HOME BLOOD PRESSURE MONITORING, BLOOD PRESSURE VARIABILITY
- Author:
Lucy Priestner
;
Rohit Khurana
- Publication Type:Journal Article
- Keywords:
Blood pressure variability;
Morning surge;
Nocturnal
- From:The Singapore Family Physician
2016;42(2):16-20
- CountrySingapore
- Language:English
-
Abstract:
Hypertension is a common chronic disease affecting nearly
one-third of the adult population and an important predictor
of cardiovascular morbidity and mortality. Blood pressure is
inherently variable and depends on an individual’s
physiological state and numerous situational factors.
Conventional office recordings to diagnose and monitor a
patient’s progress and response to treatment is notoriously
restrictive. The harmful effects of hypertension are
presumed to be due to a prolonged, elevated average BP.
Both ambulatory and home blood pressure monitoring are
increasingly adopted in clinical practice to eliminate “white
coat” and “masked” hypertension and may also be a better
prognostic indicator of cardiovascular events than office
values. There remain limitations in access and cost to
replacing office BP measurements with out-of-office
monitoring modalities. Blood pressure also displays a
normal circadian variation with nocturnal dipping and a
morning surge. Blunted nocturnal dipping and an
exaggerated morning surge are thought to correlate with
increased cardiovascular events. The pathogenic
mechanisms underlying this phenomenon are not well
understood. The threshold above which the morning surge
becomes pathological is also unclear. More clinical studies
targeting treatment of an exaggerated surge are also
necessary before clinicians can attribute more weight
towards its prognostic importance.
