J Chron Dis Vol. 37. No. I, pp. 55-57, 1984 Printed m Great Britain. All rights reserved 0021-9681/84 53.00 + 0.00 Copyright c 1984 Pergamon Press Ltd AMBULATORY BLOOD PRESSURE RECORDING TO IDENTIFY HYPERTENSIVE PATIENTS WHO TRULY NEED THERAPY B. WAEBER, B. JACOT DES COMBES, M. PORCHET, J. BIOLLAZ, M.-D. SCHALLER and H. R. BRUNNER Centre Hospitalier Universitaire, Department of Medicine, Division of Nephrology and Hyper- tension, 101 I Lausanne, Switzerland (Received in revised ,form 15 June 1983) Abstract-Ambulatory blood pressure profiles were obtained with the Remler system, a portable semi-automatic blood pressure recorder, in 245 untreated patients considered by their physician to be hypertensive. The average blood pressures recorded during the usual daily activities of the patients were > 140 mmHg for the systolic and >89 mmHg for the diastolic in only 96 (395;) and 107 (440/,,) of them respectively. Blood pressure monitoring in ambulatory patients appears to be useful for the practitioner to detect those patients who require antihypertensive therapy. Possibly, unnecessary therapy of only seemingly hypertensive patients may be avoided by this technique. INTRODUCTION OVER A period of 4 years, a total of 245 untreated subjects were referred to our outpatient clinic for evaluation of their ambulatory blood pressure with the Remler system, a portable semi-automatic blood pressure recorder [l]. All of them were considered to be hypertensive by their physician on the basis of repeated office blood pressure readings. This work reports the blood pressure results obtained in these patients. PATIENTS AND METHODS Of the 245 untreated patients, 157 were male and 88 female. Their age averaged 40.2 and ranged from 15 to 81 years. In all of them, systolic blood pressures of > 140 mmHg and/or diastolic pressure levels of > 89 mmHg had been measured on at least 3 different occasions by a practicing physician with the patient in the seated position. The patients were asked to report to our clinic between 7.30 and 8.30 a.m. At that time, an experienced nurse fitted the portable, semi-automatic blood pressure recorder (Remler M 2000, Remler Corp., San Francisco, CA). This apparatus consists mainly of a standard, patient inflatable arm cuff, a microphone, a pressure transducer and a tape recorder. The two latter are contained in a case weighing 0.7 kg which is attached to the belt of the patient. During blood pressure recording which is initiated by inflation of the cuff, the patients were instructed to remain still and to keep their arm extended in a comfortable position. In the clinic, 3 blood pressure readings in the sitting position were determined simultaneously with the recorder and by direct auscultation, via a mercury column temporarily connected with Y hook-up to the inflation system. After leaving the clinic, the patients were asked to record their blood pressure at 30 min intervals for 12 hr (in supine, sitting or upright posture) while they pursued their usual daily activities. During this day, the patients kept a diary recording position, physical exercise and mental state at time of blood pressure All correspondence should be addressed to: H. R. Brunner, Dept of Medicine. C.H.U.V.. 101 I Lausanne. Switzerland. 55