Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics (Contemporary Cardiology)

Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics provides information that will be especially useful to all who care for hyperten­ sive patients. The various chapters provide a full account of the mounting sci­ entific evidence that blood pressure recordings need to be obtained for proper diagnosis, prognosis, and therapy for these patients. The contributors are each directly involved in clinical studies ofhome and ambulatory blood pressure moni­ toring, as well as of the relationship of circadian variations in heart rate and blood pressure to cardiovascular events. As a longtime observer of the multiple facets of clinical hypertension, I have been greatly impressed with the rapid advances in this area over the last two decades. Out-of-office blood pressure monitoring has grown from a curi­ osity to a necessity. In order to improve the currently inadequate control of hypertension throughout the world, such monitoring should become routine in the diagnosis and treatment of every patient. The evidence for the role of out-of-office monitoring that is so well described in Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics should serve as a stimulus for the more widespread adoption of the procedure. Once this is understood, the constraints on the broader clinical use of ambulatory monitoring that now exist in the United States will be lifted as the value of such information becomes more generally recognized. In the meantime, self-recorded home measurements should be more widely utilized. Foreword / Norman M. Kaplan -- Pt. I. Techniques For Out-of-office Blood Pressure Monitoring -- 1. Self-monitoring Of Blood Pressure / Thomas G. Pickering -- 2. Evaluation Of Journals, Diaries, And Indexes Of Worksite And Environmental Stress / Gary D. James -- 3. Electronic Activity Recording In Cardiovascular Disease / George A. Mansoor -- 4. Ambulatory Monitoring Of The Blood Pressure: Devices, Analysis, And Clinical Utility / Yusra Anis Anwar And William B. White -- Pt. Ii. Concepts In The Circadian Variation Of Cardiovascular Disease -- 5. Circadian Rhythm And Environmental Determinants Of Blood Pressure Regulation In Normal And Hypertensive Conditions / Francesco Portaluppi And Michael H. Smolensky -- 6. Circadian Variation Of The Blood Pressure In The Population At Large / Hilde Celis And Jan A. Staessen -- 7. Importance Of Heart Rate In Determining Cardiovascular Risk / Paolo Palatini -- 8. Sodium, Potassium, The Sympathetic Nervous System, And The Renin-angiotensin System: Impact On The Circadian Variability In Blood Pressure / Domenic A. Sica And Dawn K. Wilson -- 9. Prognostic Value Of Ambulatory Blood Pressure Monitoring / Paolo Verdecchia And Giuseppe Schillaci -- 10. Circadian Rhythm Of Myocardial Infarction And Sudden Cardiac Death / Craig A. Chasen And James E. Muller -- 11. Seasonal, Weekly, And Circadian Variability Of Ischemic And Hemorrhagic Stroke / Tudor D. Vagaonescu, Robert A. Phillips And Stanley Tuhrim -- Pt. Iii. Twenty-four-hour Blood Pressure Monitoring And Therapy -- 12. Cardiovascular Chronobiology And Chronopharmacology: Importance Of Timing Of Dosing / Bjorn Lemmer -- 13. Advances In Ambulatory Blood Pressure Monitoring For The Evaluation Of Antihypertensive Therapy In Research And Practice / William B. White. Edited By William B. White. Includes Bibliographical References And Index. New research findings based on ambulatory and self-monitoring of blood pressure and heart rate have signaled the maturation of cardiovascular chronobiology and led to marked improvements in the physician's ability to detect various clinical entities in those patients suffering from hypertension and vascular diseases. In Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics, William B. White, MD, and a panel of highly experienced clinicians critically review every aspect of out-of-office evaluation of blood pressure, including home and ambulatory pressure, the relationship between whole-day blood pressure and the cardiovascular disease process, and the effects of numerous antihypertensive therapies on these blood pressure parameters. The world-class opinion leaders writing here describe all the significant advances in our understanding of the circadian pathophysiology of cardiovascular disorders and demonstrate that ambulatory blood pressure values are independent predictors of cardiovascular morbidity and mortality. They also discuss the methodology of out-of-office blood pressure monitoring, its potential in clinical trials and the general management of patients, and its usefulness during antihypertensive drug development. Comprehensive and leading-edge, Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics provides a ground-breaking demonstration of the importance of home and ambulatory blood pressure monitoring that is already being rapidly translated into better care for millions of hypertensives today Although elderly hypertensive patients are the subjects of the largest body of outcomes trial data, as a group they are not getting the maximum benefit from antihypertensive medications. In Hypertension in the Elderly, a panel of leading academic physicians comprehensively reviews all aspects of this problem using the most current clinical data. Topics range from basic concepts, epidemiology and trials, and evaluation and management, to pharmacological treatment, special populations, and adherence, all presented with an emphasis on the optimal management of patients. The authors examine in detail the mechanisms of hypertension in the elderly, particularly age-related changes in vascular stiffness, and methodically review the lifestyle and outcomes trials that were conducted in older persons. The problems of clinical evaluation, secondary hypertension, and target organ damage are also fully addressed, and a practical approach is provided for correctly determining blood pressure, one of the most important tasks in evaluating an older patient. Extensive discussions of pharmacological therapy detail the role of individual drug classes, including diuretics and [beta]-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium antagonists, [alpha]-I blockers, and combination drug therapies. Additional chapters focus on special populations, such as African Americans, patients with diabetes, and patients with arthritis, as well as on the clinician's role in improving therapeutic adherence in older patients Front Matter....Pages i-xvi Front Matter....Pages 1-1 Self-Monitoring of Blood Pressure....Pages 3-27 Evaluation of Journals, Diaries, and Indexes of Worksite and Environmental Stress....Pages 29-44 Electronic Activity Recording in Cardiovascular Disease....Pages 45-56 Ambulatory Monitoring of Blood Pressure....Pages 57-75 Front Matter....Pages 77-77 Circadian Rhythm and Environmental Determinants of Blood Pressure Regulation in Normal and Hypertensive Conditions....Pages 79-138 Circadian Variation of the Blood Pressure in the Population at Large....Pages 139-158 Importance of Heart Rate in Determining Cardiovascular Risk....Pages 159-170 Sodium, Potassium, the Sympathetic Nervous System, and the Renin—Angiotensin System....Pages 171-189 Prognostic Value of Ambulatory Blood Pressure Monitoring....Pages 191-218 Circadian Rhythm of Myocardial Infarction and Sudden Cardiac Death....Pages 219-241 Seasonal, Weekly, and Circadian Variability of Ischemic and Hemorrhagic Stroke....Pages 243-252 Front Matter....Pages 253-253 Cardiovascular Chronobiology and Chronopharmacology....Pages 255-271 Advances in Ambulatory Blood Pressure Monitoring for the Evaluation of Antihypertensive Therapy in Research and Practice....Pages 273-298 Back Matter....Pages 299-309 This work covers circadian variation in cardiovascular disease, with an emphasis on hypertension. New techniques in the monitoring of blood pressure and heart rate have led to marked improvements in our ability to detect various clinical entities, and this is discussed in great detail. Although the monitoring of antihypertensive treatment is usually performed using blood pressure readings made in the physician's office and having a blood pressure check is by far the commonest reason for visiting a physician, it is neither a reliable nor an efficient process.