Clinical InvestigationComparison of Office, Home, and Ambulatory Blood Pressure in Heart Transplant Recipients
Section snippets
Methods
The study was approved by the Colorado Multiple Institutional Review Board, and all participants provided written informed consent. Study data were managed with the use of Research Electronic Data Capture (REDCap) tools hosted at the University of Colorado, Denver.14
Results
The demographic and clinical characteristics of the 30 study participants are presented in Table 1. The population was 80% male, 83% white, and 6.7% Hispanic. Mean age at the time of study enrollment was 57 ± 13 years, and the median time after cardiac transplantation was 3,189 days (range 408–8,840 days). There was 1 current smoker in the study population, and 63.3% of participants had stage 3 or 4 chronic kidney disease. Common comorbidities included cardiac allograft vasculopathy (40%),
Discussion
In this prospective study, we sought to systematically compare office, home, and ambulatory BPs in heart transplant recipients. We found that office and home BPs were significantly correlated with ambulatory BP, but that office and home systolic BPs were significantly lower than daytime ambulatory BP. Through 24-hour ambulatory monitoring, we also found that abnormal nocturnal BP patterns and high systolic and diastolic BP loads were common in the population; 24-hour ambulatory monitoring
Conclusion
Together, our data suggest that office and home BP measurements underestimate BP burden, particularly during the daytime, in heart transplant recipients; 24-hour ambulatory monitoring appears to have advantages by providing information on abnormal circadian BP patterns and BP loads, which we found to be high in this population. Our data also suggest that ambulatory BP monitoring may identify a greater percentage of patients with masked hypertension than home BP monitoring. However, we
Acknowledgements
The authors thank the study volunteers for their participation, the nursing staff at the University of Colorado CTRC for assisting with the conduct of the study, and the University of Colorado Heart Transplant Coordinators for assisting with participant recruitment.
Disclosures
None.
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Cited by (4)
Masked Hypertension: A Systematic Review
2020, Heart Lung and CirculationCitation Excerpt :We identified 12 studies [61–72] and one meta-analysis [73] that undertook some form of comparison of the diagnostic performance of ABP and HBP for diagnosing MHT/MUCH. Of these, four studies [69–72] and the meta-analysis merely compared the prevalence of MHT/MUCH diagnosis by each method without providing any measure of diagnostic agreement or bias between the two methods. While two of these [70,73] found no difference in the prevalence of MHT/MUCH diagnosis by either method, three [69,71,72] found that ABP diagnosed MHT/MUCH in a significantly greater proportion of patients.
Abnormal Circadian Blood Pressure Profile as a Prognostic Marker in Patients with Nonischemic Dilated Cardiomyopathy
2016, Cardiology (Switzerland)
Funding: American Heart Association (10GRNT4290040 to CLA) and National Institutes of Health/National Center for Advancing Translational Sciences (UL1 TR000154 to University of Colorado).
See page 609 for disclosure information.