February 1, 2002Open Access
View Full PaperCharacteristics of conventional blood pressure in studies on the predictive power of ambulatory blood pressure
Key Result
A review of 28 studies showed ambulatory blood pressure was superior to conventional measurement for predicting cardiovascular outcomes, though conventional measurement details were often incomplete.
Structured PICO
Does 24-h ambulatory blood pressure measurement predict left ventricular mass and cardiovascular outcomes better than conventional clinic blood pressure, and what is the quality of conventional measurements in these studies?
P
Population
28 studies (21 on left ventricular mass published 1982-1993, 7 on cardiovascular morbidity/mortality published 1983-2001) evaluating the predictive power of ambulatory versus conventional blood pressure
I
Intervention
24-h ambulatory blood pressure measurement
C
Comparator
Conventional clinic or casual blood pressure measurement
O
Outcome
Association with left ventricular mass and cardiovascular morbidity/mortality, and the quality/standardization of conventional blood pressure measurement methodology
While ambulatory blood pressure is a stronger predictor of cardiovascular outcomes and LV mass than conventional clinic blood pressure, the methodology of conventional measurements in these comparative studies is often poorly standardized or incompletely reported.
Limitations
- Methodology and conditions of conventional blood pressure measurements were poorly described or standardized in several reports
- The number of measurements has not always been adequate
- Published details were often incomplete
Abstract
BACKGROUND: It is commonly believed that the associations of left ventricular mass and cardiovascular morbidity/mortality with blood pressure are stronger for 24-h ambulatory pressure than for conventional clinic or casual pressure. METHODS: The investigation comprised a review of relevant studies, with particular emphasis on the characteristics of the conventional blood pressure measurement. RESULTS: A review of 21 studies on left ventricular mass, published between 1982 and 1993, showed that the relationship between mass and blood pressure was stronger for ambulatory blood pressure than for clinic blood pressure but that the methodology and conditions of the conventional blood pressure measurements were poorly described or standardized in several reports. Between 1983 and 2001, seven studies showed that ambulatory blood pressure was superior to conventional blood pressure with regard to the prediction of cardiovascular morbidity and/or mortality. From published data and requests for additional information, it appears that recommendations for the measurement of conventional blood pressure have been reasonably well observed, although the number of measurements has not always been adequate. CONCLUSIONS: Whereas the quality of the conventional blood pressure measurements left much to be desired in the studies on left ventricular mass, the quality appeared to be reasonably good in outcome studies, even though the published details were often incomplete.