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Abstract

To investigate the status of blood pressure (BP) control in hypertensive patients who are under treatment, 568 patients (pts) aged 18 to 80 years with treated essential hypertension (EH) were evaluated by ambulatory blood pressure monitoring (ABPM) in a cross sectional study. Pts were selected from 30 hypertension centers. Inclusion crieterion was being under control (clinical comment) with drug treatment at least for 3 months. Pts with secondary hypertension, uncontrolled hypertension, pregnancy, heart, kidney or liver failure, major surgery, acute coronary event, coronary intervention or stroke for the last 6 months, atrial fibrillation or other types of major arrhythmias, hypertrophic cardiomyopathy and electrolyte disturbances with clinical significance, the use of digoxin, nitrates, KCL, lithium or major antidepressants were excluded. To obtain the ABPM profiles, 27 hour ABPM was applied and first 3 hour measurements were ignored to avoid white coat effect and initial device stress and discomfort. ABPM measurements were performed every 30 minutes between 07:00 AM and 11:00 PM (awake time(AT)), and every hour between 11:00 PM and 07:00 AM (sleep time(ST)). BP targets are accepted as 14/90 mmHg or less for office BP, 130/85 mmHg or less for awake time ABPM and 120/80 mmHg or less for sleep time ABPM. Office (O) systolic(S) BP was over target at 267 pts (47%) and O distolic (D) BP was over target at 194 pts (34.2 %) at the inclusion visit. For the AT ABPM, SBP means were over target in 258 pts (45.4 %) and DBP means were over target in 172 pts (30.3 %). On the other hand, ST SBP means were over target in 255 pts (44.9 %) where ST DBP means were over target in 113 (19.9 %). More interestingly, significant differences between the number of pts having elevated OSBP and AT SBP, and ODBP and AT DBP were detected (p<0.0001 and p<0.0001 respectively). These results indicate that, there is a significant gap between physician's comment and the status of BP control even at specialized centers.

Grant/Research Support - Boehringer Ingelheim Ilaq Pic. A.S.

Ambulatory blood pressure monitoring, Treatment, Clinical measurement
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© American Journal of Hypertension, Ltd. 2001
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