This Article Full Text Full Text (PDF) All Versions of this Article: 44/2/170    most recent 01.HYP.0000135250.57004.19v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Palatini, P. Articles by Pessina, A. C. Search for Related Content PubMed PubMed Citation Articles by Palatini, P. Articles by Pessina, A. C. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Clinical Studies Other diagnostic testing Epidemiology

(Hypertension. 2004;44:170.)
© 2004 American Heart Association, Inc.

Scientific Contributions

Prevalence and Clinical Significance of Isolated Ambulatory Hypertension in Young Subjects Screened for Stage 1 Hypertension

Paolo Palatini; Mikolaj Winnicki; Massimo Santonastaso; Lucio Mos; Daniele Longo; Vania Zaetta; Marta Dal Follo; Tiziano Biasion; Achille C. Pessina

From the Clinica Medica 4 (P.P., M.W., D.L., V.Z., A.C.P.), University of Padova; Town Hospital (M.S.), Vittorio Veneto; Town Hospital (L.M.), San Daniele del Friuli; Town Hospital (M.D.F.), Trento; and Town Hospital (T.B.), Rovereto-Ala, Italy.

Correspondence to Professor Paolo Palatini, MD, trial coordinator, Clinica Medica 4, University of Padova via Giustiniani, 2-35128 Padova, Italy. E-mail palatini{at}unipd.it

Little is known about the clinical significance of isolated ambulatory hypertension, a condition characterized by low office but elevated ambulatory blood pressure. This study aimed to investigate the prevalence and the predictive value of isolated ambulatory hypertension diagnosed after 3 months of observation for the development of sustained hypertension within a cohort of 871 never-treated stage-1 hypertensive subjects. The study end point was progression to more severe hypertension and need of antihypertensive medication. In 244 subjects (28%), clinic blood pressure declined to <140/90 mm Hg after 3 months. Of these, 124 (14.2% of total) had low clinic and ambulatory blood pressures after 3 months (nonhypertensive subjects), whereas 120 subjects (13.8% of total) showed low clinic but elevated ambulatory blood pressure (isolated ambulatory hypertension). During the 6 years of observation, the number of end points based on multiple clinic blood pressure readings progressively increased from the nonhypertensive subjects (19%) to the subjects with isolated ambulatory hypertension (35%) and to the subjects with high clinic and high ambulatory blood pressures (65%, P<0.0001). In an adjusted proportional hazard model, isolated ambulatory hypertension status was associated with a 2.2 (P=0.02) increase in the risk of reaching the end point in comparison with the nonhypertensive subjects. Final ambulatory systolic blood pressure was also higher in the former than the latter (P=0.03). Our results indicate that among subjects screened for stage 1 hypertension, individuals with isolated ambulatory hypertension after 3 months of observation have increased risk of developing sustained hypertension in later life compared with subjects in whom both clinic and ambulatory blood pressures are normal.

Key Words: blood pressure monitoring, ambulatory • hypertension, detection and control

This article has been cited by other articles:

				E. O'Brien Unmasking Hypertension Hypertension, April 1, 2005; 45(4): 481 - 482. [Full Text] [PDF]

				E. Lurbe, I. Torro, V. Alvarez, T. Nawrot, R. Paya, J. Redon, and J. A. Staessen Prevalence, Persistence, and Clinical Significance of Masked Hypertension in Youth Hypertension, April 1, 2005; 45(4): 493 - 498. [Abstract] [Full Text] [PDF]