Clinical use of ambulatory blood pressure monitoring. A review of value in patient care
A. P. Shapiro, J. K. Karschner, D. J. Glunk and B. M. Barnhill
Department of Medicine, Shadyside Hospital, Pittsburgh, PA, USA.
OBJECTIVE: To examine the value of ambulatory blood pressure monitoring in
routine clinical use. DESIGN: We retrospectively reviewed 350
determinations made over a 4-year period. SETTING AND PATIENTS: A
practice-based sample of patients attending the Hypertension Outpatient
Clinic. RESULTS: Successful records were obtained in 346 of these
procedures and night/sleep recordings were accomplished in 320. Monitor
readings compared satisfactorily with auscultatory determinations. Declines
in systolic and diastolic blood pressure during night/sleep of 8.2% and
13.2%, respectively, and a fall in the heart rate of 12.0% were noted;
these declines were significantly lesser in patients with diabetes. Age,
gender, therapy, and 24-hour average blood pressures, however, had minimal
relationship to the night/sleep declines in blood pressure and heart rate.
CONCLUSIONS: Twenty-four-hour blood pressure monitoring is acceptable to
patients. Night/sleep declines in blood pressure are blunted in diabetics.
