Does clinical and scientific practice require blood pressure load indices from ambulatory monitoring: a scoping review

The aim of this review was to answer the question of whether clinical and research practice require blood pressure load indices from ambulatory BP monitoring data. To identify related publications, a search of Pubmed, eLibrary, elpub databases and snowball sampling were used. A total of 264 publications were found. Then, publications were excluded in which the term "blood pressure load" stayed out of the context of 24-hour BP monitoring, as well as reviews and studies with fewer than 21 observations. A total of 69 publications selected were classified as follows: outcome studies; studies on target organ damage and risk factors; studies in special groups; intervention studies. The literature review showed that there are no studies with methodology provided evidence of a clear additional value of BP load compared to mean BP values. In contrast, studies with high statistical power specifically aimed at the question under study showed lack of predictive power of BP loads for either outcome or target organ damage in general and special populations. There is also no evidence that any intervention based on target BP loads is superior to treatment based on standard BP. The results of our review suggest that there is no need to calculate BP loads. Routine clinical decision-making should be based only on standard BP values compared with the thresholds adopted by medical scientific societies in clinical guidelines.