Key result
Nurse-recorded clinic blood pressure and 24-hour ambulatory blood pressure correlated equally well with left ventricular mass index (r=0.55-0.64, P<0.0001).
Why the study?
Does nurse-recorded clinic blood pressure correlate as well as ambulatory blood pressure with target organ damage in hypertensive and normotensive subjects?
Cross-Sectional (n=133)
Does nurse-recorded clinic blood pressure correlate as well as ambulatory blood pressure with target organ damage in hypertensive and normotensive subjects?
Nurse-recorded clinic blood pressure (three measurements 1 min apart) correlates as well as 24-hour ambulatory blood pressure with hypertensive target organ damage.
Nurse-recorded clinic BP may suffice for LV mass and IMT assessment in hypertension; leaves open whether ambulatory monitoring adds incremental value.
OBJECTIVE: To assess relationships between noninvasive ambulatory blood pressure (BP), clinic BP (mean value of three readings in the seated position measured by nurses), structural cardiac indices, intima-media thickness of the common carotid artery and several hormones. DESIGN: Cross-sectional study of 75 subjects with hypertension and left ventricular hypertrophy (HTH) according to echocardiography, 35 subjects with hypertension and normal left ventricular dimensions (HT) and 23 normotensive subjects (NT). RESULTS: We found an excellent correlation between mean 24-h ambulatory BP and clinic BP, the r-value for systolic BP being 0.82 and for diastolic levels 0.78 (both P < 0.0001). Clinic and ambulatory BP correlated equally well with left ventricular (LV) mass index (r-values between 0.55 and 0.64, all P < 0.0001) and to intima-media thickness of the carotid artery (r = 0.18-0.34, P < 0.01). The systolic white-coat effect (clinic BP - day-time BP) was higher in the HTH and HT compared with NT and was weakly correlated to LV mass index (r = 0.18, P = 0.04). Nondippers (mean arterial night/day BP ratio of > 0.9) had higher brain (6.1 +/- 7.5 pmol L(-1) vs. 3.7 +/- 3.2 pmol L(-1), P = 0.01) and atrial (14 +/- 3.4 pmol L(-1) vs. 9.3 +/- 5.4 pmol L(-1), P = 0.04) natriuretic peptide levels, and also exhibited a lower ejection fraction (49 +/- 8% vs. 57 +/- 9%, P = 0.006), than dippers. CONCLUSION: Clinic BP recordings performed by nurses as three measurements 1 min apart provide excellent relationship to target organ damage. Nondippers exhibited signs of a more advanced hypertensive organ damage than dippers which corresponds well with the poor prognosis linked to this condition.
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Nyström et al. (2005) conducted a cross-sectional in Hypertension (n=133). Nurse-recorded clinic blood pressure vs. 24-hour ambulatory blood pressure was evaluated on Correlation with left ventricular mass index (r=0.55-0.64, p=< 0.0001). Nurse-recorded clinic blood pressure and 24-hour ambulatory blood pressure correlated equally well with left ventricular mass index (r=0.55-0.64, P<0.0001).
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