4 ± 9.5 mmHg - p < 0,001). The Bland-Altman plots showed good agreement between HBPM and ABPM.ConclusionsHBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian state capital with elevated office BP and can be used as an alternative to ABPM.

Does a virtual functional training induce cardiovascular responses in normotensive adults after a single session and over weeks?

“…to our knowledge, no study has performed a combined analysis of acute (during and after sessions) and chronic cardiovascular responses to identify the real scientific benefits of an AVG intervention, once each study uses different AVG. Moreover, to diagnose hypertension and to control it by monitoring blood pressure at home are important [15]. Also, knowing cardiovascular responses during and after exercise is essential to perform a more effective exercise prescription, promoting cardiovascular safety to the practitioners, especially when their clinical condition is associated with high health risks [16].…”

Dificuldades no Acompanhamento de Portadores de Hipertensão Arterial Sistêmica Utilizando a Ferramenta de Monitoramento Residencial da Pressão Arterial / Difficulties in Monitoring Patients with Systemic Arterial Hypertension Using the Home Blood Pressure Monitoring Tool

“…Dentre as dificuldades apontadas, observou-se um declínio do uso da MRPA na etapa final do estudo, que os autores atribuíram a perda de motivação por parte dos participantes, além da complexidade da intervenção. Sugere-se a simplificação da ferramenta e o aumento do número de consultas associadas 5,6 .…”

“…Por meio do MRPA é possível realizar um maior número de aferições e em diferentes momentos, abrangendo as diversas atividades diárias realizadas pelos pacientes 6,10,14 .…”

“…O Monitoramento Residencial da Pressão Arterial mostrou-se eficaz de maneira unânime nos estudos avaliados [5][6][7][8][9][10][11][12][13][14] , havendo redução significativa nos valores da PA quando monitorada pela ferramenta, quando em comparação a MAPA. Desta forma, é uma importante aliada no tratamento da hipertensão arterial, quando associada ao acompanhamento da PA aferida em atendimentos realizados no consultório médico 5,8 .…”