中青年原发性高血压患者晨峰血压与血压变异性的关系

目的探讨中青年原发性高血压患者晨峰血压与血压变异性的关系。方法收集2011年11月至2015年1月在北京大学人民医院高血压病房住院,既往未治疗或已停止降压药物治疗4周以上,且同时完善了24 h动态血压监测和动态心电图监测的160例中青年原发性高血压患者,分析其24 h动态血压和动态心电图监测结果。根据晨峰血压水平是否超过28.67 mmHg(所有患者晨峰血压水平的最高四分位水平)分为晨峰血压增高组(44例)和非晨峰血压增高组(116例)进行组间比较。结果与非晨峰血压增高组相比,晨峰血压增高组患者24 h收缩压变异性、24 h舒张压变异性、夜间收缩压变异性、夜间舒张压变异性均增大,这4个血压变异性指标与晨峰血压之间的相关系数分别为0.325、0.315、0.316和0.286(均为P0.001);应用Logistic逐步回归分析校正了24 h收缩压水平、日间收缩压水平和血压节律等影响晨峰血压的因素后,除夜间舒张压变异性与晨峰血压的相关性消失外,24 h收缩压变异性、24 h舒张压变异性、夜间收缩压变异性与晨峰血压的相关性仍显著存在,OR值分别为2.43(1.06~5.59)、2.23(1.16~4.30)、1.32(1.06~1.64)。结论对于中青年原发性高血压患者,昼夜血压下降程度、24 h血压变异性和夜间血压变异性均与晨峰血压明显相关。与舒张压变异性相比,收缩压变异性与晨峰血压的相关性更强。24 h收缩压水平、日间收缩压水平和晨峰心率水平也在一定程度上影响着晨峰血压。     

老年高血压患者动态血压监测分析

目的 分析老年原发性高血压患者24h动态血压波动规律.方法 对113例原发性高血压患者与90例血压正常者分别进行24 h动态血压监测.观察血压水平、血压负荷值、血压变异性指标及晨峰数值,并进一步分析具有晨峰现象的老年高血压患者昼夜节律变化.结果 (1)高血压患者24 h及日间、夜间血压监测数值均高于对照组(P＜0.05).(2)高血压患者24 h收缩压及舒张压负荷均高于对照组,血压变异系数升高(P＜0.05).(3)老年高血压患者血压晨峰数值明显高于对照组(P＜0.05).(4)高血压组昼夜节律异常者比例较对照组明显升高(P＜0.05).其中晨峰高血压组、非晨峰高血压组与对照组相比,差异均具有统计学意义(P＜0.05).(5)昼夜节律异常(非杓型)者在高血压组内具有晨峰现象者与不具有晨峰现象者之间相比,差异依然具有统计学意义(P＜0.05).结论 老年高血压患者血压升高明显,收缩压尤其突出,血压负荷增高,变异性增高,晨峰现象更为普遍.具有晨峰现象的高血压患者昼夜节律异常比例更明显增高.     

原发性高血压患者血压变异性与糖尿病的相关性

目的探讨合并2型糖尿病(T2DM)的高血压患者与单纯原发性高血压患者动态血压水平及血压变异性的相关性。方法以800例合并T2DM的原发性高血压患者及800例单纯原发性高血压患者为研究对象,监测研究对象日间、夜间及24 h收缩压及舒张压变异性,并进行对比分析,研究原发性高血压患者血压变异性与糖尿病的相关性。结果高血压合并T2DM组24 h平均收缩压、夜间平均收缩压均明显高于高血压组(均P0.05),高血压合并T2DM组收缩压昼夜差值、舒张压昼夜差值均明显低于高血压组(均P0.05);高血压合并T2DM组24 h收缩压标准差、日间收缩压标准差、日间收缩压变异系数、夜间收缩压标准差、夜间收缩压变异系数、夜间舒张标准差、血压晨峰均明显高于高血压组(均P0.05);经相关分析发现,患者血糖水平与24 h收缩压标准差、24 h收缩压变异系数、日间收缩压标准差、日间收缩压变异系数、日间舒张标准差、日间舒张压变异系数、夜间舒张标准差、血压晨峰呈正相关(均P0.05)。结论原发性高血压合并T2DM患者血压变异性较单纯原发性高血压患者增大,提示糖尿病合并原发性高血压时对患者昼夜血压调节损害较大并可能与血糖水平有关。     

