Is "Isolated Home" Hypertension as Opposed to "Isolated Office" Hypertension a Sign of Greater Cardiovascular Risk?

Bobrie, Guillaume; Genès, N; Vaur, L; Clerson, Pierre; Vaı̈sse, B.; Mallion, Jean-Michel; Châtellier, Gilles

doi:10.1001/archinte.161.18.2205

Cited by 109 publications

(75 citation statements)

References 31 publications

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“…This finding is probably related to the fact that masked hypertensives remain undiagnosed and untreated for a long period of time. 7,11,29 This view is supported by the fact that masked hypertensives received less antihypertensive treatment and combination treatment for hypertension than white coat or sustained hypertensives.…”

Section: Discussionmentioning

confidence: 99%

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Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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Masked hypertension is defined as low clinic and elevated out-of-clinic pressure (blood pressure, BP) assessed either by patients at home or by ambulatory monitoring. This study compared the cardiovascular status and psychometric characteristics of masked, white coat and sustained hypertensives. Three groups of consecutive subjects with masked (n ¼ 100, age 59 ± 11 years), white coat (n ¼ 100, 60 ± 10 years) and sustained hypertension (n ¼ 100, 60 ± 11 years) diagnosed by ambulatory BP monitoring were compared. Masked hypertensives had higher educational level, exercised more frequently, received fewer drugs and sensed more responsibilities at work than at home. Their left ventricular hypertrophy indexes fall inbetween those with white coat and sustained, the latter having the highest values. The estimated total cardiovascular risk was intermediate between white coat and sustained, whereas their cardiovascular morbidity and renal disease was higher than that of white coat and similar to sustained. Psychological profile analysis showed lower score for type-A personality and their mood behaviour in the hypomania-euthymia range compared with white coat and sustained hypertensives. The cardiovascular risk of masked hypertensives is higher than that of white coat and similar to sustained. Masked hypertensives have higher educational level, better physical training and different personality/mood pattern than white coat and sustained.

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Section: Discussionmentioning

confidence: 99%

“…9 A number of studies have shown the powerful prognostic value of ambulatory and home BP measurements in relation to cardiovascular morbidity and mortality. 1,7,11,12 The underlying mechanisms of MH remain unclear. There is evidence that this phenomenon is related with young age, male gender and smoking.…”

Section: Introductionmentioning

confidence: 99%

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Konstantopoulou

Papargyriou

et al. 2009

J Hum Hypertens

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“…100,101 The frequency of white-coat hypertension based on home BP measurements has been reported to be 38-58% in cohorts of the general population, [102][103][104] 15% in untreated patients with hypertension 105 and 12-19% in hypertensive patients being treated. [106][107][108] The prognosis of white-coat hypertension depends on home BP levels. If high normal BP home measurements (125-135/ 80-85 mm Hg; see Chapter 9) are regarded as normal, the prognosis of white-coat hypertension tends to be poor.…”

Section: ) Measurement Of Home Bp Under Special Conditionsmentioning

confidence: 99%

“…The frequency of masked hypertension based on home BP is reported to be about 10% in cohorts of the general population 103,104 and 11-33% in hypertensive patients under treatment. 108,113,114 3. Morning hypertension, and morning and evening home BP Although there is no precise definition of morning hypertension, a condition with a specifically high BP after waking early in the morning may be referred to as morning hypertension.…”

