title: Ambulatory blood pressure monitoring in elderly patients with isolated systolic hypertension.
abstract: OBJECTIVE
  This study compared clinic and ambulatory blood pressure measurement and the reproducibility of these measurements in older patients with isolated systolic hypertension (ISH).
  
  
  METHODS
  Eighty-seven patients aged greater than or equal to 60 years with ISH on clinic measurement were followed in the placebo run-in phase of the Syst-Eur trial.
  
  
  METHODS
  Clinic blood pressure was defined as the mean of two blood pressure readings on each of three clinic visits (six readings in total). Ambulatory blood pressure was measured over 24 h using non-invasive ambulatory blood pressure monitors.
  
  
  RESULTS
  Daytime ambulatory systolic pressure was, on average, 21 mmHg lower than the clinic blood pressure, whereas diastolic pressure was, on average, similar with both techniques of measurement. In the 42 patients who had repeat measurements, clinic blood pressure levels nad the amplitude of the diurnal blood pressure profile (fitted by Fourier analysis) were equally reproducible. However, both were less reproducible than ambulatory blood pressure levels. The repeatability coefficients, expressed as per cent of near maximum variation (four times the standard deviation of a given measurement), were 52% and 45% for the clinic systolic and diastolic pressures, 56% and 42% for the amplitude of the diurnal profile, and 29% and 26% for mean 24-h pressures.
  
  
  CONCLUSIONS
  In older patients with ISH, clinic and ambulatory systolic blood pressure measurements may differ largely: the prognostic significance of this difference remains to be elucidated. Furthermore, in these patients the level of pressure is more reproducible by daytime ambulatory blood pressure measurement than by clinic measurement.
authors.affiliation: U.Z. Gasthuisberg O&N, Hypertension Unit, Leuven, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Thijs
authors.forename: A
authors.initials: A
authors.lastname: Amery
authors.forename: D
authors.initials: D
authors.lastname: Clement
authors.forename: J
authors.initials: J
authors.lastname: Cox
authors.forename: P
authors.initials: P
authors.lastname: de Cort
authors.forename: R
authors.initials: R
authors.lastname: Fagard
authors.forename: G
authors.initials: G
authors.lastname: Fowler
authors.forename: C
authors.initials: C
authors.lastname: Guo
authors.forename: G
authors.initials: G
authors.lastname: Mancia
authors.forename: R
authors.initials: R
authors.lastname: Marin
mesh_terms: D000368:Aged; D001795:Blood Pressure Determination; D015924:Blood Pressure Monitors; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results