Home and office blood pressures. Clinical observations and hemodynamic mechanisms
Wide fluctuations in arterial pressure have long been recognized as a feature in many hypertensive patients and have consistently been a major difficulty in decisions for treatment and understanding of pathophysiology. It is only in the past decade that more precise estimates of the degree of diurnal variations could be obtained by ambulatory 24-hour recordings of blood pressure from intra-arterial catheterization (1) or noninvasive methods (2–3). In the absence of these methods, it is still possible to avoid the pitfalls associated with sole dependence on office blood pressure levels by asking the patients to measure their own pressures at home or at work. This was the method used for over forty years in our center; it had many advantages that could outweigh its limited number of daily observations. Blood pressure could be followed over long periods of time and not be limited to one day; the patients developed a greater sense of participating in their follow-up and came to recognize their pressure fluctuations as a physiolgoical variable analagous to changes in daily weight.
KeywordsTarget Organ Damage Home Blood Pressure Office Blood Pressure Home Systolic Blood Pressure Left Ventricular Muscle Mass
Unable to display preview. Download preview PDF.
- 1.Raftery EB, Millar-Craig MW: Information derived from direct 24-hour recordings. In: Clement D, ed; Blood pressure variability. Lancaster, MTP Press 67 (1979).Google Scholar
- 2.Messerli FH, Glade LB, Ventura HO, Dreslinski GR, Suarez DH, MacPhee AA, Aristimuno GG, Cole FE, Frohlich ED: Diurnal variations of cardiac rhythm, arterial pressure, and urinary catecholamines in borderline and established essential hypertension. Am Heart J 104: 109–114 (1982).PubMedCrossRefGoogle Scholar
- 4.Nemec CF, Tarazi RC, Textor SC, Mujais SK, Fouad FM, Bravo EL: An evaluation of discrepancy between clinic and home blood pressures in hypertensive patients. (Submitted)Google Scholar
- 15.Rowlands DB, Ireland MA, Stallard TJ, Glover DR, McLeay RAB, Watson RDS: Assessment of left ventricular mass and its response to antihypertensive treatment. Lancet (Feb): 467–470 (1982).Google Scholar