How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring

Background: Hypertension is a common condition in modern society. As blood pressure fluctuates with time, a single blood pressure measurement is useless to diagnose hypertension. Nevertheless, no well-defined number of measurements is often used for this purpose. Diagnosis and therapeutic control of...

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Main Authors: Vincent Raymaekers, Caro Brenard, Lisa Hermans, Ines Frederix, Jan A Staessen, Paul Dendale
Format: Article
Language:English
Published: Taylor & Francis Group 2019-03-01
Series:Blood Pressure
Subjects:
Online Access:http://dx.doi.org/10.1080/08037051.2018.1557508
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author Vincent Raymaekers
Caro Brenard
Lisa Hermans
Ines Frederix
Jan A Staessen
Paul Dendale
author_facet Vincent Raymaekers
Caro Brenard
Lisa Hermans
Ines Frederix
Jan A Staessen
Paul Dendale
author_sort Vincent Raymaekers
collection DOAJ
description Background: Hypertension is a common condition in modern society. As blood pressure fluctuates with time, a single blood pressure measurement is useless to diagnose hypertension. Nevertheless, no well-defined number of measurements is often used for this purpose. Diagnosis and therapeutic control of hypertension are therefore suboptimal. Objective: To determine the number and timing of measurements needed to give a trustworthy approximation of an individual’s average blood pressure. Methods: In this observational study 306 clinically indicated 24h ABPM datasets were analysed. Hypertension was defined as a daytime blood pressure mean exceeding 135/85 mm Hg. Kappa coefficients determined the best time of day for measuring blood pressure. The optimal number of measurements was estimated using canonical correlation. Results: 162 (53%) patients were diagnosed with hypertension. Kappa statistics indicated that measuring during the afternoon gave the best agreement with the 24h blood pressure mean (κ = 0.78). According to canonical correlation, about 8–10 blood pressure readings give enough information for hypertension diagnosis. Conclusions: Eight to ten blood pressure measurements between 01:00 and 05:00 p.m. are sufficient to give a clinically useful approximation of the daytime mean blood pressure and therefore for diagnosing hypertension accurately. Future research should determine the ideal dispersion of measurements and include patient characteristics which could influence the required number and timing of measurements. These results may increase the future importance of telemonitoring in diagnosing hypertension.
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spelling doaj.art-ca31b2f40566477bb49a1447b48ecc3b2023-09-15T08:45:22ZengTaylor & Francis GroupBlood Pressure0803-70511651-19992019-03-01282939810.1080/08037051.2018.15575081557508How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoringVincent Raymaekers0Caro Brenard1Lisa Hermans2Ines Frederix3Jan A Staessen4Paul Dendale5Hasselt UniversityHasselt UniversityHasselt UniversityHasselt UniversityUniversity of LeuvenHasselt UniversityBackground: Hypertension is a common condition in modern society. As blood pressure fluctuates with time, a single blood pressure measurement is useless to diagnose hypertension. Nevertheless, no well-defined number of measurements is often used for this purpose. Diagnosis and therapeutic control of hypertension are therefore suboptimal. Objective: To determine the number and timing of measurements needed to give a trustworthy approximation of an individual’s average blood pressure. Methods: In this observational study 306 clinically indicated 24h ABPM datasets were analysed. Hypertension was defined as a daytime blood pressure mean exceeding 135/85 mm Hg. Kappa coefficients determined the best time of day for measuring blood pressure. The optimal number of measurements was estimated using canonical correlation. Results: 162 (53%) patients were diagnosed with hypertension. Kappa statistics indicated that measuring during the afternoon gave the best agreement with the 24h blood pressure mean (κ = 0.78). According to canonical correlation, about 8–10 blood pressure readings give enough information for hypertension diagnosis. Conclusions: Eight to ten blood pressure measurements between 01:00 and 05:00 p.m. are sufficient to give a clinically useful approximation of the daytime mean blood pressure and therefore for diagnosing hypertension accurately. Future research should determine the ideal dispersion of measurements and include patient characteristics which could influence the required number and timing of measurements. These results may increase the future importance of telemonitoring in diagnosing hypertension.http://dx.doi.org/10.1080/08037051.2018.1557508arterial hypertensionhbpm24 h abpmoptimal diagnosis
spellingShingle Vincent Raymaekers
Caro Brenard
Lisa Hermans
Ines Frederix
Jan A Staessen
Paul Dendale
How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
Blood Pressure
arterial hypertension
hbpm
24 h abpm
optimal diagnosis
title How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
title_full How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
title_fullStr How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
title_full_unstemmed How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
title_short How to reliably diagnose arterial hypertension: lessons from 24 h blood pressure monitoring
title_sort how to reliably diagnose arterial hypertension lessons from 24 h blood pressure monitoring
topic arterial hypertension
hbpm
24 h abpm
optimal diagnosis
url http://dx.doi.org/10.1080/08037051.2018.1557508
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