The Role of Out-of-Clinic Blood Pressure Measurements in Preventing Hypertension
- 104 Downloads
Purpose of Review
One of the possible strategies for preventing hypertension is identifying high-risk people and then implementing lifestyle modifications or therapeutic interventions. Out-of-clinic blood pressure measurements, either home or ambulatory blood pressure monitoring, may identify people with early blood pressure elevation or white-coat or masked hypertension and potentially help prevent hypertension. In this review, we will summarize the evidence on the role of out-of-clinic blood pressure measurements in preventing hypertension either from prehypertension or high normal or elevated blood pressure, or from white-coat or masked hypertension.
Early blood pressure elevation, either termed as prehypertension or as high normal or elevated blood pressure, identified by home blood pressure monitoring was associated with a 3- to 5-fold risk of sustained hypertension. White-coat and masked hypertension, identified by either home or ambulatory blood pressure monitoring, was associated with a 2- to 4-fold risk of sustained hypertension.
Out-of-office blood pressure measurements may potentially help prevent hypertension. However, to prove reversibility, controlled clinical trials are required.
KeywordsBlood pressure Hypertension Ambulatory blood pressure monitoring White-coat hypertension Masked hypertension
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 5.Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.CrossRefGoogle Scholar
- 7.Liu LS. Writing group of 2010 Chinese guidelines for the management of hypertension. 2010 Chinese guidelines for the management of hypertension. Chin J Cardiol. 2011;39(Chinese):579–615.Google Scholar
- 8.Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension 2018. 2017;71:e13–e115.Google Scholar
- 12.Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the second international consensus conference on home blood pressure monitoring. J Hypertens. 2008;26:1505–26.CrossRefGoogle Scholar
- 13.Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D, et al. Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension. and Preventive Cardiovascular Nurses Association Hypertension. 2008;52:1–9.PubMedGoogle Scholar
- 15.• Ugajin T, Hozawa A, Ohkubo T, Asayama K, Kikuya M, Obara T, et al. White-coat hypertension as a risk factor for the development of home hypertension: the Ohasama study. Arch Intern Med. 2005;165:1541–6. An earlier population study that investigated the risk of home hypertension in patients with white-coat or masked hypertension defined by home blood pressure monitoring. CrossRefGoogle Scholar
- 16.• Siven SS, Niiranen TJ, Kantola IM, Jula AM. White-coat and masked hypertension as risk factors for progression to sustained hypertension: the Finn-Home study. J Hypertens. 2016;34:54–60. A recent population study that investigated the risk of sustained hypertension in patients with white-coat or masked hypertension defined by home blood pressure monitoring. CrossRefGoogle Scholar
- 17.• Mancia G, Bombelli M, Facchetti R, Madotto F, Quarti-Trevano F, Polo Friz H, et al. Long-term risk of sustained hypertension in white-coat or masked hypertension. Hypertension. 2009;54:226–32. The only study that investigated the risk of sustained hypertension in patients with white-coat or masked hypertension defined by both home and ambulatory blood pressure monitoring. CrossRefGoogle Scholar
- 21.The Trials of Hypertension Prevention Collaborative Research Group. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The trials of hypertension prevention, phase II. Arch Intern Med. 1997;157:657–67.CrossRefGoogle Scholar
- 23.Luders S, Schrader J, Berger J, Unger T, Zidek W, Bohm M, et al. The PHARAO study: prevention of hypertension with the angiotensin-converting enzyme inhibitor ramipril in patients with high-normal blood pressure-a prospective, randomized, controlled prevention trial of the German Hypertension League. J Hypertens. 2008;26:1487–96.CrossRefGoogle Scholar