Ambulatory blood pressure monitoring is highly sensitive for detection of early cardiovascular risk factors in young adults

Abstract

We evaluated the appropriateness of 24-h ambulatory blood pressure (BP) monitoring to detect prehypertensive conditions in apparently healthy siblings of patients with premature cardiovascular disease (CVD). We performed office blood pressure measurements and 24-hour ambulatory blood pressure monitoring in 30 young adults (mean age 26 ± 3 years), whose parents have experienced premature CVD, and 30 control subjects (mean age 26 ± 3 years) with a negative family history of CVD. Positive parental CVD history group had significantly higher mean values of 24-h systolic BP (123 ± 10 mm Hg vs. 118 ± 6 mm Hg; p = 0.044), daytime systolic (127 ± 12 mm Hg vs. 121 ± 7 mm Hg; p = 0.041) and diastolic BP (77 ± 8 mm Hg vs. 73 ± 4 mm Hg; p = 0.045) as well as 24-h heart rate (71 ± 8 beats/min vs. 67 ± 8 beats/min; p =0.05) and systolic BP load (21 ± 20% vs. 10 ± 11%; p = 0.02) compared to controls. There was no significant inter-group difference in blood pressure measurements obtained by conventional office method. In addition, the study group had a considerably higher diurnal variability of blood pressure and heart rate, which is believed to be contributing to their overall CVD risk. In conclusion, slightly higher levels of blood pressure, blood pressure variability and heart rate are early determinants of higher CVD risk, which can be detected in individuals by using 24-h ambulatory blood pressure monitoring.