Comparison of Office, Home, and Ambulatory Blood Pressure in Heart Transplant Recipients

Abstract Background The purpose of this study was to prospectively evaluate the relationship between office, home, and ambulatory blood pressure (BP) in heart transplant recipients. Methods and Results The study enrolled 30 adults ≥6 months after heart transplantation. Morning seated office BP was m...

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Bibliographic Details
Published in:Journal of cardiac failure 2014-08, Vol.20 (8), p.602-610
Main Authors: Aquilante, Christina L., PharmD, Page, Robert L., PharmD, MSPH, Vu, Anh, BA, Roscoe, Nicholai, BS, Wolfel, Eugene E., MD, Lindenfeld, JoAnn A., MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Pressure - physiology
Blood Pressure Determination - methods
Blood pressure measurement
cardiac transplantation
Cardiovascular
Female
Follow-Up Studies
Heart Failure - surgery
Heart Transplantation
Humans
hypertension
Hypertension - diagnosis
Hypertension - physiopathology
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Self Care
Time Factors
Transplant Recipients
Young Adult
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Summary:Abstract Background The purpose of this study was to prospectively evaluate the relationship between office, home, and ambulatory blood pressure (BP) in heart transplant recipients. Methods and Results The study enrolled 30 adults ≥6 months after heart transplantation. Morning seated office BP was measured with the use of an automatic device at 3 outpatient visits. Seated home BP was measured in the morning and evening for 5 consecutive days. Ambulatory BP was measured over 24 hours with the use of a Spacelabs monitor. The strongest correlation was observed between home and 24-hour ambulatory BP ( r  = 0.79 systolic; r  = 0.72 diastolic). Office and home systolic BPs were significantly lower than daytime ambulatory BP (office, −3.7 mm Hg, P  = .009; home, −2.6 mm Hg, P  = .05). Ambulatory monitoring identified more participants with BP above hypertensive limits than did office or home measurements (63%, 50%, and 13%, respectively; P  = .003). Ambulatory monitoring also revealed high BP loads, abnormal nocturnal BP patterns (eg, 30% nondippers), and a high percentage of masked hypertension (37% home, 50% ambulatory). Conclusions Office and home BP monitoring are acceptable but may underestimate BP burden in heart transplant recipients. Additional studies are needed to determine which BP method is superior for the management of hypertension and associated outcomes after heart transplantation.
ISSN:1071-9164
1532-8414
DOI:10.1016/j.cardfail.2014.05.005