Ambulatory blood pressure monitoring and echocardiography—Noninvasive techniques for evaluation of the hypertensive patient

Clinic blood pressure measurements have only limited ability to determine which hypertensive patients are at greatest risk of cardiovascular events. Ambulatory blood pressure monitoring allows for noninvasive measurement of blood pressure throughout the 24-hour period. This may help to clarify discr...

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Bibliographic Details
Published in:Progress in cardiovascular diseases 1999-05, Vol.41 (6), p.397-440
Main Authors: Phillips, Robert A., Diamond, Joseph A.
Format: Article
Language:English
Subjects:
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Coronary Circulation
Diagnosis, Differential
Echocardiography
Heart Diseases - etiology
Heart Diseases - pathology
Heart Diseases - physiopathology
Humans
Hypertension - complications
Hypertension - diagnosis
Hypertension - diagnostic imaging
Hypertension - physiopathology
Hypertrophy, Left Ventricular - etiology
Risk
Ventricular Dysfunction, Left - etiology
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Summary:Clinic blood pressure measurements have only limited ability to determine which hypertensive patients are at greatest risk of cardiovascular events. Ambulatory blood pressure monitoring allows for noninvasive measurement of blood pressure throughout the 24-hour period. This may help to clarify discrepancies between blood pressure values obtained in and out of the clinic and confirm the presence of white-coat hypertension, broadly defined as an elevated clinic blood pressure but a normal ambulatory blood pressure. Ambulatory blood pressure values have been shown to have a better relationship to cardiovascular morbidity and mortality and end-organ damage than clinic blood pressure values. Further, patients with white-coat hypertension appear to be at greater risk of cardiovascular morbidity and end-organ damage than a normotensive population, although they are at less overall risk than a hypertensive population. Hypertensive heart disease is characterized by diastolic dysfunction, increased left ventricular mass, and coronary flow abnormalities. Left ventricular hypertrophy increases the risk of coronary heart disease, congestive heart failure, stroke, ventricular arrhythmias, and sudden death. A variety of invasive and noninvasive techniques are described herein that measure left ventricular mass, diastolic function, and coronary blood flow abnormalities. Most antihypertensive treatments promote regression of left ventricular hypertrophy and reversal of diastolic dysfunction, which may decrease symptoms of congestive heart failure and improve survival. Copyright © 1999 by W.B. Saunders Company Progress in Cardiovascular Diseases, Vol. 41, No. 6 (May/June), 1999: pp 397-440
ISSN:0033-0620
1532-8643
DOI:10.1016/S0033-0620(99)70019-8