Evaluation of Unattended Automated Office, Conventional Office and Ambulatory Blood Pressure Measurements and Their Correlation with Target Organ Damage in an Outpatient Population of Hypertensives: Study Design and Methodological Aspects
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Accurate measurement of blood pressure (BP) has a pivotal role in the management of patients with arterial hypertension. Recently, introduction of unattended office BP measurement has been proposed as a method allowing more accurate management of hypertensive patients and prediction of hypertension-mediated target organ damage (HMOD). This approach to BP measurement has been in particular proposed to avoid the white coat effect (WCE), which can be easily assessed once both attended and unattended BP measurements are obtained. In spite of its interest, the role of WCE in predicting HMOD remains largely unexplored. To fill this gap the Young Investigator Group of the Italian Hypertension Society (SIIA) conceived the study “Evaluation of unattended automated office, conventional office and ambulatory blood pressure measurements and their correlation with target organ damage in an outpatient population of hypertensives”. This is a no-profit multicenter observational study aiming to correlate attended and unattended BP measurements for quantification of WCE and to correlate WCE with markers of HMOD, such us left ventricular hypertrophy, left atrial dilatation, and peripheral atherosclerosis. The Ethical committee of the Federico II University hospital has approved the study.
KeywordsWhite coat effect Left ventricular hypertrophy Ankle brachial index Echocardiography
We thank Prof. Giovanni de Simone for critical revision and improvement of the paper.
Compliance with Ethical Standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Ethical Committee authorities of Federico II University of Naples, approval number: 338/18.) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, Reboussin DM, Rahman M, Oparil S, Lewis CE, Kimmel PL, Johnson KC, Goff DC Jr, Fine LJ, Cutler JA, Cushman WC, Cheung AK, Ambrosius WT. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–16.CrossRefGoogle Scholar
- 3.Mancia G, Fagard R, Narkiewicz K, 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). Eur Heart J. 2013;34(28):2159–219.CrossRefGoogle Scholar
- 8.Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD. 2017 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 Pr. J Am Coll Cardiol. 2017. pii: S0735-1097(17)41519-1.Google Scholar
- 9.Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschi. 2018 ESC/ESH Guidelines for the management of arterial hypertension. J Hypertens. 2018;36(10):1953–2041.CrossRefGoogle Scholar
- 10.Verdecchia P, Reboldi G, Porcellati C, Schillaci G, Pede S, Bentivoglio M, Angeli F, Norgiolini S, Ambrosio G. Risk of cardiovascular disease in relation to achieved office and ambulatory blood pressure control in treated hypertensive subjects. J Am Coll Cardiol. 2002;39(5):878–85.CrossRefGoogle Scholar
- 11.O’Brien E, Parati G, Stergiou G, Asmar R, Beilin L, Bilo G, Clement D, de la Sierra A, de Leeuw P, Dolan E, Fagard R, Graves J, Head GA, Imai Y, Kario K, Lurbe E, Mallion JM, Mancia G, Mengden T, Myers M, Ogedegbe G, Ohkubo T, Omboni S, Palatini P, Redon. European Society of Hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31(9):1731–68.CrossRefGoogle Scholar
- 12.Parati G, Stergiou G, O’Brien E, Asmar R, Beilin L, Bilo G, Clement D, de la Sierra A, de Leeuw P, Dolan E, Fagard R, Graves J, Head GA, Imai Y, Kario K, Lurbe E, Mallion JM, Mancia G, Mengden T, Myers M, Ogedegbe G, Ohkubo T, Omboni S, Palatini P, Redon. European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring. J Hypertens. 2014;32(7):1359–66.CrossRefGoogle Scholar
- 24.De Marco M, Gerdts E, Mancusi C, Roman MJ, Lønnebakken MT, Lee ET, Howard BV, Devereux RB, de Simone G. Influence of left ventricular stroke volume on incident heart failure in a population with preserved ejection fraction (from the strong heart study). Am J Cardiol. 2017;119(7):1047–52.CrossRefGoogle Scholar
- 26.Cioffi G, Senni M, Tarantini L, Faggiano P, Rossi A, Stefenelli C, Russo TE, Alessandro S, Furlanello F, de Simone G. Analysis of circumferential and longitudinal left ventricular systolic function in patients with non-ischemic chronic heart failure and preserved ejection fraction (from the CARRY-IN-HFpEF study). Am J Cardiol. 2012;1(109):383–9.CrossRefGoogle Scholar
- 28.Kuznetsova T, Haddad F, Tikhonoff V, Kloch-Badelek M, Ryabikov A, Knez J, Malyutina S, Stolarz-Skrzypek K, Thijs L, Schnittger I, Wu JC, Casiglia E, Narkiewicz K, Kawecka-Jaszcz K, Staessen JA and Investigat, European Project On Genes in Hypertension (EPOGH). Impact and pitfalls of scaling of left ventricular and atrial structure in population-based studies. J Hypertens. 2016. 34:1186-94.CrossRefGoogle Scholar