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Results for “Blood Pressure Monitoring, Ambulatory”

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At least 19 recordsLinked to original sources

PubMed2026

Reassessment of the effect of oral l-arginine on blood pressure: A systematic review and meta-analysis based on ambulatory blood pressure monitoring.

OBJECTIVE: This meta-analysis aimed to evaluate the effect of oral l-arginine supplementation on ambulatory blood pressure (ABP). METHODS: A systematic search of PubMed, Cochrane Library, Embase, and Web of Science databases was conducted from their inception through March 1, 2026. Randomized controlled trials (RCTs) assessing the effects of oral l-arginine intervention were included. Outcome measures included 24-h systolic blood pressure (24h SBP), 24-h diastolic blood pressure (24h DBP), daytime systolic blood pressure (dSBP), daytime diastolic blood pressure (dDBP), nighttime systolic blood pressure (nSBP), and nighttime diastolic blood pressure (nDBP). Meta-analysis was performed using Stata 17.0. The weighted mean difference (WMD) was used as the effect size, and the results were pooled with 95% confidence intervals (CIs). RESULTS: A total of 5 RCTs comprising 202 participants were included. Meta-analysis results demonstrated that oral l-arginine significantly reduced 24h SBP (WMD = -4.23 mmHg, 95% CI [-5.87, -2.58]; P < 0.01) and 24h DBP (WMD = -3.04 mmHg, 95% CI [-4.48, -1.59]; P < 0.01). Significant reductions were also observed for dSBP (WMD = -4.16 mmHg, 95% CI [-5.90, -2.41]; P < 0.01) and dDBP (WMD = -4.25 mmHg, 95% CI [-5.85, -2.66]; P < 0.01). Furthermore, oral l-arginine significantly lowered nSBP (WMD = -5.70 mmHg, 95% CI [-7.81, -3.58]; P < 0.01) and nDBP (WMD = -4.18 mmHg, 95% CI [-6.27, -2.09]; P < 0.01). CONCLUSION: Oral l-arginine supplementation significantly reduces ABP. However, the number of included studies was limited, and further validation through additional relevant research is warranted.

Arginine↗

PubMed2026

HYPNOSA: Study protocol for a prospective observational cohort of patients with obstructive sleep apnea.

BACKGROUND: Obstructive Sleep Apnea (OSA) is a common chronic disease that affects more than 20% of the adult population. One of the most frequent and characteristic symptoms of OSA is excessive daytime sleepiness (EDS). This symptom is typically treated in patients with OSA with the application of continuous positive airway pressure (CPAP), the gold-standard treatment for this disease. In some patients who are adequately treated with CPAP, residual excessive daytime sleepiness (REDS) persists. The prevalence, associations, and outcomes associated with REDS remain poorly understood. METHODS: Multicenter, prospective, observational cohort study including 1000 patients. Participants will undergo a sleep study for the diagnosis of obstructive sleep apnea (OSA), 24-h ambulatory blood pressure monitoring, clinical assessment, quality-of-life questionnaires, Epworth Sleepiness Scale, and collection of biochemical variables and biological samples. Patients with OSA will receive standard care, and those prescribed continuous positive airway pressure (CPAP) will be monitored for treatment adherence. OSA patients will be assessed at baseline and at 6, 12, and 24 months. DISSCUSION: We aim to establish a prospective observational cohort of patients with obstructive sleep apnea (OSA) treated with CPAP, with and without REDS. The HYPNOSA project will create the largest available registry of patients with OSA and REDS using real-world data, providing accurate prevalence estimates and long-term outcomes. Biological samples will be analyzed to assess the role of specific biomarkers. TRIAL REGISTRATION: Registered at ClinicalTrials.gov. Identifer: NCT06514482.

Adult↗

PubMed2026

Wearable wrist-watch type cuff oscillometric blood pressure monitors: consensus statement by the European Society of Hypertension Working Group on blood pressure monitoring.

