0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

ABPM Is Valuable for the Management of Hypertension

Lawrence R. Krakoff, MD; Thomas Pickering, MD, DPhil; Robert Phillips, MD, PhD
Arch Intern Med. 2002;162(13):1528-1530. doi:.
Text Size: A A A
Published online

Extract

Both the article by Grandi et al1 showing that patients with IOH, or white-coat hypertension, had increased left ventricular mass and the accompanying editorial2 recommending that patients with IOH should be given medication misrepresent the relationship between ABPM and echocardiographic assessment of left ventricular mass as found in many larger and better-designed studies. Furthermore, Dr Moser's extrapolation of the results of this single study1 to long-term outcomes avoids the central issue: which assessments of BP best predict future cardiovascular morbidity and mortality and provide some basis for selecting treatment? Abundant epidemiologic surveys indicate that the long-term average BP, corrected for regression dilution, is the best predictor of risk.3 Short-term measurement of office BPs, especially when they are near cutoff points for normal, all too often result in a false-positive diagnosis of hypertension.4 Hence, supplemental BP readings, taken at home with reliable methods or with ABPM, provide more precise averages. These BP readings are better correlated with future cardiovascular mortality and morbidity than are clinic BP readings.5,6 These less biased and more accurate measurements should be the basis for treatment, especially in younger subjects (as in Grandi and colleagues' study), who have nothing to gain from antihypertensive drug treatment in the immediate future.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

July 8, 2002
Marvin Moser, MD
Arch Intern Med. 2002;162(13):1531-1532. doi:.
July 8, 2002
Anna M. Grandi, MD; Achille Venco, MD
Arch Intern Med. 2002;162(13):1530-1531. doi:.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Scenario

Users' Guides to the Medical Literature
Example 1: Diabetes and Target Blood Pressure

brightcove.createExperiences();