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Interpretation of Ambulatory Blood Pressure Monitoring for Risk Stratification in Hypertensive Patients: The
Fabio Angeli1,2, Gianpaolo Reboldi3,4, Francesco Giuseppe Solano4
1Department of Medicine and Technological Innovation (DiMIT), University of Insubria, 21100 Varese, Italy.
Abstract:
Several outcome-based prospective investigations have provided solid data which support the prognostic value of 24 h ambulatory blood pressure over and beyond cardiovascular traditional risk factors. Average 24 h, daytime, and nighttime blood pressures are the principal components of the ambulatory blood pressure profile that have improved cardiovascular risk stratification beyond traditional risk factors. Furthermore, several additional ambulatory blood pressure measures have been investigated. The correct interpretation in clinical practice of ambulatory blood pressure monitoring needs a standardization of methods. Several algorithms for its clinical use have been proposed. Implementation of the results of ambulatory blood pressure monitoring in the management of individual subjects with the aim of improving risk stratification is challenging. We suggest that clinicians should focus attention on ambulatory blood pressure components which have been proven to act as the main independent predictors of outcome (average 24 h, daytime, and nighttime blood pressure, pulse pressure, dipping status, BP variability).
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Pre-Procedural Guidelines for Assessing Blood Pressure
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.
Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Assessment of blood pressure in brachial artery(two-step method)
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure: