Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement

Head, Geoffrey A., McGrath, Barry P., Mihailidou, Anastasia S., Nelson, Mark R, Schlaich, Markus P., Stowasser, Michael, Mangoni, Arduino A., Cowley, Diane, Brown, Diane, Ruta, Lee-Anne and Wilson, Alison (2012) Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement. Journal of Hypertension, 30 2: 253-266.


Author Head, Geoffrey A.
McGrath, Barry P.
Mihailidou, Anastasia S.
Nelson, Mark R
Schlaich, Markus P.
Stowasser, Michael
Mangoni, Arduino A.
Cowley, Diane
Brown, Diane
Ruta, Lee-Anne
Wilson, Alison
Title Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement
Journal name Journal of Hypertension   Check publisher's open access policy
ISSN 0263-6352
1473-5598
Publication date 2012-02
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/HJH.0b013e32834de621
Volume 30
Issue 2
Start page 253
End page 266
Total pages 14
Place of publication London, United Kingdom
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract Objective:
Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines.

Methods:
A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring.

Results:

ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments.

Conclusion:
Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.
Keyword Bblood pressure
Cardiovascular risk
Consensus
Guidelines
Masked hypertension
White-coat hypertension
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
 
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