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Discrepancy between tonometric ambulatory and cuff-based office blood pressure measurements in patients with type 1

Simone Theilade1, Maria Lajer, Christel Joergensen

  • 1Steno Diabetes Center, Gentofte, Denmark. ktld@steno.dk

Journal of Clinical Hypertension (Greenwich, Conn.)
|October 4, 2012
PubMed

Insights

Ambulatory blood pressure (ABP) monitoring is feasible and preferred by patients with type 1 diabetes. This method reveals hypertension in over half of patients, highlighting discrepancies with office blood pressure readings.

Area of Science:

  • Cardiology
  • Endocrinology
  • Hypertension Management

Background:

  • Type 1 diabetes is associated with an increased risk of cardiovascular complications, including hypertension.
  • Accurate blood pressure monitoring is crucial for managing hypertension and preventing complications in diabetic patients.
  • Traditional office blood pressure (OBP) measurements may not fully capture the blood pressure profile.

Purpose of the Study:

  • To compare ambulatory blood pressure (ABP) with office blood pressure (OBP) for diagnosing hypertension (HTN) in individuals with type 1 diabetes.
  • To assess the prevalence of masked uncontrolled hypertension and isolated uncontrolled clinic hypertension.
  • To evaluate patient tolerance and preference for tonometric ABP measurements.

Main Methods:

  • A cross-sectional study involving 569 patients with type 1 diabetes.
  • Ambulatory blood pressure (ABP) measured by tonometry and office blood pressure (OBP) by sphygmomanometry.
  • Hypertension defined as blood pressure ≥ 130/80 mm Hg.

Main Results:

  • Hypertension was diagnosed in 45% (24-hour ABP) to 66% (daytime ABP) of patients.
  • Significant disagreement in diagnosing HTN between ABP and OBP was observed in 31% to 37% of patients.
  • Tonometric ABP measurements were well-tolerated, successful in 98%, and preferred by 83% of patients.

Conclusions:

  • Tonometric ABP measurement is a feasible and well-accepted method in type 1 diabetes patients.
  • ABP monitoring reveals a higher prevalence of hypertension and significant discrepancies with OBP, indicating potential underdiagnosis with OBP alone.
  • A substantial proportion of type 1 diabetes patients do not achieve target blood pressure goals, underscoring the need for improved monitoring and management strategies.

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