Wearable wristwatch-type cuff oscillometric blood pressure (BP) monitors represent a new category of BP devices and are the first wearable monitors to use established cuff-oscillometric BP measurement technology. This consensus statement by the European Society of Hypertension Working Group on BP Monitoring reviews the published evidence on their design, accuracy, validation, clinical application, and remaining research questions. Of 281 articles identified through a systematic PubMed search, 26 were relevant. Several devices are currently available; however, only two have published validation studies performed according to established standards (Omron HeartGuide and Huawei Watch D/D2). Static validation studies generally showed acceptable accuracy, whereas data on 24-h ambulatory use, in special populations, and clinical applications remain limited. Potential advantages include self-initiated measurement at home, at work, and in other settings and conditions; more convenient and repeatable 24-h ambulatory monitoring; more convenient and accurate assessment of asleep BP; capture of stress-related and other BP-related episodes. However, proper wrist position, user adherence, ambulatory performance, and clinical applications require further investigation. More research is needed to establish the accuracy and clinical utility of these novel devices and their role in improving the diagnosis and management of hypertension.

Humans↗

PubMed1979

Assessment of the antihypertensive effect of atenolol with 24 h ambulatory monitoring of blood pressure.

1. Twenty-four hour intra-arterial blood pressure measurements and electrocardiograms were obtained from 12 subjects with untreated essential hypertension. 2. The patients kept records of their activity, paying particular attention to times of retiring to bed, and times of waking in the morning. 3. All subjects were treated with a single daily dose of atenolol (50 to 200 mg) for between 2 and 9 months, and then underwent a second 24 h blood pressure study. 4. Arterial blood pressure was lowered significantly throughout the 24 h period with a single daily dose of atenolol.

Adult↗

PubMed2025

Identification and prognosis of low office and ambulatory blood pressure in patients with heart failure.

BACKGROUND: Low blood pressure (BP) limits the up-titration of guideline-directed medical therapies (GDMTs) and predicts poor outcomes in heart failure (HF). We assessed the value of ambulatory BP monitoring (ABPM) in detecting low BP and its impact on GDMTs optimization and prognosis in HF. METHODS: In 491 HF patients initiating GDMTs from the Risk Evaluation and Management in Heart Failure (REM-HF) study since April 2018 to December 2022, ABPM was measured in addition to office BP. Participants were classified as sustained low systolic BP (SBP) (24-hour and office SBP < 120 mmHg), masked low SBP (24-hour SBP < 120 mmHg, office SBP ≥ 120 mmHg), and no low SBP. The primary outcome was a composite of all-cause mortality and HF rehospitalization. GDMTs target dose achievement was assessed at 3 months. Logistic regression and Cox regression models were used to assess GDMTs optimization and outcomes across SBP groups. RESULTS: Sustained, masked, and no low SBP were observed in 25.3%, 30.8%, and 44.0% of patients, respectively. Both sustained (OR 2.36, 95%CI 1.25-4.47) and masked low SBP (OR 2.32, 95%CI 1.11-4.87) groups were associated with lower likelihood of achieving GDMTs target doses. Over a median 21-month follow-up, all-cause mortality and HF rehospitalization rates were higher in sustained (HR 2.45, 95% CI 1.56-3.86) and masked low SBP (HR 1.68, 95% CI 1.08-2.62) groups. No difference was found in the target dose achievement and outcomes between the two low SBP groups. CONCLUSION: Sustained and masked low SBP were common in HF and both associated with GDMTs intolerance and adverse outcomes.

Humans↗

PubMed2026

Seasonal variation in the office and ambulatory blood pressure control in patients treated with two dual antihypertensive therapies.

