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Home Blood Pressure Monitoring in Heart Transplant Recipients: Comparison with Ambulatory Blood Pressure Monitoring.
MedLine Citation:
PMID:  24142029     Owner:  NLM     Status:  Publisher    
BACKGROUND: How reliable is home blood pressure monitoring (HBPM) in heart transplant recipients is not known. Possibly, it may underestimate hypertensive burden, because blood pressure (BP) nondipper profile is frequent among these patients. This prospective study has been designed to determine whether HBPM adequately identifies hypertension in heart transplant recipients.
METHOD: We compared HBPM with ambulatory blood pressure monitoring (ABPM) for the diagnosis of uncontrolled hypertension in 74 patients 13.5±6.7 years after heart transplantation. HBPM was measured with a validated semiautomatic device twice every morning and twice every evening on 7 consecutive days, within 15 days of ABPM. We also measured the relationship between HBPM, ABPM, and organ damage as measured by albuminuria and left ventricular mass.
RESULTS: A nondipper profile was found in 53 (72%) patients. HBPM and ABPM were close according to Pearson bivariate correlations. There was no significant correlation between left ventricular mass and BP either at HBPM or ABPM. Proteinuria significantly correlated with systolic BP either at HBPM (R=0.42; P=0.0002) or ABPM (R=0.25; P=0.03). HBPM adequately classified 61 of 74 (82%) patients as hypertensives or as nonhypertensives or controlled hypertensives.
CONCLUSION: Despite a high prevalence of nondipper profile, HBPM gives a reliable estimate of BP burden in most heart transplant recipients. Thus, our results strongly suggest that HBPM is useful for the long-term follow-up of heart transplant recipients.
Pierre Ambrosi; Bernard Kreitmann; Gilbert Habib
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-17
Journal Detail:
Title:  Transplantation     Volume:  -     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Department of Cardiology, La Timone Hospital, Aix-Marseille University, Marseille, France. 2 Department of Cardiac Surgery, La Timone Hospital, Aix-Marseille University, Marseille, France. 3 Address correspondence to: Pierre Ambrosi, M.D., Ph.D., Department of Cardiology, La Timone Hospital, Aix-Marseille University, 13385 Marseille, France.
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