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Background: Twenty four hour ambulatory blood pressure monitoring (24-H ABPM) plays an important role in the management of hypertensive patients. The aim of our study was to determine the frequency of seven known adverse prognostic features in an ambulatory assisted hypertensive patient population. Methods: The study included all the 957 hypertensive patients with a performed 24-H ABPM, examined in the 2008-2011 period in a preventive ambulatory cardiology system. The studied adverse prognostic features were: daytime systolic blood pressure (BP) >140 mmHg, daytime diastolic BP >90 mmHg, nighttime systolic BP >125 mmHg, nighttime diastolic BP >75 mmHg, nocturnal dipping <10%, early morning hypertension >140/90 mm Hg, pulse pressure >53 mm Hg. Patient data were introduced in an integrated patient data management system as an electronic health record. The frequency of adverse prognostic features was compared in type 2 diabetic versus nondiabetic patients, and in patients with or without manifest cardiovascular complications (ischemic heart disease, stroke, lower extremity arterial disease). Results: The frequency of the studied adverse prognostic features was as follows: high daytime systolic BP 38.1%, high daytime diastolic BP 21.4%, high nighttime systolic BP 45.5%, high nighttime diastolic BP 31.3%, absent nocturnal dipping 59.9%, morning hypertension 33.6%, high pulse pressure 51.5%, morning surge 5.1%. A large proportion of subjects (86.2%) had one or more adverse features reported on the 24-H ABPM. Conclusions: In clinical practice there is a frequent association of multiple adverse prognostic features of ambulatory blood pressure monitoring. The presence of some prognostic features is associated with the presence of diabetes, stroke history, ischemic heart disease or lower extremity arterial disease. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a cardiovascular risk factor which according to the SEPHAR study is therapeutically controlled in about 22.3% of patients. Therefore it is imperative to increase the efficiency of treatment in order to improve control of blood pressure. Material and methods: We conducted a prospective study on a total of 44 patients-11 patients with first grade, 17 patients with second grade and 22 patients with third grade hypertension, with uncontrolled blood pressure. We adjusted the treatment and used telemetry monitoring of blood pressure over a period of two weeks with treatment readjustment after 1 week. Statistical analysis was performed using ANOVA test for paired data, and the GraphPad software, both for the entire group and on sub groups according to hypertension grade. Results: Blood pressure decreased by day 3 by 6.2 mmhg (p < 0.05) and on day 9 after readjustment we found a further decrease in blood pressure reaching 10.29 mmHg from day 1 (p < 0.001. Analysis by subgroup showed in the first grade hypertensive no statistically significant benefit (p = 0.6). In patients with grade 2 hypertension, there was a reduction by 9.56 mmHg on day 11 (p < 0.05). In the subgroup with grade 3 hypertension compared to day 1 we found a decrease by 10.72 mmHg on day 5 (p < 0.05) and 14.25 mmHg on day 9 (p < 0.001). Conclusion: Telemetry is an effective method of tracking blood pressure values and provides useful feedback for effective titration of antihypertensive treatment and achieving target values. [ABSTRACT FROM AUTHOR]