OBJECTIVE: Ambulatory blood pressure monitoring (ABPM) is a tool to diagnose resistant hypertension (RH). The objective of this study is to describe the pattern of 24-h ABPM in patients using at least three anti hypertensive drugs without blood pressure (BP) control, classifying them as true RH or white-coat RH. METHODS: A cross-sectional study involving resistant hypertensives that were submitted to clinical, laboratory and 2D-echocardiographic evaluation. Ambulatory blood pressure monitoring was used to diagnose true or white-coat RH. The chi-squared test was used for comparisons among categorical variables and Kruskall-Wallis test for continuous ones. RESULTS: Of the 286 patients, 161 (56.3%) were classified as true RH and 125 (43.7%) as white-coat RH. Sex, age, office BP and the cardiovascular risk factors for both groups were similar. True resistant hypertensives had more target organ damage then white-coat resistant hypertensives; nephropathy (40.1 versus 23.9%, P=0.007) and left ventricular hypertrophy (83.3 versus 76.3%, P=0.05). In ABPM, the true RH group had a smaller nocturnal systolic and diastolic BP reduction (6.4+/-8.8 versus 9.8+/-7.5 mmHg, P=0.0004; 10.4+/-9.6 versus 13.6+/-9.2 mmHg, P=0.001) and 68.7% of them were non-dippers versus 49.6% in the white-coat RH group (P=0.001). True RH also had a larger 24 h pulse pressure (65.8+/-13.7 versus 51.5+/-10.0 mmHg, P < 0.0001). CONCLUSIONS: Ambulatory blood pressure monitoring is a fundamental tool to diagnose RH, and to check treatment efficacy. The presence of a greater pulse pressure and a lower nocturnal blood pressure reduction in true RH patients may be responsible for this increased cardiovascular risk profile.
OBJECTIVE: Ambulatory blood pressure monitoring (ABPM) is a tool to diagnose resistant hypertension (RH). The objective of this study is to describe the pattern of 24-h ABPM in patients using at least three anti hypertensive drugs without blood pressure (BP) control, classifying them as true RH or white-coat RH. METHODS: A cross-sectional study involving resistant hypertensives that were submitted to clinical, laboratory and 2D-echocardiographic evaluation. Ambulatory blood pressure monitoring was used to diagnose true or white-coat RH. The chi-squared test was used for comparisons among categorical variables and Kruskall-Wallis test for continuous ones. RESULTS: Of the 286 patients, 161 (56.3%) were classified as true RH and 125 (43.7%) as white-coat RH. Sex, age, office BP and the cardiovascular risk factors for both groups were similar. True resistant hypertensives had more target organ damage then white-coat resistant hypertensives; nephropathy (40.1 versus 23.9%, P=0.007) and left ventricular hypertrophy (83.3 versus 76.3%, P=0.05). In ABPM, the true RH group had a smaller nocturnal systolic and diastolic BP reduction (6.4+/-8.8 versus 9.8+/-7.5 mmHg, P=0.0004; 10.4+/-9.6 versus 13.6+/-9.2 mmHg, P=0.001) and 68.7% of them were non-dippers versus 49.6% in the white-coat RH group (P=0.001). True RH also had a larger 24 h pulse pressure (65.8+/-13.7 versus 51.5+/-10.0 mmHg, P < 0.0001). CONCLUSIONS: Ambulatory blood pressure monitoring is a fundamental tool to diagnose RH, and to check treatment efficacy. The presence of a greater pulse pressure and a lower nocturnal blood pressure reduction in true RHpatients may be responsible for this increased cardiovascular risk profile.
Authors: Ramón C Hermida; Diana E Ayala; María T Ríos; José R Fernández; Artemio Mojón; Michael H Smolensky Journal: Curr Hypertens Rep Date: 2014-07 Impact factor: 5.369
Authors: David A Calhoun; John N Booth; Suzanne Oparil; Marguerite R Irvin; Daichi Shimbo; Daniel T Lackland; George Howard; Monika M Safford; Paul Muntner Journal: Hypertension Date: 2013-12-09 Impact factor: 10.190
Authors: Juan Carlos Yugar-Toledo; Heitor Moreno Júnior; Miguel Gus; Guido Bernardo Aranha Rosito; Luiz César Nazário Scala; Elizabeth Silaid Muxfeldt; Alexandre Alessi; Andrea Araújo Brandão; Osni Moreira Filho; Audes Diógenes de Magalhães Feitosa; Oswaldo Passarelli Júnior; Dilma do Socorro Moraes de Souza; Celso Amodeo; Weimar Kunz Sebba Barroso; Marco Antônio Mota Gomes; Annelise Machado Gomes de Paiva; Eduardo Costa Duarte Barbosa; Roberto Dischinger Miranda; José Fernando Vilela-Martin; Wilson Nadruz Júnior; Cibele Isaac Saad Rodrigues; Luciano Ferreira Drager; Luiz Aparecido Bortolotto; Fernanda Marciano Consolim-Colombo; Márcio Gonçalves de Sousa; Flávio Antonio de Oliveira Borelli; Sérgio Emanuel Kaiser; Gil Fernando Salles; Maria de Fátima de Azevedo; Lucélia Batista Neves Cunha Magalhães; Rui Manoel Dos Santos Póvoa; Marcus Vinícius Bolívar Malachias; Armando da Rocha Nogueira; Paulo César Brandão Veiga Jardim; Thiago de Souza Veiga Jardim Journal: Arq Bras Cardiol Date: 2020 May-Jun Impact factor: 2.000