Clinic blood pressure underestimates ambulatory blood pressure
medwireNews: Researchers report that ambulatory blood pressure (ABP) is higher than clinic BP (CBP) in healthy employed people, in contrast to “a widely held belief.”
These findings suggest that “physicians should probably be more concerned that the clinic BP underestimates, rather than overestimates, the patient’s average daytime BP,” write Joseph Schwartz (Stony Brook University, New York, USA) and colleagues.
The team found that among 888 middle-aged people without a diagnosis of hypertension who participated in the Masked Hypertension Study, the mean awake ABP was significantly higher, at 123.0/77.4 mmHg, compared with an average CBP of 116.0/75.4 mmHg taken from nine readings over three visits.
Furthermore, systolic awake ABP exceeded CBP by at least 10 mmHg in over a third of study participants. A “substantial” 15.7% of participants who were classed as normotensive by CBP (<140/90 mm Hg) had masked hypertension (ABP≥135/85 mm Hg), which “may warrant treatment or at least monitoring,” note the authors in Circulation.
They conclude that CBP–ABP gradients “could provide guidance for primary care physicians as to when, for a given CBP, 24-hour ABP would be useful to identify or rule out masked hypertension.”
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