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<a target="_blank" rel="noopener" href="https://fatcat.wiki/container/cs2xolsnircr5p7bv56jqe2dky" style="color: black;">The Journal of Clinical Hypertension</a>
and Aim: Ambulatory BP (ABP) is probably a better predictor of cardiovascular events (CE) than office BP (OBP), although its role in treated hypertensives in real life conditions is less known. The Cardiorisc Event study aimed to evaluate the association of ABP with the development of CE in high-risk patients included in the Spanish ABPM Registry. Methods: A total of 2115 hypertensive patients with either three or more additional risk factors, diabetes, documented target organ damage or<span class="external-identifiers"> <a target="_blank" rel="external noopener noreferrer" href="https://doi.org/10.1111/j.1751-7176.2011.00459.x">doi:10.1111/j.1751-7176.2011.00459.x</a> <a target="_blank" rel="external noopener" href="https://fatcat.wiki/release/37l4vselybbwdgx67nefyawiru">fatcat:37l4vselybbwdgx67nefyawiru</a> </span>
more »... cardiovascualr or renal disease were included. They entered the Spanish ABPM Registry between 2005 and 2006. Vital status and the development of CE were checked during 2009. The primary combined endpoint was the sum of death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke and coronary or peripheral revascularization procedures. Results: They were 268 primary events. The relationship between ABP values and the appearance of cardiovascular events is detailed in the Table. Conclusion: After adjustment for OBP and cardiovascular risk factors and diseases, ABP is related with the development of CE. Systolic and pulse pressures measured 24-hour, daytime and nighttime, all show positive correlations. In the case of diastolic BP, this relationship is only observed with nighttime values. A high night/day ratio is also associated with a higher risk for cardiovascular events. Table. Differences in BP between patients with and without cardiovascular events Parameter With CV event Without CV event Unadjusted P Adjusted by OBP* Adjusted by OBP and confounders** 24-hour SBP 136.0 AE 18.0 130.7 AE 15.3 The mercury sphygmomanometer is regarded as the most accurate device for blood pressure (BP) measurement against which new devices should be validated. However, for environmental reasons mercury devices are progressively banned. This study validated a hybrid mercury-free auscultatory device (Nissei DM3000) aiming to replace the mercury sphygmomanometer for office use and also as a standard for the validation of new devices. The tested device was validated using the European Society of Hypertension International Protocol (ESH-IP) 2010 with simultaneous BP measurements and increased number of BP comparisons. Thirty-three subjects fulfilling the ESH-IP requirements had 6 BP measurements taken simultaneously by a supervisor (S) using the tested device and 2 observers (A and B) using mercury sphygmomanometers (198 readings). The ESH-IP analysis based on 99 BP readings showed: mean device-observer systolic/diastolic BP difference 0.2 AE 2.0/0.1 AE 2.0 mmHg; systolic BP differences 5/10/15 mmHg in 97/99/99 readings respectively and diastolic 98/99/99; all 33 subjects with 2 of 3 BP differences 5 mmHg and none without a difference 5 mmHg (systolic and diastolic). Further analysis based on 198 BP readings showed: mean differences S-A 0.1 AE 2.4/0.2 AE 2.4 mmHg (systolic/diastolic), S-B 0.3 AE 2.1/ 0.2 AE 2.2, A-B 0.2 AE 2.4/0.0 AE 2.3; Differences 2 mmHg S-A in 88/84% (systolic/diastolic), S-B 87/85%, A-B 87/86% and 4 mmHg S-A 95/96%, S-B 95/96%, A-B 95/98%. These data suggest that a hybrid mercury-free auscultatory BP monitor comfortably passed the ESH-IP 2010 validation requirements for clinical use and has the same level of accuracy as the mercury sphygmomanometer. This device appears to be a reliable alternative to the mercury sphygmomanometer for office use and also as a standard for future validation studies of new BP devices.
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