The importance of 24 hour ambulatory blood pressure monitoring in evaluating circadian blood pressure profile in different patient groups

Written by Belényi Boglárka, Magdás Annamária, Incze Sándor

Introduction: The results of the 24- hour blood pressure monitoring (ABPM) are more closely related to target organ damage, cardiovascular risk, than office blood pressure (OBPM) values. The average nighttime systolic blood pressure (BP) is the most significant risk factor in the definition of the cardiovascular risk. Objectives: Our goal was to evaluate the circadian profile in patient with secondary hypertension by ABPM, to assess OBPM and to evaluate the correlation between BP values and cardiovascular risk factors in different groups of patients. Material and methods: 33 inefficiently treated hypertensive patients were included in the study. Group I: 18 subjects with type 2 diabetes (12 female, 8 male, mean age: 64,5±12,22 years), and 15 (9 female, 6 male, mean age: 56,80±14,64 years) with chronic kidney disease. We compared the ABPM values with OBPM values. We assessed the correlation between daytime, nighttime blood pressure mean and cardiovascular risk factors. Results: We observed the “white coat” effect in almost all patients. Patients with diabetes head greater systolic daytime (p=0.0125) and nighttime (p=0.0480) BP means compared to patients with chronic kidney disease. We observed positive correlation between asleep systolic BP and body mass index (p=0.0167) in patients with type 2 diabetes. In the group with chronic kidney disease positive correlation was found between asleep systolic BP and glomerular filtration rate (p=0.0282). Conclusion: The cardiovascular risk of the patients with type 2 diabetes mellitus is higher than those with chronic kidney disease. Therefore, to confirm the diagnosis, to individualize antihypertensive therapy, and to reduce cardiovascular risk, ABPM should be considered the “gold standard”.


Keywords: 24 hour blood pressure monitoring, white-coat effect, type 2 diabetes mellitus, chronic kidney disease

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