The Key Role of Ambulatory Blood Pressure Monitoring in the Detection of Masked Hypertension and Other Phenomena in Frail Geriatric Patients

. 2021 Nov 09 ; 57 (11) : . [epub] 20211109

Jazyk angličtina Země Švýcarsko Médium electronic

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/pmid34833439

Background and Objectives: This study aims to determine prevalence of masked uncontrolled hypertension (MUH) in frail geriatric patients with arterial hypertension and thus show the role of ambulatory blood pressure monitoring (ABPM) since hypertension occurs in more than 80% of people 60+ years and cardiovascular diseases are the main cause of death worldwide. Despite modern pharmacotherapy, use of combination therapy and normal office blood pressure (BP), patients' prognoses might worsen due to inadequate therapy (never-detected MUH). Materials and Methods: 118 frail geriatric patients (84.2 ± 4.4 years) treated for arterial hypertension with office BP < 140/90 mmHg participated in the study. 24-h ABPM and clinical examination were performed. Results: Although patients were normotensive in the office, 24-h measurements showed that BP values in 72% of hypertensives were not in the target range: MUH was identified in 47 (40%) patients during 24 h, in 48 (41%) patients during daytime and nocturnal hypertension in 60 (51%) patients. Conclusions: ABPM is essential for frail geriatric patients due to high prevalence of MUH, which cannot be detected based on office BP measurements. ABPM also helps to detect exaggerated morning surge, isolated systolic hypertension, dipping/non-dipping, and set and properly manage adequate treatment, which reduces incidence of cardiovascular events and contributes to decreasing the financial burden of society.

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Lawes C.M., Hoorn S.V., Rodgers A. International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513–1518. doi: 10.1016/S0140-6736(08)60655-8. PubMed DOI

Lloyd-Jones D., Morris P.B., Ballantyne C.M., Birtcher K.K., Daly D.D., DePalma S., Minissian M.B., Orringer C.E., Smith S.C. 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J. Am. Coll Cardiol. 2017;70:1785–1822. doi: 10.1016/j.jacc.2017.07.745. PubMed DOI

Wang Y., Wang Q.J. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: New challenges of the old problem. Arch. Intern. Med. 2004;164:2126–2134. doi: 10.1001/archinte.164.19.2126. PubMed DOI

Gijón-Conde T., Graciani A., López-García E., García-Esquinas E., Laclaustra M., Ruilope L.M., Rodríguez-Artalejo F., Banegas J.R. Frailty, Disability, and Ambulatory Blood Pressure in Older Adults. J. Am. Med. Dir. Assoc. 2018;19:433–438. doi: 10.1016/j.jamda.2017.11.014. PubMed DOI

Mediavilla García J.D., Jaén Águila F., Fernández Torres C., Gil Extremera B., Jiménez Alonso J. Ambulatory blood pressure monitoring in the elderly. Int. J. Hypertens. 2012;2012:548286. doi: 10.1155/2012/548286. PubMed DOI PMC

Williams B., Mancia G., Spiering W., Rosei E.A., Azizi M., Burnier M., Clement D.L., Coca A., de Simone G., Dominiczak A., et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J. Hypertens. 2018;36:1953–2041. doi: 10.1097/HJH.0000000000001940. PubMed DOI

SHEP Cooperative Research Group Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP) JAMA. 1991;265:3255–3264. doi: 10.1001/jama.1991.03460240051027. PubMed DOI

Gasowski J., on behalf of the Systolic Hypertension in Europe Investigators. Staessen J., Celis H., Fagard R., Thijs L., Birkenhäger W., Bulpitt C., Fletcher A., Arabidze G., et al. Systolic Hypertension in Europe (Syst-Eur) trial phase 2: Objectives, protocol, and initial progress. Systolic Hypertension in Europe Investigators. J. Hum. Hypertens. 1999;13:135–145. doi: 10.1038/sj.jhh.1000769. PubMed DOI

Beckett N.S., Peters R., Fletcher A.E., Staessen J.A., Liu L., Dumitrascu D., Stoyanovsky V., Antikainen R.L., Nikitin Y., Anderson C., et al. Treatment of hypertension in patients 80 years of age or older. N. Engl. J. Med. 2008;358:1887–1898. doi: 10.1056/NEJMoa0801369. PubMed DOI

