AUTOMATED - 24 H BLOOD PRESSURE PARAMETERS EVALUATED

IN A GROUP OF PATIENTS WITH ESSENTIAL HYPERTENSION

A. ANDRITOIU , G. ANDRITOIU, M. SURDULESCU,

N. GAVRILA

MILITARY HOSPITAL - CRAIOVA DEPARTAMENT OF INTERNAL MEDICINE

OBJECTIVE

• to quantify the pulsatile , tonic and variability parameters by ABPM - 24 h

in the absence of treatment, in a group of patients with arterial hypertension

METHODS

• monitor evaluation - oscillometric device

INNOMED- EBPM ( Hungary )

• record BP every

* 15 min. ; daytime 7.00 - 22.00

** 60 min. ; night - time 22.00 - 7.00 • comparing to upper limits of the normal ( control subjects)

BP daytime 130 / 85 mmHg

BP night- time 125 / 80 mmHg

STUDY GROUP

• no . of pts. = 45 ( 84 % males )

• mean age : 50,4 +/- 12,5 ( 32 - 77 yr)• BMI : 26,8 +/- 3,4 ( 21-- 34 Kg/m2)• history of HBP = 1 - 15 yr• office BP (mmHg)

SBP = 173,4 +/- 12,6

DBP = 109,5 +/- 13,4

RESULTS

PARAMETER DAYTIME NIGHT-TIME 24 - H

SBP (mmHg) 138,3 +/- 17,6 128,2 +/- 20,1 136,5 +/- 17,4

DBP (mmHg) 89,6 +/- 18,1 80,0 +/- 19,7 87,6 +/- 17,9

MAP(mmHg) 105,6 +/- 17,7 96,0 +/- 19,4 103,8 +/- 17,3

PP (mmHg) 48,3 +/- 8,0 46,7 +/- 9,6 48,1 +/- 8,1

HR ( mmHg) 71,7 +/- 12,4 63,5 +/- 11,4 70,1 +/- 12,0

VARIABILITY PARAMETERS

• DI - MAP ……………………..9,6 +/- 7 %

• SBP-SD / 24 h ………. 13,4 +/- 4,7 mmHg

• DIPPER ……………………………. 56 %

• NON- DIPPER ……………………...44 %

• BP LOAD = mean 41,4 +/- 4% ( 0 - 100 %)

PATTERNS OF HBP ( ABPM method)

28 %24 %

40 %

8 %

WCH EPISODIC SUSTAINED DIURNAL

ACCURACY ( 1381 readings)

83%

17%

CONCLUSIONS

• ABPM may offer supplemental informations concerning the type and severity of arterial hypertension in pre - treatment phase of clinical evaluation ;

• the dipper and sustained form is more frecquently in essential HBP, but the white coate or episodic HBP are also frecquently encountered ;

• the accuracy of ABPM device is a important aspect in this diagnostic procedure .