Long-term reproducibility of ambulatory blood pressure

Mansoor, George A.; McCabe, Ellen J.; White, William Β.

doi:10.1097/00004872-199406000-00011

Cited by 113 publications

(66 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…24,25,58 exists when the ABPM technique is used 47 and BP In a recent study from our laboratory, 36 we found values tend to be similar on repeated measurements that, in 574 consecutive adult OSA patients, 55.9% over weeks or months. [48][49][50] were positional patients and in those with only a Another limitation is the small number of patients mild to moderate degree of severity of OSA, this in our study, and it is mandatory that these results figure reached 69%. We found that the likelihood of should be verified in a larger group of patients.…”

Section: Bp Variabilitymentioning

confidence: 85%

Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients

Berger

Oksenberg

Silverberg³

et al. 1997

J Hum Hypertens

View full text Add to dashboard Cite

Obstructive sleep apnea (OSA), is a common clinical inexpensive method for avoiding the supine posture during sleep, namely the tennis ball technique. condition affecting at least 2-4% of the adult population. Hypertension is found in about half of all OSA Of the 13 patients, all had a reduction in 24-h mean BP (MBP). The mean 24-h systolic/diastolic (SBP/DBP) fell by patients, and about one-third of all patients with essential hypertension have OSA. There is growing 6.4/2.9 mm Hg, the mean awake SBP/DBP fell by 6.6/3.3 mm Hg and the mean sleeping SBP/DBP fell by 6.5/2.7 evidence that successful treatment of OSA can reduce systemic blood pressure (BP). Body position appears mm Hg, respectively. All these reductions were significant (at least P Ͻ 0.05) except for the sleeping DBP. The to have an important influence on the incidence and severity of these sleep-related breathing disturbmagnitude of the fall in SBP was significantly greater in the hypertensive than in the normotensive group for the ances.We have investigated the effect of avoiding the supine 24 h period and for the awake hours. In addition, a significant reduction in BP variability and load were found. position during sleep for a 1 month period on systemic BP in 13 OSA patients (six hypertensives and seven Since the majority of OSA patients have supine-related breathing abnormalities, and since about a third of all normotensives) who by polysomnography (PSG) were found to have their sleep-related breathing disturbances hypertensive patients have OSA, avoiding the supine position during sleep, if confirmed by future studies, could mainly in the supine position. BP monitoring was performed by 24-h ambulatory BP measurements before and become a new non-pharmacological form of treatment for many hypertensive patients. after a 1 month intervention period. We used a simple, Keywords: obstructive sleep apnea; ambulatory blood pressure monitoring; sleep position; body posture ous positive airway pressure (nCPAP). [1][2][3] However, Introductionthe long term compliance with nCPAP is often disObstructive sleep apnea (OSA) is a clinical entity appointing. 28 Other methods of treatment of OSA characterised by intermittent partial or complete include weight reduction, 29 use of oral devices that collapse of the upper airway during sleep. [1][2][3] Studies advance the mandible and/or the tongue 30 and difover the last few years have shown that the prevaferent surgical interventions of which the most lence of essential hypertension is much higher in popular is uvulopalatopharyngoplasty (UPPP). 31 patients with OSA (50%) 4-7 than it is in the general Although weight reduction, when achieved, is effecpopulation (20%). 8 Conversely, the prevalence of tive in improving or even curing many overweight OSA is much higher in patients with essential OSA patients, 29 the long term compliance with this hypertension (30%) 9-12 than it is in the general form of therapy is often poor. 32 There is insufficient population (2-4%). 13 As summarised by ourselves long term data avai...

show abstract

Section: Bp Variabilitymentioning

confidence: 85%

Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients

Berger

Oksenberg

Silverberg³

et al. 1997

J Hum Hypertens

View full text Add to dashboard Cite

show abstract

“…Potential selection bias was partly minimised by not including from the normotensive controls subjects with a positive past and/or family history of hypertension and by choosing volunteers from all Australian states across a wide geographical distribution. However, selection bias is possible because some ISH patients included in the study were already on BP medication and because ambulatory BP monitoring (which can reduce false-positive response, white-coat influence and observer bias) [20][21][22][23][24][25][26] was not used for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

