Office and home blood pressure measurements were comparable in treated hypertensive patients, with a non-significant diastolic difference of 0.2 mm Hg (95% CI -0.36 to 0.81; P=.40).
RCT (n=926)
randomized
Yes
Are office and home blood pressures comparable in treated hypertensive patients, and does office BP target separation prevail at home?
Office and home blood pressures measured with the same semiautomatic device are comparable in treated hypertensive patients, and office-based target separations are maintained at home.
Effect estimate: Difference 0.2 mm Hg (95% CI -0.36 to 0.81)
p-value: p=.40
The Hypertension Optimal Treatment Study is a prospective trial conducted in 26 countries. The aims are to (1) evaluate the relationship between three levels of target office diastolic blood pressure (BP) (< or = 80, < or = 85, or < or = 90 mm Hg) and cardiovascular morbidity and mortality in hypertensive patients and (2) examine the effects on cardiovascular morbidity and mortality of 75 mg aspirin daily versus placebo. A total of 19,193 patients between 50 and 80 years of age had been randomized by the end of April 1994. Treatment was initiated with felodipine 5 mg daily, and additional therapy was given in accordance with a set protocol. The present substudy of 926 patients performed in nine countries aimed to (1) compare home with office BP in a representative subsample of the HOT population after the titration of treatment was completed and (2) clarify whether the separation into the target groups could be expanded into the out-of-office setting. The differences between office and home measurements in diastolic BP of 0.2 mm Hg (SD, 9; 95% confidence interval, -0.36 to 0.81; P=.40) and systolic BP of 0.5 mm Hg (SD, 15; 95% confidence interval, -0.53 to 1.46; P=.21) were not significant. The group differences in home BP were 1.9 mm Hg (< or = 80 versus < or = 85) and 1.2 mm Hg (< or = 85 versus < or = 90) for diastolic BP (F=11.69; ANOVA, P<.0001) and 2.6 and 2.1 mm Hg for systolic BP (F=8.44, P=.0002). Thus, office and home BPs measured with the same semiautomatic device are comparable in treated hypertensive subjects in the HOT Study, and the separation into the target groups based on office readings prevails at home.
Kjeldsen et al. (Wed,) conducted a rct in Hypertension (n=926). Target office diastolic blood pressure (≤80, ≤85, or ≤90 mm Hg) vs. Different BP targets was evaluated on Difference between office and home measurements in diastolic BP (Difference 0.2 mm Hg, 95% CI -0.36 to 0.81, p=.40). Office and home blood pressure measurements were comparable in treated hypertensive patients, with a non-significant diastolic difference of 0.2 mm Hg (95% CI -0.36 to 0.81; P=.40).