慢性疾病与住院老年人餐后低血压的偏相关分析

目的探讨慢性疾病对住院老年人餐后低血压(PPH)的影响。方法餐前15 min测1次血压为餐前血压,进第1口饭开始计时,20、40、60、90、120 min各测血压1次,以餐后血压变化最大值为餐后血压,将患者分高血压组与无高血压组;餐前高血压〔收缩压(SBP)≥140和(或)舒张压(DBP)≥90 mm Hg〕者与餐前血压正常者;服用降压药者与未用降压药者。并将糖尿病、原发性高血压、冠状动脉粥样硬化性心脏病、慢性阻塞性肺部疾病、心功能、脑卒中、肾脏疾病、下肢静脉曲张、营养不良、服用降压药、年龄等因素对餐后血压变化情况进行偏相关分析。结果早、中、晚餐发生PPH的人数分别为82、61、54例,3组差异显著(P=0.005);餐后20、40、60、90、120 min发生PPH的人数分别为74、95、112、103、99例,5组差异显著(P=0.001);餐前高血压者与餐前血压正常者早中晚餐餐后SBP变化最大值比较有统计学意义(P=0.000),早餐SBP变化最大值比较有统计学意义(P=0.006);偏相关分析显示:早餐后SBP变化最大值与肾功能、服用降压药相关(r=0.189、-0.180,P=0.035、0.044),晚餐后SBP变化最大值与冠心病相关(r=0.185,P=0.039);早餐DBP变化最大值与年龄相关(r=0.580,P=0.000);晚餐后SBP变化最大值与原发性高血压相关(r=0.194,P=0.030)。结论早餐及餐后60⁹0 min易发生PPH,餐前高血压患者餐后血压下降幅度较大,PPH与冠心病、肾功能、原发性高血压、服用降压药物及年龄有关。     

进食和慢性疾病对住院老年人餐后血压的影响

目的探讨进食和慢性疾病对住院老年人餐后血压的影响。方法餐前15min测1次血压,进第1口饭开始计时,20、40、60、90和120min各测血压1次,以餐后血压变化最大值作为餐后血压,将152例患者分为高血压组(127例)和无高血压组(25例),餐前高血压与餐前血压正常者,服用降压药与未服用降压药者。观察年龄、降压药物及主要慢性疾病对餐后低血压(PPH)的影响。结果餐后20、40、60、90和120min发生PPH分别为60、81、93、81和83例,5个时间点比较差异有统计学意义(P=0.004);与餐前血压正常者餐后收缩压变化最大值比较,餐前高血压者收缩压下降幅度大(P=0.000);早餐后收缩压变化最大值与脑卒中、服用降压药物及年龄相关(P=0.017,P=0.050,P=0.019);晚餐后收缩压变化最大值与冠心病相关(P=0.037);早餐后舒张压变化最大值与脑卒中、下肢静脉曲张及服用降压药物相关(P=0.009,P=0.033,P=0.047)。结论餐后60min易发生PPH,餐前高血压患者餐后血压下降幅度较大,餐后血压变化与脑卒中、冠心病、下肢静脉曲张、服用降压药物及年龄有关。     

苯磺酸左旋氨氯地平不同给药时间治疗老年高血压患者餐后低血压的效果

目的探讨不同服药时间对老年高血压患者餐后低血压(PPH)的影响。方法 200例老年原发性高血压合并PPH患者按随机数表法分为对照组和治疗组,每组100例。14 d安慰剂洗脱后所有患者予以苯磺酸左旋氨氯地平5 mg口服治疗,其中对照组于晨起后立即服药,治疗组于早餐后2 h(10∶00)服药,持续治疗8 w。比较两组治疗前后血压的变化和PPH治疗效果,多因素分析筛选影响PPH疗效的风险因素。结果治疗8 w后,对照组与治疗组24 h平均收缩压、24 h平均舒张压、中餐及晚餐后血压下降幅度无明显差异,治疗组早餐后血压下降幅度明显低于对照组。治疗组早晨后PPH比例明显低于对照组,且早餐PPH新增发病率明显低于对照组(P0. 05);中餐和晚餐PPH发生概率两组无明显差异。治疗组治疗后总体有效率明显高于对照组(P0. 05)。多因素Logistic回归提示:年龄、不同给药时间、入院时餐后血压下降幅度与PPH治疗效果有关。结论对于年纪较轻、入院时餐后血压下降幅度较低的老年高血压患者将苯磺酸左旋氨氯地平改为10∶00服药(早晨与中餐之间)治疗PPH安全、有效。     

