Head, GA and McGrath, BP and Mihailidou, AS and Nelson, MR and Schlaich, MP and Stowasser, M and Mangoni, AA and Cowley, D and Brown, MA and Ruta, LA and Wilson, A, Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement, Journal of Hypertension, 30, (2) pp. 253-266. ISSN 0263-6352 (2012) [Refereed Article]
Copyright 2012 Lippincott Williams & Wilkins, Inc.
Objective: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines.
Methods: A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring.
Results: ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost–benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments.
Conclusion: Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.
|Item Type:||Refereed Article|
|Keywords:||blood pressure, cardiovascular risk, consensus, guidelines, masked hypertension, white-coat hypertension|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Nelson, MR (Professor Mark Nelson)|
|Web of Science® Times Cited:||92|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||2 View Download Statistics|
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