Document Detail

Office blood pressure underestimates ambulatory blood pressure in peripheral arterial disease in comparison to healthy controls.
MedLine Citation:
PMID:  14973514     Owner:  NLM     Status:  MEDLINE    
Patients with peripheral arterial disease (PAD) constitute a subgroup of high-risk hypertensives, but controlled studies on 24-h blood pressure (BP) and diurnal variation of BP are lacking. This study was performed in order to test the hypothesis that office BP (OBP) may underestimate 24-h BP in PAD patients in comparison to a matched control group. In all, 98 male patients (mean age 68 years) with a history of intermittent claudication and an ankle/brachial index less than 0.9, and 94 controls matched for age but without PAD or ischaemic heart disease performed 24-h recordings of ambulatory BP. A total of 59 patients had a history of hypertension and 69 were on treatment with BP-lowering drugs as compared to 17 and 23 of the control subjects, respectively. Office as well as 24-h systolic BP (SBP) were higher in patients as compared to controls (151 +/- 22 vs 140 +/- 20 mmHg, P < 0.001 and 142 +/- 14 vs 133 +/- 15 mmHg, P < 0.001, respectively), but did not differ with regard to diastolic BP. In an analysis of covariance with the continuous factors age, office SBP and the categorical factor antihypertensive treatment, 24-h SBP was higher in PAD patients compared to controls (P < 0.05). The difference between office and night SBP was lower in PAD patients with antihypertensive treatment compared to controls (P = 0.01). In conclusion, Male patients with PAD had higher systolic but not diastolic BP than age-matched control subjects. In PAD patients, 24-h SBP was higher than expected from OBP compared to controls. Night SBP was higher only in patients with antihypertensive treatment. In PAD patients, especially when on antihypertensive treatment, the severity of hypertension may be underestimated when based on OBP only.
P Svensson; U de Faire; U Niklasson; J Ostergren
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of human hypertension     Volume:  18     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-19     Completed Date:  2004-07-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  193-200     Citation Subset:  IM    
Department of Cardiology, Karolinska Hospital, Sweden.
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MeSH Terms
Blood Pressure / physiology
Blood Pressure Determination / methods
Blood Pressure Monitoring, Ambulatory / methods*
Hypertension / diagnosis,  epidemiology,  physiopathology*
Middle Aged
Office Visits
Peripheral Vascular Diseases / epidemiology,  physiopathology*

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