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Office Blood Pressure Testing Cannot Predict Mortality

Ambulatory testing helps pinpoint resistant hypertensive patients at greatest risk

TUESDAY, Nov. 25 (HealthDay News) -- Ambulatory blood pressure monitoring of patients with resistant hypertension can help predict their risk of cardiovascular morbidity and mortality, but office blood pressure measurements have no such prognostic value, according to the results of a study published in the Nov. 24 issue of the Archives of Internal Medicine.

Gil F. Salles, M.D., Ph.D., and colleagues at the Federal University of Rio de Janeiro in Brazil conducted a study of 556 patients with resistant hypertension who underwent both 24-hour ambulatory blood pressure monitoring and clinical laboratory monitoring and who were followed-up for a median 4.8 years.

The primary endpoint of fatal and non-fatal cardiovascular events and all-cause and cardiovascular mortality, was reached by 109 patients (19.6 percent), the researchers report. There were 70 deaths, of which 46 were cardiovascular-related. Office blood pressure monitoring could not predict the patients' morbidity or mortality, but higher mean ambulatory blood pressure was an independent predictor of mortality and morbidity due to cardiovascular and all-causes, the report indicates.

"Ambulatory systolic and diastolic blood pressure were equivalent predictors, and both were better than pulse pressure; nighttime blood pressure was superior to daytime blood pressure," the authors write. "For all-cause mortality, only the ambulatory blood pressure monitoring diagnosis of true resistant hypertension was an independent predictor."

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