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Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group.

Publication ,  Journal Article
Staessen, JA; O'Brien, ET; Atkins, N; Amery, AK
Published in: J Hypertens
November 1993

OBJECTIVE: To delineate more precisely an operational threshold for making clinical decisions based on ambulatory blood pressure (ABP) measurement by studying the ABP in subjects who were diagnosed as either normotensive or hypertensive by conventional blood pressure (CBP) measurement. SUBJECTS: Twenty-four research groups recruited 7069 subjects. Of these, 4577 were normotensive (CBP < or = 140/90 mmHg), 719 were borderline hypertensive (systolic CBP 141-159 mmHg or diastolic CBP 91-94 mmHg) and 1773 were definitely hypertensive. Of the subjects in the last of these categories, 1324 had systolic hypertension (systolic CBP > or = 160 mmHg) and 1310 had diastolic hypertension (diastolic CBP > or = 95 mmHg). Hypertension had been diagnosed from the mean of two to nine (median two) CBP measurements obtained at one to three (median two) visits. RESULTS: The 95th centiles of the 24-h ABP distributions in the normotensive subjects were (systolic and diastolic, respectively) 133 and 82 mmHg. Of the subjects with systolic hypertension, 24% had 24-h systolic ABP < 133 mmHg. Similarly, 30% of those with diastolic hypertension had 24-h diastolic ABP < 82 mmHg. The probability that hypertensive subjects had 24-h ABP below these thresholds tended to increase with age and was two- to fourfold greater if the CBP of the subject had been measured at only one visit and if fewer than three CBP measurements had been averaged for establishing the diagnosis of hypertension. By contrast, for each 10-mmHg increment in systolic CBP, this probability decreased by 54% for 24-h systolic ABP and by 26% for 24-h diastolic ABP, and for each 5-mmHg increment in diastolic CBP it decreased by 6 and 9%, respectively. CONCLUSIONS: The ABP distributions of the normotensive subjects included in the present international database were not materially different from those in previous reports in the literature. One-fifth to more than one-third of hypertensive subjects had an ABP which was below the 95th centile of the ABP of normotensive subjects, but this proportion decreased if the hypertensive subjects had shown a higher CBP upon repeated measurement. The prognostic implications of elevated CBP in the presence of normal ABP remain to be determined.

Duke Scholars

Published In

J Hypertens

ISSN

0263-6352

Publication Date

November 1993

Volume

11

Issue

11

Start / End Page

1289 / 1297

Location

Netherlands

Related Subject Headings

  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Child
  • Cardiovascular System & Hematology
  • Blood Pressure Determination
  • Blood Pressure
  • Aged, 80 and over
 

Citation

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Staessen, J. A., O’Brien, E. T., Atkins, N., & Amery, A. K. (1993). Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group. J Hypertens, 11(11), 1289–1297.
Staessen, J. A., E. T. O’Brien, N. Atkins, and A. K. Amery. “Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group.J Hypertens 11, no. 11 (November 1993): 1289–97.
Staessen JA, O’Brien ET, Atkins N, Amery AK. Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group. J Hypertens. 1993 Nov;11(11):1289–97.
Staessen, J. A., et al. “Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group.J Hypertens, vol. 11, no. 11, Nov. 1993, pp. 1289–97.
Staessen JA, O’Brien ET, Atkins N, Amery AK. Short report: ambulatory blood pressure in normotensive compared with hypertensive subjects. The Ad-Hoc Working Group. J Hypertens. 1993 Nov;11(11):1289–1297.

Published In

J Hypertens

ISSN

0263-6352

Publication Date

November 1993

Volume

11

Issue

11

Start / End Page

1289 / 1297

Location

Netherlands

Related Subject Headings

  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Child
  • Cardiovascular System & Hematology
  • Blood Pressure Determination
  • Blood Pressure
  • Aged, 80 and over