Accuracy, reproducibility and usefulness of ambulatory blood pressure recording obtained with the Remler system

Summary

The Remler M2000, a portable semi-automatic blood pressure recorder, was used to measure ambulatory blood pressure during customary daily activities of normotensive and hypertensive subjects. Systolic and diastolic pressures measured simultaneously by this device and by the conventional auscultatory method were closely related throughout the day, after an acute physical exercise as well as at rest. In unselected, untreated subjects, the average of the recorded pressures was most often lower than pressures measured in the office, but ambulatory pressures could not be predicted from office readings. There was a highly significant correlation between pressure levels determined at a 3 to 4 month interval with both the conventional auscultatory method in the office and the Remler system. In hypertensive patients who were either untreated or treated chronically with beta-blocking agents, diuretics or a combinaton of both drugs, a clear diurnal variation of blood pressure was revealed by the ambulatory recordings, the lowest levels being reached in the early afternoon. Neither this diurnal variation nor blood pressure variability was influenced by antihypertensive therapy. The Remler system was also used to evaluate blood pressure outside the physician’s office in untreated subjects considered by their physician to be hypertensive. The average of blood pressures recorded during the usual daily activities of the subjects were > 140 mmHg for the systolic and > 89 mmHg for the diastolic in only 39% and 44% of them, respectively. Thus, the Remler system provides accurate, reproducible blood pressure profiles in the ambulatory state which are not predictable based on office blood pressure measurements. It seems particularly useful for identifying those patients who, although hypertensive in the physician’s office, remain normotensive during usual daily activities.