Key result
Ambulatory and non-invasive central blood pressure measurements showed significant associations with end organ damage markers (LVMI, CIMT, PWV, and GFR) compared to office blood pressure, with systolic AMBP demonstrating 98% sensitivity for ABI.
Why the study?
Both ambulatory blood pressure and non-invasive central blood pressure monitoring can predict early hypertensive end organ damage, but the comparison between these two methods needs more clarification.
Does ambulatory and central blood pressure monitoring improve the detection of hypertensive end organ damage compared to office blood pressure measurement in hypertensive patients?
Cross-Sectional (n=100)
No
Does ambulatory and central blood pressure monitoring improve the detection of hypertensive end organ damage compared to office blood pressure measurement in hypertensive patients?
Ambulatory and central blood pressure monitoring are superior to office blood pressure measurements for predicting early hypertensive end-organ damage such as increased LVMI, CIMT, and PWV.
Answers are grounded in this paper and cite their sources.
May support ambulatory/central BP over office readings for end-organ damage assessment; leaves open prospective validation before practice change.
BACKGROUND: Both ambulatory blood pressure (AMBP) and non-invasive central blood pressure (NCBP) monitoring could be used as predictors for early detection of hypertensive end organ damage (EOD). However, the comparison between these two methods needs more clarification. Our cross-sectional study included 100 hypertensive patients with a mean age of 47.52 ± 8.35 years on regular antihypertensive treatment for ≥ 1 year (50 controlled, 50 uncontrolled). We compared associations, sensitivity, and specificity of EOD parameters with office, AMBP, and NCBP measurements. We measured left ventricular mass index (LVMI), carotid intimal medial thickness (CIMT), ankle-brachial index (ABI), serum creatinine, glomerular filtration rate (GFR), and pulse wave velocity (PWV). RESULTS: We found a significant relation between SBP of NCBP, AMBP and LVMI, and CIMT, PWV, and GFR respectively (P < 0.05) while office SBP showed no significant relation. Systolic AMBP showed a high sensitivity to ABI (98%) and CIMT (92%) while systolic NCBP had 92% specificity and DBP showed 90% sensitivity for ABI. CONCLUSION: AMBP and NCBP show a significant relation to LVMI, CIMT, PWV, and GFR with little superiority of central BP while office BP does not. Systolic ABPM has high sensitivity to ABI and CIMT and systolic NCBP has a high sensitivity and specificity to ABI.
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Fouad et al. (2019) conducted a cross-sectional in Hypertension (n=100). Ambulatory and non-invasive central blood pressure monitoring vs. Office blood pressure measurement was evaluated on Association with end organ damage parameters (LVMI, CIMT, PWV, GFR, ABI) (p=<0.05). Ambulatory and non-invasive central blood pressure measurements showed significant associations with end organ damage markers (LVMI, CIMT, PWV, and GFR) compared to office blood pressure, with systolic AMBP demonstrating 98% sensitivity for ABI.
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