老年原发性高血压患者餐后低血压与缺血性脑卒中相关性研究

目的：探讨老年原发性高血压患者餐后低血压（PPH）与缺血性脑卒中的相关性。方法：纳入2020年1月至2021年3月于心内科住院治疗的180例老年原发性高血压患者。24 h动态血压监测仪监测患者24 h血压,记录患者午餐前,餐后即刻,餐后30、60、90和120 min连续6次血压,以最低血压值作为餐后血压。根据PPH诊断标准,患者分为PPH组（n=95）和非餐后低血压（NPPH）组（n=85）。结果：在180例患者中,PPH组缺血性脑卒中87例（91.6%）,NPPH组62例（72.9%）。单因素分析结果显示,2组缺血性脑卒中、餐后心率、餐前收缩压、餐前舒张压、餐前平均动脉压和餐后平均动脉压水平的差异均有统计学意义（P均<0.05）。PPH组餐后平均动脉压明显低于餐前（P<0.001）。Logistic回归分析显示,PPH和缺血性脑卒中有相关性（P=0.002）;餐后心率水平、餐前收缩压和舒张压水平,餐前餐后平均动脉压水平和餐前餐后平均动脉压变异值均与PPH有相关性（P均<0.05）。结论：PPH与缺血性脑卒中发生相关,餐前收缩压、舒张压水平,餐后心率水平,餐前餐后平...     

住院老年高血压患者伴发餐后低血压的临床观察

目的观察住院老年原发性高血压患者餐后血压变化,探讨餐后低血压(PPH)临床特点及其与心、肾等靶器官损害的相关性。方法选取2013年3月至2014年10月大连医科大学附属第一医院高血压病房住院治疗的老年原发性高血压患者191例,行24h动态血压监测,根据PPH诊断标准分为PPH组(n=153)和非PPH组(NPPH组,n=38),探讨PPH临床特点及相关因素。行心脏超声、肾功能检查,探讨PPH对心脏及肾脏损害的影响。结果住院老年原发性高血压患者191例中,153例在不同餐次出现至少一次PPH,PPH总发生率80.1%。早餐及午餐PPH发生率高于晚餐(P0.05);早餐、午餐餐后收缩压下降幅度大于晚餐[(18.3±14.9)、(20.3±14.6)比(15.5±13.0)mm Hg,均P0.05],三餐后舒张压下降幅度差异无统计学意义(P0.05)。不同年龄组PPH发生率差异无统计学意义,但80~89岁高龄老年组早餐后收缩压下降幅度较60~69岁低龄老年组增大[(26.3±12.1)比(16.8±15.0)mm Hg,P0.05]。根据三餐的餐前收缩压之和取平均值分为3组,餐前平均收缩压较高的C组(≥160mm Hg)与B组(140~160mm Hg)的PPH发生率高于收缩压较低的A组(140mm Hg)(P0.05);且C组和B组三餐后收缩压下降幅度高于A组。多因素Logistic回归分析显示,三餐餐前平均收缩压是PPH发生的独立影响因素(OR1.050,95%CI 1.021~1.079)。PPH组左心室质量指数大于NPPH组(P0.05),而PPH组与NPPH组在肾功能方面的差异无统计学意义。结论住院老年原发性高血压患者的PPH发生率为80.1%,三餐中以早餐及午餐PPH发生率较高,晚餐PPH发生率最低;三餐餐前平均收缩压是住院老年原发性高血压患者PPH发生的独立影响因素;PPH的发生可能会引起住院老年原发性高血压患者左心室结构的改变。     