The 460Trp polymorphism of the human α-adducin gene is not associated with isolated systolic hypertension in elderly Australian Caucasians

et al. 2000

View full text Add to dashboard Cite

The study was undertaken to determine whether polymorphic variants of the ␣-adducin gene are associated with isolated systolic hypertension (ISH) in elderly Australian Caucasians. Participants were classified with ISH (n ‫؍‬ 87, systolic blood pressure (SBP) у160 mm Hg and diastolic blood pressure (DBP) р90 mm Hg) or normotension (n ‫؍‬ 124, SBP Ͻ140 mm Hg and DBP Ͻ90 mm Hg with no family history of hypertension). To collect demographic data, a structured questionnaire was used. DNA was extracted using standard techniques from 211 subjects (age range 61-89, mean age 73 ؎ 6.6 years, male: female ratio 1.1:1). Genotypes (gly/gly, trp/gly and trp/trp) were assigned in triplicate by polymerase chain reaction (PCR) followed by electrophoresis, using a laser scanning electrophoresis unit. The validity of the method was confirmed by sequencing. Frequencies of allele distribution in ISH or control groups were determined by Chi-square tests and a stepwise logistic regression model, which controlled for potential confounders, was used to examine any independent association between ␣-adducin genotypes or

show abstract

“…By recording multiple blood pressure measurements outside the physician's office, this method substantially reduces intra-individual variability and is a better correlate of the true blood pressure burden. 3,7 Consequently, at least 80% of participants were within 10 mm Hg of systolic blood pressure and 5 mm Hg of diastolic blood pressure after a repeated 24-h blood pressure measurement. 3 Accordingly, ambulatory blood pressure measurement is a better predictor of cardiovascular morbidity and mortality than office blood pressure.…”

Section: Introductionmentioning

confidence: 99%

“…3,7 Consequently, at least 80% of participants were within 10 mm Hg of systolic blood pressure and 5 mm Hg of diastolic blood pressure after a repeated 24-h blood pressure measurement. 3 Accordingly, ambulatory blood pressure measurement is a better predictor of cardiovascular morbidity and mortality than office blood pressure. [8][9][10][11][12][13][14][15] Randomized studies using ambulatory blood pressure measurement for the management of antihypertensive treatment are scarce.…”

Section: Introductionmentioning

confidence: 99%

“…First, because of the elevated variability of office blood pressure, less than 50% of subjects are within 10 mm Hg of systolic blood pressure after repeated office blood pressure measurement. 3 Second, office blood pressure is taken in an artificial environment and does not necessarily reflect an individual's blood pressure outside the physician's office, such that white coat hypertension is diagnosed in around 20% of individuals with office hypertension. [4][5][6] Ambulatory blood pressure measurement overcomes most of these limitations.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

2008

View full text Add to dashboard Cite

The aim of this study was to assess whether the use of 24-h blood pressure (BP) measurement in the management of antihypertensive therapy improves BP in patients with sustained hypertension. Patients with sustained hypertension (office BP X140/90 mm Hg, and 24-h systolic BP X130/80 mm Hg) were randomly assigned to a strategy using 24-h BP to manage antihypertensive treatment (target o130/80 mm Hg) or to a standard strategy using office BP (target o140/90 mm Hg). The primary end point was change in 24-h systolic BP at 1 year of follow-up. We included 136 patients in the primary analysis. After 1 year of follow-up, the change in 24-h systolic BP was significantly greater in the ambulatory BP group compared with the office BP group (mean difference (95% confidence interval) À3.6 (À7.0, À0.3), P ¼ 0.03). Intentionto-treat analysis revealed essentially unchanged results.The mean number of antihypertensive drugs per participant at 1 year of follow-up was 1.76 ± 1.1 and 1.95 ± 0.9 in the ambulatory and office BP group, respectively (P ¼ 0.049). The benefit of ambulatory BP monitoring was mainly seen in patients with previously known hypertension (mean difference À7.2 (À11.6, À2.8), P ¼ 0.002), but not in those with newly detected hypertension (mean difference 0.2 (À4.9, 5.4), P ¼ 0.93). In conclusion, using 24-h BP for the management of antihypertensive therapy in patients with sustained hypertension leads to a greater BP reduction compared with a standard treatment strategy using office BP, although fewer antihypertensive drugs were used in the ambulatory BP group.

show abstract

Long-term reproducibility of ambulatory blood pressure

Cited by 113 publications

References 0 publications

Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients

Avoiding the supine position during sleep lowers 24 h blood pressure in obstructive sleep apnea (OSA) patients

The 460Trp polymorphism of the human α-adducin gene is not associated with isolated systolic hypertension in elderly Australian Caucasians

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

Contact Info

Product

Resources

About