Newly Published
Correspondence  |   January 2020
Ambulatory and Perioperative Blood Pressure: Reply
Author Notes
  • Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, and Outcomes Research Consortium, Cleveland, Ohio (B.S.). bernd.saugel@gmx.de
  • Accepted for publication November 25, 2019.
    Accepted for publication November 25, 2019.×
Article Information
Correspondence
Correspondence   |   January 2020
Ambulatory and Perioperative Blood Pressure: Reply
Anesthesiology Newly Published on January 6, 2020. doi:https://doi.org/10.1097/ALN.0000000000003108
Anesthesiology Newly Published on January 6, 2020. doi:https://doi.org/10.1097/ALN.0000000000003108
Dr. Alexander Avidan asserts that hypotension is only associated with adverse outcomes. In fact, a randomized trial identified a 27% reduction in the relative risk of a composite of serious complications in patients assigned to tight individualized versus routine blood pressure management.1  Available evidence thus suggests a causal relationship.
Dr. Avidan asks whether various monitoring methods might explain differences between ambulatory and perioperative pressures in our recent report.2  We recorded ambulatory pressures with upper-arm cuff oscillometry, a well-validated technique.3  Oscillometric ambulatory pressures better estimate individual blood pressure than single office measurements4  and are considered the reference method for assessing out-of-office pressures.5  For example, an international consensus group recently defined automated ambulatory blood pressure monitoring as “the optimal method to establish baseline values” before surgery.6