Ambulatory vs. Office Blood Pressure as Inclusion Criteria for the SPRINT Trial Interview with:
Alejandro de la Sierra, MD, PhD, FESC, FAHA
Professor of Medicine
Head, Internal Medicine Department
Hospital Mutua Terrassa
University of Barcelona, Spain What is the background for this study? What are the main findings?

Response: The Systolic Blood Pressure Intervention (SPRINT) trial has demonstrated that a strategy of systolic blood pressure (BP) reduction to a goal of 120 mmHg in selected hypertensive patients prevents the development of cardiovascular complications and mortality. The trial used automated office BP measurements. However, ambulatory BP monitoring (ABPM) has demonstrated to be superior to office BP in predicting cardiovascular events and mortality. We aimed to evaluate ambulatory BP values in hypertensive patients from the Spanish ABPM Registry who meet eligibility criteria for the SPRINT trial.

The results indicated that one third of our hypertensive population met such eligibility criteria and that ABPM values were considerably lower than office BP, with 42% of subjects having daytime BP below 130 mmHg and 21% with 24-hour BP below 120 mmHg. What should readers take away from your report?

Response: ABPM gives additional information to office blood pressure, as allows a large number of measurements obtained in a setting away from doctor’s office and includes the main sources of circadian variability (activity-rest). It helps to better characterize true BP from an individual, which is important in terms of planning treatment decisions. In patients with a possible indication of intensive BP reduction, previous knowledge of ambulatory blood pressure values could help to the selection of patients and to better monitor future treatments. What recommendations do you have for future research as a result of this study?

Response: Future trials of antihypertensive treatments or strategies should consider the use of ABPM to better select candidates for such strategies and to better monitor the impact of treatment on a better estimate of the true individual’s blood pressure. Is there anything else you would like to add?

Response: ABPM should be more widely used in patients with suspected  blood pressure elevation as a help in both diagnosis and management. Thank you for your contribution to the community.


Ambulatory Blood Pressure in Hypertensive Patients with Inclusion Criteria for the SPRINT Trial
Alejandro de la Sierra, José R. Banegas, Juan A. Divisón, Manuel Gorostidi, Ernest Vinyoles, Juan J. de la Cruz, Julián Segura, Luis M. Ruilope
Publication stage: In Press Accepted Manuscript
Published online: November 4, 2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 8, 2016 by Marie Benz MD FAAD