中老年男性高血压患者血压晨峰临床分析

目的 研究中老年男性高血压患者血压晨峰发生情况与血压变异性、降压药物的关系.方法 对2009年1月至2010年12月住院或体检的中老年军人进行问卷及体格检查、实验室检查及动态血压监测,并根据血压晨峰程度是否超过35 mm Hg(1 mm Hg =0.133 kPa)分为晨峰组(101例)和非晨峰组(420例)进行组间比较.结果 中老年男性高血压患者血压晨峰的发生率为19.4％,其中老年和超高龄患者血压晨峰患病率高于中年患者(18.9％、21.8％、5.6％,P＜0.01);与非晨峰组比较,晨峰组具有较高的日间平均收缩压[(132.8±13.3) mm Hg比(128.8±13.3)mm Hg]、空腹血糖水平[(5.96±1.59) mmol/L比(5.68±1.22) mmol/L,P＜0.05]以及24h血压变异性;服用利尿剂组晨峰发生率较未服用组高(27.4％比17.6％,P＜0.05).结论 老年高血压患者易出现血压晨峰现象,空腹血糖水平、24h血压变异性可能是血压晨峰的影响因素,利尿剂可能不利于血压晨峰的控制.     

高血压患者合并代谢综合症的血压变异性研究

目的探讨合并代谢综合征(MS)对高血压患者血压变异性(BPV)和血压晨峰的影响。方法入选住院的高血压患者183例,根据是否合并MS,分为单纯高血压组97例与高血压伴MS组86例,进行24h动态血压,分析两组的BPV和血压晨峰指标。结果合并MS的高血压患者24h平均收缩压(24h SBP)、日间平均收缩压(d SBP)、夜间平均收缩压(n SBP)、24h收缩压标准差(24h SBPSD)、日间收缩压标准差(d SBPSD)、夜间收缩压标准差(n SBPSD)、血压晨峰明显高于单纯高血压患者。结论代谢综合征可增加原发性高血压患者收缩压BPV以及血压晨峰。     

Blood pressure measurement

Blood pressure measurement is the basis for the diagnosis, management, treatment, epidemiology and research of hypertension and the decisions affecting these aspects of hypertension will be influenced by the accuracy of measurement. Although blood pressure measurement is one of the most common clinical techniques, there are some factors affecting it, such as blood pressure variability or blood pressure measuring devices. Blood pressure can be measured in different ways: Clinic blood pressure measurement is taken in physician's office. The accurate measurement of blood pressure in clinical practice is dependent on the individual, the equipment used and the observer; this is the most common when considering therapeutic decisions. Self blood pressure measurement provides us with values on different days, in settings as close to daily life conditions as possible, having no white-coat effect. Ambulatory blood pressure measurement. With this method, using devices that permit the automatic monitoring of blood pressure in a patients normal life, health professionals are able to have blood pressure values over 24 hours, as well as the possibility of average blood pressure values over a requested period, such as the day or the night.     

Measurement of arm blood pressure using different oscillometry manometers compared to auscultatory readings

Five different semiautomatic manometers were tested, where oscillometry is the measuring principle. Three of the manometers (Omron R4, A&D UB 322 and Braun) were wrist manometers, where the occluding cuff is placed around the volar surface of the wrist. Two of the manometers (A&D UA 777 and Omron M4) measure on the upper arm. The investigation included 72 patients with systolic blood pressure (SBP) ranging between 110 and 200, and diastolic blood pressure (DBP) between 62 and 114 mmHg. Forty-five of the subjects were on antihypertensive medication when the manometer tests were carried out. Each of the manometers was tested with double measurements of blood pressure against 2 × 2 auscultatory measurements done before and after the semiautomatic readings. The auscultatory measurements are all performed by the same observer, who was blinded for the measurements with semiautomatic manometers. The mean difference between the oscillometric recordings compared to auscultatory measurements varied from +1.2 to -8.5 mmHg for SBP and from -0.5 to -8.3 mmHg for DBP. However, the interindividual differences varied considerable with standard deviation of the difference varying from 8 to 18 mmHg for SBP with the highest values for wrist manometers. Concerning DBP, the standard deviation of difference for all five manometers was between 6 and 8 mmHg, with the highest values for wrist manometers. None of the tested manometers fulfilled the criteria for grading A or B in the previously introduced grading by the British Hypertension Society. To conclude, the upper-arm manometers have a measuring accuracy for SBP a little higher than that of the wrist manometers, while there is no bigger difference in the measuring accuracy of DBP. The most important point is that the measuring accuracy in a single patient is unpredictable. If home readings are prepared, a test of the accuracy against auscultatory recordings should be done in every single patient. In the clinical wards, it is important to be aware of the measuring accuracy if oscillometric measurements are introduced replacing auscultatory measurements.     

Association between B‐type natriuretic peptide and within‐visit blood pressure variability

Background

Blood pressure variability (BPV) has been shown to predict cardiovascular events. Within‐visit BPV is the simplest and easiest measure of BPV, but previous studies have shown conflicts as to whether within‐visit BPV correlates with target organ damage. We aimed to evaluate whether within‐visit BPV correlates with B‐type natriuretic peptide (BNP) in a general population.

Hypothesis

Within‐visit BPV correlates with BNP in a general population.

Methods

This was a cross‐sectional study that included 633 individuals, randomly selected, age 45 to 99 years, registered in the primary care program from an urban medium‐sized town. Patients were scheduled for a single‐day visit that consisted of clinical evaluation and laboratory tests. Three blood pressure (BP) readings, 1 minute apart, were done, and within‐visit BPV was determined as the coefficient of variation (CV) of the 3 BP measures. Our main outcome was to correlate BNP and within‐visit BPV. A multivariable model was estimated using a generalized linear model to evaluate the independent effects of different variables on BNP levels.

Results

The median age was 57 years. Median BNP was 16 pg/mL, and the median systolic and diastolic BP‐CV were, respectively, 3.9% and 3.5%. There was a weak but positive correlation between BNP and both systolic BP‐CV and diastolic BP‐CV (r = 0.107 and P = 0.007 and r = 0.092 and P = 0.019, respectively). In multiple regression equation, systolic BP, diastolic BP‐CV, body mass index, and estimated glomerular filtration rate were associated with BNP.

Conclusions

In the present study, there was a positive, albeit weak, correlation between within‐visit BPV and BNP. In addition, diastolic BPV was associated with BNP even after adjustment for multiple confounders.     

急性出血性脑卒中患者动态血压特征及与预后的关系

目的研究急性出血性脑卒中患者入院7天内动态血压变化规律以及血压变化对预后的影响。方法入选141例急性新发出血性脑卒中患者,连续监测患者7天的24 h动态血压,采集每2 h奇数时点的血压值。收集患者相关临床资料,采用患者入院30天后的格拉斯哥预后评分(glasgow outcome scale,GOS)判断预后,GOS评分4~5分记为预后好组,GOS评分1~3分记为预后差组。分析患者入院收缩压(SBP)和舒张压(DBP)、7天白天SBP和DBP均值、7天夜间SBP和DBP均值及7天昼夜节律变化等与患者预后的关系。结果急性新发出血性脑卒中患者7天内24 h血压均呈逐渐下降的趋势,两组第7天24 h血压均值比第1天血压均值有明显的下降(P0.05),多因素分析显示入院24 h平均SBP高、入院格拉斯哥评分(glasgow coma scale,GCS)低、入院白细胞高、出血量多、基底节出血是出血性脑卒中患者近期不良预后的危险因素(P0.05)。结论急性出血性脑卒中患者7天各种血压指标在预后差组中偏高。患者入院时病情严重,基底节出血量大,入院第1天的平均24 h SBP高对患者的近期不良预后影响较大,重视急性期24 h血压监测尤其是凌晨的血压变化,并积极控制患者的血压和出血量有利于改善患者的预后。     

动态血压监测在评价慢性肾脏病合并高血压患者血压达标中的价值

目的 比较动态血压及诊室血压评价慢性肾脏病（CKD）合并高血压患者血压达标率的差异。方法 选取2012年5月～2013年2月在中南大学湘雅三医院就诊的225例慢性肾脏病合并高血压患者。收集并分析研究对象的人口学、实验室检查及血压资料。结果 （1） 诊室血压监测和动态血压监测均随着肾功能恶化,血压达标率下降。其中诊室收缩压达标率CKD5期较CKD1～2期下降有统计学意义（18.3%比36.6%,P<0.05）,动态血压监测平均血压、日间收缩压、夜间血压达标率CKD5期较CKD1～2期下降均有统计学意义（P<0.05）。（2） CKD1～2期患者动态血压高血压检出率高于诊室血压高血压检出率（79.6%比61.3%,P0.038）,而CKD5期患者动态血压高血压检出率低于诊室血压高血压检出率（83.5%比93.0%,P0.029）。结论 （1） 随着肾功能恶化,CKD合并高血压患者血压达标率逐渐降低;（2）仅使用诊室血压评价CKD患者血压是否达标及昼夜血压达标情况存在不当,推荐CKD合并高血压患者使用动态血压监测。     

