Key result
Elevated BMI and renal disease were associated with a lower likelihood of achieving a successful ambulatory blood pressure monitoring session (increasing BMI OR 0.78; 95% CI 0.65-0.93; P=0.005).
Why the study?
Do specific patient characteristics predict the success of ambulatory blood pressure monitoring?
Observational (n=530)
No
Do specific patient characteristics predict the success of ambulatory blood pressure monitoring?
Odds Ratio: 0.78 (95% CI 0.65–0.93)
p-value: p=0.005
Elevated BMI and renal disease are associated with a lower likelihood of obtaining a successful ambulatory blood pressure monitoring session, suggesting a need for individualized approaches in these patients.
May support alternative BP monitoring in obese or renally impaired patients; leaves open prospective validation of tailored ABPM protocols.
STUDY OBJECTIVE: To examine the influence of specific patient characteristics on the success of ambulatory blood pressure monitoring (ABPM). DESIGN: Retrospective analysis. SETTING: University-affiliated family care center. PATIENTS: Five hundred thirty patients (mean age 52.7 yrs, range 14-90 yrs) who were undergoing ABPM between January 1, 2001, and July 1, 2007. MEASUREMENT AND MAIN RESULTS: Specific patient characteristics were identified through an electronic medical record review and then examined for association with ABPM session success rate. These patient characteristics included age, sex, weight, height, body mass index (BMI), occupation, clinic blood pressure, travel distance to clinic, and presence of diabetes mellitus or renal disease. The percentage of valid readings obtained during an ABPM session was analyzed continuously (0-100%), whereas overall session success was analyzed dichotomously (0-79% or 80-100%). Univariate and multivariate regression analyses were performed to examine the influence of patient characteristics on the percentage of valid readings and the overall likelihood of achieving a successful session. In the 530 patients, the average percentage of valid readings was 90%, and a successful ABPM session (>or= 80% valid readings) was obtained in 84.7% (449 patients). A diagnosis of diabetes was found to negatively predict ABPM session success (continuous variable analysis, p=0.019; dichotomous variable analysis, odds ratio [OR] 0.45, 95% confidence interval [CI] 0.23-0.87, p=0.019), as did renal disease (continuous variable analysis, p=0.006; dichotomous variable analysis, OR 0.39, 95% CI 0.17-0.90, p=0.027) and increasing BMI (continuous variable analysis, p<0.001; dichotomous variable analysis, OR 0.78, 95% CI 0.65-0.93, p=0.005). Renal disease and BMI remained significant predictors in adjusted analyses. CONCLUSION: For most patients, ABPM was successful; however, elevated BMI and renal disease were associated with less complete ABPM session results. Adaptation and individualization of the ABPM process may be necessary to improve results in these patients.
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Fravel et al. (2008) conducted an observational in Indication for ambulatory blood pressure monitoring (n=530). Elevated BMI and renal disease vs. Lower BMI and absence of renal disease was evaluated on Successful ABPM session (≥80% valid readings) (OR 0.78, 95% CI 0.65-0.93, p=0.005). Elevated BMI and renal disease were associated with a lower likelihood of achieving a successful ambulatory blood pressure monitoring session (increasing BMI OR 0.78; 95% CI 0.65-0.93; P=0.005).
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