Ambulatory Blood Pressure Monitoring

The availability of new technologies that enable blood pressure to be measured and re­ corded continuously or repetitively during prolonged observation periods has created ex­ citing opportunities for studying the physiology of blood pressure regulation and the characteristics of clinical hypertension. Ambulatory blood pressure monitoring has been based on three types of approach. The first of these has utilized an intra-arterial catheter that allows blood pressure to be meas­ ured directly and continuously during a full 24-hour period. The second approach is based on non-invasive techniques, and utilizes devices capable of automatically inflating conventional arm cuffs and recording blood pressures at pre-set intervals throughout the day. The third, and most simple method, has depended upon semiautomated techniques that require the subject to inflate a cuff at convenient intervals during the period of obser­ vation. During the last few years, concerted research into these differing techniques has exposed their strengths and shortcomings. Overall, however, there has been a growing perception that these approaches to the measurement of blood pressure might add con­ siderably to the information obtained in the doctor's office by the traditional single or casual reading. This book summarizes the state of the art in ambulatory blood pressure monitoring.

Section I: Techniques.- Ambulatory blood pressure monitoring: recorders, applications and analyses.- Ambulatory blood pressure — direct and indirect.- Can short-term recording of blood pressure in supine patients replace ambulatory blood pressure monitoring.- Ambulatory blood pressure monitoring: methods to assess severity of hypertension, variability and sleep changes.- Interfacing the Del Mar Avionics Model 1978 PIII system with the Apple IIe computer.- Blood pressure fluctuation and amplitude in normal human subjects.- Accuracy and reproducibility of ambulatory blood pressure recorder measurements during rest and exercise.- Adaptation to non-invasive continuous blood pressure monitoring.- Accuracy, reproducibility and usefulness of ambulatory blood pressure recording obtained with the Remler system.- Reproducibility of ambulatory blood pressure recordings.- Blood pressure measurement in an ambulatory setting.- Home and office blood pressures. Clinical observations and hemodynamic mechanisms.- Home vs clinic blood pressure in essential hypertension with and without behavioral therapy.- Aerospace applications of ambulatory blood pressure monitoring.- Section II: Physiology.- Understanding hypertension. The contribution of direct ambulatory blood pressure monitoring.- Ambulatory blood pressure in 199 normal subjects, a collaborative study.- Non-invasive automated blood pressure monitoring in ambulatory normotensive men.- Chronobiologic assessment of human blood pressure variation in health and disease.- The effect of age on circadian rhythm of blood pressure, catecholamines, plasma renin activity, prolactin and corticosteroids in essential hypertension.- Blood pressure monitors in studies of cardiovascular response.- Familial influences on ambulatory blood pressure: studies of normotensive twins.- The role of ambulatory blood pressure monitoring in the evaluation of adolescent hypertension induced by exercise.- Essential hypertension in the elderly: circadian variation of arterial pressure.- Non-invasive assessment of cardiac anatomy and blood pessure in patients with borderline hypertension.- Ambulatory monitoring of blood pressure: the importance of blood pressure during work.- Usefulness of several devices for intermittent blood pressure monitoring in the assessment of the efficacy of antihypertensive therapy.- Section III: Therapy.- Blood pressure variability in hypertensive patients during and immediately following treatment with propranolol and clonidine.- Evaluation of the posology of pindolol therapy of hypertension with automatic indirect ambulatory blood pressure monitoring.- A comparison of once daily and twice daily antihypertensive therapy with enalapril using noninvasive ambulatory BP monitoring.- Continuous blood pressure monitoring in the evaluation of the effectiveness of antihypertensive drugs.- Intra-arterial ambulatory blood pressure monitoring in the assessment of antihypertensive drugs.- Effects of atenolol on 24-hour arterial pressure and heart rate in essential hypertension.- Authors’ Index.