Objective: To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting.
Design: Randomized controlled parallel group trial with 12-month follow-up.
Setting: One hundred and ten general practices in all regions of Denmark.
Participants: One thousand forty-eight patients with essential hypertension.
Intervention: Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring.
Primary Outcome Measures: Mean day- and night-time systolic and diastolic 24-hour ambulatory blood pressure.
Secondary Outcome Measures: Change in systolic and diastolic office blood pressure and change in cardiovascular risk profile.
Results: Of the patients, 515 (49%) were allocated to the usual group, and 533 (51%) to the intensive group. The reductions in day- and night-time 24-hour ambulatory blood pressure were similar (usual group: 4.6 ± 13.5/2.8 ± 82 mmHg; intensive group: 5.6 ± 13.0/3.5 ± 8.2 mmHg; P = 0.27/P = 0.20). Cardiovascular risk scores were reduced in both groups at follow-up, but more so in the intensive than in the usual group (P = 0.02).
Conclusion: An intensive blood pressure monitoring strategy led to a similar blood pressure reduction to conventional monitoring. However, the intensive strategy appeared to improve patients' cardiovascular risk profile through other effects than a reduction of blood pressure.
Trial Registration: Clinical Trials NCT00244660.
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http://dx.doi.org/10.1093/fampra/cmx106 | DOI Listing |
Curr Cardiol Rep
January 2025
Section of Pediatric Nephrology, Department of Pediatrics, Yale University School of Medicine, New Haven, USA.
Purpose Of Review: To review the benefits of ambulatory blood pressure monitoring and home blood pressure monitoring in children and to discuss implementation of guideline-recommended ambulatory blood pressure monitoring.
Recent Findings: Compared with office blood pressure, ambulatory blood pressure monitoring and home blood pressure monitoring provide superior accuracy, reproducibility, and stronger associations with target organ damage although future work is needed to determine the utility of home blood pressure monitoring to predict hypertension status on ambulatory blood pressure monitoring. Due to the benefits of out-of-office blood pressure measurement, ambulatory blood pressure monitoring has been recommended to confirm the diagnosis of hypertension in children and adolescents since publication of the 2017 American Academy of Pediatrics clinical practice guidelines on hypertension.
J Endocrinol Invest
January 2025
Division of Internal Medicine 4 and Hypertension Unit, Department of Medical Sciences, University of Torino, Torino, Italy.
Purpose: The delayed or missed diagnosis of secondary hypertension contributes to the poor blood pressure control worldwide. This study aimed to assess the diagnostic approach to primary aldosteronism (PA) and pheochromocytoma (PHEO) among Italian centers associated to European and Italian Societies of Hypertension.
Methods: Between July and December 2023, a 10-items questionnaire was administered to experts from 82 centers of 14 Italian regions and to cardiologists from the ARCA (Associazioni Regionali Cardiologi Ambulatoriali) Piemonte.
JA Clin Rep
January 2025
Department of Anesthesiology and Pain Medicine, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Background: Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia that induces blood coagulation and hemolysis upon exposure to cold temperatures. Strict temperature control is essential to mitigate these effects, especially during surgical procedures where hypothermia is possible.
Case Presentation: A 57-year-old male, 165 cm and 72 kg, diagnosed with CAD, underwent cerebral vascular anastomosis.
Clin Exp Nephrol
January 2025
Internal Medicine Department, El Qabbary General Hospital, Ministry of Health, Alexandria, Egypt.
Background: Oral nutritional supplements (ONS) are commonly prescribed to provide protein and energy to hemodialysis (HD) patients. There is a debate about the appropriate timing to administer ONS. We aimed to study the effect of different timings of ONS on variable outcomes in HD patients.
View Article and Find Full Text PDFCurr Hypertens Rep
January 2025
Department of Internal Medicine, Aristotle University, Hypertension, Hypertension-24h ambulatory blood pressure monitoring center, Papageorgiou Hospital, Thessaloniki, Greece.
Purpose Of The Review: Τhe association between nocturnal blood pressure (BP) and alterations in the retinal microvasculature remains understudied, with few available studies to provide conflicting results. Therefore, we conducted a systematic review and meta-analysis to determine whether an association exists between retinal microvascular alterations and nocturnal BP patterns, determined by 24h ambulatory BP measurement.
Recent Findings: Our search concluded to 1002 patients (6 studies).
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