Ambulatory blood pressure monitoring (ABPM) provides a more comprehensive assessment than clinic blood pressure and has been reported to better predict health outcomes than clinic or home pressure. The Kahn Center is using an ABPM patch that makes monitoring simple and comfortable. Does the extra information matter?
STUDY
The study aimed to examine associations of the clinic and 24-h ABPM with all-cause and cardiovascular mortality in a large cohort of primary care patients referred for assessment of hypertension across Spain for 223 primary care centers between 2004 and 2013 with follow-up in 2019.
FINDINGS:
During a median follow-up of 10 years, 7174 (12·1%) of 59 124 patients died, including 2361 (4·0%) from cardiovascular causes.
24-h systolic blood pressure from ABPM was more strongly associated with all-cause death than clinic systolic blood pressure.
Compared with the informativeness of clinic systolic blood pressure (100%), night-time systolic blood pressure was most informative about the risk of all-cause death (591%) and cardiovascular death (604%).
Relative to blood pressure within the normal range, elevated all-cause mortality risks were observed for masked hypertension and sustained hypertension but not white-coat hypertension, and elevated cardiovascular mortality risks were observed for masked hypertension and sustained hypertension but not white-coat hypertension.
IMPORTANCE:
Ambulatory blood pressure monitoring, or ABPM for 24 hours, provides much more information related to risk and future death than clinical blood pressure. Particularly, night-time blood pressure was more informative about the risk of all-cause death and cardiovascular death than clinic blood pressure.
The new 24-hour ABPM patch used at the Kahn Center has made this testing very simple and comfortable.