TY - JOUR
T1 - The ambulatory blood pressure in normotensive and hypertensive subjects
T2 - results from an international database
AU - Thijs, Lutgarde
AU - Staessen, Jan
AU - O'Brien, Eoin
AU - Amery, Antoon
AU - Atkins, Neil
AU - Baumgart, Peter
AU - De Cort, Paul
AU - Degaute, Jean Paul
AU - Dolenc, Primoz
AU - De Gaudemaris, Régis
AU - Enström, Inger
AU - Fagard, Robert
AU - Gosse, Philippe
AU - Gourlay, Steve
AU - Hayashi, Hiroshi
AU - Imai, Yutaki
AU - James, Gary
AU - Kawasaki, Teruo
AU - Kuschnir, Emilio
AU - Kuwajima, Iwao
AU - Lindholm, Lars
AU - Liu, Lisheng
AU - Macor, Franco
AU - Mancia, Giuseppe
AU - McGrath, Barry
AU - Middeke, Martin
AU - Ming, Jian
AU - Omboni, Stefano
AU - Otsuka, Kuniaka
AU - Palatini, Paolo
AU - Parati, Gianfranco
AU - Pieper, Carl
AU - Verdecchia, Poalo
AU - Zachariah, Prince
AU - Zhang, Weizhong
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1995/2
Y1 - 1995/2
N2 - Objective: To delineate more precisely an operational threshold for making clinical decisions based on ambulatory blood pressure (ABP) measurement by studying the ABP in subjects who were diagnosed as either normotensive or hypertensive by conventional blood pressure (CBP) measurement. Subjects: Twenty-four research groups recruited 7069 subjects. Of these, 4577 were normotensive (systolic CBP ≤ 140 mmHg and diastolic CBP ≤ 90 mmHg) and 1773 were hypertensive (systolic CBP ≥ 160 mmHg and/or diastolic CBP ≥ 90 mmHg). Of the latter, 1324 had systolic and 1310 had diastolic hypertension. Results: Ninety-five percent of the normotensive subjects had a 24-h ABP below (systolic and diastolic, respectively) 133 and 82 mmHg. Of the patients with systolic hypertension, 24% had a 24-h systolic ABP of < 133 mmHg. Similarly, 30% of those with diastolic hypertension had a 24-h diastolic ABP of < 82 mmHg. The probability that hypertensive patients had a 24-h ABP below these thresholds was higher in women than in men, increased with age and was 2- to 4-fold greater if the CBP of the patient had been measured at only one visit and if fewer than 3 CBP measurements had been averaged to establish the diagnosis of hypertension. By contrast, for each 10-mmHg increment in systolic CBP, this probability decreased by 54% for the 24-h systolic ABP and by 25% for the 24-h diastolic ABP, and for each 5 mmHg increment in diastolic CBP it increased by 6 and 9%, respectively. Conclusion: The ABP distributions of the normotensive subjects included in the present international database were not materially different from those in previous reports in the literature. One-fifth to more than one-third of the hypertensive patients had an ABP which was below the 95th centile of the ABP in normotensive subjects, but this proportion decreased if the hypertensive patients had shown a higher CBP upon repeated measurement. The prognostic implications of elevated CBP in the presence of normal ABP remain to be determined.
AB - Objective: To delineate more precisely an operational threshold for making clinical decisions based on ambulatory blood pressure (ABP) measurement by studying the ABP in subjects who were diagnosed as either normotensive or hypertensive by conventional blood pressure (CBP) measurement. Subjects: Twenty-four research groups recruited 7069 subjects. Of these, 4577 were normotensive (systolic CBP ≤ 140 mmHg and diastolic CBP ≤ 90 mmHg) and 1773 were hypertensive (systolic CBP ≥ 160 mmHg and/or diastolic CBP ≥ 90 mmHg). Of the latter, 1324 had systolic and 1310 had diastolic hypertension. Results: Ninety-five percent of the normotensive subjects had a 24-h ABP below (systolic and diastolic, respectively) 133 and 82 mmHg. Of the patients with systolic hypertension, 24% had a 24-h systolic ABP of < 133 mmHg. Similarly, 30% of those with diastolic hypertension had a 24-h diastolic ABP of < 82 mmHg. The probability that hypertensive patients had a 24-h ABP below these thresholds was higher in women than in men, increased with age and was 2- to 4-fold greater if the CBP of the patient had been measured at only one visit and if fewer than 3 CBP measurements had been averaged to establish the diagnosis of hypertension. By contrast, for each 10-mmHg increment in systolic CBP, this probability decreased by 54% for the 24-h systolic ABP and by 25% for the 24-h diastolic ABP, and for each 5 mmHg increment in diastolic CBP it increased by 6 and 9%, respectively. Conclusion: The ABP distributions of the normotensive subjects included in the present international database were not materially different from those in previous reports in the literature. One-fifth to more than one-third of the hypertensive patients had an ABP which was below the 95th centile of the ABP in normotensive subjects, but this proportion decreased if the hypertensive patients had shown a higher CBP upon repeated measurement. The prognostic implications of elevated CBP in the presence of normal ABP remain to be determined.
KW - Ambulatory blood pressure
KW - Blood pressure measurement
KW - Conventional blood pressure
KW - Hypertension
KW - Normotension
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U2 - 10.1016/0300-2977(94)00057-G
DO - 10.1016/0300-2977(94)00057-G
M3 - Review article
C2 - 7885522
AN - SCOPUS:0028797423
VL - 46
SP - 106
EP - 114
JO - Netherlands Journal of Medicine
JF - Netherlands Journal of Medicine
SN - 0300-2977
IS - 2
ER -