Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network

Jinho Shin*, Kazuomi Kario, Yook Chin Chia, Yuda Turana, Chen Huan Chen, Peera Buranakitjaroen, Romeo Divinagracia, Jennifer Nailes, Satoshi Hoshide, Saulat Siddique, Jorge Sison, Arieska Ann Soenarta, Guru Prasad Sogunuru, Jam Chin Tay, Boon Wee Teo, Yu Qing Zhang, Sungha Park, Huynh Van Minh, Tomoyuki Kabutoya, Narsingh VermaTzung Dau Wang, Ji Guang Wang

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

Abstract

Ambulatory blood pressure monitoring (ABPM) can measure 24-hour blood pressure (BP), including nocturnal BP and diurnal variations. This feature of ABPM could be of value in Asian populations for preventing cardiovascular events. However, no study has yet investigated regarding the use of ABPM in actual clinical settings in Asian countries/regions. In this study, 11 experts from 11 countries/regions were asked to answer questionnaires regarding the use of ABPM. We found that its use was very limited in primary care settings and almost exclusively available in referral settings. The indications of ABPM in actual clinical settings were largely similar to those of home BP monitoring (HBPM), that is, diagnosis of white-coat or masked hypertension and more accurate BP measurement for borderline clinic BP. Other interesting indications, such as nighttime BP patterns, including non-dipper BP, morning BP surge, and BP variability, were hardly adopted in daily clinical practice. The use of ABPM as treatment guidance for detecting treated but uncontrolled hypertension in the Asian countries/regions didn't seem to be common. The barrier to the use of ABPM was primarily its availability; in referral centers, patient reluctance owing to discomfort or sleep disturbance was the most frequent barrier. ABPM use was significantly more economical when it was reimbursed by public insurance. To facilitate ABPM use, more simplified indications and protocols to minimize discomfort should be sought. For the time being, HBPM could be a reasonable alternative.

Original languageEnglish
Pages (from-to)384-390
Number of pages7
JournalJournal of Clinical Hypertension
Volume22
Issue number3
DOIs
StatePublished - 1 Mar 2020

Keywords

  • ambulatory blood pressure/home blood pressure monitor
  • Asian patient
  • clinical management of high blood pressure (HBP)
  • cost/economics
  • primary care issues

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