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Should ambulatory blood pressure monitoring be mandatory for future studies in resistant hypertension: a perspective

Doumas, Michaela; Anyfanti, Panagiotab; Bakris, Georgec

doi: 10.1097/HJH.0b013e328352c3c7

Recent technologic advances rekindled interventional management of resistant hypertension, either by carotid baroreceptor activation or renal sympathetic denervation. Interventional techniques result in impressive falls in office blood pressure (BP); however, ambulatory BP reductions are rather modest. This disparity between office and ambulatory BP reductions is observed with antihypertensive drugs, but at a much lower degree. Available explanations are not convincing, therefore, we propose that sympathetic overactivity may partially explain this divergence. Further studies are needed to prove or disprove our hypothesis.

aHypertension Unit, Veterans Affairs Medical Centre, George Washington University, Washington, District of Columbia, USA

bHypertension Unit, Second Prop Department of Internal Medicine, Aristotle University, Thessaloniki, Greece

cHypertensive Diseases Unit, University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA

Correspondence to Michael Doumas, Hypertension Unit, Veterans Affairs Medical Centre, George Washington University, 50 Irving Street NW, Washington, DC 20422, USA. Tel: +1 202 745 8334; fax: +1 202 745 8636; e-mail:

Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; OSA, obstructive sleep apnea; RSD, renal sympathetic denervation

© 2012 Lippincott Williams & Wilkins, Inc.