Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al .European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring

Department of Clinical Medicine and Prevention, University of Milano-Bicocca
Journal of Hypertension (Impact Factor: 4.72). 09/2008; 26(8):1505-26. DOI: 10.1097/HJH.0b013e328308da66
Source: PubMed


This document summarizes the available evidence and provides recommendations on the use of home blood pressure monitoring in clinical practice and in research. It updates the previous recommendations on the same topic issued in year 2000. The main topics addressed include the methodology of home blood pressure monitoring, its diagnostic and therapeutic thresholds, its clinical applications in hypertension, with specific reference to special populations, and its applications in research. The final section deals with the problems related to the implementation of these recommendations in clinical practice.

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Available from: Peter de Leeuw
    • "Blood pressure and heart rate were measured according to the guidelines of the European Society of Hypertension (Parati et al., 2008). Participants rested for five minutes, after which heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure were measured five times consecutively with an automated device (Omron 705 IT, MSH, Glabbeek, Belgium). "
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    ABSTRACT: Background: Vascular changes may underpin the association between airborne black carbon (BC) and cardiovascular events. Accurate assessment of personal exposure is a major challenge in epidemiological research. BC concentrations are strongly related to time–activity patterns, which is particularly relevant when investigating short-termeffects. We investigated associations between arterial stiffness and personal short-term BC exposure. Methods: This panel study included 54 healthy adults (92% women, mean age 40.7 years). BC exposure was monitored individually with a micro-aethalometer during one workweek. Functional and structural properties of the carotid artery were examined ultrasonographically on two separate days. The effect of different short-term personal BC exposure windows (1, 2, 4, 6, 8, 24 and 48 h before the ultrasound examination) on carotid artery stiffness was estimated using mixed models while adjusting for other known correlates of arterial stiffness. Results: Median personal BC exposures within the same day ranged from 599.8 to 728.9 ng/m3 and were associated with carotid arterial stiffness measures. Young's elastic modulus and pulse wave velocity, both measures of stiffness, were positively associated with BC exposure, while the distensibility and compliance coefficient, measures of elasticity, were negatively associated with BC exposure. The strongest associations were observed with BC exposure 8 h before the clinical examination. For each 100 ng/m3 increase in exposure within this time window, Young's elastic modulus increased by 2.38% (95% CI: 0.81 to 3.97; P = 0.0033), while the distensibility coefficient decreased by 2.27% (95% CI: −3.62 to −0.92; P=0.0008). Conclusions: Short-term elevations in personal BC exposure, even within hours, are associated with increased arterial stiffness. This response may reflect a pathway by which air pollution triggers cardiovascular events.
    No preview · Article · Mar 2016 · Environment international
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    • "There are diurnal variations in HBPM averages, and current guidelines recommend the BP measurements to be performed at least in the morning and in the evening [8] [9] [10] [11] [12]. "
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    ABSTRACT: Background. The morning home blood pressure (BP) rise is a significant asymptomatic target organ damage predictor in hypertensives. Our aim was to evaluate determinants of home-based morning-evening difference (MEdiff) in Argentine patients. Methods. Treated hypertensive patients aged ≥ 18 years participated in a cross-sectional study, after performing home morning and evening BP measurement. MEdiff was morning minus evening home average results. Variables identified as relevant predictors were entered into a multivariable linear regression analysis model. Results. Three hundred sixty-seven medicated hypertensives were included. Mean age was 66.2 (14.5), BMI 28.1 (4.5), total cholesterol 4.89 (1.0) mmol/L, 65.9% women, 11.7% smokers, and 10.6% diabetics. Mean MEdiff was 1.1 (12.5) mmHg systolic and 2.3 (6.1) mmHg diastolic, respectively. Mean self-recorded BP was 131.5 (14.1) mmHg systolic and 73.8 (7.6) mmHg diastolic, respectively. Mean morning and evening home BPs were 133.1 (16.5) versus 132 (15.7) systolic and 75.8 (8.4) versus 73.5 (8.2) diastolic, respectively. Significant beta-coefficient values were found in systolic MEdiff for age and smoking and in diastolic MEdiff for age, smoking, total cholesterol, and calcium-channel blockers. Conclusions. In a cohort of Argentine medicated patients, older age, smoking, total cholesterol, and use of calcium channel blockers were independent determinants of home-based MEdiff.
    Full-text · Article · Dec 2014 · International Journal of Hypertension
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    • "Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured with an automated device (Stabilograph, Stolberg, Germany) according to the guidelines of the European Society of Hypertension (Parati et al., 2008). After the participants had rested in a sitting position for 5 min, SBP, DBP and HR were measured five times consecutively during each of the 4 study visits. "
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    ABSTRACT: Exposure to ambient particulate matter and elevated blood pressure are risk factors for cardiovascular morbidity and mortality. Microvascular changes might be an important pathway in explaining the association between air pollution and blood pressure. The objective of the study was to evaluate the role of the retinal microcirculation in the association between black carbon (BC) exposure and blood pressure.We estimated subchronic BC exposure based on 1-week personal measurements (μ-Aethalometer, AethLabs) in 55 healthy nurses. Blood pressure and retinal microvasculature were measured on four different days (range: 2–4) during this week.Subchronic BC exposure averaged (± SD) 1334 ± 631 ng/m3 and ranged from 338 ng/m3 to 3889 ng/m3. An increased exposure of 631 ng/m3 BC was associated with a 2.77 mm Hg (95% CI: 0.39 to 5.15, p = 0.027) increase in systolic blood pressure, a 2.35 mm Hg (95% CI: 0.52 to 4.19, p = 0.016) increase in diastolic blood pressure and with 5.65 μm (95% CI: 1.33 to 9.96, p = 0.014) increase in central retinal venular equivalent. Mediation analysis failed to reveal an effect of retinal microvasculature in the association between blood pressure and subchronic BC exposure.In conclusion, we found a positive association between blood pressure and subchronic black carbon exposure in healthy adults. This finding adds evidence to the association between black carbon exposure and cardiovascular health effects, with elevated blood pressure as a plausible intermediate effector. Our results suggest that the changes in a person's blood pressure as a result of subchronic black carbon exposure operate independently of the retinal microcirculation.
    Full-text · Article · Nov 2014 · Environment International
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