Nesbitt SD, Amerena JA, Jamerson KA, Julius S
Prediction of blood pressure trends in borderline hypertension
16th Scientific Meeting of the International Society of Hypertension
ISH Abstract Book
(Jun) 16: 1996
The goal of this study was to clinical management of borderline hypertension
(BH)
by indentifying predictors of their future BP trends.
Re-examining the data of the Tecumseh study,
it was found that, using home BP readings, of 79 participants with BH, 38
remained
hypertensive (sustained = SHT) and 41 remained normotensive (transient =
THT). Both groups had dyslipidemia, higher insulin values and were
overweight, features NOT predictive of BP trends. The most significant
finding of this study was that a home BP of 128/83 detected SHT with 48%
sensitivity and 93% specificity. SHT patients did have a higher forearm
resistance (p < .01) suggesting arteriolar re-structuring, and at ages 6 and
23, the SHT had BP highher than NT or THT (p<0.01 -.001). MOST intriguing
was that the authors (as emphasized by Dr. Julius, himself) are quite
aggressive in non-pharmacologic treatment in those with home BP of greater
than or
equal to 128/83; if non-pharmacologic treatment fails, then
pharmacologic intervention MAY be considered. Normotensive patients (home BP
less than or equal to 120/80) are seen biannually, and those in between, are
treated nonpharmacologically and seen annually.
(Richard Dart, M.D., Marshfield Clinic, Marshfield, WI)
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16th Scientific Meeting of the International Society of Hypertension
H: Exam and lab tests :
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H: Special problems :
Outcomes