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Continuous recording of blood pressure in cerebrovascular disease: when should it be done?
Javier Tejada1, Luís Hernández-Echebarría, Beatriz Ballesteros
1Section of Neurology, Department of Internal Medicine, Hospital de León, León, Spain. jtejada@hleo.insalud.es
Insights
Ambulatory blood pressure (BP) monitoring aids hypertension management and cerebrovascular event prevention. Continuous BP recording offers prognostic value for stroke development and recovery, especially in elderly patients.
Area of Science:
- Cardiology
- Neurology
- Hypertension Research
Background:
- Hypertension (HT) poses risks to target organs, including the brain.
- Ambulatory blood pressure (BP) monitoring is indicated for hypertension management.
- Cerebrovascular processes are susceptible to HT-related vascular damage.
Purpose of the Study:
- To review the utility of continuous BP recording in cerebrovascular disease (CVD).
- To assess the prognostic value of BP patterns in CVD development and recovery.
- To examine BP patterns across different stroke subtypes and patient demographics.
Main Methods:
- Systematic review of published articles from the Medline database.
- Analysis of studies investigating continuous BP recording in CVD.
- Inclusion of research on BP patterns in subjects with and without prior CVD.
Main Results:
- BP patterns correlate with stroke risk in various populations, including essential hypertension patients (adults and elderly).
- Continuous BP monitoring provides prognostic insights into silent and symptomatic CVD.
- BP monitoring is significant for functional recovery prediction post-stroke.
Conclusions:
- BP monitoring is valuable for managing pathological BP variations in hypertensive patients.
- The technique is particularly useful in elderly patients due to impaired cerebral circulation regulation.
- Circadian rhythm of BP is crucial for primary and secondary prevention of cerebrovascular events.
Background And Objectives:
Ambulatory blood pressure (BP) monitoring has found some specific clinical indications in the treatment and control of hypertension (HT). As with other target organs exposed to vascular damage dependent on HT, ambulatory BP monitoring can be a useful tool in the prevention of cerebrovascular processes.
Method:
Review of published articles (Medline database) which have investigated the value of continuous recording of BP in cerebrovascular disease (CVD).
Results:
Research on the BP patterns and its relationship with stroke has been carried out in subjects with no previous history of CVD (cohort studies and in patients with essential HT, differentiating between adults and elderly patients) and patients after a cerebral ischemic event. The study objectives are aimed at determining its prognostic value in the development of silent and symptomatic CVD, and its prognostic significance regarding functional recovery and the differences of the BP patterns according to the different stroke subtypes.
Conclusions:
BP monitoring is a useful technique with applications in the control and treatment of the pathological variations of BP in hypertensive patients, with and without a previous history of cerebral ischemia, and mainly in elderly patients, due to the deterioration of the cerebral circulation regulation mechanisms. Clinical research has confirmed the importance of factors related to the circadian rhythm of BP in the primary and secondary prevention of cerebrovascular processes.
Related Concept Videos
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(two-step method)
Measurement of Blood Pressure
Pre-Procedural Guidelines for Assessing Blood Pressure
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
