33
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      MONITORIZACIÓN AMBULATORIA DE LA PRESIÓN ARTERIAL, MÉTODOS, INDICACIONES Y UTILIDADES Translated title: AMBULATORY BLOOD PRESSURE MONITORING. METHODS, INDICATIONS AND UTILITIES

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introducción. El exámen registra automáticamente la presión arterial en el paciente, en forma intermitente, durante sus actividades habituales, en vigilia y en sueño; es útil para: diagnóstico de hipertensión arterial y valoración del efecto de los antihipertensivos. Objetivos. Mostrar resultados del registro de 24 horas de la presión arterial, sus indicaciones y utilidades y establecer frecuencia y valores de referencia. Métodos. Estudiados 245 pacientes. El registro fue dividido en dos periodos: vigilia y sueño. Se consideraron estudios validos, aquellos mayores a 40. Variables analizadas: edad, sexo, motivos de estudio: sospecha de hipertensión, de hipotensión y evaluación de tratamiento antihipertensivo, caida nocturna, cargas presóricas, alzas tensionales. Criterios de anormalidad: cifras de presión anormales, ausencia de caida nocturna, cargas presóricas mayores de 50%, alzas tensionales mayores a 3, hipotensión arterial. Resultados. Edad media, 52 años. Mujeres 63%. Sospecha de hipertensión 125, de hipotensión 9 y evaluación de tratamiento 111. En 14% no hubo caída nocturna. Cargas presóricas anormales en 27%. Alzas tensionales en 64%. Hipertensión de bata blanca en 33%. Presiones medias anormales en 23%. Tratamiento insuficiente en 69%. Resultados anormales en 70%, por presiones aumentadas en 36% , en 55% por alzas tensionales, en 6%,por hipotensión y en 2% por ausencia de caída nocturna. Conclusiones. Se muestra la experiencia inicial del registro ambulatorio de la presión arterial. Se menciona la utilidad del examen, para definir la variación circadiana y las presiones medias de 24 horas, sistólicas y diastólicas, en vigilia y en sueño.

          Translated abstract

          Introduction. The test automatically recorded blood pressure in the patient, intermittently, during their usual activities in wakefulness and sleep and is useful for diagnosing hypertension arterial and assessing the effect of the antihypertensive drugs. Objetives. Show, results of 24 hour record of blood pressure, indications, Utilities and to establish frecuency an reference values. For study: suspicion of hypertension, hypotension and evaluation of antihypertensive treatment: sleeping blood pressure declines, blood pressure load, pressures peaks. Criteria of abnormality: Abnormal pressure levels, absence of sleeping blood pressure declines, pressure loads greater than 50%, pressure peaks greater than 3, low blood pressure. Results. Average age: 52. Women 63%. Suspected hipertensión 125, hypotension 9 and evaluation treatment 111. In 14% there was no sleeping blood pressure decline. Blood pressure loads abnormal 27%. Pressure peaks 64%. White coat hypertension 33%. Mean pressures abnormal 23%. Insufficient treatment 69%. Abnormal results 70%, increased presures in 36%, in 55% pressure peaks, hypotension in 6% and 2% for lack sleeping blood pressure declines. Conclusions. Shows the initial experience of the ambulatory recording arterial blood pressure. The usefulness of the test is mentioned, to define the circadian variation and the average pressures of 24 hours, systolic an diastolic, in waking and sleep.

          Related collections

          Most cited references48

          • Record: found
          • Abstract: found
          • Article: not found

          Circadian blood pressure changes and left ventricular hypertrophy in essential hypertension.

          The effects of circadian blood pressure (BP) changes on the echocardiographic parameters of left ventricular (LV) hypertrophy were investigated in 235 consecutive subjects (137 unselected untreated patients with essential hypertension and 98 healthy normotensive subjects) who underwent 24-hour noninvasive ambulatory blood pressure monitoring (ABPM) and cross-sectional and M-mode echocardiography. In the hypertensive group, LV mass index correlated with nighttime (8:00 PM to 6:00 AM) systolic (r = 0.51) and diastolic (r = 0.35) blood pressure more closely than with daytime (6:00 AM to 8:00 PM) systolic (r = 0.38) and diastolic (r = 0.20) BP, or with casual systolic (r = 0.33) and diastolic (r = 0.27) BP. Hypertensive patients were divided into two groups by presence (group 1) and absence (group 2) of a reduction of both systolic and diastolic BP during the night by an average of more than 10% of the daytime pressure. Casual BP, ambulatory daytime systolic and diastolic BP, sex, body surface area, duration of hypertension, prevalence of diabetes, quantity of sleep during monitoring, funduscopic changes, and serum creatinine did not differ between the two groups. LV mass index, after adjustment for the age, the sex, the height, and the daytime BP differences between the two groups (analysis of covariance) was 82.4 g/m2 in the normotensive patient group, 83.5 g/m2 in hypertensive patients of group 1 and 98.3 g/m2 in hypertensive patients of group 2 (normotensive patients vs. group 1, p = NS; group 1 vs. group 2, p = 0.002).(ABSTRACT TRUNCATED AT 250 WORDS)
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Evaluation of the extent and duration of the "ABPM effect" in hypertensive patients.