We investigated seasonal variation in the office and ambulatory blood pressure control in hypertensive patients treated with two single-pill dual-combination antihypertensive therapies. The study participants (n = 560) were hypertensive patients enrolled in a 24-week therapeutic study. Antihypertensive treatment was initiated with amlodipine/benazepril 5/10 mg/day or benazepril/hydrochlorothiazide 10/12.5 mg/day, with the possible up-titration to 10/20 mg/day or 20/25 mg/day during follow-up, respectively. Office blood pressure was measured at each clinic visit, and ambulatory blood pressure monitoring was performed at baseline and 24-week follow-up. At 24 weeks of follow-up, in patients who continued antihypertensive treatment (n = 511), the proportion of up-titration to higher dosages was significantly different across seasons of treatment commencement in the benazepril/hydrochlorothiazide group (P = 0.002), but not in the amlodipine/benazepril group (P = 0.84). The between-group difference was significantly different in 134 patients who commenced treatment in winter (18.9% vs. 5.0%, P = 0.02), but not in 377 patients who commenced treatment in the other seasons (P ≥ 0.33). The control rate of office blood pressure (<140/90 mmHg) was significantly different across seasons of treatment commencement in the amlodipine/benazepril group (P = 0.01), but not in the benazepril/hydrochlorothiazide group (P = 0.16). The mean changes from baseline to 24-week follow-up tended to be smaller in the benazepril/hydrochlorothiazide than amlodipine/benazepril group in 24-h (mean between-group difference, -2.8 mmHg) and daytime diastolic blood pressure (mean between-group difference, -3.2 mmHg) in patients who commenced treatment in winter, though statistical significance was not achieved (P ≥ 0.07). In conclusion, there was seasonality in the clinic and ambulatory blood pressure-lowering effect of antihypertensive drug combinations, with a marginally significant difference in treatment intensity and blood pressure control between treatment with amlodipine or hydrochlorothiazide in combination with benazepril.

Ambulatory blood pressure↗

PubMed1979

Physical activity and the circadian rhythm of blood pressure.

1. Ambulatory blood pressure monitoring was carried out in 10 subjects for a period of 48 h, the first or second 24 h part of which was selected randomly to be a period of complete bed rest. 2. Heart rate was significantly lower throughout the period of bed rest except for the period 04.00-08.00 hours, when there was little difference. 3. The circadian variation of blood pressure was reduced during the day of bed rest but this was mainly due to higher night-time pressures.

Adult↗

PubMed2024

Acute physical exercise and ambulatory blood pressure in resistant hypertension.

OBJECTIVES: The effects of acute physical exercise in patients with resistant hypertension remain largely unexplored compared with hypertensive patients in general. We assessed the short-term effects of acute moderate-intensity (MICE) and high-intensity interval exercise (HIIE) on the clinic (BP) and 24-h ambulatory blood pressure (ABP) of patients with resistant hypertension. METHODS: Using a crossover randomized controlled design, 10 participants (56 ± 7 years) with resistant hypertension performed three experimental sessions: MICE, HIIE, and control. MICE consisted of continuous treadmill exercise at an intensity of 3-4 metabolic equivalents of energy (METs) until completing 3 kcal/kg and was energy-matched to HIIE (which included six to eight intervals of 3 min duration at 6-7 METs interspersed with 1.5-min rests at 3 METs). In the control session, participants remained seated for 50 min. Flow-mediated vasodilation, autonomic nervous system balance (heart rate variability), exerkines [interleukin (IL)-6, IL-8, IL-15, vascular endothelial growth factor A, irisin, adiponectin, and angiopoietin] and 71 inflammatory-related proteins were also measured. RESULTS: Compared with baseline, HIIE and MICE reduced clinic SBP immediately ( P  < 0.001 for both) and 90 min ( P  = 0.001 and P  = 0.041, respectively) postexercise. HIIE and MICE also reduced clinic DBP immediately postexercise ( P  = 0.003 and P  = 0.025). By contrast, no changes were found in the control session. On the other hand, no significant effects were noted for 24 h ABP measures or for the rest of variables. CONCLUSION: Although in patients with resistant hypertension, acute aerobic exercise induces short-term reductions in clinic BP, this stimulus does not suffice to reduce 24 h ABP or to impact on potential biological mechanisms.

Humans↗

PubMed2025

Effects of room temperature on home morning, evening, and sleep blood pressure: the Shizuoka study.

