HYPERTENSION WATCH

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Home BP Monitoring Helps Lower Need for Drugs

A study reported in Hypertension (December 1, 2007) looked at whether antihypertensive treatment based on self-measurement of blood pressure (BP) decreases the use of medication without the loss of BP control.

For the study, 430 patients with hypertension were randomly assigned for treatment using self-measured pressures (n = 216) or office pressures (n = 214). Throughout the 1-year follow-up, BP was measured by office measurement, ambulatory monitoring, and selfmeasurement. The researchers also assessed drug use, associated costs, and level of target organ damage. The researchers concluded that self-measurement results in less medication use, compared with office BP measurement. For more information on this study, visit www.morningbp.com/pt31


Day, Night BP Readings Both Vital

A study of 7500 participants, reported recently in The Lancet, questioned that high nighttime blood pressure (BP) readings are better signs of health risk, compared with daytime BP readings.

"Some people have said that blood pressure at night is the best predictor of risk," said Thomas Pickering, MD, who was not involved with the research. "This study says that is not actually the case, that the pressure over the whole 24-hour period is [best]."

Dr. Pickering chaired an American Heart Association committee that in 2005 recommended that physicians and patients start doing 24-hour BP monitoring. "We are going to make new recommendations about home blood pressure monitoring to say that it should be used much more widely than it is at the moment."

For information on this study, visit www.morningbp.com/pt33


BP and BMI Play a Role in Heart Failure

Patients with higher blood pressure (BP) and body mass index (BMI) in mid-life face greater risk of heart failure later in life, according to a study reported in Hypertension (November 1, 2007).

Of the 3362 participants who had routine examinations between 1969 and 1994, 518 developed heart failure. The researchers assessed the patients' BP and pulse measure and BMI measurements. The results indicated that recent systolic BP, pulse pressure, and BMI were all linked with the danger of heart failure. The findings stressed the importance of screening for elevated BP early in life. For information on this study, visit www.morningbp.com/pt35


Preeclampsia Associated with Heart Disease

Norwegian researchers found that women with cardiovascular risk markers have greater risk of developing preeclampsia, according to a study reported in the November 10, 2007, issue of the British Medical Journal.

The study of 3494 women found that those women who had high blood pressure (BP), high cholesterol, and high blood glucose levels before pregnancy increased the risk of preeclampsia 7-fold. The findings also showed that women with a family history of high BP, heart disease, or diabetes had twice the risk of developing preeclampsia.

?The findings suggest that preeclampsia and cardiovascular diseases may share a common origin, and that the increased risk of cardiovascular disease subsequent to preeclampsia, at least partly, is due to an underlying biological trait of the woman,? said research fellow Elisabeth Balstad Magnussen.

The findings emphasize the need for women with a history of high BP to monitor their BP at home during pregnancy. For information on this study, visit www.morningbp.com/pt32


Not All Home BP Monitors Meet Validation Protocols

Blood pressure (BP) monitors that fail validation protocols can lead to BP errors that expose patients to preventable risks of heart disease, renal failure, and mental decline, emphasized Clarence Grim, BS, MS, MD, and Carlene M. Grim, BSN, MSN, SpDN, NP, during a poster presentation at the recent American College of Nurse Practitioners Clinical Conference.

To avoid home BP devices that have failed validation protocols from being sold in the United States, they recommend that all home devices be required to have passed one of the standard validation protocols, such as the one established by the European Society of Hypertension or the Association for the Advancement of Medical Instrumentation. In addition, any device used by a patient or the physician?s office must be validated as accurate in each individual patient. This process should be done every 6 months. For information on this presentation, visit www.morningbp.com/pt34

F A S T   F A C T : Preeclampsia is the leading cause of maternal and fetal death.