Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension: Baseline observations in the Syst-Eur trial

Dmitri Emelianov, Lutgarde Thijs, Jan A. Staessen, Hilde Celis, Denis Clement, Christopher Davidson, Jerzy Gasowski, Blas Gil-Extremera, Roberto Fogari, Matti Jääskivi, Aapo Lehtonen, Sergey Nedogoda, Eoin O'Brien, Paolo Palatini, Gianfranco Parati, Antonio Salvetti, Hannu Vanhanen, John Webster, Robert Fagard

Research output: Contribution to journalArticle

Abstract

Objectives. To compare clinic and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension and their reproducibilities. Patients. In total 610 patients aged ≥ 60 years with isolated systolic hypertension detected by clinic measurement were monitored during the placebo run-in phase of the Syst-Eur trial. Methods. The time-weighted 24 h blood pressure, clock-time day and night blood pressures, the cumulative-sum-derived crest and trough blood pressures and the high and low blood pressure levels according to the square-wave model were computed. The daily alteration between the high and low spans of blood pressure was quantified using the day-night difference, the cumulative-sum-derived magnitude of circadian alteration, the Fourier amplitude and the difference between the high and low blood pressure levels of the square-wave model. Results. The daytime ambulatory systolic blood pressure was, on average, 21 mmHg lower than the clinic systolic blood pressure, whereas diastolic pressure was, on average, similar with both techniques of measurement. Clinic levels of blood pressure in the 141 patients who underwent repeat measurements and the parameters describing the difference between the daily high and low spans of blood pressure were equally reproducible. However, both were less reproducible than the ambulatory blood pressure levels. The reproducibility coefficients, expressed as percentages of near maximum variation, were 49 and 50% for the clinic systolic and diastolic blood pressures, 30 and 32% for the mean 24 h systolic and diastolic blood pressures and 45-55% for the parameters describing the daily alteration between the high and low spans of blood pressure. Conclusions. Values of blood pressure in old patients with isolated systolic hypertension were more reproducible for ambulatory than they were for clinic measurements. Levels in patients selected because they have a high clinic blood pressure may be substantially higher with conventional than they are with daytime ambulatory measurement. The prognostic significance of this difference for the present patients is currently under investigation.

Original languageEnglish
Pages (from-to)173-180
Number of pages8
JournalBlood Pressure Monitoring
Volume3
Issue number3
Publication statusPublished - 1998

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Blood Pressure
Hypertension
Hypotension
Placebos

Keywords

  • Ambulatory blood pressure
  • Conventional sphygmomanometry
  • Isolated systolic hypertension
  • Reproducibility

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Emelianov, D., Thijs, L., Staessen, J. A., Celis, H., Clement, D., Davidson, C., ... Fagard, R. (1998). Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension: Baseline observations in the Syst-Eur trial. Blood Pressure Monitoring, 3(3), 173-180.

Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension : Baseline observations in the Syst-Eur trial. / Emelianov, Dmitri; Thijs, Lutgarde; Staessen, Jan A.; Celis, Hilde; Clement, Denis; Davidson, Christopher; Gasowski, Jerzy; Gil-Extremera, Blas; Fogari, Roberto; Jääskivi, Matti; Lehtonen, Aapo; Nedogoda, Sergey; O'Brien, Eoin; Palatini, Paolo; Parati, Gianfranco; Salvetti, Antonio; Vanhanen, Hannu; Webster, John; Fagard, Robert.

In: Blood Pressure Monitoring, Vol. 3, No. 3, 1998, p. 173-180.

Research output: Contribution to journalArticle

Emelianov, D, Thijs, L, Staessen, JA, Celis, H, Clement, D, Davidson, C, Gasowski, J, Gil-Extremera, B, Fogari, R, Jääskivi, M, Lehtonen, A, Nedogoda, S, O'Brien, E, Palatini, P, Parati, G, Salvetti, A, Vanhanen, H, Webster, J & Fagard, R 1998, 'Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension: Baseline observations in the Syst-Eur trial', Blood Pressure Monitoring, vol. 3, no. 3, pp. 173-180.
Emelianov, Dmitri ; Thijs, Lutgarde ; Staessen, Jan A. ; Celis, Hilde ; Clement, Denis ; Davidson, Christopher ; Gasowski, Jerzy ; Gil-Extremera, Blas ; Fogari, Roberto ; Jääskivi, Matti ; Lehtonen, Aapo ; Nedogoda, Sergey ; O'Brien, Eoin ; Palatini, Paolo ; Parati, Gianfranco ; Salvetti, Antonio ; Vanhanen, Hannu ; Webster, John ; Fagard, Robert. / Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension : Baseline observations in the Syst-Eur trial. In: Blood Pressure Monitoring. 1998 ; Vol. 3, No. 3. pp. 173-180.
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abstract = "Objectives. To compare clinic and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension and their reproducibilities. Patients. In total 610 patients aged ≥ 60 years with isolated systolic hypertension detected by clinic measurement were monitored during the placebo run-in phase of the Syst-Eur trial. Methods. The time-weighted 24 h blood pressure, clock-time day and night blood pressures, the cumulative-sum-derived crest and trough blood pressures and the high and low blood pressure levels according to the square-wave model were computed. The daily alteration between the high and low spans of blood pressure was quantified using the day-night difference, the cumulative-sum-derived magnitude of circadian alteration, the Fourier amplitude and the difference between the high and low blood pressure levels of the square-wave model. Results. The daytime ambulatory systolic blood pressure was, on average, 21 mmHg lower than the clinic systolic blood pressure, whereas diastolic pressure was, on average, similar with both techniques of measurement. Clinic levels of blood pressure in the 141 patients who underwent repeat measurements and the parameters describing the difference between the daily high and low spans of blood pressure were equally reproducible. However, both were less reproducible than the ambulatory blood pressure levels. The reproducibility coefficients, expressed as percentages of near maximum variation, were 49 and 50{\%} for the clinic systolic and diastolic blood pressures, 30 and 32{\%} for the mean 24 h systolic and diastolic blood pressures and 45-55{\%} for the parameters describing the daily alteration between the high and low spans of blood pressure. Conclusions. Values of blood pressure in old patients with isolated systolic hypertension were more reproducible for ambulatory than they were for clinic measurements. Levels in patients selected because they have a high clinic blood pressure may be substantially higher with conventional than they are with daytime ambulatory measurement. The prognostic significance of this difference for the present patients is currently under investigation.",
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T1 - Conventional and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension

