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The effect of antihypertensive treatment is greater on office blood pressure than on ABP, and is unevenly distributed between day and night. This suggests caution when interpreting trials on cardiovascular protection by antihypertensive treatment that are based only on office blood pressure readings, and advocates a more systematic adoption of ABP monitoring in these trials. The conflicting data provided by the main HOPE study and by the HOPE-ABP monitoring substudy on the role of blood pressure reduction in explaining the reduced event rates associated with treatment by angiotensin-converting enzyme inhibitors are a clear example of the importance of performing ABP monitoring in trials on cardiovascular protection.
Mancia et al. (Mon,) studied this question.