Intensive treatment of clinic BP resulted in lower nighttime, daytime and 24 hour ambulatory BP
Dr. Sanjay M Agrawal
Hypertension is considered to be an important modifiable risk factor for cardiovascular events, end-stage renal disease (ESRD), and mortality. In a traditional manner, blood pressure (BP) is measured in the clinic setting using the auscultatory method and a mercury sphygmomanometer. However, technologic advances have led to betterments in measuring clinic BP and allowed for measuring BP outside the clinic. Home BP and 24-hour ambulatory BP have bettered our ability to evaluate the risk of target-organ damage and hypertension-related morbidity and mortality. Measuring home BPs may lead to more active participation in health care by patients and has the potential to improve BP control. Ambulatory BP monitoring enables measuring nighttime BPs and diurnal changes, which may be the most accurate predictors of risk associated with elevated BP. Additionally, reducing nighttime BP is executable and may be an important component of effective antihypertensive therapy. However, in a country like India with constraints in resource setting and poor medical literacy, clinicians still resort to in-clinic BP measurements for management of hypertension. In this review, we aim to have a sneaking look into the available clinical evidence as to how intensive treatment of clinic BP have resulted in lower nighttime, daytime and 24 hour ambulatory BP.