The American Journal of Medicine
Volume 122, Issue 12 , Pages 1136-1141 , December 2009

Discrepancies between Office and Ambulatory Blood Pressure: Clinical Implications

  • José R. Banegas, MD

      Affiliations

    • Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain
    • CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  • ,
  • Franz H. Messerli, MD

      Affiliations

    • Division of Cardiology, St. Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY
  • ,
  • Bernard Waeber, MD

      Affiliations

    • Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Switzerland
  • ,
  • Fernando Rodríguez-Artalejo, MD

      Affiliations

    • Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain
    • CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  • ,
  • Alex de la Sierra, MD

      Affiliations

    • Hypertension Unit, Clinic Hospital, Barcelona, Spain
  • ,
  • Julián Segura, MD

      Affiliations

    • Hypertension Unit, Doce de Octubre Hospital, Madrid, Spain
  • ,
  • Alex Roca-Cusachs, MD

      Affiliations

    • Hypertension Unit, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
  • ,
  • Pedro Aranda, MD

      Affiliations

    • Nephrology Department, Hospital Regional Universitario Carlos Haya, Málaga, Spain
  • ,
  • Luis M. Ruilope, MD

      Affiliations

    • Hypertension Unit, Doce de Octubre Hospital, Madrid, Spain
    • Corresponding Author InformationRequests for reprints should be addressed to Luis M. Ruilope, MD, Hypertension Unit, Doce de Octubre Hospital, Av. Cordoba s/n, Madrid 28041, Spain

References 

  1. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic: the Antihypertensive and Lipid Lowering treatment to prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–2997
  2. The ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–1559
  3. Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al. A calcium antagonist versus and non-calcium antagonist hypertension treatment strategy in patients with coronary artery disease: the International Verapamil-Trandolapril Study (INVEST). JAMA. 2003;290:2805–2816
  4. Brown MJ, Palmer CR, Castaigne A, et al. Morbidity and mortality in patients randomised to double-blind treatment with long-acting calcium channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT). Lancet. 2000;356:366–372
  5. Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet. 2004;363:2022–2031
  6. Dahlöf B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359:995–1003
  7. Dahlöf B, Sever PS, Poulter NR, et al. ASCOT Investigators Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet. 2005;366:895–906
  8. Weber MA, Julius S, Kjeldsen SE, et al. Blood pressure dependent and independent effects of antihypertensive treatment on clinical events in the VALUE trial. Lancet. 2004;363:2049–2051
  9. Turnbull F, Neal B, Ninomiya T, et al. Blood Pressure Lowering Treatment Trialists' Collaboration Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527–1535
  10. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305–1315
  11. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003;21:1055–1076
  12. Verdecchia P, Reboldi G, Angeli F, et al. Angiotensin-converting enzyme inhibitors and calcium channel blockers for coronary heart disease and stroke prevention. Hypertension. 2005;46:386–392
  13. Telmisartan Randomised AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) Investigators. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet. 2008;372:1174–1183
  14. Yusuf S, Diener HC, Sacco RL, et al. PRoFESS Study Group Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med. 2008;359:1225–1237
  15. Kikuya M, Ohkubo T, Asayama K, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality (The Ohasama study). Hypertension. 2005;45:240–245
  16. Dolan E, Stanton A, Thijs L, et al. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin Outcome Study. Hypertension. 2005;46:156–161
  17. Staessen JA, Thijs L, Fagard R, et al. Systolic Hypertension in Europe Trial Investigators Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. JAMA. 1999;282:539–546
  18. Hansen TW, Jeppesen J, Rasmussen S, et al. Ambulatory blood pressure and mortality: a population-based study. Hypertension. 2005;45:499–504
  19. Sega R, Facchetti R, Bombelli M, et al. Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population (Follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) Study). Circulation. 2005;111:1777–1783
  20. Gorostidi M, Sobrino J, Segura J, et al. Ambulatory blood pressure in hypertensive patients with cardiovascular risk. J Hypertens. 2007;25:977–984
  21. Banegas JR, Segura J, Sobrino J, et al. Effectiveness of blood pressure control outside the medical setting. Hypertension. 2007;49:62–68
  22. Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305–1315
  23. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–1187
  24. Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572
  25. Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals. Part 1: blood pressure measurement in humans. A Statement for Professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45:142–161
  26. O'Brien E, Asmar R, Beilin L, et al. European Society of Hypertension Working Group on Blood Pressure Monitoring Practice guidelines of the European Society of Hypertension for clinic, ambulatory and self blood pressure measurement. J Hypertens. 2005;23:697–701
  27. Svensson P, de Faire U, Sleight P, et al. Comparative effect of ramipril on ambulatory and office blood pressures: a HOPE substudy. Hypertension. 2001;38:E28–E32
  28. Wang TJ, Vasan RS. Epidemiology of uncontrolled hypertension in the United States. Circulation. 2005;112:1651–1662
  29. Messerli FH, Mancia G, Conti CR, et al. Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous?. Ann Intern Med. 2006;144:884–893

 Funding: The main funding for the study was obtained from Lacer Spain, SA, through an unrestricted educational grant.

 Conflict of Interest: None.

 Authorship: We verify that all authors had access to the data and a role in writing the manuscript.

PII: S0002-9343(09)00665-2

doi: 10.1016/j.amjmed.2009.05.020

The American Journal of Medicine
Volume 122, Issue 12 , Pages 1136-1141 , December 2009