June 1, 1996Journal of Hypertension
Difference between office and ambulatory blood pressure and response to antihypertensive treatment
Why the study?
Does antihypertensive treatment or placebo alter the difference between clinic and ambulatory blood pressure in patients with mild or moderate essential hypertension?
Population
382 mild or moderate essential hypertensive patients, mean age 51.5 +/- 9.2 years.
Comparison
Antihypertensive treatment with calcium… vs Placebo administration for 4-8 weeks (n=116).
Design
Cohort
Follow-up
4-8 weeks
Authors
Discussion
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Implication
Habituation attenuates clinic-ambulatory BP differences even with placebo; may overestimate treatment effects in clinic-only monitoring and leaves open need for ambulatory confirmation in trials.
Structured PICO
Does antihypertensive treatment or placebo alter the difference between clinic and ambulatory blood pressure in patients with mild or moderate essential hypertension?
P
Population
382 mild or moderate essential hypertensive patients, mean age 51.5 +/- 9.2 years.
I
Intervention
Antihypertensive treatment with calcium antagonists or angiotensin converting enzyme inhibitors for 4-8 weeks (n=266).
C
Comparator
Placebo administration for 4-8 weeks (n=116).
O
Outcome
Difference between clinic and daytime average blood pressure (surrogate measure of the 'white-coat effect') for systolic and diastolic blood pressures.surrogate
The clinic-ambulatory blood pressure difference attenuates over time with both active treatment and placebo, likely reflecting habituation, which can lead to overestimation of treatment efficacy if only clinic blood pressures are measured.
Cite This Study
Parati et al. (1996) studied this question.