血压变异性与女性冠心病的相关分析

目的　探讨诊室血压正常的患者夜间血压负荷增加对女性冠状动脉硬化的影响。方法　选择诊室血压正常的女性患者190例,每个患者进行血总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖、糖化血红蛋白、体质指数、动态血压测定及冠状动脉造影检查,根据冠状动脉造影结果分为冠心病组（n＝98）和对照组（n＝92）。结果　女性冠状动脉狭窄与夜间血压变异性（OR＝1.446,95%CI　1.163～1.798）、夜间收缩压均值的升高（OR＝3.630,95%CI　2.954～4.311）及夜间收缩压血压负荷（OR＝1.314,95%CI　1.151～1.500）及舒张压血压负荷（OR＝2.086,95%CI　1.344～3.237）的增加呈正相关（P<0.05）。结论　夜间血压变异性增大、夜间血压负荷增加与冠状动脉狭窄相关。     

Situational Anxiety and Blood Pressure Lability in the Physician's Office

In order to evaluate the association between situational anxiety levels and blood pressure variability during physician's office visits, 19 patients were assessed at the beginning of the visit and before and after being examined by the physician. Assessment included blood pressure measurement as well as self-report of current anxiety level. Previous findings that systolic readings do significantly diminish over the course of the visit were replicated for both hypertensive and normotensive patients, accompanied by correlative decreases in state anxiety. Diastolic blood pressure readings were more stable and less associated with fluctuations in state anxiety, except in patients with initially higher diastolic readings. Results were interpreted as indicating the importance of using more than one blood pressure measurement in diagnosing hypertension and monitoring its management. In particular, patients’ anxiety responses upon entering the examining room may produce artificial elevations.     

血压正常高值者动态血压负荷及血压变异性与肿瘤坏死因子α的相关性

目的探讨血压正常高值者动态血压负荷及血压变异性与肿瘤坏死因子α(TNF-a)的关系。方法选择理想血压者100例,血压正常高值者105例,高血压患者110例,进行24 h动态血压监测,分别计算三组动态血压负荷及血压变异性,并测定TNF-a水平。结果血压正常高值组TNF-a水平、24 h、白昼及夜间动态血压负荷高于理想血压组,低于高血压组(P<0.01)。血压正常高值组24 h、白昼及夜间血压变异性高于理想血压组,24 h及白昼收缩压变异性、24 h及夜间舒张压变异性低于高血压组(P<0.05)。Pearson相关分析及多元逐步线性回归分析显示,血压正常高值组TNF-α与24 h收缩压负荷、24 h舒张压负荷、24 h收缩压变异性、白昼收缩压负荷、夜间舒张压负荷、夜间收缩压变异性呈正相关(P<0.05),24 h收缩压负荷及变异性、夜间收缩压负荷及变异性是TNF-α的影响因素(P<0.01)。结论血压正常高值者动态血压负荷及血压变异性与TNF-α相关,高血压早期炎症与血压升高有关。     

Interest of home blood pressure measurements (HBPM) to establish degree of hypertensive control

Aims: To establish the validity and clinical value of home blood pressure measurements (HBPM) in the treatment follow-up of patients with essential hypertension to rule out or to confirm poor control of blood pressure obtained in the doctor's office with a mercury sphygmomanometer. Material and methods: Observational, cross-sectional study was carried out to validate HBPM in treated hypertensive patients poorly controlled by office-based casual blood pressure measurements. Measurements were made on 2 consecutive days with six readings taken per day. To do this, 2 × 2 tables were drawn up to validate the HBPM using ABPM as the reference method. Sensitivity (S), specificity (Sp), positive probability quotient (+PQ) and negative probability quotient (-PQ) were calculated. The study population (n = 149) was selected by consecutive sampling of the hypertensive patients seen in the Vallada Health Centre. Only 124 patients could be evaluated. Results: Values obtained with HBPM were: S 97.3% (95% CI 90.4-99.7%), Sp 62.7% (48.1-75.9%), +PQ 2.61 (1.82-3.73) and -PQ 0.04 (0.01-0.71). Conclusions: Home monitoring of blood pressure is a useful alternative to ABPM to rule out office-based poor control of hypertensive patients, but not to confirm it.