Clinical Use of Ambulatory Blood Pressure MonitoringA Review of Value in Patient Care
Alvin P. Shapiro, MD;
J. Kimberly Karschner, MD;
Daniel J. Glunk, MD;
Bruce M. Barnhill
Arch Fam Med. 1995;4(8):691-696.
Abstract
Objective
To examine the value of ambulatory blood pressure monitoring in routine clinical use.
Design
We retrospectively reviewed 350 determinations made over a 4-year period.
Setting and Patients
A practice-based sample of patients attending the Hypertension Outpatient Clinic.
Results
Successful records were obtained in 346 of these procedures and night/sleep recordings were accomplished in 320. Monitor readings compared satisfactorily with auscultatory determinations.
Declines in systolic and diastolic blood pressure during night/sleep of 8.2% and 13.2%, respectively, and a fall in the heart rate of 12.0% were noted; these declines were significantly lesser in patients with diabetes. Age, gender, therapy, and 24-hour average blood pressures, however, had minimal relationship to the night/sleep declines in blood pressure and heart rate.
Conclusions
Twenty-four-hour blood pressure monitoring is acceptable to patients. Night/sleep declines in blood pressure are blunted in diabetics.
Author Affiliations
From the Department of Medicine and the Shea Medical Center, Shadyside Hospital (Drs Shapiro, Karschner, and Glunk and Mr Barnhill), and the Division of Hypertension, Department of Medicine, University of Pittsburgh School of Medicine (Dr Shapiro), Pittsburgh, Pa.
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