Continuous Blood Pressure Monitoring Pred... (activity of the heart is of little use i...)

Continuous Blood Pressure Monitoring Predicts Risks

Date:11/24/2008

activity of the heart, is of little use in forecasting future coronary problems for people with chest pain.

On the hypertension front, previous studies have indicated that "ambulatory blood pressure measurements do predict things better, in part because they are so frequent," said Dr. William C. Cushman, professor of preventive medicine and medicine at the University of Tennessee.

"There is a growing body of evidence that ambulatory blood pressure measurements may be more accurate than taking office blood pressures," Cushman said.

And yet, he added, "there clearly have been dramatic benefits from treatment based on office blood pressures."

An unanswered question is whether treatment based on nighttime blood pressure measurements can reduce the risks of hypertension, Cushman said. "The real problem is that virtually all the studies showing that treatment is effective have been based on office readings," he said.

That echoed the findings of the Brazilian researchers, who wrote that their study "raises the question of whether therapeutic interventions directed specifically at controlling nighttime hypertension will be able to improve cardiovascular prognosis compared with the traditional approach of controlling daytime blood pressure levels. This important clinical question should be addressed in future prospective interventional studies."

What is needed is a study in which people with resistant high blood pressure would be randomly selected to receive treatment based either on office readings or round-the-clock measurements, Cushman said. "We don't have treatment studies that have used that approach," he said.

Resistant hypertension can be treated successfully with combinations of drugs such as diuretics, ACE inhibitors and calcium channel blockers, he said.

Not all doctors are convinced that round-the-clock monitoring is the total solution.

It's clearly of value in treating peop
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