BACKGROUND: Cold ambient temperatures are known to increase blood pressure (BP), but the influence of room temperature remains understudied. This study examined the impact of room temperature in morning, evening, and sleep BP measured at home. METHODS: The study included 779 adults (mean age: 70.7 years) from a community-based longitudinal study. Home BP was measured for 1 week using a conventional cuff-oscillometric device, whereas sleep BP was automatically recorded at 00 : 00, 02 : 00, and 04 : 00 using a timer-equipped BP monitor. Room temperature was measured concurrently using a thermometer in the BP monitor. RESULTS: A 1°C decrease in room temperature increased morning systolic and diastolic BPs by 0.863 and 0.342 mmHg, respectively ( P  < 0.001). The evening systolic and diastolic BPs increased by 0.721 and 0.320 mmHg, respectively ( P  < 0.001). However, sleep systolic (0.076 mmHg, P = 0.181) and diastolic (0.078 mmHg, P  = 0.039) BPs showed weaker associations. The association between morning systolic and diastolic BPs remained significant after adjusting for ambient temperature (0.809 and 0.304 mmHg, respectively; P  < 0.001). Age was the only factor associated with room temperature-related BP changes. Among 433 normotensive individuals (based on 1-week average morning BP), 93 were hypertensive on the coldest day. These participants had higher average morning BPs within the normal range and were more likely to use antihypertensive medication. CONCLUSION: Room temperature significantly influenced home morning and evening BPs but not sleep BP, independent of ambient temperature. Maintaining appropriate room temperatures may aid in BP management at home.

Humans↗

PubMed1979

Monitoring blood-pressure.

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Ambulatory Care↗

PubMed2025

Immune Cell Type-Specific DNA Methylation Regions Associate With 24-Hour Blood Pressure Regulation in Black People.

BACKGROUND: DNA methylation and immune cells have been linked to blood pressure (BP) regulation and the development of hypertension. However, the immune cell profiles and the cell type-specific DNA methylation associated with BPs remain unclear. METHODS: This study evaluates the 19 cell type deconvolution algorithms using reduced representation bisulfite sequencing data, comparing them to in silico mixtures derived from whole-genome bisulfite sequencing. The top-performing algorithm, Epigenetic Dissection of Intra-Sample Heterogeneity (EpiDISH)-Robust Partial Correlations, was applied to 281 Black inpatients with 24-hour BP monitoring. The immune cell profiles and cell type-specific DNA methylation regions associated with these BP phenotypes were further investigated using regression analysis. RESULTS: In patients with hypertension, B-cell and CD4 effector memory T-cell abundances were significantly elevated. Monocyte and CD8 effector memory T-cell fractions positively correlated with nighttime BP, and CD3 T cells were inversely associated with office BP. These associations remained robust after covariate adjustments and were partially validated in the Medical Information Mart for Intensive Care-IV cohort. For the first time, we identified several cell type-specific DNA methylation regions as being associated with BP phenotypes and patterns across 13 immune cells, with approximately one third predominantly found in effector CD8 T cells. CONCLUSIONS: These findings provide novel insights into the epigenetically regulated immune mechanisms underlying BP regulation and identify potential targets for hypertension management.

Humans↗

PubMed2025

Morning-to-evening change in home blood pressure as a predictor of fatal and nonfatal cardiovascular events.

OBJECTIVE: We investigated the morning-to-evening changes in home blood pressure (BP) in relation to the risk of fatal and nonfatal cardiovascular events. METHOD: The study participants (≥18 years of age) were outpatients enrolled in the China Nationwide Ambulatory and Home Blood Pressure Registry. Home BP was measured at baseline for 7 consecutive days in the morning and evening five times consecutively, of which the first three readings were averaged for analysis. The morning-to-evening changes in home BP were calculated by subtracting the BP values in the morning from that in the evening. RESULT: During a mean (±SD) follow-up of 4.9 (±2.6) years, 184 cardiovascular events occurred among the 5057 study participants. The mean morning-to-evening change in home SBP/DBP was -2.2 ± 8.1/-2.5 ± 4.5 mmHg. The age and sex-standardized incident rate was highest in quartile 1 of the changes in both SBP and DBP for fatal and nonfatal cardiovascular events, stroke (log-rank test, P  < 0.001). After adjustment for confounding factors, including the mean of morning and evening BP, the hazard ratios for patients in quartile 1 of the morning-to-evening change relative to the overall study participants reached statistical significance for SBP [1.39, 95% confidence interval (95% CI) 1.03-1.88] and DBP (1.59, 95% CI: 1.17-2.15) in relation to fatal and nonfatal stroke, and for diastolic BP in relation to fatal and nonfatal cardiovascular events (1.42, 95% CI: 1.13-1.77). CONCLUSION: In outpatients, a mild to moderate BP drop from morning to evening was associated with a significantly higher risk of all cardiovascular events, especially stroke.