Bulpitt C., Fletcher A., Beckett N., Coope J., Gil-Extremera B., Forette F., Nachev C., Potter J., Sever P., Staessen J.A., et al. Hypertension in the Very Elderly Trial (HYVET): Protocol for the main trial. Drugs Aging. 2001;18:151–164. doi: 10.2165/00002512-200118030-00001. PubMed DOI

Williamson J.D., Supiano M.A., Applegate W.B., Berlowitz D., Campbell R.C., Chertow G.M., Fine L.J., Haley W.E., Hawfield A.T., Ix J.H., et al. Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial. JAMA. 2016;315:2673–2682. doi: 10.1001/jama.2016.7050. PubMed DOI PMC

Benetos A., Labat C., Rossignol P., Fay R., Rolland Y., Valbusa F., Salvi P., Zamboni M., Manckoundia P., Hanon O., et al. Treatment With Multiple Blood Pressure Medications, Achieved Blood Pressure, and Mortality in Older Nursing Home Residents: The PARTAGE Study. JAMA Intern. Med. 2015;175:989–995. doi: 10.1001/jamainternmed.2014.8012. PubMed DOI

Kawano Y., Horio T., Matayoshi T., Kamide K. Masked hypertension: Subtypes and target organ damage. Clin. Exp. Hypertens. 2008;30:289–296. doi: 10.1080/10641960802071026. PubMed DOI

Franklin S.S., O’Brien E., Staessen J.A. Masked hypertension: Understanding its complexity. Eur. Heart J. 2017;38:1112–1118. doi: 10.1093/eurheartj/ehw502. PubMed DOI

Yano Y., Bakris G.L. Recognition and management of masked hypertension: A review and novel approach. J. Am. Soc. Hypertens. 2013;7:244–252. doi: 10.1016/j.jash.2013.02.002. PubMed DOI

Pierdomenico S.D., Pierdomenico A.M., Coccina F., Porreca E. Prognosis of Masked and White Coat Uncontrolled Hypertension Detected by Ambulatory Blood Pressure Monitoring in Elderly Treated Hypertensive Patients. Am. J. Hypertens. 2017;30:1106–1111. doi: 10.1093/ajh/hpx104. PubMed DOI

Babu M., Drawz P. Masked Hypertension in CKD: Increased Prevalence and Risk for Cardiovascular and Renal Events. Curr. Cardiol. Rep. 2019;21:58. doi: 10.1007/s11886-019-1154-4. PubMed DOI

Rockwood K., Song X., MacKnight C., Bergman H., Hogan D.B., McDowell I., Mitnitski A. A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005;173:489–495. doi: 10.1503/cmaj.050051. PubMed DOI PMC

Cacciolati C., Hanon O., Alpérovitch A., Dufouil C., Tzourio C. Masked hypertension in the elderly: Cross-sectional analysis of a population-based sample. Am. J. Hypertens. 2011;24:674–680. doi: 10.1038/ajh.2011.23. PubMed DOI

Ohkubo T., Kikuya M., Metoki H., Asayama K., Obara T., Hashimoto J., Totsune K., Hoshi H., Satoh H., Imai Y. Prognosis of “masked” hypertension and “white-coat” hypertension detected by 24-h ambulatory blood pressure monitoring 10-year follow-up from the Ohasama study. J. Am. Coll Cardiol. 2005;46:508–515. doi: 10.1016/j.jacc.2005.03.070. PubMed DOI

Spannella F., Filipponi A., Giulietti F., Balietti P., Bernardi B., Rosettani G., Sarzani R. Prognostic role of masked and white-coat hypertension: 10-Year mortality in treated elderly hypertensives. J. Hum. Hypertens. 2019;33:741–747. doi: 10.1038/s41371-018-0140-4. PubMed DOI

Bobrie G., Chatellier G., Genes N., Clerson P., Vaur L., Vaisse B., Menard J., Mallion J.-M. Cardiovascular prognosis of “masked hypertension” detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–1349. doi: 10.1001/jama.291.11.1342. PubMed DOI

