Doctor’s office blood pressure reading not telling the whole story, study reports

Doctor’s office blood pressure reading not telling the whole story, study reports




Last Modified: Nov 29, 2011 12:30PM


Ambulatory blood pressure — not the doctor’s office blood pressure — can best predict the progression of small vessel brain disease and the decline of cognitive function in older people, according to a recent study in Circulation: Journal of the American Heart Association.

Ambulatory blood pressure is measured by monitoring blood pressure at regular intervals using a special recording device under normal living and working conditions. Clinical or in-office blood pressure is taken in a healthcare provider’s office.

“This study showed for the first time in an older population that blood pressure measured over a 24-hour period was associated with the progression of vascular brain disease, whereas the typical office blood pressure was not,” said William B. White, M.D., senior author of the study and professor of hypertension and clinical pharmacology in the Calhoun Cardiology Center at the University of Connecticut School of Medicine in Farmington.

To determine the effect blood pressure had on the progression of brain disease, researchers examined the change in blood pressure and volume of white matter hyperintensities (WMH) in the brain at baseline and after two years.

White matter hyperintensities are a sign of small vessel brain damage that can be detected using an MRI. In addition to looking for WMH, researchers measured cognitive ability and physical mobility over the two-year time period. Previous studies by the authors and other researchers have shown that increased WMH is associated with cognitive decline.

A worsening in ambulatory blood pressure was associated with an increase in WMH and a decrease in cognitive and mobility functions.

If medical professionals target average ambulatory blood pressure, it could reduce the progression of small vessel brain disease, researchers said.

“Interventional studies underway can determine the appropriate level of ambulatory systolic blood pressure for both home and office to prevent the accumulation of cerebrovascular disease in older people,” White said.

RESOURCES

The American Heart Association: http://www.heart.org/

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