Monitoring ABP helps identify true resistant hypertension

Ambulatory blood-pressure monitoring is a useful diagnostic tool for differentiating between true and “white-coat resistant” hypertension (blood pressure that spikes in the doctor’s office), reported a study published online in Hypertension.

The study sought to estimate the prevalence of resistant hypertension through both office and ambulatory blood-pressure monitoring (ABPM). Investigators used the Spanish ABPM registry to identify 8,295 patients with office blood pressure greater than or equal to 140 and/or 90 mmHg while being treated with 3 or more antihypertensive drugs, including 1 diuretic.

After ABPM, the investigators found that 62.5% of patients were defined as having true resistant hypertension and 37.5% had white-coat resistance. Those with true resistant hypertension were younger, more often male, had a longer duration of hypertension, and a worse cardiovascular risk profile. In addition, the group included larger proportions of smokers; diabetics; target organ damage, including left ventricular hypertrophy, impaired renal function, and microalbuminuria; and documented cardiovascular disease.

"It must be emphasized that ABPM continues to be needed and must be encouraged for a correct diagnosis and management of all hypertensive patients not controlled on 3 or more antihypertensive drugs," the authors wrote.

Several authors disclosed financial ties to Lacer Laboratories.