Abstract 5149: Ambulatory Blood Pressure in a Large Cohort of Treated Hypertensive Subjects
Aim: To examine the concordance of blood pressure control by means of both clinic (office) measurements and ambulatory blood pressure monitoring (ABPM), in a large cohort of treated hypertensive subjects from the Spanish Ambulatory Blood Pressure Monitoring registry
Methods: A total number of 43 499 hypertensives under antihypertensive treatment were analyzed. Office BP control was defined if the patient had BP below 140/90 mmHg. Ambulatory BP control was considered by means of 3 different criteria:
if daytime BP (based on patient’s reported activity) was below 135/85 mmHg.
if 24-hour BP was below 130/80 mmHg, and
if nighttime BP was below 120/70 mmHg.
Clinical characteristics were compared between patients with daytime BP below or above 135/85 mmHg
Results: Table 1⇓ shows numbers and proportions of patient having control or lack of control by means of office and ABPM (the 3 criteria used). Concordant control of BP was present in 17.4%, 15.7%, and 12.9%, by the 3 different criteria. The main source of difference between office and ABPM was the proportion of patients with isolated office resistance, the proportion of which, using the 3 aforementioned criteria was 34.5%, 29.1%, and 26.8%, respectively. When compared to patients with normal ABPM values, the presence of elevated daytime BP (higher than 135/85 mmHg) was associated (p<0.001 for all comparisons) with male gender (57.5% vs 47.7%), diabetes (25.1% vs 20.9%), smoking (17.5% vs 12.5%), left ventricular hypertrophy on EKG (11.1 vs 9.1), and chronic kidney disease (3.0% vs 2.0%).
Conclusion: Blood pressure control in the treated hypertensive population by using ABPM is twice as observed by office measurements. The proportion of patients with isolated office resistance (white coat) is relatively large. Normal values of ABPM in treated patients are more frequent in women, nondiabetic, and nonsmokers subjects, as well as in those without organ damage.