title: Impact on hypertension reclassification by Ambulatory Blood Pressure Monitoring (ABPM) according to the V Brazilian Guidelines on ABPM.
abstract: BACKGROUND
  New recommendations on reference values for normal test results in ambulatory blood pressure monitoring (ABPM) were proposed by the V Brazilian Guidelines on Ambulatory Blood Pressure Monitoring, based mainly on the IDACO study.
  
  
  OBJECTIVE
  This epidemiological study is aimed at evaluating the impact of adopting these new standards in an arterial hypertension referral center.
  
  
  METHODS
  The results of 1,567 ABPM tests carried out between 2005 and 2010 were analyzed; 481 patients were excluded from the sample for not meeting minimum quality criteria of the test. Reference values from the IV Brazilian Guidelines on ABPM (2005) were used for the classification of these tests regarding the abnormality and compared with the changes proposed by the V Brazilian Guidelines on ABPM (2011). Statistical analysis was performed by Pearson's chi-square method and p values < 0.05 were considered statistically significant.
  
  
  RESULTS
  For the 1,086 tests evaluated, there was a significant difference in the proportion of patients with altered ABPM results, especially for the variable systolic pressure in the sleeping period: 49% when adopting the cutoff values of 2005 and 71% when adopting the values of 2011, with statistical significance, p < 0.0001.
  
  
  CONCLUSIONS
  The recommendations of the new guidelines had a great impact on the hypertension classification by ABPM test results in the study population. The question of thresholds of these tests for therapeutic targets of patients known to be hypertensive is still open and requires further studies, preferably national ones, for better definition of the subject.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brasil. daniel_foresti@hotmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Forestiero
authors.forename: Juliana Lustoza
authors.initials: JL
authors.lastname: Mauad
authors.forename: Camila
authors.initials: C
authors.lastname: Forestiero
authors.forename: Mario Lins
authors.initials: ML
authors.lastname: Peixoto
authors.forename: Fabio Peixoto
authors.initials: FP
authors.lastname: Ganassin
authors.forename: Carolina
authors.initials: C
authors.lastname: Gonzaga
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Cordeiro
authors.forename: Gabriel Doreto
authors.initials: GD
authors.lastname: Rodrigues
authors.forename: Tiago Bueno da
authors.initials: TB
authors.lastname: Silveira
authors.forename: Celso
authors.initials: C
authors.lastname: Amodeo
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000592:standards*; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards*; D012016:Reference Values; D012307:Risk Factors; D012890:Sleep / Q000502:physiology