Document Detail


Ambulatory blood pressure in heart failure.
MedLine Citation:
PMID:  11525234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ambulatory blood-pressure monitoring (ABPM) is accepted in the evaluation and management of hypertension. The use of ABPM in heart failure has received considerably less attention. Many patients with advanced heart failure experience disabling fatigue, orthostatic dizziness and symptoms of coronary and cerebrovascular insufficiency that may relate to periods of hypotension. These may be exacerbated by vasodilator drug therapy and may be difficult to evaluate by casual clinic recordings. ABPM in heart failure may help in the following: (i) evaluating time-dependent pharmacodynamic drug effects, such as peak and end-of-dose phenomena, tolerance and rebound; (ii) titrating ACE inhibitors and other drugs to highest-tolerated doses; and (iii) correlating circadian blood-pressure profiles with symptoms, quality of life, severity of heart failure, progression of ventricular and renal dysfunction, risks of stroke and myocardial infarction, and life expectancy. Devices for ABPM have been beset by problems of inaccuracy and unreliability. Standards for their manufacture and sale (including bench tests of accuracy against sphygmomanometry and intra-arterial recordings, and field tests of reliability) have been devised independently by several agencies, including the British Hypertension Society (BHS) and US Association for the Advancement of Medical Instrumentation (AAMI). A joint BHS/AAMI set of guidelines is in preparation. These guidelines emphasize the suitability of ABPM devices for hypertensive patients and those under general anesthesia, and may not be applicable to ambulant individuals with heart failure and blood pressures at or below the lower end of the evaluated ranges. Prospective studies of the accuracy and reliability of ABPM devices, their clinical utility and research potential should be undertaken in patients with heart failure before their informal and uncontrolled use in this population becomes widespread.
Authors:
M J Jamieson; C Jamieson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  31 Suppl 2     ISSN:  0014-2972     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2001  
Date Detail:
Created Date:  2001-08-29     Completed Date:  2001-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  18-25     Citation Subset:  IM    
Affiliation:
Department of Pharmacology, University of Texas Health Science Center San Antonio, 78249-6205, USA. jamieson@uthscsa.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure Monitoring, Ambulatory*
Heart Failure / diagnosis*
Humans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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