Section: Masked Hypertensionmentioning

confidence: 99%

The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

et al. 2012

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INTRODUCTIONSince Riva-Rocci invented indirect brachial cuff sphygmomanometry in 1896 1 and Korotkoff proposed the auscultatory method in 1905, 2 the method for blood pressure (BP) measurements has remained essentially unchanged for the past 100 years.In 1969, Posey et al. 3 identified mean BP on the basis of the cuff-oscillometric method. With subsequent theoretical and technical improvements, the method to determine systolic and diastolic BP (S and D, respectively) was introduced to the cuff-oscillometric method. As a result, many of the automatic electronic sphygmomanometers available today have adopted this method, and those different from the auscultatory method have begun to be used in general clinical practice. Since the advent of indirect methods for sphygmomanometry, the past century has developed the practical and clinical sciences of hypertension. However, BP information necessary for the diagnosis and treatment of hypertension is still obtained essentially on the basis of casual measurements at the outpatient clinic (clinic BP). However, the reliability of clinic BP was called into question 40 years after the advent of indirect sphygmomanometry. In 1940, Ayman and Goldshine 4 widely adopted the concept of self-BP measurements in the field of clinic BP measurements and demonstrated discrepancies between clinic BP and self-BP measurements. Bevan, 5 in the United Kingdom, first reported the results of ambulatory BP (ABP) monitoring (ABPM) using a direct arterial BP measurement method in 1969, and showed that human BP changes markedly with time. The quantity and quality of BP information vary greatly according to different methods, and the problem of interpreting clinic BP, which is obtained specifically in a medical environment, has been an issue in the clinical practice of hypertension during the past 50 years.However, the practice and epidemiology of hypertension still depend entirely on BP information obtained in a medical environment (clinic BP/BP at a health examination), resulting in the

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“…Of note, we found in our study an unexpected high rate of patients with isolated home BP at the end of the study. A cross-sectional study 28 has suggested these patients to be at a higher cardiovascular risk, as long as they have been found with more risk factors and a more frequent history of cardiovascular diseases, in comparison with other patients. However, we should have to wait for 3 years to know whether this hypothesis is confirmed or not, by a longitudinal approach.…”

Section: Comparison Of Office and Home Bp Measurementsmentioning

confidence: 99%

Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVERESTE study

et al. 2002

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This multicentre study was aimed at comparing the trough effect of telmisartan and perindopril on diastolic blood pressure (DBP), using self blood pressure measurement (SBPM). A second objective was to compare the data obtained from SBPM with those provided by automatic office BP measurement. A total of 441 mild-to-moderate hypertensive patients were randomised to receive either telmisartan 40 mg or perindopril 4 mg for a period of 12 weeks. Patients whose clinic DBP remained higher than or equal to 90 mmHg at the end of the 6th week (W6) were given a double-dose regimen. Office BP and SBPM were performed at baseline (W0), at W6 and at week 12 (W12), both with the same automatic device. A greater diminution of trough DBP was obtained with telmisartan (À6.6 7 6.7 mmHg) than with perindopril (À5.1 7 7.0 mmHg; P ¼ 0.018). Regarding clinic BP, the same results were observed. Doubling dose was significantly less frequent with telmisartan (41%; n ¼ 85) than with perindopril (55%; n ¼ 115, P ¼ 0.005). Mean values of SBPM were lower than office BP values, with a difference of a greater importance at W0 than at W12: 6.6 vs 4.7 mmHg for systolic blood pressure (Po0.005) and 3.2 vs 1.4 mmHg for DBP (Po0.0001). At W12, isolated office hypertension was found in 9% of the patients (n ¼ 37), while there were 14% of the patients (n ¼ 55) with isolated home hypertension. In conclusion, the trough effect on DBP was statistically higher with telmisartan than with perindopril. SBPM values were lower than office BP values, with greater differences before than after treatment. About a quarter of the patients were found to be controlled with a method but not with the other one.

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Is "Isolated Home" Hypertension as Opposed to "Isolated Office" Hypertension a Sign of Greater Cardiovascular Risk?

Abstract: This retrospective analysis suggests that patients with isolated home hypertension belong to a high-risk subgroup. The 3-year follow-up of these patients will provide prospective data about the cardiovascular prognosis of these subgroups.

Cited by 109 publications

References 31 publications

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters

The Japanese Society of Hypertension Guidelines for Self-monitoring of Blood Pressure at Home (Second Edition)

Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVERESTE study

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