            The goal of this study was to test and quantify the extent and duration over time of a possible pressor effect due to ambulatory monitoring. The use of ambulatory blood pressure monitoring has provided a method of blood pressure (BP) assessment that compensates for some of the limitations of office values. While a "white-coat" pressor effect on conventional measurements has been defined and frequently used for the improved evaluation of hypertensive patients, there has not been clear indication that the ambulatory technique could also influence BP. We studied 538 mild-to-moderate hypertensive patients (233 men), 54.2 +/- 14.2 (mean +/- SD) years of age. Blood pressure and heart rate were measured at 20-min intervals during the day and at 30-min intervals at night for 48 consecutive hours, and physical activity was simultaneously evaluated at 1-min intervals with a wrist actigraph. One-third of the patients were evaluated twice or more times. In both treated and untreated hypertensive patients evaluated for the first time, results indicate a statistically significant (p < 0.001) reduction during the second day of monitoring as compared with the first in the diurnal mean of systolic and diastolic BP, but not in heart rate or physical activity. This pressor effect remains statistically significant for the first 6 h to 8 h of monitoring independently of gender, days of the week of monitoring or number of antihypertensive drugs used by the treated patients. The nocturnal mean of BP was, however, similar between both days of sampling. This "ambulatory monitoring effect" was not observed when the patients were evaluated after the same sampling scheme for the second or successive times three months apart. Ambulatory monitoring for 48 consecutive hours reveals a statistically significant pressor response that could reflect a novelty effect in the use of the monitoring device for the first time. This effect has marked implications in both research and clinical daily practice for a proper diagnosis of hypertension and evaluation of treatment efficacy by the use of ambulatory monitoring.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Risk of cardiovascular disease in relation to achieved office and ambulatory blood pressure control in treated hypertensive subjects.

              We investigated the prognostic impact of 24-h blood pressure control in treated hypertensive subjects. There is growing evidence that ambulatory blood pressure improves risk stratification in untreated subjects with essential hypertension. Surprisingly, little is known on the prognostic value of this procedure in treated subjects. Diagnostic procedures including 24-h noninvasive ambulatory blood pressure monitoring were undertaken in 790 subjects with essential hypertension (mean age 48 years) before therapy and after an average follow-up of 3.7 years (2,891 patient-years). At the follow-up visit, 26.6% of subjects achieved adequate office blood pressure control (<140/90 mm Hg), and 37.3% of subjects achieved adequate ambulatory blood pressure control (daytime blood pressure <135/85 mm Hg). Months or years after the follow-up visit, 58 patients suffered a first cardiovascular event. Event rate was lower (0.71 events/100 person-years) among the subjects with adequate ambulatory blood pressure control than among those with higher blood pressure levels (1.87 events/100 person-years) (p = 0.0026). Ambulatory blood pressure control predicted a lesser risk for subsequent cardiovascular disease independently of other individual risk factors (RR 0.36; 95% confidence intervals: 0.18 to 0.70; p = 0.003), including age, diabetes and left ventricular hypertrophy. Office blood pressure control was associated with a nonsignificant lesser risk of subsequent events (RR 0.63; 95% confidence intervals: 0.31 to 1.31; p = NS). In-treatment ambulatory blood pressure was more potent than pre-treatment blood pressure for prediction of subsequent cardiovascular disease. Ambulatory blood pressure control is superior to office blood pressure control for prediction of individual cardiovascular risk in treated hypertensive subjects.
                Bookmark

                Author and article information

                Contributors
                Role: ND
                Journal
                rmcmlp
                Revista Médica La Paz
                Rev. Méd. La Paz
                Colegio Médico de La Paz (La Paz, , Bolivia )
                1726-8958
                2009
                : 15
                : 2
                : 5-14
                Affiliations
                [01] La Paz orgnameCentro de Electrocardiología 'La Paz' roblavadenz2001@ 123456yahoo.com
                Article
                S1726-89582009000200002
                768d61fe-02d1-427a-9437-9e73782c2336

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 23 March 2011
                : 10 March 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 39, Pages: 10
                Product

                SciELO Bolivia


                Hipertensión arterial,Monitorización ambulatoria de la Presión arterial,Variación circadiana,Circadian variation,ambulatory blood pressure monitorization,Arterial hypertension

                Comments

                Comment on this article