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(Ivanhoe Newswire) -- A high blood pressure reading at the doctors office may not be as predictive of heart risks as a high blood pressure reading at home.
About 10 to 30 percent of people with high blood pressure have a condition known as resistant hypertension. For these patients blood pressure remains high despite treatments like antihypertensive drugs and diuretics. Ambulatory blood pressure monitoring (measuring blood pressure at regular intervals throughout the day, is increasingly important in managing patients with resistant hypertension because of what is known as the white-coat effect, when an individual only has high blood pressure at the doctors office.
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Researchers studied 556 patients with resistant hypertension who attended an outpatient clinic between 1999 and 2004. Participants were examined and had their blood pressure monitored continually during a 24-hour period. They were then followed up with three to four times a year through 2007.
At the mid-point follow-up period, 19 percent of the participants had a cardiovascular event or died of cardiovascular disease and 12.6 percent of the patients died of other cardiovascular causes. Blood pressure measured at the clinic did not predict any of these events, whereas higher average ambulatory blood pressure was associated with the occurrence of both the fatal and non-fatal cardiovascular events.
Study authors conclude this research has important clinical implications in both reinforcing the importance of ambulatory blood pressure monitoring and looking at specific therapeutic interventions for at risk patients.
SOURCE: Archives of Internal Medicine, 2008;168:2340-2346
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