Overview of services offered at the Hypertension Center
Ambulatory blood pressure monitoring
Ambulatory blood pressure monitoring is a very important tool in the diagnosis and evaluation of treatment success in hypertension patients. The daytime average indicates whether hypertension is present, and if so, its level of severity. When interpreting elevated blood pressure readings (> 140/90 mmHg) in the absence of data from controlled studies, clinical hypertension is assumed to be present if 25-30% of the readings are higher than 140/90 mmHg. Studies have shown that ambulatory blood pressure monitoring correlates more closely to cardiovascular prognoses than individual measurements performed in a medical practice. At least 60 evaluable readings within a 24-hour period are required for an assessment.
|Daytime average||< 135/85 mmHg|
|Nighttime average||< 120/75 mmHg|
|24-h average||< 130/80 mmHg|
|Mild hypertension||135-146/85-89 mmHg|
|Moderate hypertension||147-156/90-95 mmHg|
|Severe hypertension||> 157/>96 mmHg|
If an unstable blood pressure response is present, this blood pressure monitoring technique makes it possible to evaluate blood pressure response to everyday stress levels under standardized conditions.
Upper limits for blood pressure response during and after cardiac stress testing:
|Recovery minute 5
Blood pressure telemetry now makes it possible to transmit everyday blood pressure readings to the attending physician so that any required changes to treatment plans can be made more effectively. This guarantees personalized treatment.
Duplex sonography of the renal arteries is currently the best-suited diagnostic method to differentiate between hemohemodynamically relevant (≥ 70 %) and non-relevant stenosis: In unilateral stenosis, a lateral difference of the mean intrarenal resistance (RI) > 0.05 is seen as a reliable sign of a stenosis of at least 70%. In bilateral significant stenosis, however, this parameter is unusable, which is why an extended acceleration period (> 0.07 seconds) of the intrarenal Doppler spectrum must be employed.
MR angiography can provide a fairly accurate image of the anatomy of the renal arteries without using X-rays. This imaging technique allows for exact planning when suspecting stenosis or preparing for renal denervation.
In special cases, such as ICD patients, CT angiography can serve as a suitable alternative to MR angiography. Computed tomography of the adrenal glands can also be beneficial when investigating secondary forms of hypertension in order to rule out aldosterone-producing tumors (primary hyperaldosteronism).
- Patient education
- Behavioral therapy
- Dietary advice
- Drug therapy
- Renal sympathetic denervation
- Metabolic surgery