Isolated office hypertension:: are there any markers of future blood pressure status?

Background The introduction of ambulatory blood pressure monitoring into clinical practice has defined a clinical condition called 'isolated office hypertension'. Objective The aim of this study was to evaluate the long-term systolic and diastolic blood pressure changes in patients with isolated office hypertension and to identify the presence of markers capable of identifying which patients will develop sustained hypertension. Methods All the 407 patients enrolled had a random office systolic or/and diastolic blood pressure of over 140/90 mmHg and a mean daytime ambulatory blood pressure of 130/84 mmHg or less. At enrolment, each patient underwent a 'baseline examination' made up of a physical evaluation, a 24 h ambulatory blood pressure monitoring, and a mental arithmetic test performed at the end of the 24 h ambulatory monitoring. Results Of the 173 patients finally studied, 102 (58.9%) developed sustained hypertension with an increase in both ambulatory systolic and diastolic blood pressure. At the time of the baseline examination, the patients were divided into two groups. Group A included patients with mean ambulatory systolic and diastolic blood pressures in the first hour of 130/84 mmHg or teas; group B included patients with mean ambulatory systolic and diastolic pressures in the first hour of greater than 130/84 mmHg. During the mental arithmetic test, the systolic and heart rate values increased significantly only in group B patients. Of the 102 patients who had become hypertensive by the time of the follow-up examination, 84 (82%) belonged to group B. Conclusion These data suggest that isolated office hypertension may indeed be a transitional state towards the development of sustained hypertension. Moreover, the mean ambulatory blood pressure value during the first hour can be considered to be a marker of a higher risk of developing sustained hypertension. Blood Press Monit 5:249-254 (C) 2000 Lippincott Williams & Wilkins.