A comparison of home measurement and ambulatory monitoring of blood pressure in the adjustment of antihypertensive treatment

Niiranen, Toni J. U.; Ruuska, Marja; Johansson, Jouni K.; Kantola, Ilkka

doi:10.1016/j.amjhyper.2005.03.108

Cited by 7 publications

(7 citation statements)

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“…On the other hand, a small study among 98 participants with daytime ambulatory blood pressure of at least 85 mm Hg found similar blood pressure control rates whether antihypertensive therapy was adjusted based on home or 24-h blood pressure measurement. 25 Treatment target in this study was a diastolic blood pressure of 80 mm Hg in both groups. Thus, this study suggests that home blood pressure measurement may be a suitable alternative if a correct blood pressure target is chosen, but more studies are needed before home blood pressure can be recommended for antihypertensive treatment titration.…”

Section: Discussionmentioning

confidence: 96%

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

2008

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The aim of this study was to assess whether the use of 24-h blood pressure (BP) measurement in the management of antihypertensive therapy improves BP in patients with sustained hypertension. Patients with sustained hypertension (office BP X140/90 mm Hg, and 24-h systolic BP X130/80 mm Hg) were randomly assigned to a strategy using 24-h BP to manage antihypertensive treatment (target o130/80 mm Hg) or to a standard strategy using office BP (target o140/90 mm Hg). The primary end point was change in 24-h systolic BP at 1 year of follow-up. We included 136 patients in the primary analysis. After 1 year of follow-up, the change in 24-h systolic BP was significantly greater in the ambulatory BP group compared with the office BP group (mean difference (95% confidence interval) À3.6 (À7.0, À0.3), P ¼ 0.03). Intentionto-treat analysis revealed essentially unchanged results.The mean number of antihypertensive drugs per participant at 1 year of follow-up was 1.76 ± 1.1 and 1.95 ± 0.9 in the ambulatory and office BP group, respectively (P ¼ 0.049). The benefit of ambulatory BP monitoring was mainly seen in patients with previously known hypertension (mean difference À7.2 (À11.6, À2.8), P ¼ 0.002), but not in those with newly detected hypertension (mean difference 0.2 (À4.9, 5.4), P ¼ 0.93). In conclusion, using 24-h BP for the management of antihypertensive therapy in patients with sustained hypertension leads to a greater BP reduction compared with a standard treatment strategy using office BP, although fewer antihypertensive drugs were used in the ambulatory BP group.

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Section: Discussionmentioning

confidence: 96%

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

2008

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“…As is well known, the primary recommendation for the treatment of high BP starts with lifestyle modification; however, if the BP is not sufficiently lowered, treatment with antihypertensive medication is necessary. 5 Previous studies have reported that BP control at normal levels is difficult, with only 25-62% of patients being properly controlled; 13,[57][58][59] consequently, most hypertensive patients receive antihypertensive medication. In Brazil, 76% of patients are using drug therapy.…”

Section: Discussionmentioning

confidence: 99%

ACE polymorphisms and the acute response of blood pressure to a walk in medicated hypertensive patients

Goessler

Cornelissen

Oliveira

et al. 2015

J Renin Angiotensin Aldosterone Syst

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Hypothesis/Introduction: Polymorphisms of the angiotensin converting enzyme (ACE) gene can interfere with exercise-induced acute blood pressure (BP) reduction. This cross-over study investigated the acute effect of a single walk on BP and tested whether polymorphisms of the ACE gene might explain the variation in BP responses. Materials and methods: Thirty-four healthy medicated individuals were randomized to one control and one walking session at 60-75% of heart rate reserve. Subjects left the laboratory wearing an ambulatory BP monitor until waking the next morning. Results: Overall, systolic BP was somewhat lower following the walking session (p=.06), which could be attributed to a consistently lower systolic BP for 5 h after exercise (p-interaction<.04) compared with control rest. Similarly, II/ID individuals had a lower systolic BP (p-interaction=.02) and diastolic BP (p-interaction<.01) for 5 h after walking compared with control rest. Among DD individuals, a single walk did not induce a reduction in BP (p-interaction>.05). Conclusions: Our results showed that postexercise hypotension can occur after a walk at moderate intensity in carriers of the I allele; we were not able to demonstrate this in DD individuals. Our results suggest that genetic variation in the ACE gene might affect the BP response to exercise, although more research is needed to confirm these findings.

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“…These studies, however, were limited by use of the same normalcy thresholds for OBP and HBP. When treatment decisions driven either by ABPM or HBPM were directly compared, no difference in BP changes was seen [180]. A relatively low (75%) agreement between ABPM and HBPM has been reported in the evaluation of poorly controlled hypertension, HBPM classifying a lower proportion of patients as WCH than ABPM [178].…”

Section: Blood Pressure Control By Treatmentmentioning

confidence: 99%

European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring

Parati

Stergiou²,

Asmar

et al. 2008

Journal of Hypertension

757

646

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A comparison of home measurement and ambulatory monitoring of blood pressure in the adjustment of antihypertensive treatment

Cited by 7 publications

References 0 publications

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

Twenty-four hour ambulatory blood pressure for the management of antihypertensive treatment: a randomized controlled trial

ACE polymorphisms and the acute response of blood pressure to a walk in medicated hypertensive patients

European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring

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