Value of home blood pressures as predictor of target organ damage in mild arterial hypertension.
BACKGROUND
Home blood pressure measurement has gained increasing importance for the management of hypertensive patients. The aim of our study was to compare levels of clinic (CBP), ambulatory (ABP), and home blood pressure (HBP) measurements, and their relationships with various indexes of target organ damage in I-II grade essential hypertension.


METHODS
Thirty-eight essential hypertensives underwent evaluation of clinic, ambulatory and home blood pressures. Each patient recorded HBP for 2 days with a digital BP monitor three times daily, the first time on the same day during which ABP monitoring was simultaneously performed. Moreover, in all subjects electrocardiogram recording, echocardiographic study, microalbuminuria assay and fundus oculi examination were obtained.


RESULTS
The average HBPs obtained on the first day, in particular systolic values, were quite similar to mean daytime ambulatory BP recorded on the same day. Clinic BP, both systolic and diastolic, showed no significant correlation with left ventricular mass index (LVMI) and with albumin excretion rate (AER), whereas a correlation barely significant was observed with an index of global target organ damage (GTODi), including cardiac, renal and retinal parameters. On the contrary, home blood pressures, especially those recorded on the second day, correlated significantly, and more tightly than clinic BP, with LVMI, AER and GTODi.


CONCLUSIONS
Our study seems to justify the adoption of home BP monitoring in the management of hypertensive patients, as a useful complement to clinical readings, and may provide additional prognostic information.
Mulè
Giuseppe
G
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Centro Ipertensione, University of Palermo, Italy. giusemme@email.it
Caimi
Gregorio
G
Cottone
Santina
S
Nardi
Emilio
E
Andronico
Giuseppe
G
Piazza
Giuseppe
G
Volpe
Vito
V
Federico
Maria Rosa
MR
Cerasola
Giovanni
G
D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology; D000554:Ambulatory Care Facilities; D018660:Blood Pressure Monitoring, Ambulatory / Q000592:standards*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000503:physiopathology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013223:Statistics as Topic