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(Hypertension. 2005;45:1070.)
© 2005 American Heart Association, Inc.

Editorial Commentaries

Out-of-Office Blood Pressure Measurement

A New Era

From the Hypertension Unit, Department of Medicine, Hadassah University Hospital, Mount-Scopus, Jerusalem, Israel.

Correspondence to Michael Bursztyn, MD, FAHA, Hypertension Unit, Department of Medicine, Hadassah University Hospital, Mount Scopus, PO Box 24035, Jerusalem 91240, Israel. E-mail bursz@cc.huji.ac.il

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Twenty years ago in a seminal article, Modan et al,¹ fueled the interest in metabolic abnormalities of hypertension by showing that independent of obesity but frequently associated with it, patients with hypertension are glucose intolerant and hyperinsulinemic. This is now commonly acknowledged as the metabolic syndrome (or parts of it).

An enormous volume of research had emerged that tried (somewhat in vain) to attribute hypertension to hyperinsulinemia. Despite the large progress in understanding the fascinating and expanding interrelationship between obesity, adipose tissue, sympathetic drive, renin angiotensin system, leptin, adiponectin, NO, etc, there is still much to learn about the diversity of their relationships and the heterogeneity of effector and signaling systems.

At more or less the same time period, out-of-office measurements of blood pressure evolved gradually from research to clinical tools. These are now accomplished by 24-hour ambulatory blood pressure monitoring (ABPM) and self-measured or home blood pressure (HBP), as the recent American Heart Association (AHA) scientific statement recommends.²

The advantages of ABPM is objectivity, independence of the alerting reaction, evaluation of blood pressure during sleep, and better correlation with hypertensive target organ damage and outcome than clinic blood pressure. Those of HBP are convenience, ability to repeat measurements without limitations, lower costs, and involvement of patients in their care as well as their empowerment.

The Agency for Healthcare Research and Quality (AHRQ) has issued an evidence report that has addressed many aspects of these out-of-office measurements³ and suggested future research directions. Some of the questions raised by AHRQ have . . . [Full Text of this Article]