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European Journal of Heart Failure 2005 7(2):149-156; doi:10.1016/j.ejheart.2004.05.010
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© 2005 European Society of Cardiology

Ambulatory blood pressure monitoring in heart failure: a systematic review

Deepak Goyala, Robert J. Macfadyena, Robert D. Watsonb and Gregory Y.H. Lip*,a

a University Department of Medicine, Sandwell and West Birmingham NHS Trust, City Hospital Dudley Road, Birmingham B18 7QH, UK
b Department of Cardiology, Sandwell and West Birmingham NHS Trust, City Hospital Birmingham B18 7QH, UK

* Corresponding author. Tel.: +44-121-5075080; fax: +44-121-5544083. E-mail address: g.y.h.lip{at}bham.ac.uk


  Abstract

Ambulatory blood pressure monitoring has established its use in the definition of white coat hypertension and monitoring of treatment of essential hypertension. Any role for ambulatory blood pressure monitoring in heart failure is not well defined. However, from the limited studies available, ambulatory blood pressure monitoring may be used to optimise heart failure therapy, and as a prognosis marker in this patient group.

Most studies that have examined the circadian pressure profile have found blunting of decline of blood pressure during sleep in patients with heart failure. In advanced heart failure, this may be due to hypoperfusion of vital organs partly due to pump failure and partly due to multiple drug therapy associated with the treatment of heart failure. Ambulatory blood pressure monitoring may also clarify hypoperfusion effects on vital organs in individual patients and improve the risk/benefit ratio of treatments in advanced heart failure. Prospective controlled studies on the impact of treatments on circadian blood pressure profile in congestive heart failure patients are needed.

Key Words: Ambulatory blood pressure • Congestive heart failure • Angiotensin-converting enzyme inhibitors • Circadian variation • Non-dippers

Received March 24, 2004; Accepted May 27, 2004


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