Blood pressure that has been recorded over a 24-hour period can help to predict complications more accurately than blood pressure measured on a single occasion. If detected early, high blood pressure is the most treatable risk factor for cardiovascular diseases and the arterial system.
This international study was coordinated by Professors Jan A. Staessen and Zhen-Yu Zhang of KU Leuven in Belgium. Dr. Gladys Maestre from the University of Texas, Rio Grande Valley School of Medicine supervised the study in Venezuela as one of the participating countries. Published in the Journal of the American Medical Association, the study focused on 11,135 participants who were followed for 14 years.
“Although heart and vascular disease are strongly associated with blood pressure, irrespective of how it is measured, until now we did not know which type of blood pressure measurement captured risk in the most accurate way,” Dr. Maestre said.
The study participants included residents of twelve countries in Europe, East Asia, and Latin America. Researchers compared the accuracy of blood pressure measurements made by a healthcare provider in an office setting to blood pressure readings that had been recorded for 24 hours. They found that the probability of heart and vascular disease during the follow-up period was closely associated with blood pressure readings that were taken over the 24-hour period.
Automated Blood Pressure Monitors
Before the start of the study, researchers took individual blood pressure measurements and determined other risk factors of cardiovascular disease. During the study, blood pressure was monitored over a 24-hour period using automated portable blood pressure monitors.
During the daytime, measurements were taken on average 30 times, while during sleep, it was taken ten times on average. One advantage of taking blood pressure during the night when participants were laying down was that the results were not influenced by daytime activities or meals. This helps to explain the accuracy of nighttime blood pressure readings in predicting cardiovascular illness.
“Our research highlights the necessity of using 24-hour measurements to diagnose high blood pressure and to institute and fine tune its treatment,” said Dr. Maestre. “Nevertheless, most health insurers in the US reimburse 24-hour ambulatory blood pressure monitoring only when blood pressure is found to be high in the clinical setting, but is suspected to be normal otherwise, or if undetected or masked hypertension is suspected. However, 24-hour ambulatory blood pressure monitoring is cost effective: It enables the prevention of cardiovascular disease by starting treatment in a timely manner.”
High blood pressure is the leading treatable risk factor for heart disease and the vascular system. As high blood pressure is the cause of over 10 million deaths each year, studies such as this are imperative for preventing risk factors of cardiovascular disease. Complications of high blood pressure can include chest pain caused by narrowing of the arteries of the heart, myocardial infarction, and stroke.
About 30% of all adults and 60% of people aged 60 and over have high blood pressure, but prevention can reduce the risk of premature disability and death, thereby avoiding the suffering of patients and their families.