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Continuous blood pressure monitoring
Continuous blood pressure monitoring can predict and prevent severe hypertensive incidents in certain specific types of hypertension.
For both doctors and patients, continuous blood pressure monitoring provides comprehensive blood pressure data and the range of fluctuations, which can effectively control blood pressure and the dosage of antihypertensive medications.
Continuous blood pressure monitoring can confirm blood pressure fluctuations during each period, allowing for a comparison between daily activities and sleep patterns.
By confirming continuous blood pressure readings in home settings, hospitals, or even workplaces and schools, these intervals of blood pressure variations can help indicate potential risks of cardiovascular diseases.
We hope that every patient with potential cardiovascular diseases can achieve self-monitoring of their daily life to prevent unexpected accidents!
Why continues blood preasure?
From the observation of 24-hour dynamic blood pressure variations and rhythms, it has been found that under normal circumstances, the daytime blood pressure of healthy individuals should not exceed 140/90mmHg, and nighttime blood pressure should not exceed 120/80mmHg.
If it exceed these values, it is referred to as blood pressure overload.
Such complex patients often experience damage to the target organs, indicating that elevated blood pressure is a risk factor for target organ damage.
The term "blood pressure variability" refers to the degree of fluctuation in blood pressure over a certain period of time.
According to Professor Giuseppe Mancia from the University of Milano-Bicocca in Italy, the degree of blood pressure variability is directly proportional to the extent of damage to target organs.
In other words, the greater the variability in blood pressure, the more severe the damage to target organs (Heimark, S. et al. ,2023) .
In normal individuals, daytime blood pressure exhibits higher fluctuations.At around 8 PM, blood pressure gradually decreases, reaching its lowest point between 2 to 3 AM. Blood pressure then starts to rise in the early morning, reaching its peak between 6 to 8 AM.
If hypertensive patients can maintain this regular pattern, it may indicate early or stage one hypertension. However, if this normal rhythm disappears, it could be stage two hypertension, often associated with damage to target organs such as the heart, kidneys, and brain.
Blood pressure tends to rise significantly between 6 a.m. and 8 a.m., and this change in blood pressure may lead to cardiovascular accidents in hypertensive patients.
Furthermore, between 4 PM and 6 PM in the afternoon, there is also an upward trend in blood pressure. Hypertensive patients often experience symptoms such as dizziness and headaches during this period, which can potentially lead to cardiovascular incidents.
Current diagnosis of hypertension
In clinical practice, doctors often rely on blood pressure measurements taken in hospitals as the basis for diagnosing hypertension.
However, single blood pressure measurements may not be accurate and can be influenced by other factors such as anxiety, time pressure, the white coat hypertension, and so on.
These factors can result in elevated blood pressure readings and lead to suboptimal medication treatment outcomes.
Self-blood pressure monitoring
Self-monitoring blood pressure is more effective in achieving blood pressure targets and improving the effectiveness of medication treatment compared to hospital outpatient testing.
Many international research reports have confirmed this statement.
A study published in JAMA in 2004 reported that a higher percentage of individuals who self-monitored their blood pressure stopped using antihypertensive medications compared to those who had their blood pressure measured in a hospital setting (JAMA, 2004).
Self-monitoring of blood pressure can improve blood pressure control and is becoming an increasingly common part of hypertension management (Hond, E.D. et al. ,2004).
This type of monitoring can be accompanied by additional support, such as assistance from nurses or pharmacists.
(Monitoring your blood pressure at home ,2023)
Reference
1. Conen, D., Tschudi, P. and Martina, B. (2008) ‘Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: A randomized controlled trial’, Journal of Human Hypertension, 23(2), pp. 122–129. doi:10.1038/jhh.2008.106.
2. Frisk-Holmberg, M. (1984) ‘Continuous Blood Pressure Monitoring in the evaluation of the effectiveness of antihypertensive drugs’, Ambulatory Blood Pressure Monitoring, pp. 229–232. doi:10.1007/978-3-662-05685-1_30.
3. Heimark, S. et al. (2023) ‘Middle-aged and older patients with left ventricular hypertrophy: Higher mortality with drug treated systolic blood pressure below 130 mm hg’, Hypertension, 80(8), pp. 1739–1748. doi:10.1161/hypertensionaha.123.21454.
4. Hond, E.D. et al. (2004) ‘Antihypertensive treatment based on home or office blood pressure???the thop trial’, Blood Pressure Monitoring, 9(6), pp. 311–314. doi:10.1097/00126097-200412000-00008.
5. 血壓節律性波動與血壓自我監測之成效 (no date) 藥學雜誌電子報95期. Available at: https://jtp.taiwan-pharma.org.tw/96/087-091.html.
6. Monitoring your blood pressure at home (2023) www.heart.org. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home (Accessed: 13 September 2023).
7. Palatini, P. (2000) ‘Importance of various methods of blood pressure measurement in clinical trials’, Current Hypertension Reports, 2(4), pp. 362–369. doi:10.1007/s11906-000-0039-6.
8. Prospective Studies Collaborayion. Age-specific releavance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 765-74.
9. Ragot, S. et al. (2016) ‘Prevalence and management of hypertensive patients in clinical practice: Cross-sectional registry in five countries outside the European Union’, Blood Pressure, 25(2), pp. 104–116. doi:10.3109/08037051.2015.1110922.
10. White, W.B. (2000) ‘The evaluation of antihypertensive therapy using 24-H Ambulatory Monitoring Technology’, Blood Pressure Monitoring, 5(Sup 2). doi:10.1097/00126097-200010002-00004.
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