Key result
Abnormal awake ambulatory blood pressure (>136/86) was associated with a higher rate of requiring antihypertensive treatment at 1 year compared to normal ABP.
Why the study?
Does abnormal awake ambulatory blood pressure monitoring predict increased left ventricular mass index and the need for antihypertensive treatment over 1 year in untreated patients with borderline hypertension?
Cohort (n=127)
Does abnormal awake ambulatory blood pressure monitoring predict increased left ventricular mass index and the need for antihypertensive treatment over 1 year in untreated patients with borderline hypertension?
Ambulatory blood pressure monitoring in borderline hypertension effectively identifies patients with true hypertension who have higher left ventricular mass and are more likely to require pharmacological treatment within one year.
Answers are grounded in this paper and cite their sources.
Does not support routine ABPM in borderline hypertension; leaves open its role in predicting treatment need.
The role of ambulatory blood pressure (ABP) monitoring in the assessment of mild/borderline hypertension (BHT) is unclear. The aim of this study was to test the hypothesis that measurement of ABP in borderline hypertensives differentiates patients with true mild hypertension from those with isolated clinic hypertension (raised office BP but normal ABP) and that a raised ABP identifies a subgroup who are more likely to progress to and require treatment over 1 year. Consecutive untreated patients with BHT (n = 127, 44 +/- 13 years, 45% male) were divided into two groups according to awake ABP: Group 1 (normal ABP < or = 136/86, n = 48), and Group 2 (abnormal ABP > 136/86, n = 79). Left ventricular mass index (LVMI) was greater (116 +/- 30 vs 101 +/- 25 g/m2, p < 0.01) and the proportion of patients with an increased LVMI was significantly higher (34% vs 17%, p = 0.05) in Group 2. During 1 year of follow-up, significantly more patients in Group 2 (34%) required antihypertensive treatment compared with Group 1 (8%, p = 0.01). ABP monitoring usefully discriminates between patients with true BHT and those with isolated clinic hypertension. An elevated awake ABP on initial assessment is associated with a higher LVMI and a greater likelihood of progression to moderate hypertension requiring pharmacological treatment.
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Manning et al. (2001) conducted a cohort in Borderline hypertension (n=127). Abnormal awake ambulatory blood pressure (> 136/86) vs. Normal awake ambulatory blood pressure (<= 136/86) was evaluated on Requiring antihypertensive treatment (p=0.01). Abnormal awake ambulatory blood pressure (>136/86) was associated with a higher rate of requiring antihypertensive treatment at 1 year compared to normal ABP.
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