Usefulness of ambulatory blood pressure measurement for hypertension management in India: the India ABPM study

Kaul, Upendra; Arambam, Priyadarshini; Rao, S S; Kapoor, Sunil; Swahney, J P S; Sharma, Kamal; Nair, Tiny; Chopda, Manoj; Hiremath, Jagdish; Ponde, C K; Oomman, Abraham; Srinivas, Budanur Chikkaswamy; Suvarna, Viraj; Jasuja, Sanjiv; Borges, Eric; Verberk, Willem J.

doi:10.1038/s41371-019-0243-6

Cited by 12 publications

(15 citation statements)

References 36 publications

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“…In India-ABPM study, a large clinic-based study involving 27472 subjects, MH and WCH were found in 19.3% and 12% respectively. 19 Though our study population was comparable to India-ABPM, the differences in prevalence may be due to the smaller sample size in our study. CV morbidity was found to be lower in WCH than sustained HTN and is said to be on par with that in normotensives in many previous studies.…”

Section: Discussionmentioning

confidence: 63%

Short term blood pressure variability and target organ damage-an observational study of ambulatory blood pressure monitoring in a clinic setting in South India

Hegde¹,

Aroor²,

Janardhana³

et al. 2021

Preprint

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High blood pressure (BP) is an important risk factor for Cardiovascular diseases. The association of short term BP Variability (BPV) with target organ damage(TOD) is not clearly established. We conducted this observational study to evaluate the degree of concordance between Office Blood Pressure monitoring(OBPM) and Ambulatory Blood Pressure Monitoring (ABPM) and to study the effect of short term BPV on TOD. Patients attending clinics of the authors between January 2018 and August 2019 were enrolled. Their BP status was determined by OBPM and ABPM and the degree of concordance analysed. ABPM parameters between those with TOD and without TOD were compared using appropriate statistical measures. Data from 968 subjects (males 61.5%,mean age 59.39 ± 14.86 years) were analysed. Masked hypertension and white coat hypertension were seen in 138 (14.3%) and 50 participants (5.2%) respectively. There was moderate Concordance between ABPM and OBPM readings (Cohen’s kappa =0.692). There were 530(54.8%) non dippers and 189 (19.5%) reverse dippers. High morning surge (MS) was seen in 193(19.9%) and TOD in 225 (23.2%). Percent time elevation (PTE) of systolic BP (P=0.004,OR 1.009,95%CI 1.003,1.016) and diastolic BP in active period (p=0.034,OR 1.009,CI 1.001,1.017) and PTE of diastolic BP in passive period(p=0.006,OR 1.011,95%CI 1.003,1.018) ,as assessed by ABPM were significantly associated with TOD.Dipping status ,diurnal index and MS were not associated with TOD. ABPM is a useful tool for diagnosis and accurate categorisation of hypertension. Analysis of ABPM parameters helps to identify the patients with significant BP load who are at risk of developing TOD.

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Section: Discussionmentioning

confidence: 63%

Short term blood pressure variability and target organ damage-an observational study of ambulatory blood pressure monitoring in a clinic setting in South India

Hegde¹,

Aroor²,

Janardhana³

et al. 2021

Preprint

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“…For patients who were not on any medication, this misclassification percentage was higher than in those who were treated (35.2% vs. 26.7%; p<0.0001) as we have found in our study. 5…”

Section: Resultsmentioning

confidence: 99%

“…This misclassification percentage was higher than in those who were treated (35.2% vs. 26.7%; p<0.0001). 5 In this study, we evaluated use of ABPM in evaluation of young subjects who were found to be hypertensive with manual blood pressure recordings during routine medical examination before induction to high altitude areas.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the manual blood pressure record with ambulatory blood pressure monitoring in young patients found to be hypertensive during routine medical examination before induction to high altitude areas

