Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement

Geoffrey A. Head, Barry P. McGrath, Anastasia S. Mihailidou, Mark R. Nelson, Markus P. Schlaich, Michael Stowasser, Arduino A. Mangoni, Diane Cowley, Mark A. Brown, Lee Anne Ruta, Alison Wilson

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Objective: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines. Methods: A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring. Results: ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments. Conclusion: Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.

Original languageEnglish
Pages (from-to)253-266
Number of pages14
JournalJournal of Hypertension
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2012
Externally publishedYes

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Ambulatory Blood Pressure Monitoring
Ambulatory Monitoring
Blood Pressure
Hypertension
Cardiovascular Diseases
Masked Hypertension
White Coat Hypertension
Guidelines
Costs and Cost Analysis
Antihypertensive Agents
Cost-Benefit Analysis
Observational Studies
Therapeutics
Clinical Trials
Pregnancy

Cite this

Head, G. A., McGrath, B. P., Mihailidou, A. S., Nelson, M. R., Schlaich, M. P., Stowasser, M., ... Wilson, A. (2012). Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement. Journal of Hypertension, 30(2), 253-266. https://doi.org/10.1097/HJH.0b013e32834de621
Head, Geoffrey A. ; McGrath, Barry P. ; Mihailidou, Anastasia S. ; Nelson, Mark R. ; Schlaich, Markus P. ; Stowasser, Michael ; Mangoni, Arduino A. ; Cowley, Diane ; Brown, Mark A. ; Ruta, Lee Anne ; Wilson, Alison. / Ambulatory blood pressure monitoring in Australia : 2011 consensus position statement. In: Journal of Hypertension. 2012 ; Vol. 30, No. 2. pp. 253-266.
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Head, GA, McGrath, BP, Mihailidou, AS, Nelson, MR, Schlaich, MP, Stowasser, M, Mangoni, AA, Cowley, D, Brown, MA, Ruta, LA & Wilson, A 2012, 'Ambulatory blood pressure monitoring in Australia: 2011 consensus position statement' Journal of Hypertension, vol. 30, no. 2, pp. 253-266. https://doi.org/10.1097/HJH.0b013e32834de621

Ambulatory blood pressure monitoring in Australia : 2011 consensus position statement. / Head, Geoffrey A.; McGrath, Barry P.; Mihailidou, Anastasia S.; Nelson, Mark R.; Schlaich, Markus P.; Stowasser, Michael; Mangoni, Arduino A.; Cowley, Diane; Brown, Mark A.; Ruta, Lee Anne; Wilson, Alison.

In: Journal of Hypertension, Vol. 30, No. 2, 02.2012, p. 253-266.

Research output: Contribution to journalArticle

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T1 - Ambulatory blood pressure monitoring in Australia

T2 - 2011 consensus position statement

AU - Head, Geoffrey A.

AU - McGrath, Barry P.

AU - Mihailidou, Anastasia S.

AU - Nelson, Mark R.

AU - Schlaich, Markus P.

AU - Stowasser, Michael

AU - Mangoni, Arduino A.

AU - Cowley, Diane

AU - Brown, Mark A.

AU - Ruta, Lee Anne

AU - Wilson, Alison

PY - 2012/2

Y1 - 2012/2

N2 - Objective: Although most national guidelines for the diagnosis and management of hypertension emphasize that the initiation and modification of blood pressure (BP)-lowering treatment should be related to absolute cardiovascular disease (CVD) risk, there is only limited information on how to incorporate ambulatory BP (ABP) monitoring into this framework. The objective of this initiative is to provide ABP equivalents for BP cut-points for treatment initiation and targets to be included into guidelines. Methods: A critical analysis of the best available evidence from clinical trials and observational studies was undertaken to develop a new consensus statement for ABP monitoring. Results: ABP monitoring has an important place in defining abnormal patterns of BP, particularly white-coat hypertension (including in pregnancy), episodic hypertension, masked hypertension, labile BP and nocturnal or morning hypertension. This consensus statement provides a framework for appropriate inclusion of ABP equivalents for low, moderate and high CVD risk patients. The wider use of ABP monitoring, although justified, is limited by its availability and cost due to the lack of medical subsidy in Australia. However, cost-benefit analysis does suggest a cost-saving in reduced numbers of inappropriate antihypertensive treatments. Conclusion: Although clinic measurement of BP will continue to be useful for screening and management of suspected and true hypertension, ABP monitoring provides considerable added value toward accurate diagnosis and the provision of optimal care in uncomplicated hypertension, as well as for patients with moderate or severe CVD risk.

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KW - guidelines

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