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Published on: May 17, 2016
[Control of arterial hypertension based on self-measurement of blood pressure: APACHE study]
1Unidad de Hipertensión. Hospital Clínico. Universidad de Valencia. Valencia. España. josep.redon@uv.es
Insights
Hypertension control rates are low, particularly in the early morning, even with self-monitoring. New strategies are essential to improve blood pressure management in hypertensive patients.
Area of Science:
- Cardiology
- Hypertension Management
- Preventive Medicine
Context:
- Hypertension affects a significant portion of the adult population worldwide.
- Effective blood pressure control is crucial for reducing cardiovascular disease risk.
- Current antihypertensive treatments and monitoring methods require ongoing evaluation.
Purpose:
- To analyze hypertension control rates using self-measured blood pressure (BP) in a large cohort.
- To determine if early morning BP control differs from control throughout the rest of the day.
Summary:
- A study of 9,227 hypertensive patients on treatment revealed low overall BP control rates.
- Early morning BP readings were significantly higher than later in the day.
- Control rates were notably lower in the morning and in male patients.
Impact:
- Findings highlight the inadequacy of current hypertension control strategies, especially for morning BP.
- Suggests a need for novel approaches to enhance BP management.
- Emphasizes the importance of considering diurnal BP variations in treatment plans.
Background And Objective:
The objective was to analyze the control rates of hypertension in a large group of hypertensives on antihypertensive treatment by means of blood pressure (BP) self-measurements, and to assess if the degree of control at early morning hours differs from that at the rest of the day.
Patients And Method:
9,227 subjects [4,398 men, mean age 61.0 (11.4) yr, body mass index 28.4 (4.1) kg/m2] who had hypertension and were on antihypertensive treatment at least during one month before were included. Patients were recruited from primary care physicians. After receiving training, six BP measurements over one day were performed by means of a Braun Precision Sensor BP 2550 monitor, which measures BP at wrist level.
Results:
Whole day SBP and DBP averages were 138.4 (16.5) mmHg and 85.4 (8.7) mmHg, respectively. Both SBP and DBP in early morning hours were significantly higher than those observed before lunch or before dinner. The percentage of subjects with BP < 130/80 mmHg was 15.5%; 15.4% had SBP < 130 mmHg but DBP > 80 mmHg, and 2.0% had DBP < 80 mmHg and SBP > 130 mmHg). Control rates were lower at early morning hours and in men.
Conclusions:
By using BP self-measurement, control rates of hypertension are low, especially in early morning hours as compared to the rest of the day. New strategies are needed to further increase the control of hypertension.
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