Predicting Cardiovascular Risk Using Conventional vs Ambulatory Blood Pressure in Older Patients With Systolic Hypertension

Abstract

Ambulatory monitoring makes it possible to record blood pressure (BP) throughout the day while subjects engage in their routine activities. In comparison with conventional BP measurements, automated recordings are devoid of digit preference and observer bias and minimize the white-coat effect.¹ As a consequence of these advantages and the large number of measurements, a single ambulatory BP recording provides a reliable estimate of a person's BP. To gain equivalent information, conventional BP readings must be standardized and repeated at frequent intervals.² Furthermore, several studies support the hypothesis that ambulatory BP, in comparison with conventional BP, is better correlated with hypertensive target organ damage, such as left ventricular hypertrophy,^3-5 or with other cardiovascular complications.^5-10 In the framework of the Systolic Hypertension in Europe (Syst-Eur) Trial,^11,12 we compared the prognostic accuracy of conventional and ambulatory BP measurements.^13,14 We also validated diagnostic thresholds^15,16 for BP monitoring through follow-up of morbidity and mortality of the placebo group.