Is near basal blood pressure a more accurate predictor of cardiorenal manifestations of hypertension than casual blood pressure?

Measurement of casual and near basal systolic and diastolic blood pressures were correlated with the severity of cardiorenal manifestations of hypertension in 471 patients. There was a significant association of each of the four blood pressure measurements with each other (P < 0.001). Systolic blood pressure and mamfestations of hypertension increased with age. Blacks had higher blood pressures and more manifestations than whites. All four blood pressure measurements were significantly associated (r 2 0.78. P -c 0.0005) with grade 3 fundi. proteinuria and casts in the urme. electrocardiographic left ventricular hypertrophy. cardiomegaly by chest X-ray and aortic dilatation and/or elongation by chest X-ray. The /er~I of blood pressure is rhe important correlate of these manifestations of hypertension. This is equally true whether systolic, diastolic. casual or near basal measurements are used. Near basal blood pressure does not correlate better with the cardiorenal manifestations of hypertension than casua! blood pressure. neither does diastolic blood pressure correlate better with these manifestations than systolic blood pressure. MANY PATIENTS whose blood pressure is raised in the physician’s office may have normal blood pressure at other times, an observation which is the basis for the traditional distinction between fixed and labile hypertension [l, 23. Some who accept this distinction believe that basal blood pressure is more important in prognosis than casual blood pressure [3,4]. To avoid the inconvenience of hospitalization, near basal readings have been used as an approximation of the basal blood pressure [S]. We compared casual with near basal blood pressure and systolic with diastolic pressure as to indications of the clinical manifestations of hypertension. We found that both casual and systolic blood pressure correlate as well with the manifestations of hypertension as near basal and diastolic blood pressure.