Franklin S.S., Thijs L., Hansen T.W., Li Y., Boggia J., Kikuya M., Björklund-Bodegård K., Ohkubo T., Jeppesen J., Torp-Pedersen C., et al. Significance of white-coat hypertension in older persons with isolated systolic hypertension: A meta-analysis using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes population. Hypertension. 2012;59:564–571. doi: 10.1161/HYPERTENSIONAHA.111.180653. PubMed DOI PMC

Franklin S.S., Thijs L., Li Y., Hansen T., Boggia J., Liu Y., Asayama K., Björklund-Bodegård K., Ohkubo T., Jeppesen J., et al. Masked hypertension in diabetes mellitus: Treatment implications for clinical practice. Hypertension. 2013;61:964–971. doi: 10.1161/HYPERTENSIONAHA.111.00289. PubMed DOI PMC

Franklin S.S., O’Brien E., Thijs L., Asayama K., Staessen J.A. Masked hypertension: A phenomenon of measurement. Hypertension. 2015;65:16–20. doi: 10.1161/HYPERTENSIONAHA.114.04522. PubMed DOI

Agarwal R., Sinha A.D., Light R.P. Toward a definition of masked hypertension and white-coat hypertension among hemodialysis patients. Clin. J. Am. Soc. Nephrol. 2011;6:2003–2008. doi: 10.2215/CJN.02700311. PubMed DOI PMC

Schrader J., Lüders S., Middeke M. Antihypertensiva immer abends—Bloß nicht oder sinnvoll? (Antihypertensives always evenings-absolutely not or sensible?) Internist. 2020;61:980–988. doi: 10.1007/s00108-020-00806-z. PubMed DOI

Parati G., Ochoa J.E., Bilo G., Agarwal R., Covic A., Dekker F., Fliser D., Heine G.H., Jager K.J., Gargani L., et al. Hypertension in Chronic Kidney Disease Part 2: Role of Ambulatory and Home Blood Pressure Monitoring for Assessing Alterations in Blood Pressure Variability and Blood Pressure Profiles. Hypertension. 2016;67:1102–1110. doi: 10.1161/HYPERTENSIONAHA.115.06896. PubMed DOI

Yano Y., Inokuchi T., Hoshide S., Kanemaru Y., Shimada K., Kario K. Association of poor physical function and cognitive dysfunction with high nocturnal blood pressure level in treated elderly hypertensive patients. Am. J. Hypertens. 2011;24:285–291. doi: 10.1038/ajh.2010.224. PubMed DOI

Kario K., Schwartz J.E., Pickering T.G. Ambulatory physical activity as a determinant of diurnal blood pressure variation. Hypertension. 1999;34:685–691. doi: 10.1161/01.HYP.34.4.685. PubMed DOI

Guo H., Tabara Y., Igase M., Yamamoto M., Ochi N., Kido T., Uetani E., Taguchi K., Miki T., Kohara K. Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: The J-SHIPP study. Hypertens. Res. 2010;33:32–36. doi: 10.1038/hr.2009.172. PubMed DOI

Goldstein I.B., Bartzokis G., Guthrie D., Shapiro D. Ambulatory blood pressure and brain atrophy in the healthy elderly. Neurology. 2002;59:713–719. doi: 10.1212/WNL.59.5.713. PubMed DOI

Forte G., De Pascalis V., Favieri F., Casagrande M. Effects of Blood Pressure on Cognitive Performance: A Systematic Review. J. Clin. Med. 2019;9:34. doi: 10.3390/jcm9010034. PubMed DOI PMC

Franklin S.S., Jacobs M.J., Wong N.D., L’Italien G.J., Lapuerta P. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: Analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension. 2001;37:869–874. doi: 10.1161/01.HYP.37.3.869. PubMed DOI

Young J.H., Klag M.J., Muntner P., Whyte J.L., Pahor M., Coresh J. Blood pressure and decline in kidney function: Findings from the Systolic Hypertension in the Elderly Program (SHEP) J. Am. Soc. Nephrol. 2002;13:2776–2782. doi: 10.1097/01.ASN.0000031805.09178.37. PubMed DOI

Uallachain G.N., Murphy G., Avalos G. The RAMBLER study: The role of ambulatory blood pressure measurement in routine clinical practice: A cross-sectional study. Iran. Med. J. 2006;99:276–279. PubMed

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