J Korean Soc Hypertens.  2010 Dec;16(4):1-8.

Perfect 24-Hour BP Management for High-Risk Hypertension

• Shimizu M
• Kario K

Abstract

Out-of-clinic blood pressure (BP) measurements such as home BP measurement and ambulatory BP monitoring (ABPM) have been shown to have clinical values comparable to, or greater than, that of clinic BP measurement. Especially for the management of BP through a 24-hour period, the importance of ABPM has been emphasized. The average of BP level, nocturnal BP fall, and morning BP surge have been recognized as potential risks for cardiovascular disease. In high-risk hypertensive patients with diabetes, chronic kidney disease (CKD), cerebrovascular disease (CVD), or coronary heart disease (CHD), strict BP control is recommended, because the risk of cardiovascular disease is particularly high. Moreover, diabetes, CKD, or CVD could be related to the nocturnal hypertension with a non-dipper/riser pattern. While, it has also been suggested that aggressive antihypertensive treatment paradoxically can cause an increased incidence of cardiovascular disease, the socalled J-curved phenomenon, in patients with CVD or CHD. Therefore, individualized, perfect, 24-hour BP management is required in high-risk hypertensive patients. In this review, we present the role of ABPM in the management of BP through a 24-hour period in high-risk hypertensive patients.

Keyword

Hypertension; Ambulatory Blood pressure monitoring (ABPM); High-Risk Hypertensive Patients

MeSH Terms

Blood Pressure
Cardiovascular Diseases
Coronary Disease
Humans
Hypertension
Incidence
Renal Insufficiency, Chronic