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The prevalence and clinical significance of nocturnal hypertension in pregnancy.

2 Verdecchia P, Schillaci G, Borgioni C, Ciucci A, Gattobigio R, Porcellati C.

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 complete report. 1 Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure National Heart, Lung, and Blood Institute National High Blood Pressure Education Program Coordinating Committee.In obese patients and children, the use of an appropriate cuff size is of paramount importance. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. They have the advantage of being able to take multiple measurements. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. Hybrid devices that use electronic transducers instead of mercury have promise. Aneroid devices are suitable, but they require frequent calibration.

The use of mercury is declining, and alternatives are needed. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. Customer Service and Ordering InformationĪccurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure–related risk, and to guide management.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).

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