Why the study?
Does a systematic ABPM and follow-up protocol improve blood pressure control in patients with elevated clinic blood pressure entering cardiac rehabilitation?
Does a systematic ABPM and follow-up protocol improve blood pressure control in patients with elevated clinic blood pressure entering cardiac rehabilitation?
Systematic use of ABPM in cardiac rehabilitation effectively identifies white-coat hypertension and facilitates high rates of overall blood pressure control.
ABPM protocol was associated with high BP control in cardiac rehab; hypothesis-generating and requires randomized confirmation before practice change.
The aim of this study was to assess the effectiveness of the systematic identification and sustained follow-up protocol of hypertensive patients using ambulatory blood pressure monitoring (ABPM) superimposed on Phase III cardiac rehabilitation (CR). Methods: Patients with elevated blood pressure (BP) (clinic measurement) on entry to CR had protocol cycles of ABPM, lifestyle education, medication changes and clinic BP monitoring, throughout CR and up to 6 months follow-up until BP control was achieved. Results: Initial assessment using clinic measurement identified 30% (129) patients with uncontrolled hypertension but following initial ABPM 62% (n=80) were normal with 38% (49) diagnosed as uncontrolled. These were followed-up using protocol cycles up to six times. Of those originally identified as hypertensive, 81% (104) achieved control. Conclusion: This systematic identification and sustained follow-up of hypertensive patients using ABPM in CR was a convenient, successful method in identifying and controlling a significant amount of uncontrolled hypertension.
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Fallon et al. (2014) studied this question.
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