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Titolo:
Ambulatory blood pressure in heart failure
Autore:
Jamieson, MJ; Jamieson, C;
Indirizzi:
Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78249 USA Univ Texas San Antonio TX USA 78249 Pharmacol, San Antonio, TX 78249 USA
Titolo Testata:
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
, volume: 31, anno: 2001, supplemento:, 2
pagine: 18 - 25
SICI:
0014-2972(2001)31:<18:ABPIHF>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYPERTENSION-SOCIETY PROTOCOL; CIRCADIAN VARIATION; DIURNAL-VARIATION; MEASURING DEVICES; VARIANT ANGINA; NON-DIPPERS; INHIBITOR; STANDARD; RHYTHMS; ACE;
Keywords:
ambulatory blood pressure; heart failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Jamieson, MJ Univ Texas, Hlth Sci Ctr, Dept Pharmacol, 7703 Floyd Curl Dr,San Antonio,TX 78249 USA Univ Texas 7703 Floyd Curl Dr San Antonio TX USA 78249 49 USA
Citazione:
M.J. Jamieson e C. Jamieson, "Ambulatory blood pressure in heart failure", EUR J CL IN, 31, 2001, pp. 18-25

Abstract

Ambulatory blood-pressure monitoring (ABPM) is accepted in the evaluation and management of hypertension. The use of ABPM in heart failure has received considerably less attention. Many patients with advanced heart failure experience disabling fatigue, orthostatic dizziness and symptoms of coronaryand cerebrovascular insufficiency that may relate to periods of hypotension. These may be exacerbated by vasodilator drug therapy and may be difficult to evaluate by casual clinic recordings. ABPM in heart failure may help in the following: (i) evaluating time-dependent pharmacodynamic drug effects, such as peak and end-of-dose phenomena, tolerance and rebound; (ii) titrating ACE inhibitors and other drugs to highest-tolerated doses; and (iii) correlating circadian blood-pressure profiles with symptoms, quality of life, severity of heart failure, progression of ventricular and renal dysfunction, risks of stroke and myocardial infarction, and life expectancy. Devicesfor ABPM have been beset by problems of inaccuracy and unreliability. Standards for their manufacture and sale (including bench tests of accuracy against sphygmomanometry and intra-arterial recordings, and field tests of reliability) have been devised independently by several agencies, including the British Hypertension Society (BHS) and US Association for the Advancementof Medical Instrumentation (AAMI). A joint BHS/AAMI set of guidelines is in preparation. These guidelines emphasize the suitability of ABPM devices for hypertensive patients and those under general anesthesia, and may not beapplicable to ambulant individuals with heart failure and blood pressures at or below the lower end of the evaluated ranges. Prospective studies of the accuracy and reliability of ABPM devices, their clinical utility and research potential should be undertaken in patients with heart failure before their informal and uncontrolled use in this population becomes widespread.

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Documento generato il 28/11/20 alle ore 21:40:02