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Continuous blood pressure monitoring better in predicting risks

Rio de Janeiro, Brazil, November 26: A 24-hour blood pressure recording holds greater value in predicting potential cardiovascular outcomes than occasional readings taken during routine medical visits, a Brazilian research concludes.

The 24-hour screening therapy especially holds true for patients with ‘resistant hypertension’, blood pressure that remains dangerously high despite standard drug therapy, researchers averred.

The study conducted at the Federal University of Rio de Janeiro, Brazil, monitored 556 ‘resistant high blood pressure’ patients who visited a local outpatient clinic between 1999 and 2004.

While half went through the traditional blood pressure recording method during their usual doctor visits, the others underwent a continuous monitoring at home. Equipped with a small device, the blood pressure readings were automatically taken every 15 minutes during the day and every 30 minutes at night.

During the follow-up period of 4.8 years, 19.6 percent patients reported a cardiovascular trouble including 44 strokes, 21 heart attacks, 10 fresh heart attacks and 5 sudden deaths.

While office blood pressure recordings failed to predict any of these events, the 24-hour blood pressure screening using the ambulatory blood pressure monitor did not, the report highlights.

The average of night time readings was even more accurate in predicting these events, a condition most unlikely in office blood pressure measurements, researchers noted.

Interestingly, a nighttime surge of 22 mm Hg or above in the systolic blood pressuredefine (the upper reading) increased the risk of heart events by 38 percent, whereas a 14 mm Hg increase in diastolic blood pressure (the lower blood pressure reading) increased heart risks by 36 percent.

While in healthy adults the blood pressure usually dips at night, signifying a resting phase of the cardiovascular system, a blood pressure hike at night, the condition medically known as riser pattern, in turn makes the system function more actively, thus elevating the chances of cardiovascular troubles, researchers explained.

"Ambulatory blood pressure monitoring should be performed during the whole 24 hours, with separate analysis of the daytime and nighttime periods, because it seems that nighttime blood pressures are better cardiovascular risk factors than are daytime blood pressure," the results of the study featuring in the Nov. 24 issue of Archives of Internal Medicine read.

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