Role of Ambulatory Blood Pressure Monitoring in Hypertensive Patients

Abstract

Introduction: Ambulatory Blood Pressure Monitoring (ABPM) measures blood pressure during daily activities and sleep, offering a thorough evaluation of hypertension and cardiovascular (CV) risk. It is superior to office blood pressure (OBP) measurements in predicting CV events and mortality. This study aimed to explore the role of both office and ambulatory BP monitoring in the management of treated hypertensive patients.

Methodology: This prospective study involved 271 hypertensive patients with controlled office BP per JNC 8 guidelines. Detailed demographic data and antihypertensive medication were recorded. OBP was measured following standard practices, and ABP was recorded over 24 hours using a portable device, with measurements at 15-minute intervals during the day and 30-minute intervals at night.

Results: The enrolled patients had a mean age of 48.47 years, predominantly female (66.05%). Among them, 16.2% had White Coat Hypertension (WCH), and 17.4% had Masked Uncontrolled Hypertension (MUCH). Diuretics + ARBs were the most common medication regimen (16%). Non-dippers were 51%, normal dippers 35%, extreme dippers 8%, and reverse dippers 6%. Systolic OBP had a sensitivity of 78.73% and specificity of 41.62%, while diastolic OBP showed 76.26% sensitivity and 67.29% specificity.

Conclusion: ABPM is essential for managing hypertension, providing a more thorough assessment than single OBP measurements. It accurately detects white-coat and masked hypertension, helping with cardiovascular risk stratification. Routine use of ABPM is advised for optimizing antihypertensive treatment.