Advice from the BP Measurement Experts
This year marked the 23rd scientific meeting of the European Society of Hypertension (ESH) on "Hypertension and Cardiovascular Protection". While the ESH annual meeting is always filled with the latest in hypertension research, this year's highlight was the presentation of the newest edition of the ESH/ESC (European Society of Cardiology) Guidelines for the management of arterial hypertension.
The presentation was held at the end of a full day of sessions, and on a Saturday. But that did not affect attendance; the auditorium was full, including all standing room. Many people were watching in overflow areas and the presentation was broadcast live via the ESH conference website for those interested from around the globe.
So what is new? The key highlights for me were mainly related to recommendations surrounding BP measurement. First, the guidelines related to Home BP Monitoring (HBPM) were strengthened to include a section on its prognostic significance.
"ABPM and HBPM provide somewhat different information on the subject's BP status"Also included in this section is the mention of several studies comparing HBPM to Ambulatory BP Monitoring (ABPM) to show that HBPM has similar prognostic significance. Ultimately the guidelines suggest that "ABPM and HBPM provide somewhat different information on the subject's BP status and risk and the two methods should be regarded as complementary rather than competitive or alternative."
Secondly, the instructions for correct in-office BP measuremet were updated. The guidelines now include the recommendation that averaging should be considered when taking multiple measurements. Additionally, taking repeated measurements in patients with arrythmias, such as atrial fibrulation, will improve accuracy. Finally, suspected hypotensive patients should have additional readings taken at 1 and 3 minutes (adjusted from 5 minutes) after standing.
Of course these do not cover the bredth of changes included in the 2013 ESH/ESC guidelines. The full publicaiton can be read here: http://www.esh2013.org/esh-esc-new-guidelines-on-hypertension.
There is also a section upfront with a summary of the major differences from the 2003 and 2007 guidelines to help make it easier to navigate. Happy reading!