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S268 Heart, Lung and CirculationAbstracts 2009;18S:S1–S286

Vascular/Hypertension

61424 HOUR AMBULATORY BLOOD PRESSURE MONI-TORING: A STUDY OF REFERRAL PATTERNS ANDRESULTS

Zoe Johnson, Stuart Cox, Nick Youngs, J.D. Cameron, IanT. Merideth

Monash Cardiovascular Research Centre, MonashHEART andMonash University Department of Medicine (MMC), Mel-bourne, Australia

Background: 24 h ambulatory blood pressure monitor-ing (ABPM) is used to monitor the blood pressure ofpatients for an array of reasons. The aim of this study was toexamine patterns of referral for ABPM in a tertiary referralcentre.

Methods: Indications and results for 428 consecutivepatients over an eighteen-month period were analysed.Patient data included age, gender, initial systolic and dias-tolic values (sitting), taken both manually (blood pressurecuff and stethoscope) and automatically (ABPM monitor).Also recorded was 24 h average diastolic and systolic BPand the percentage of readings that were classed as hyper-tensive (greater than 140/90 during the day and 120/80during the night).

Results: There were eleven general categories of refer-ral, “?hypertension” (58.2%), “hypertension” (12.7%), “?BPcontrol” (12.4%), “labile BP” (4.3%), “white coat hyper-tension” (3.4%), “dizzy episodes” (3.1%), “fluctuating BP”(3.1%), “?hypotension” (1.2%), “potential kidney donor”(.6%), “family history”(.6%) and “?mild hypertension”(.3%).

Men were more commonly referred for “?white coathypertension” (5.9%) then women (1.2%), and morewomen (6.4%) then men (2%) were referred for “labile BP”.For all other reasons there was no sex difference.

Patients referred for “Hypertension” were more likely tobe hypertensive (66.67%) than those referred for “?hyper-tension” (35.8%). Results for ?hypertensive patientsshowed a 13% as white coat hypertension and 8% asmasked hypertension.

Conclusion: The predominant usage of ABPM in ourservice is to confirm clinic blood pressure. A significantnumber of cases of white coat and masked hypertensionwere identified which may otherwise be missed.

doi:10.1016/j.hlc.2009.05.660

61524 HOUR AMBULATORY BLOOD PRESSURE MON-ITORING: ACCURACY OF MONITORS AND THEIMPACT ON PATIENT RESULTS

Zoe Johnson, Stuart Cox, Nick Youngs, J.D. Cameron, IanT. Merideth

Monash Cardiovascular Research Centre, MonashHEART andMonash University Department of Medicine (MMC), Mel-bourne

Background: 24 h ambulatory blood pressure moni-toring (ABPM) is used to monitor the blood pressureof patients for an array of reasons, including hyperten-sion. ABPM is a diagnostic modality able that providesadditional BP information in over and above manualclinic sphygmomanometry. The aim of this study was todetermine level of consistency between manual (cuff andstethoscope) and automatic (24 h ambulatory blood pres-sure monitor) BP readings and further to determine ifany between method difference has the potential to affectpatient management.

Method: Results for 428 patients were tabulated over aneighteen-month period. Patient details examined includedage, gender, initial systolic and diastolic BP (sitting) bothmanual and automatic. Additional information recordedwas 24 h average diastolic and systolic BP and the per-centage of readings classed as hypertensive (greater than140/90 during the day and 120/80 during the night).

Results: The difference between the systolic bloodpressure recorded manually and automatically increasedas the average blood pressure increased. The averagedifference between initial manual and automatic sys-tolic readings was −3.08 mmHg (range −68 to 53 mmHg).The average difference between diastolic readings was−.90 mmHg (range −29 to 59 mmHg). 69.6% of sys-tolic and 79.7% of diastolic differences respectively were>10 mmHg.

For hypertensive initial manual readings 91.4% of auto-matic readings were hypertensive. For hypertensive initialautomatic readings 83.4% were hypertensive.

Conclusion: Discrepancies between manual and ABPMassessment of BP increased as the average blood pres-sure increased however this did not significantly affectinterpretation as patients continued to be classified ashypertensive on standard criteria.

doi:10.1016/j.hlc.2009.05.661