T2 - Baseline observations in the Syst-Eur trial

AU - Emelianov, Dmitri

AU - Thijs, Lutgarde

AU - Staessen, Jan A.

AU - Celis, Hilde

AU - Clement, Denis

AU - Davidson, Christopher

AU - Gasowski, Jerzy

AU - Gil-Extremera, Blas

AU - Fogari, Roberto

AU - Jääskivi, Matti

AU - Lehtonen, Aapo

AU - Nedogoda, Sergey

AU - O'Brien, Eoin

AU - Palatini, Paolo

AU - Parati, Gianfranco

AU - Salvetti, Antonio

AU - Vanhanen, Hannu

AU - Webster, John

AU - Fagard, Robert

PY - 1998

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N2 - Objectives. To compare clinic and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension and their reproducibilities. Patients. In total 610 patients aged ≥ 60 years with isolated systolic hypertension detected by clinic measurement were monitored during the placebo run-in phase of the Syst-Eur trial. Methods. The time-weighted 24 h blood pressure, clock-time day and night blood pressures, the cumulative-sum-derived crest and trough blood pressures and the high and low blood pressure levels according to the square-wave model were computed. The daily alteration between the high and low spans of blood pressure was quantified using the day-night difference, the cumulative-sum-derived magnitude of circadian alteration, the Fourier amplitude and the difference between the high and low blood pressure levels of the square-wave model. Results. The daytime ambulatory systolic blood pressure was, on average, 21 mmHg lower than the clinic systolic blood pressure, whereas diastolic pressure was, on average, similar with both techniques of measurement. Clinic levels of blood pressure in the 141 patients who underwent repeat measurements and the parameters describing the difference between the daily high and low spans of blood pressure were equally reproducible. However, both were less reproducible than the ambulatory blood pressure levels. The reproducibility coefficients, expressed as percentages of near maximum variation, were 49 and 50% for the clinic systolic and diastolic blood pressures, 30 and 32% for the mean 24 h systolic and diastolic blood pressures and 45-55% for the parameters describing the daily alteration between the high and low spans of blood pressure. Conclusions. Values of blood pressure in old patients with isolated systolic hypertension were more reproducible for ambulatory than they were for clinic measurements. Levels in patients selected because they have a high clinic blood pressure may be substantially higher with conventional than they are with daytime ambulatory measurement. The prognostic significance of this difference for the present patients is currently under investigation.

AB - Objectives. To compare clinic and ambulatory measurements of blood pressure in old patients with isolated systolic hypertension and their reproducibilities. Patients. In total 610 patients aged ≥ 60 years with isolated systolic hypertension detected by clinic measurement were monitored during the placebo run-in phase of the Syst-Eur trial. Methods. The time-weighted 24 h blood pressure, clock-time day and night blood pressures, the cumulative-sum-derived crest and trough blood pressures and the high and low blood pressure levels according to the square-wave model were computed. The daily alteration between the high and low spans of blood pressure was quantified using the day-night difference, the cumulative-sum-derived magnitude of circadian alteration, the Fourier amplitude and the difference between the high and low blood pressure levels of the square-wave model. Results. The daytime ambulatory systolic blood pressure was, on average, 21 mmHg lower than the clinic systolic blood pressure, whereas diastolic pressure was, on average, similar with both techniques of measurement. Clinic levels of blood pressure in the 141 patients who underwent repeat measurements and the parameters describing the difference between the daily high and low spans of blood pressure were equally reproducible. However, both were less reproducible than the ambulatory blood pressure levels. The reproducibility coefficients, expressed as percentages of near maximum variation, were 49 and 50% for the clinic systolic and diastolic blood pressures, 30 and 32% for the mean 24 h systolic and diastolic blood pressures and 45-55% for the parameters describing the daily alteration between the high and low spans of blood pressure. Conclusions. Values of blood pressure in old patients with isolated systolic hypertension were more reproducible for ambulatory than they were for clinic measurements. Levels in patients selected because they have a high clinic blood pressure may be substantially higher with conventional than they are with daytime ambulatory measurement. The prognostic significance of this difference for the present patients is currently under investigation.

KW - Ambulatory blood pressure

KW - Conventional sphygmomanometry

KW - Isolated systolic hypertension

KW - Reproducibility

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