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The Impact of Various Blood Pressure Measurements on Cardiovascular Outcomes
Constantinos Bakogiannis1, Konstantinos Stavropoulos2, Christodoulos Papadopoulos1
1Third Department of Cardiology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Insights
High blood pressure (BP) measurement methods vary in predicting cardiovascular events. Out-of-office BP monitoring, like ambulatory BP monitoring, shows greater prognostic value than traditional office BP readings.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- Hypertension is a major risk factor for cardiovascular morbidity and mortality.
- High blood pressure (BP) is closely linked to all-cause and cardiovascular mortality.
- Traditional office BP measurement is the gold standard but has limitations.
Purpose of the Study:
- To review the prognostic value of different BP measurement methods.
- To explore the advantages and pitfalls of each BP measurement technique.
- To assess the predictive capability of central and out-of-office BP measurements for cardiovascular events.
Main Methods:
- Review of existing literature on BP measurement techniques.
- Analysis of studies comparing prognostic values of office, central, and out-of-office BP.
- Evaluation of unattended automated office BP, ambulatory BP monitoring, and home BP measurements.
Main Results:
- Unattended automated office BP shows promising results.
- Ambulatory BP monitoring and home BP measurements appear to be better predictors of cardiovascular events and mortality.
- Data on central BP association with cardiovascular outcomes remain conflicting.
- Out-of-office BP measurements can help distinguish hypertensive phenotypes.
Conclusions:
- Ambulatory BP monitoring and home BP measurements offer superior prognostic value for cardiovascular outcomes compared to traditional office BP.
- Further research is needed to directly compare BP measurement methods and their prognostic utility.
- Central BP data requires more extensive investigation to clarify its role in predicting cardiovascular events.
Abstract:
Hypertension is a potent risk factor for cardiovascular morbidity and mortality. High blood pressure (BP) correlates closely with all-cause and cardiovascular mortality. Although the gold standard remains office BP (auscultatory or automated), other methods (central or out-of-office) are gaining popularity as better predictors of CV events. In this review, we investigated the prognostic value of each method of BP measurement and explored their advantages and pitfalls. Unattended automated office BP is a novel technique of BP measurement with promising data. Ambulatory BP monitoring, and to a lesser extent, home BP measurements, seem to predict cardiovascular events and mortality outcomes better, while at the same time, they can help distinguish hypertensive phenotypes. Data on the association of central BP levels with cardiovascular and mortality outcomes, are conflicting. Future extensive cross-sectional and longitudinal studies are needed to evaluate head-to-head the corresponding levels and results of each method of BP measurement, as well as to highlight disparities in their prognostic utility.
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