Humans↗

PubMed1979

The effects of metoprolol on ambulatory blood pressure.

1. Continuous monitoring of arterial pressure was performed via an indwelling cannula over 24 h in 12 hypertensive patients before treatment and again 2-4 months after starting metoprolol (100 mg twice daily). 2. During treatment, heart rate and systolic and diastolic pressures were significantly reduced. 3. The circadian patterns of heart rate and blood pressure changes were similar before and during therapy.

Adult↗

PubMed2026

Home blood pressure telemonitoring reveals race-specific patterns of target organ damage.

BACKGROUND: Racial differences in cardiac and renal target organ damage (TOD) may persist at comparable blood pressure levels. This study compared TOD in high-risk, non-African-American Black and White patients in relation to the home blood pressure (HBP). METHODS: UPRIGHT-HTM (NCT04299529) is an ongoing international trial comparing risk stratification strategies in asymptomatic patients, aged 55-75  years, with ≥5 risk factors. Patients engage in HBP telemonitoring (OMRON HEM 9210-T). After 34.7 months (median), 287 Black and 154 White patients underwent echocardiography. At baseline, their chronic kidney disease (CKD) grade was assessed by cross-classification of the race-free estimated glomerular filtration rate and albuminuria (2024 KDIGO guideline). HBP was stratified by the 2024 ESC thresholds. Linear and logistic regression models, including a race-by-HBP interaction term, were applied to assess associations with the home systolic HBP. RESULTS: The number of HBP readings was 252 215. Median systolic/diastolic HBP was 127/77 mmHg with 142 patients (32.2%) having home hypertension. Fewer Black patients received statins or combination therapy for hypertension or diabetes. Among nonhypertensive White compared to Black patients, left atrial dimensions, mitral annular s', and stroke volume had a steeper slope in relation to systolic HBP. All patients had concentric left ventricular remodeling, but only 4 Black and 13 White patients had an ejection fraction < 50%. CKD grade was worse in Black than White patients without association with HBP. CONCLUSIONS: TOD primarily affects the kidney in Black and the heart in White patients. Intensifying pharmacological treatment in sub-Saharan Africa, including antihypertensives, lipid-lowering agents, antidiabetic medications, and aspirin, should create an opportunity for improved overall cardiovascular and metabolic prevention.

Aged↗

PubMed2026

Association Between 24-Hour Blood Pressure and Rates of Retinal Nerve Fiber Layer Progression in Glaucoma: The Vascular Imaging in Glaucoma Study.

PURPOSE: Low systemic blood pressure (BP) has been implicated as a risk factor for glaucoma progression. The purpose of this study was to investigate the association between 24-hour BP and rates of retinal nerve fiber layer (RNFL) loss in eyes with primary open-angle glaucoma. DESIGN: Prospective cohort study. PARTICIPANTS: Seventy-nine eyes from 42 subjects with glaucoma (mean age, 68.5 ± 7.6 years) enrolled in the Vascular Imaging in Glaucoma Study at the Bascom Palmer Eye Institute. METHODS: Participants underwent 24-hour ambulatory BP monitoring at baseline. Follow-up evaluations were conducted at 4-month intervals and included ophthalmic examination, BP measurement, and peripapillary RNFL thickness measurement with spectral-domain optical coherence tomography. The association between BP and RNFL loss over time was assessed using linear mixed-effects models adjusted for age, sex, race, baseline RNFL thickness, central corneal thickness, and intraocular pressure. MAIN OUTCOME MEASURES: The effect of baseline 24-hour mean arterial pressure (MAP), systolic BP (SBP), and diastolic BP (DBP) on the rate of average RNFL loss over time. RESULTS: Eyes underwent an average of 13 ± 3 optical coherence tomography exams over 43 ± 10 months of follow-up. The mean rate of RNFL loss was -0.34 ± 0.64 µm/y (median: -0.32; interquartile range: -0.66 to -0.04 µm/y). After adjusting for confounding factors, every 10 mm Hg lower in 24-hour minimum MAP, SBP, and DBP was associated with -0.542 µm/y (P < .001), -0.360 µm/y (P = .003), and -0.458 µm/y (P = .008) faster RNFL loss, respectively. Eyes in the lowest quartile of average 24-hour MAP (81-90 mm Hg) and minimum 24-hour DBP (35-47 mm Hg) experienced significantly faster progression compared to those in the highest quartile, with differences of -0.68 µm/y (P = .017) and -0.63 µm/y (P = .030), respectively. CONCLUSIONS: Lower systemic BP, especially minimum MAP, SBP, and DBP measured by 24-hour ambulatory BP monitoring, is associated with faster rates of RNFL loss in primary open-angle glaucoma eyes. 24-hour BP monitoring may help predict glaucoma patients at greater risk of progression.

