title: Isolated clinical hypertension diagnosis: self-home BP, ambulatory BP monitoring, or both simultaneously?
abstract: Self-blood pressure (BP) measurement (SBPM) and ambulatory BP measurement (ABPM) are suitable for the isolated clinical hypertension (ICH) or 'white-coat' hypertension diagnosis. However, patients with ICH have a different cardiovascular risk according to the measurement technique used for the diagnosis.
  
  
  OBJECTIVE
  To describe baseline cardiovascular risk of patients with hypertension and with ICH according to SBPM and daytime ABPM.
  
  
  METHODS
  Six hundred and sixty-four newly diagnosed and never treated patients with hypertension and with an average age of 59.3 years (standard deviation=12.0) were included (52% men) in this study. Clinical data, analytical data with urinary albumin excretion rate, estimated glomerular filtration rate, retinography, SBPM, and ABPM were performed. Cardiovascular risk was estimated from the European Society of Hypertension and Systemic Coronary Risk Evaluation tables.
  
  
  RESULTS
  ICH prevalence varies according to the ambulatory measurement technique used: SBPM=24.2%, daytime ABPM=8.1, and 5.2% if criteria are required from both techniques. In the 403 patients with hypertension and who had SBPM and ABPM, the percentage of patients with high or very high baseline cardiovascular risk, falls progressively from 31.2% of patients with sustained hypertension to 20.0% of patients with ICH measured using SBPM, to 15.1% of patients with ICH measured using ABPM-day and to 9.5% of patients who present ICH using both techniques (P<0.005 for trend).
  
  
  CONCLUSIONS
  The baseline results show that patients with hypertension and with ICH using SBPM and daytime ABPM are those who have a lower baseline cardiovascular risk and allow ICH to be defined on the basis of normal ambulatory readings using both techniques.
authors.affiliation: Research Unit, Healthcare Institute, Department of Medical Sciences, CIBERESP, University of Girona, C/Jardins de Can Cendra s/n, Anglès, Girona, Spain. gcolld@meditex.es
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coll de Tuero
authors.forename: Joan Bayó
authors.initials: JB
authors.lastname: Llibre
authors.forename: Antonio Rodriguez
authors.initials: AR
authors.lastname: Poncelas
authors.forename: Carme Roca
authors.initials: CR
authors.lastname: Saumell
authors.forename: Marc
authors.initials: M
authors.lastname: Saez
authors.forename: Quintí Foguet
authors.initials: QF
authors.lastname: Boreu
authors.forename: Narcís Salleres
authors.initials: NS
authors.lastname: Marcó
authors.forename: Antoni Dalfó
authors.initials: AD
authors.lastname: Baqué
authors.forename: M Rosa Senán
authors.initials: MR
authors.lastname: Sanz
authors.forename: Mireia Ventura
authors.initials: MV
authors.lastname: Fontanet
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors