Home blood pressure measurement correlated with target organ damage at least as well as 24-hour ambulatory monitoring, with equivalent home systolic cut-offs being approximately 5 mmHg higher.
Observational (n=325)
Does self-measurement of blood pressure at home correlate with target organ damage as well as 24-h ambulatory blood pressure monitoring in hypertensive patients?
Home blood pressure monitoring correlates with target organ damage at least as well as ambulatory monitoring, supporting its use in clinical practice with appropriately adjusted diagnostic cut-offs.
OBJECTIVE: Ambulatory blood pressure (BP) monitoring and home blood pressure measurements predicted the presence of target organ damage and the risk of cardiovascular events better than did office blood pressure. METHODS: To compare these two methods in their correlation with organ damage, we consecutively included 325 treated (70%) or untreated hypertensives (125 women, mean age = 64.5 +/- 11.3) with office (three measurements at two consultations), home (three measurements morning and evening over 3 days) and 24-h ambulatory monitoring. Target organs were evaluated by ECG, echocardiography, carotid echography and detection of microalbuminuria. Data from 302 patients were analyzed. RESULTS: Mean BP levels were 142/82 mmHg for office, 135.5/77 mmHg for home and 128/76 mmHg for 24-h monitoring (day = 130/78 mmHg; night = 118.5/67 mmHg). With a 135 mmHg cut-off, home and daytime blood pressure diverged in 20% of patients. Ambulatory and Home blood pressure were correlated with organ damage more closely than was office BP with a trend to better correlations with home BP. Using regression analysis, a 140 mmHg home systolic blood pressure corresponded to a 135 mmHg daytime systolic blood pressure; a 133 mmHg daytime ambulatory blood pressure and a 140 mmHg home blood pressure corresponded to the same organ damage cut-offs (Left ventricular mass index = 50 g/m, Cornell.QRS = 2440 mm/ms, carotid intima media thickness = 0.9 mm). Home-ambulatory differences were significantly associated with age and antihypertensive treatment. CONCLUSION: We showed that home blood pressure was at least as well correlated with target organ damage, as was the ambulatory blood pressure. Home-ambulatory correlation and their correlation with organ damage argue in favor of different cut-offs, that are approximately 5 mmHg higher for systolic home blood pressure.
Gaborieau et al. (Fri,) conducted a observational in Hypertension (n=325). Home blood pressure measurement vs. 24-h ambulatory blood pressure monitoring was evaluated on Correlation with target organ damage (evaluated by ECG, echocardiography, carotid echography and microalbuminuria). Home blood pressure measurement correlated with target organ damage at least as well as 24-hour ambulatory monitoring, with equivalent home systolic cut-offs being approximately 5 mmHg higher.