Humans↗

PubMed2026

Treatment of OSA using mandibular advancement versus CPAP in improving cardiovascular health.

BACKGROUND: Obstructive sleep apnea is a significant risk factor for hypertension. We assessed the relative effectiveness of mandibular advancement device (MAD) versus continuous positive airway pressure (CPAP) in reducing 24 h ambulatory blood pressure (BP) and other health-related outcomes over 12 months. METHODS: In a randomized, non-inferiority trial, 321 participants with hypertension and increased cardiovascular risk were recruited for polysomnography. Of these, 220 with moderate-to-severe OSA (apnea-hypopnea index (AHI) ≥15 events/hour) were randomized to MAD or CPAP (1:1). We report the final outcomes at the 12-month follow-up. RESULTS: A total of 180 participants (MAD: 89; CPAP: 91) completed the 12-month follow-up. Median usage for MAD and CPAP was 5.5 and 4.9 h per night, respectively. Compared to baseline, the 24 h mean arterial BP at 12 months decreased by 2.3 mmHg (P = 0.200) in the MAD group and by 1.0 mmHg (P = 0.999) in the CPAP group. The difference between-groups was -0.6 mmHg (95% confidence interval: -2.53 to 1.39, non-inferiority P < 0.019). The MAD group demonstrated a larger reduction in asleep BP compared to the CPAP group. The prevalence of excessive daytime sleepiness in the MAD group decreased from 30.3% at baseline to 10.1% at 12-month follow-up (P = 0.001), and from 38.5% to 7.7% in the CPAP group (P < 0.001). The between-group difference was 10.6% (P = 0.097). No significant within-group or between-group differences were observed in the prevalence of arrhythmias and plasma levels of cardiac biomarkers. CONCLUSION: At 12-month, MAD is non-inferior to CPAP for reducing 24 h mean arterial BP in participants with hypertension and increased cardiovascular risk. TRIAL REGISTRATION: NCT04119999.

Humans↗

PubMed2026

Deprescribing after hypotensive syncope: Recurrence burden and ambulatory blood pressure targets.

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Ambulatory blood pressure monitoring↗

PubMed1975

Comparison of dopa decarboxylase inhibitor (carbidopa) combined with levodopa and levodopa alone on the cardiovascular system of patients with parkinson's disease.

The effects of carbidopa combined with levodopa (carbidopa/levodopa) and levodopa alone on the cardiovascular system of patients with Parkinson's disease were evaluated. Thirty-eight patients who had been on stable doses of levodopa underwent a complete cardiac examination, including measurement of recumbent and erect blood pressure and 24 hour ambulatory electrocardiographic monitoring. Patients were classified with respect to the presence or absence of clinically significant heart disease and ventricular arrhythmias. Nineteen of the 38 patients (50 percent) had heart disease, and 12 (32 percent) had significant ventricular arrhythmias. Eleven of the 12 with arrhythmias had underlying heart disease. The incidence of arrhythmias did not correlate with the dose of levodopa. The patients were subsequently randomly assigned to treatment groups receiving either carbidopa/levodopa or levodopa alone. There was no significant difference in the severity of ventricular arrhythmias or in the incidence of orthostatic hypotension in the group assigned to carbidopa/levodopa compared with the group receiving levodopa.

Adult↗