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Analysis of home and office blood pressures
60
ABSTRACTS:
HIGH
BLOOD PRESSURE CONTROL
A-55 THE RELATIONSHIP OF WEIGHT HYPERTENSIVE ADOLESCENT Robert Harold
A. A.
Dershewitz, Kahn; Neil
LOSS AND SALT
The Johns Solomon
Hopkins
INTAKE
Medical
TO BLOOD
PRESSURE
Institutions,
There is evidence from studies on adults that both weight loss intake will lower blood pressure. However, such documentation nonexistent in the pediatric population.
IN THE OBESE,
Baltimore,
Maryland;
and salt restricted is practically
Office records of one practitioner specializing in weight reduction were retrospectively reviewed. Adolescents between 15-18 years of age who were obese and hypertensive (defined as systolic blood pressure >140 mnHg and/or diastolic blood pressure > 90 mnHg) were studied. Patients with secondary hypertension were excluded. All weight and blood pressure determinations were uniform and all subjects were extensively counselled by an office dietitian, who placed patients on a routine restricted salt and daily caloric diet. Several statistical tests were performed, including regression analyses. Twenty patients had complete follow-up for at least one year. Of the 15 patients who lost a significant amount of weight, all had a dramatic fall in systolic, but The five patients who did not lose only a slight fall in diastolic blood pressure. weight had insignificant changes in the olood pressure. Even though this study did not discern duction and salt restriction, we have obese, hypertensive adolescent. What studies to elucidate the relationships
A-56 ANALYSIS
OF HOWE AND OFFICE
Arthur R. De Simone Columbia University New York.
the individual importance of weight redemonstrated an effective way to treat the is now needed are prospective, controlled of weight, salt, and blood pressure.
BLOOD PRESSURES
and Leslie College of
Baer, Department of Medicine, Physicians & Surgeons, New York,
Serial home blood pressure (HBP) determinations were compared to office blood pressure (OBP) in 32 hypertensive patients. They were followed for periods of up to 5 years. Reliability of HBP was documented by reviewing each patient's and/or relative's BP technique and their equipment. Daily HBP readings for at least 10 days immediately prior to OBP were analyzed for 3 consecutive office visits. Two different BP patterns emerged. Group A (n=16) diastolic OBP was within 10 nunHq of HBP (HBP 145/91 + 4/l, OBP 146/91 + 4/l). Group B (n=16) diastolic OBP was 113 mmHg orhigher when compared to HBP (HBP 140/90 + 3/2, OBP 163/105 t 6/21. Analysis of home and office diastolic BP'& both groups indicated a similar degree of variability. Group A did distribution,
not
differ weight,
significantly diagnosis,
from endorgan
Group B in mean age, sex involvement or medications.
We conclude that home blood pressure consistently differs from office blood pressure in a significant fraction of hypertensive patients. Home blood pressure may improve the management of hypertensive patients by identifying office blood pressures that are not representative of the patient's average daily blood pressure.
ABSTRACTS:
HIGH
BLOOD PRESSURE CONTROL
A-55 THE RELATIONSHIP OF WEIGHT HYPERTENSIVE ADOLESCENT Robert Harold
A. A.
Dershewitz, Kahn; Neil
LOSS AND SALT
The Johns Solomon
Hopkins
INTAKE
Medical
TO BLOOD
PRESSURE
Institutions,
There is evidence from studies on adults that both weight loss intake will lower blood pressure. However, such documentation nonexistent in the pediatric population.
IN THE OBESE,
Baltimore,
Maryland;
and salt restricted is practically
Office records of one practitioner specializing in weight reduction were retrospectively reviewed. Adolescents between 15-18 years of age who were obese and hypertensive (defined as systolic blood pressure >140 mnHg and/or diastolic blood pressure > 90 mnHg) were studied. Patients with secondary hypertension were excluded. All weight and blood pressure determinations were uniform and all subjects were extensively counselled by an office dietitian, who placed patients on a routine restricted salt and daily caloric diet. Several statistical tests were performed, including regression analyses. Twenty patients had complete follow-up for at least one year. Of the 15 patients who lost a significant amount of weight, all had a dramatic fall in systolic, but The five patients who did not lose only a slight fall in diastolic blood pressure. weight had insignificant changes in the olood pressure. Even though this study did not discern duction and salt restriction, we have obese, hypertensive adolescent. What studies to elucidate the relationships
A-56 ANALYSIS
OF HOWE AND OFFICE
Arthur R. De Simone Columbia University New York.
the individual importance of weight redemonstrated an effective way to treat the is now needed are prospective, controlled of weight, salt, and blood pressure.
BLOOD PRESSURES
and Leslie College of
Baer, Department of Medicine, Physicians & Surgeons, New York,
Serial home blood pressure (HBP) determinations were compared to office blood pressure (OBP) in 32 hypertensive patients. They were followed for periods of up to 5 years. Reliability of HBP was documented by reviewing each patient's and/or relative's BP technique and their equipment. Daily HBP readings for at least 10 days immediately prior to OBP were analyzed for 3 consecutive office visits. Two different BP patterns emerged. Group A (n=16) diastolic OBP was within 10 nunHq of HBP (HBP 145/91 + 4/l, OBP 146/91 + 4/l). Group B (n=16) diastolic OBP was 113 mmHg orhigher when compared to HBP (HBP 140/90 + 3/2, OBP 163/105 t 6/21. Analysis of home and office diastolic BP'& both groups indicated a similar degree of variability. Group A did distribution,
not
differ weight,
significantly diagnosis,
from endorgan
Group B in mean age, sex involvement or medications.
We conclude that home blood pressure consistently differs from office blood pressure in a significant fraction of hypertensive patients. Home blood pressure may improve the management of hypertensive patients by identifying office blood pressures that are not representative of the patient's average daily blood pressure.