TWENTY FOUR HOUR AMBULATORY BLOOD PRESSURE MONITORING-POPULATION CHANGES OVER TIME WITH REGARDS TO ADVERSE PROGNOSTIC FEATURES

Introduction: Over the course of last decade, recognition and treatment of hypertension has assumed a greater importance. This study is designed to show if such a change in attitudes and practice in managing high blood pressure has led to subjects presenting with less adverse prognostic features on 24‐H ABPM.

Materials and Methods: Two cohorts of patients were compared with regards to prevalence of 24 H ABPM features associated with adverse cardiovascular prognosis including High daytime ambulatory SBP, High daytime ambulatory DBP, High night time ambulatory SBP, High night time ambulatory DBP, Absent nocturnal dip, Morning hypertension and High total pulse pressure. The first cohort consisted of 1187 subjects, who had had 24 H ABPM carried out in the 12 months period starting from 1st August 2002. The 2nd cohort consisted of 2117 subjects referred for 24 H ABPM in the 12 months period starting from 1st of August 2011.

Results: The 2011-12 compared to 2002-03 cohort was significantly older (61.52 Years ±14.99 vs 59.13 years ±13.92) with lower average day time SBP (135.96±14.31 mmHg vs 138.30±15.19 mmHg p<0.001), Higher average night time DBP (71.6±10.43 mmHg vs 70.82±10.77 mmHg p=0.040) reduced average Systolic BP dip at night (10.12±8.27 vs 11.31±8.45 p<0.001) lower morning DBP surge (20.71±11.77 vs 22.03±11.89 p=0.002) and lower total pulse pressure (52.45±10.56 vs 54.87±11.51 p<0.001). In general, there was a trend for decrease in the number of adverse features in the 2011-12 Cohort.

Conclusion: Despite being older, the 2011-12 Cohort had lower daytime SBP and total pulse pressure, which may well relate to the better blood pressure management in general. In contrast control of night time blood pressure still remains a problem as evidenced by higher night time DBP and lower nocturnal dip.