[Diagnosis of early hypertension with continuous ambulatory blood pressure monitoring].

Characteristics of a 24-hour blood pressure monitoring and its usefulness in the diagnosis of early hypertension have been discussed. Measurements of ambulatory blood pressure in normotensive individuals are lower than those achieved with continuous monitoring at daytime whereas the situation in hypertensive subjects is reverse. Office blood pressure measurements produce higher values already in borderline hypertension and may use as differentiating diagnostic parameter. Continuous blood pressure monitoring enables to detect "white coat hypertension" estimated to occur in 7% of the general population and in 21% of patients with mild hypertension. Even a few hours of the continuous blood pressure monitoring identifies subjects with "white coat hypertension" and office hypertension and consequently avoidance of the unnecessary pharmacologic treatment. Ambulatory blood pressure monitoring is also useful in the diagnosis of early hypertension in adolescents provided that the tests will be carried out during school hours. Some investigators believe that the proportion of abnormal measurements (over 140/90 mm Hg), i.e. so-called blood pressure load, is more important at early stages of the disease because there closer correlation between blood pressure and organ damage than mean values of blood pressure. However, it was not established yet what is a percentage of abnormal blood pressure measurements in normotensive and hypertensive subjects. Blood pressure circadian rhythm in various groups but the highest changes are found in borderline hypertension. Blood pressure variability expressed as standard deviations from the mean values calculated from the ambulatory blood pressure monitoring is an individual feature considered also as a predictor of hypertension development with all its sequelae.