Sharma

Pandit²

2020

Int J Adv Med

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Background: Ambulatory blood pressure monitoring (ABPM) measurements has been found to be superior to Outpatient Department (OPD) blood pressure measurements (OBPM) for predicting clinical outcomes. There have been various indications of ABPM like to exclude white coat hypertension, evaluation of symptomatic hypotension and hypertension, pregnancy induced hypertension etc. We studied use of ABPM in evaluation of young subjects who were found to be hypertensive in OBPM.Methods: This prospective study was performed at Command Hospital, Kolkata, India from December 2017 to November 2019.This study had a total of 100 subjects. All patients were young healthy individuals and found to have high blood pressure (BP) readings during routine examination done before induction to high altitude areas (>9000 feet). All subjects who were found to be hypertensive in OBPM were evaluated with 24 hours ABPM at least one week after cessation of all medications. Data expressed as the mean±SD. Comparisons of (a) the peripheral hospital mean systolic and diastolic BP over 01 week and (b) 24 hours mean ABPM. Results: In the study, the Mean Systolic BP was 143.33±11.82 with corresponding ABPM 123.92±13.17 which is statistically significant. The mean diastolic BP was 87.30±7.20 mm with corresponding ABPM as 71.55±4.11 MAP in manual blood pressure is 125.55 mm and 103.6 mm in ABPM. The results are highly significant.Conclusions: The study concludes that automated BP recordings may provide a more accurate estimate of a patient's BP status and may prevent unnecessary labelling of young patients as hypertensive.

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“…India ABPM study reported white-coat hypertension and masked hypertension prevalence of 12% and 19.3%, respectively. The study reported contradiction of hypertension diagnosis in about one-third of patients with office-based BP measurement versus ABPM [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Spanish Society of Hypertension ABPM registry support its usefulness in the primary care setting for the diagnosis and treatment of hypertension [ 1 ]. A multi-center, Indian ABPM study has also demonstrated the usefulness of ABPM for the management of hypertension in Indian patients [ 8 ]. A systematic review has suggested that home-based BP monitoring helps in improvement of patient-centered care, control of BP and patient outcomes [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Ambulatory Blood Pressure Monitoring: Our Experience in Routine Clinical Practice

Dube

Dube²,

Damle

et al. 2021

Cureus

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Objective: To evaluate feasibility and usefulness of ambulatory blood pressure monitoring (ABPM) in outpatient setting. Material and methods: In this prospective study, data of 58 patients who were evaluated with ABPM for diagnosis or therapeutic efficacy purpose were collected from their records. Demographic details of these were recorded. Patients were categorized into different categories based on 24 hours BP pattern. Dipping pattern was compared based on the gender, age, and presence of diabetes or hypertension. Number of patients diagnosed as hypertensive with ABPM reports was compared with office and home BP measurement. Results: Fifty-eight patients (mean age 57.8 years; 70.69% males) were included of whom 22 (37.93%) underwent ABPM for diagnostic purposes. There was gender-wise significant difference in terms of purpose of performing ABPM (p=0.040). Diabetes was present in 22 (37.93%) patients. Out of 36 known hypertensive patients, 17 (47.22%) patients were receiving dual therapy. Out of 45 patients whose records for active BP variability were available, 26 (57.78%) had high variability. The number and percentage of dippers, extreme dippers and reverse dippers as 23 (42.79%), three (5.56%), and six (11.11%), respectively. Depending on the age, there was significant difference in the dipping pattern (p=0.013). On office blood pressure measurement, 35 (64.81%) patients were found to have hypertension. ABPM revealed hypertension in 32 (59.26%). Masked hypertension and white-coat hypertension was observed in nine (16.17%) and 12 (22.22%) patients, respectively. Conclusion: ABPM is feasible and useful in routine outpatient clinical practice for diagnosis of essential hypertension, pattern of dipping, masked hypertension, and white-coat hypertension and also for the therapeutic evaluation of patients in clinical practice.

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Usefulness of ambulatory blood pressure measurement for hypertension management in India: the India ABPM study

Cited by 12 publications

References 36 publications

Short term blood pressure variability and target organ damage-an observational study of ambulatory blood pressure monitoring in a clinic setting in South India

Short term blood pressure variability and target organ damage-an observational study of ambulatory blood pressure monitoring in a clinic setting in South India

Comparison of the manual blood pressure record with ambulatory blood pressure monitoring in young patients found to be hypertensive during routine medical examination before induction to high altitude areas

Ambulatory Blood Pressure Monitoring: Our Experience in Routine Clinical Practice

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