Twenty four-hour ambulatory blood pressure monitoring in detection and management of hypertension compared to clinic readings

Blood pressure measurements taken in a physicianis clinic or by patients themselves don't represent readings throughout the day. Ambulatory blood pressure monitoring [ABPM] overcomes this problem by providing multiple readings over time with minimal intrusion into the patient's daily activities. The purpose of our study was to evaluate the value of 24-hour ABPM in detection and management of hypertension over traditional over traditional office measurements. A total of 100 never-treated or already known essential hypertensive patients divided into 2 groups, first group included 50 patients managed according to 24 hour ambulatory blood pressure monitoring results and the second group 50 patients according to office blood pressure measurements. All patients underwent the following procedures: [i] repeated clinic blood pressure measurements, [ii] blood sampling for routine chemistry examinations; [iii] 24-hour urine collection for microalbuminuria; [iv]echocardiography; and ABPM for the first group. Main indications for ABPM were borderline hypertension [44%], de novo hypertension 20%] and resistant hypertension [36%]. Mean age of the first group was 44.1 +/- 9.8 versus 54.4 +/- 11.6 years [p=0.002] and 24-hour ambulatory blood pressure was 129/80 mmHg with mean +/- SD 11.4/10.1. ambulatory blood pressure monitoring has changed our treatment strategy in 80% of patients. Its parameters were significantly correlated with left ventricular hypertrophy [p=0.04], diastolic dysfunction [p=0.012], hypertension duration and body mass index than traditional clinic measurements did. Twenty four hours ambulatory blood pressure monitoring is an important yet underused tool for the management of hypertension patients especially those with borderline, recent onset and even resistant hypertension. Our collective results revealed superiority over office blood pressure measurement