Cardiovascular

Blood Pressure Monitoring

November 2002

Clinical Focus*

Blood Pressure (BP) Readings

• What is the distribution of the BP differences between clinic, ambulatory, and self-measured blood pressure (SMBP) readings? If there are differences, are these differences reproducible?
• What is the prevalence of white coat hypertension (WCH) as defined by SMBP? Is this pattern reproducible?
• What is the prevalence of WCH as defined by ambulatory blood pressure (ABP) measurement? Is this pattern reproducible?

SMBP and Clinical Outcomes

• Is SMBP more or less strongly associated with BP-related target organ damage than clinic BP measurements?
• Does SMBP predict subsequent clinical outcomes?
• What is the incremental gain in prediction of clinical outcomes from use of self-measurement devices beyond prediction from clinic BP alone?
• What is the effect of treatment guided by SMBP in comparison to treatment guided by clinic BP, in terms of:
  • BP-related target organ damage.
  • Symptoms.
  • Use of anti-hypertensive drug therapy.
  • BP control.

ABP and Clinical Outcomes

• Is ambulatory blood pressure more or less strongly associated with BP-related target organ damage than clinic BP measurements?
• Does ambulatory blood pressure predict subsequent clinical outcomes?
• What is the incremental gain in prediction of clinical outcomes from use of ambulatory devices beyond prediction from clinic BP alone?
• What is the effect of treatment guided by ABP in comparison to treatment guided by clinic BP, in terms of:
  • BP-related target organ damage.
  • Symptoms.
  • Use of anti-hypertensive drug therapy.
  • BP control.

Findings by Subgroups

• Does the evidence for the above questions vary according to a patient's age, gender, income level, race/ethnicity, and clinical subgroups (e.g., hypertensive/normotensive, diabetic, renal transplant status)?

*Addressed in the summary or evidence report.

Utility of Blood Pressure Monitoring Outside of the Clinic Setting
Summary (Publication No. 03-E003, November 2002)
Evidence Report (Publication No. 03-E004, November 2002)
(PDF Files; File Download)

EPC: Johns Hopkins University
Topic Nominator: National Heart, Lung, and Blood Institute's National High Blood Pressure Education Program

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