[What are the therapeutic consequences of evaluating hypertensive patients with 24-hour blood pressure monitors and blood pressure self-measurement?].
Arterial hypertension is an important risk factor for excessive cardiovascular morbidity and mortality due to its high prevalence of about 20% in the adult population. Causal readings, which have been obtained for diagnosis and control of treatment in hypertension are of limited value. They are not reproducable due to physiologic variability of blood pressure, which causes a rise of blood pressure, if a straining situation (e.g. in doctor's office) occurs (white-coat-hypertension). Furthermore, no correlation between causal readings and signs of endorgan-damage (EOD) such as left ventricular hypertrophy (LVH) can be observed. Especially the development of LVH comprises an independent risk factor and worsens prognosis. Results of ambulatory monitoring and self-measurement of blood pressure are reproducable and show an excellent correlation to EOD. Both methods are able to exclude white-coat-hypertension. Furthermore, ambulatory blood pressure monitoring allows to obtain blood pressure values during sleep, which may give further information concerning secondary hypertension, EOD and prognosis. Self measurement of blood pressure reinforces compliance of the patient and gives the possibility of self-titration and long-term control of antihypertensive drug treatment. The non-consensus concerning normal values is one limitation of both methods, but the cut-off level of office blood pressure recordings appears arbitrary, too. For optimal concomittance of hypertensives both methods have to reach more importance for diagnosis, evaluation of prognosis as well as treatment control.
Zweiker
R
R
Abteilung für Kardiologie, Medizinischen Universitätsklinik Graz.
Eber
B
B
Schumacher
M
M
Stoschitzky
K
K
Pokan
R
R
Pieber
T
T
Klein
W
W
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018660:Blood Pressure Monitoring, Ambulatory; D015924:Blood Pressure Monitors; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D011379:Prognosis; D012016:Reference Values; D012648:Self Care
D000959:Antihypertensive Agents