Comparison of Office, Home, and Ambulatory Blood Pressure in Heart Transplant Recipients

BackgroundThe purpose of this study was to prospectively evaluate the relationship between office, home, and ambulatory blood pressure (BP) in heart transplant recipients.Methods and ResultsThe study enrolled 30 adults ≥6 months after heart transplantation. Morning seated office BP was measured with the use of an automatic device at 3 outpatient visits. Seated home BP was measured in the morning and evening for 5 consecutive days. Ambulatory BP was measured over 24 hours with the use of a Spacelabs monitor. The strongest correlation was observed between home and 24-hour ambulatory BP (r = 0.79 systolic; r = 0.72 diastolic). Office and home systolic BPs were significantly lower than daytime ambulatory BP (office, −3.7 mm Hg, P = .009; home, −2.6 mm Hg, P = .05). Ambulatory monitoring identified more participants with BP above hypertensive limits than did office or home measurements (63%, 50%, and 13%, respectively; P = .003). Ambulatory monitoring also revealed high BP loads, abnormal nocturnal BP patterns (eg, 30% nondippers), and a high percentage of masked hypertension (37% home, 50% ambulatory).ConclusionsOffice and home BP monitoring are acceptable but may underestimate BP burden in heart transplant recipients. Additional studies are needed to determine which BP method is superior for the management of hypertension and associated outcomes after heart transplantation.