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[Measurement of blood pressure: best way to assess cardiovascular risk?]
1Division d'hypertension, CHUV, Lausanne, Suisse.
Insights
Physician blood pressure measurement is key for cardiovascular risk assessment. Ambulatory and self-measurement help identify hypertension and guide treatment, even for those with white coat hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Context:
- Physician blood pressure (BP) measurement is a cornerstone of cardiovascular risk evaluation.
- The "white coat" effect, a BP rise in clinical settings, can be mitigated by ambulatory and self-measurement.
- Accurate BP monitoring is crucial for identifying hypertension and guiding antihypertensive therapy.
Purpose:
- To explore the significance of various blood pressure measurement methods in cardiovascular risk assessment.
- To highlight the importance of identifying and managing the "white coat" effect.
- To emphasize regular follow-up for patients with fluctuating BP readings.
Summary:
- Physician-measured blood pressure is essential for cardiovascular risk assessment.
- Ambulatory and self-measurement techniques help counteract the "white coat" effect, improving hypertension diagnosis.
- Patients with "white coat" hypertension require regular monitoring, even if immediate treatment is deferred.
Impact:
- Improved identification of patients who will benefit from antihypertensive therapy.
- Enhanced understanding of cardiovascular risk stratification through accurate blood pressure monitoring.
- Long-term patient management strategies for hypertension and associated cardiovascular risks.
Abstract:
Measurement of the blood pressure by the physician remains an essential step in the evaluation of cardiovascular risk. Ambulatory measurement and self-measurement of blood pressure are ways of counteracting the "white coat" effect which is the rise in blood pressure many patients experience in the presence of doctors. Thus, it is possible to define the cardiovascular risk of hypertension and identify the patients with the greatest chance of benefiting from antihypertensive therapy. However, it must be realised that normotensive subjects during their everyday activities and becoming hypertensive in the doctor's surgery, may become hypertensive with time, irrespective of the means used to measure blood pressure. These patients should be followed up regularly even if the decision to treat has been postponed.