Published online before print September 22, 2008, doi: 10.1161/HYPERTENSIONAHA.108.120055
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(Hypertension. 2008;52:795.)
© 2008 American Heart Association, Inc.
Editorial Commentaries |
On Treatment Blood Pressures
Which Can Be Trusted, Home or Clinic?
From the Department of Medicine, Mount Sinai School of Medicine, New York.
Correspondence to Lawrence R. Krakoff, MD, Department of Medicine, Englewood Hospital & Medical Center, Englewood NJ 07631. E-mail Lawrence.krakoff@mssm.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
High arterial pressure is clearly related to risk of future cardiovascular disease and reduction of high pressure is effective for prevention. These concepts are now thoroughly familiar to physicians, other health care providers, and many of those who consume health care (patients) as well. Most of the epidemiology relating cardiovascular risk and the outcome trials demonstrating benefit of drug treatment were, in past decades, based on measurement in clinics using the ancient methods that were developed at the end of the 19th century. We are now at the end of the first decade of the 21st century, and times are changing. Clinical science has clearly shown that blood pressures measured in the clinic are inferior to those measured outside the clinic in "real life" for predicting future cardiovascular mortality and morbidity. Two strategies have been widely studied in this regard: 24-hour ambulatory blood pressure monitoring and home blood pressure recording.1,2 Both have also been assessed for their role in determining the effectiveness of antihypertensive treatment. Most reports have assessed one or the other modality, but not both.
It might be assumed that the daytime component of 24-hour blood pressure monitoring would be similar to home blood pressure recording. However, this need not be so, as home recordings omit the effects of other environments, in particular the work site and other out-of-the home settings (shopping, classes, visiting others, etc). An orderly and comprehensive comparison of clinic pressures, ambulatory monitoring pressures, and home blood pressures during antihypertensive treatment may yield important insights
Related Article:
Hypertension 2008 52: 856-864.