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24 hour blood pressure readings better predict mortality

Measuring blood pressure over 24 hours rather than just taking one reading in the clinic can better predict mortality, according to an international study. 

Measuring blood pressure every 20-30 minutes over a period of 24 hours allows particular types of hypertension such as masked and white –coat associated, with a high risk of death, to be diagnosed. Results of the study suggest that taking measurements over 24 hours would also allow for better diagnosis and management of hypertension.

Masked hypertension is when blood pressure is normal in the clinic but raised outside the clinic and white-coat hypertension is when blood pressure is raised in the clinic but is normal out-of-clinic. 

This full day technique uses an Ambulatory Blood Pressure Monitoring (ABPM) device, which accurately measures the usual level of blood pressure. Blood pressure varies a lot during the day and blood pressure measured with ABPM is also a better predictor of cardiovascular and all causes of death than pressure taken in the office/clinic. This is because ABPM is able to report how blood pressure changes over the course of the day, however patients often become anxious when in the clinic and so the one reading may be misleading.

Results also revealed that those with masked hypertension almost triplicate their mortality risk and white-coat hypertension doubles it in comparison to those with normal blood pressure both in and out clinic. 

The study was conducted looking gat 63,000 patients in a Spanish registry who were followed up for up to 10 years. The study was a collaboration between researchers in Spain and Professor Bryan Williams at University College London. 

Professor Williams said that this research shows that ABPM should be part of the evaluation and follow-up of most patients with hypertension. Routine use will improve diagnostic accuracy for patients. It will also help the sustainability of the health system due to better diagnosis and treatment.

Spanish researchers recommend ABPM as part of the evaluation and follow-up of most patients with hypertension. Routine use may improve the health of patients and the sustainability of the health system due to better diagnosis and treatment.

To read the full paper visit New England Journal of Medicine.