Blood Pressure Variability By Setting Also Varies By Age

George S. Stergiou, MD, FRCP Professor of Medicine & Hypertension Hypertension Center STRIDE-7 Third University Department of Medicine Sotiria Hospital Athens, GreeceMedicalResearch.com Interview with:
George S. Stergiou, MD, FRCP
Professor of Medicine & Hypertension
Hypertension Center STRIDE-7
Third University Department of Medicine
Sotiria Hospital Athens, Greece

Medical Research: What is the background for this study? What are the main findings?

Dr. Stergiou: This study explored the relationship among blood pressure measurements taken in the office, at home and with daytime ambulatory monitoring in 642 untreated subjects aged from 5 to 78 years referred to a university hospital hypertension clinic.

The main finding is that the relationship between office and out-of-office blood pressure (home and ambulatory) differs across different age groups. More specifically, in children daytime ambulatory blood pressure is higher than both office and home blood pressure. The differences are progressively eliminated with increasing age and after the age of 30 years daytime ambulatory blood pressure is similar to home blood pressure and both are lower than office blood pressure. In individuals aged 60 years and older daytime ambulatory blood pressure may be lower than home blood pressure. Age, gender and hypertension status are the main predictors of the differences among blood pressure values obtained by different methods.

Medical Research: What should clinicians and patients take away from your report?

Dr. Stergiou: It is known that the measured blood pressure values differ when obtained by using different measurement methods, e.g. in the office, at home and with ambulatory monitoring. However, the differences among these measurements are not the same across all age groups.

Current guidelines recommend that average home blood pressure levels are similar to average daytime ambulatory blood pressure levels, and both of them are by about 5 mmHg lower than the conventional office blood pressure measurements (systolic and diastolic). However, these differences appear to be present only in middle aged adults (older than 30 years) and not so in younger individuals, and are entirely different in children, adolescents and young adults.

Because differences between office and out-of-office blood pressure measurements are common across all ages and unpredictable in the individual (due the white coat hypertension and the masked hypertension phenomena), the above information is particularly important in the management of such cases in clinical practice.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Stergiou: Large prospective studies are needed providing direct comparisons of all the three blood pressure measurement methods in terms of blood pressure levels but also of prognostic ability across all the spectrum of age. In young individuals such data can only be obtained by setting endpoints of preclinical target organ damage. Future relevant research should include both general and selected populations, such as individuals referred for elevated blood pressure, because the latter are the most likely candidates for both office and out-of-office blood pressure evaluation in clinical practice.

Citation:

Changing relationship among clinic, home and ambulatory blood pressure with increasing age

Stergiou, George S. et al.

Journal of the American Society of Hypertension
Published Online: April 24, 2015
DOI: http://dx.doi.org/10.1016/j.jash.2015.04.002

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MedicalResearch.com Interview with: George S. Stergiou, MD, FRCP (2015). Blood Pressure Variability By Setting Also Varies By Age 

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