Ambulatory BP Helps Identify Resistant Hypertension

Monitoring ambulatory blood pressure differentiates true from white coat hypertension

TUESDAY, March 29 (HealthDay News) -- Ambulatory blood pressure monitoring is a useful prognosis tool to differentiate between true and white coat resistant hypertension, according to a study published online March 28 in Hypertension.

Alejandro de la Sierra, M.D., from the University of Barcelona in Spain, and colleagues estimated the prevalence of resistant hypertension in a large cohort of treated hypertensive patients from the Spanish ambulatory blood pressure monitoring (ABPM) registry, who had information on office blood pressure measurements, and good quality ABPM. They identified 8,295 patients with resistant hypertension, defined as office blood pressure greater than or equal to 140 over 90 mm Hg, while being treated with three or more hypertensive drugs including one diuretic.

The investigators found that, after ABPM, 62.5 percent of patients were defined as true resistant hypertensives, and 37.5 percent were classified as having white coat resistance. Those with true resistant hypertension were younger, more often male, had a longer duration of hypertension, and a worse cardiovascular risk profile. The true resistant group included larger proportions of smokers, diabetics, and those with target organ damage, including left ventricular hypertrophy, decreased renal function, and microalbuminuria, and previous cardiovascular disease.

"It must be emphasized that ABPM continues to be needed and must be encouraged for a correct diagnosis and management of all hypertensive patients not controlled on three or more antihypertensive drugs," the authors write.

Several authors disclosed financial ties to Lacer Laboratories.

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