March 1, 1996Hypertension
Ambulatory Monitoring Uncorrected for Placebo Overestimates Long-term Antihypertensive Action
Why the study?
Does active antihypertensive treatment reduce blood pressure compared to placebo in older patients with isolated systolic hypertension when assessed by conventional vs ambulatory monitoring?
Population
337 older patients with isolated systolic hypertension by conventional sphygmomanometry at the clinic.
Comparison
Active treatment consisting of nitrendipine… vs Placebo.
Design
RCT, Randomized to placebo or active treatment
Follow-up
13 months (median)
Authors
Discussion
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Member takes
Implication
Ambulatory BP reductions require placebo correction to avoid overestimation; challenges assumptions of minimal placebo effects on out-of-office measurements.
Structured PICO
Does active antihypertensive treatment reduce blood pressure compared to placebo in older patients with isolated systolic hypertension when assessed by conventional vs ambulatory monitoring?
P
Population
337 older patients (≥ 60 years) with isolated systolic hypertension by conventional sphygmomanometry at the clinic.
I
Intervention
Active treatment consisting of nitrendipine (10 to 40 mg/d), with the possible addition of enalapril (5 to 20 mg/d) and/or hydrochlorothiazide (12.5 to 25 mg/d) for median 13 months.
C
Comparator
Placebo.
O
Outcome
Blood pressure (BP) changes assessed by conventional and ambulatory BP measurement at median 13 months.surrogate
Ambulatory blood pressure monitoring uncorrected for placebo overestimates long-term antihypertensive action, as a substantial proportion of BP changes during active treatment may be attributed to placebo effects.
Cite This Study
Staessen et al. (1996) studied this question.