1. Home blood pressure in poorly controlled hypertension: relationship with ambulatory blood pressure and organ damage.
- Author
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Martínez MA, Sancho T, García P, Moreno P, Rubio JM, Palau FJ, Antón JL, Cirujano FJ, Sanz J, and Puig JG
- Subjects
- Aged, Albuminuria etiology, Carotid Arteries diagnostic imaging, Carotid Arteries pathology, Cross-Sectional Studies, Echocardiography, Female, Heart Ventricles pathology, Humans, Hypertension complications, Hypertension pathology, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Blood Pressure Monitoring, Ambulatory methods, Hypertension physiopathology
- Abstract
Objectives: (1) To assess whether home blood pressure measurement is a reliable alternative to ambulatory blood pressure monitoring for the evaluation of treated patients with inadequate blood pressure control at the clinic; and (2) to evaluate the relationship between home blood pressure and several target-organ damage markers., Basic Methods: A cross-sectional study was performed in 225 treated hypertensive patients with persistently high blood pressure values at the clinic (systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg). All study participants underwent clinic blood pressure measurement, 24-h ambulatory blood pressure and home blood pressure monitoring. A subgroup of patients underwent the following procedures: carotid echography (n=74), microalbuminuria determination (n=88) and echocardiography (n=43). We defined out-of-clinic normotension as an average ambulatory or home blood pressure less than 135 mmHg (systolic) and 85 mmHg (diastolic)., Main Results: The sensitivity, specificity and positive and negative predictive values of the home blood pressure method for predicting out-of-clinic normotension (with the ambulatory method used as reference), expressed as percentages, were 50, 87, 64 and 79%, respectively. Systolic home blood pressure correlated significantly with left ventricular mass (r=0.33, P<0.05) and microalbuminuria (r=0.24, P<0.05). Similar correlation coefficients were found for systolic ambulatory blood pressure (r=0.32, P<0.05 and r=0.24, P<0.05, respectively). Clinic blood pressure did not correlate with either left ventricular mass or microalbuminuria (r=0.19, P=0.09 and r=0.19, P=0.24, respectively). Diastolic home blood pressure, but not ambulatory blood pressure, correlated negatively with mean carotid intima-media thickness (r=-0.27, P<0.05)., Conclusion: Our results suggest that, in patients with poorly controlled hypertension at the clinic, home blood pressure represents a complementary test rather than an alternative to ambulatory blood pressure, and correlates with several target-organ damage markers.
- Published
- 2006
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