Context. - Ambulatory blood pressure (ABP) monitoring is used increasingly in clinical practice, but how it affects treatment of blood pressure has not been determined.
- To compare conventional blood pressure (CBP) measurement and ABP measurement in the management of hypertensive patients.
Deslgn. - Multicenter, randomized, parallel-group trial.
Selling. - Family practices and outpatient clinics at regional and university hospitals.
- A total of 419 patients (=18 years), whose untreated diastolic blood pressure (DBP) on CBP measurement averaged 95 mm Hg or higher, randomized to CBP or ABP arms.
- Antihypertensive drug treatment was adjusted in a stepwise fashion based on either the average daytime (from 10 AM to 8 PM) ambulatory DBP (n=213) or the average of 3 sitting DBP readings (n=206).
If the DBP guiding treatment was above (>89 mm Hg), at (80-89 mm Hg), or below (<80 mm Hg) target, 1 physician blinded to the patients'randomization intensified antihypertensive treatment, left it unchanged, or reduced it, respectively.
Main Outcome MeasuresThe CBP and ABP levels, intensity of drug treatment, electrocardiographic and echocardiographic left ventricular mass, symptoms reported by questionnaire, and cost.
- At the end of the study (median follow-up, 182 days ; 5th to 95th percentile interval, 85-258 days), more ABP than CBP patients had stopped antihypertensive drug treatment (26.3% vs 7.3%). (...)
Mots-clés Pascal : Hypertension artérielle, Etude comparative, Randomisation, Pression artérielle, Ambulatoire, Monitorage, Traitement, Evaluation, Technique mesure, Etude multicentrique, Homme, Rapport coût bénéfice, Appareil circulatoire pathologie, Economie santé
Mots-clés Pascal anglais : Hypertension, Comparative study, Randomization, Arterial pressure, Ambulatory, Monitoring, Treatment, Evaluation, Measurement technique, Multicenter study, Human, Cost benefit ratio, Cardiovascular disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0514912
Code Inist : 002B12B05B. Création : 13/02/1998.