February 10, 1989JAMA
Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension
Why the study?
Does office hypertension cause cardiac end-organ damage compared to sustained daytime hypertension or normotension?
Population
Age-matched patients categorized by casual and ambulatory blood pressures into three groups: 'office'…
Comparison
Office hypertension vs Normotensives and daytime hypertensives
Design
Cohort
Authors
Discussion
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Implication
Office hypertension was associated with preserved cardiac structure/function like normotension; leaves open whether ambulatory BP better identifies end-organ damage risk.
Key Points
- This research aims to identify how different types of blood pressure measurements relate to cardiac health in hypertensive patients.
- Identified three groups of patients based on casual and ambulatory blood pressure measurements.
- Conducted assessments of left atrial index, left ventricular mass index, heart function at rest, and exercise.
- Collected and analyzed data to compare cardiac measurements across the defined groups.
- Patients with office hypertension had cardiac size and function similar to normotensives, differing from daytime hypertensives.
- Left ventricular filling rate and ejection fraction were better in office hypertensives compared to daytime hypertensives.
- Average daily blood pressure was found to be a better predictor of cardiac end-organ damage than office measurements.
Structured PICO
Does office hypertension cause cardiac end-organ damage compared to sustained daytime hypertension or normotension?
P
Population
Age-matched patients categorized by casual (office) and ambulatory blood pressures into three groups: 'office' hypertensives, normotensives, and 'daytime' hypertensives.
I
Intervention
Office hypertension (office blood pressure >140/90 mm Hg and awake ambulatory blood pressure <=130/80 mm Hg)
C
Comparator
Normotensives (office blood pressure <135/85 mm Hg and awake ambulatory blood pressure <=130/80 mm Hg) and daytime hypertensives (office blood pressure >140/90 mm Hg and awake ambulatory blood pressure >=140/90 mm Hg)
O
Outcome
Cardiac size (left atrial index, left ventricular mass index) and function (left ventricular filling rate at rest, ejection fraction at peak exercise)surrogate
Average daily ambulatory blood pressure, rather than office blood pressure, is the primary determinant of hypertensive cardiac end-organ damage.
Cite This Study
William B. White (1989) studied this question.