Document Detail


Effect of hospitalization on 24-h ambulatory blood pressure of hypertensive patients.
MedLine Citation:
PMID:  20664547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study is to assess the effect of hospital admission on 24-h ambulatory blood pressure (ABP) in hypertensive subjects. Treated or untreated hypertensive adults with open-angle glaucoma underwent inpatient and outpatient 24-h ABP monitoring in a random order 4 weeks apart. Awake ambulatory hours, awake in-bed hours and sleep hours were reported by participants. The nighttime-to-daytime ABP dip (%) and the sleeping-to-awake dip (ambulatory and in-bed) were determined using the two ABP recordings. A total of 40 subjects were analyzed (mean age 65.7 ± 8.4 (s.d.) years, n=19 men). Daytime systolic BP (SBP) was lower in the hospital than in the outpatient setting (mean difference 4.3 ± 10.4 mm Hg, P=0.01), as was the awake ambulatory SBP (mean difference 5.0 ± 11.1 mm Hg, P=0.008). No differences were detected in 24 h, nighttime or sleeping SBP or in any of the respective diastolic outpatient vs. inpatient ABP measurements. The nighttime SBP dip (vs. daytime) was larger in the outpatient setting (8.9 ± 7.5% and 5.2 ± 4.7%, respectively; P=0.003). Sleeping SBP dip (vs. awake ambulatory and awake in-bed) was also larger in the outpatient setting (11.1 ± 7.3 and 7.8 ± 5.9%, respectively; P=0.02) with no difference in diastolic ABP. These data suggest that inpatient 24-h ABP monitoring does not reflect the usual BP level during routine daily life, nor does it represent the usual diurnal pattern of an individual. Relying on the 24-h ABP monitoring performed in the hospital environment may lead to an underestimation of ABP and an overdiagnosis of non-dippers. Therefore, 24-h ABP monitoring for decision making regarding diagnosis and treatment of hypertension should be performed only in the routine daily conditions of each individual.
Authors:
Maria I Pikilidou; Efrosyni Tsirou; George S Stergiou; Anastasios G Konstas; Pantelis A Sarafidis; Anastasia Ptinopoulou; Lina S Hadjistavri; Panagiotis Georgianos; Dimitrios G Mikropoulos; Anastasios N Lasaridis
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-07-22
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  33     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-05     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  995-9     Citation Subset:  IM    
Affiliation:
Hypertension Center, 1st Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece. m_pikilidou@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / physiology*
Female
Glaucoma / physiopathology
Hospitalization*
Humans
Hypertension / physiopathology*
Inpatients*
Male
Middle Aged
Outpatients*
Sleep / physiology
Wakefulness / physiology

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


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