[Use of 48-hour ABPM in specialist care. Experience in our centre]

Abstract

Ambulatory blood pressure monitoring (ABPM) is a basic tool in the diagnosis and treatment of hypertension (HT). Validity is based on the number of readings taken and their duration. Our aim was to study in our 48-hour ABPM series whether extending the duration of ABPM to 48 hours is justified.

Material and methods: Retrospective analysis of a case series comprising 81 patients with 48-hour ABPM over a 5-year period (2013 to 2018). We analysed the differences between the first and second day.

Results: Eighty-one patients, 44 men, mean age of 52 years (± 18). The mean blood pressure (BP) was higher on the first day (132/77 mmHg vs. 130/76 mmHg, p ≤ .01) and there was also a greater proportion of patients with HT on the first day (59 vs. 50%; p ≤ .05). The patients with chronic kidney disease (CKD) (n = 33) had higher systolic BP (SBP) on the second night (p ≤ .05), a circadian rhythm of higher risk on the second day (dipper 13.6 vs. 86.4%, non-dipper 60.7 vs. 41.7%, and riser 30.3 vs. 18.8%; p ≤ .05), more diabetes (39%, p ≤ .01) and more left ventricular hypertrophy (LVH) (74%, p ≤ .05).

Conclusions: 48-hour ABPM could determine BP readings and circadian rhythm better than 24-hour ABPM, especially in patients with CKD and diabetes, both diseases carrying high cardiovascular risk.

Keywords: Ambulatory blood pressure monitoring; Chronic kidney disease; Enfermedad renal crónica; Hipertensión arterial; Hypertension; Monitorización ambulatoria de la presión arterial.