Document Detail

Changes in home versus clinic blood pressure with antihypertensive treatments: a meta-analysis.
MedLine Citation:
PMID:  18809791     Owner:  NLM     Status:  MEDLINE    
Home blood pressure (HBP) monitoring is recommended for assessing the effects of antihypertensive treatment, but it is not clear how the treatment-induced changes in HBP compare with the changes in clinic blood pressure (CBP). We searched PubMed using the terms "home or self-measured blood pressure," and selected articles in which the changes in CBP and HBP (using the upper arm oscillometric method) induced by antihypertensive drugs were presented. We performed a systematic review of 30 articles published before March 2008 that included a total of 6794 subjects. As there was significant heterogeneity in most of the outcomes, a random effects model was used for the meta-analyses. The mean changes (+/-SE) in CBP and HBP (systolic/diastolic) were -15.2+/-0.03/-10.3+/-0.03 mm Hg and -12.2+/-0.04/-8.0+/-0.04 mm Hg respectively, although there were wide varieties of differences in the reduction between HBP and CBP. The reductions in CBP were correlated with those of HBP (systolic BP; r=0.66, B=0.48, diastolic BP; r=0.71, B=0.52, P<0.001). In 7 studies that also included 24-hour BP monitoring, the reduction of HBP was greater than that of 24-hour BP in systolic (HBP; -12.6+/-0.06 mm Hg, 24-hour BP; -11.9+/-0.04 mm Hg, P<0.001). In 5 studies that included daytime and nighttime systolic BP separately, HBP decreased 15% more than daytime ambulatory BP and 30% more than nighttime ambulatory BP. In conclusion, HBP falls approximately 20% less than CBP with antihypertensive treatments. Daytime systolic BP falls 15% less and nighttime systolic BP falls 30% less than home systolic BP.
Joji Ishikawa; Deirdre J Carroll; Sujith Kuruvilla; Joseph E Schwartz; Thomas G Pickering
Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-09-22
Journal Detail:
Title:  Hypertension     Volume:  52     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-23     Completed Date:  2008-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  856-64     Citation Subset:  IM    
Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York 10032, USA.
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MeSH Terms
Ambulatory Care Facilities*
Antihypertensive Agents / therapeutic use*
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory*
Circadian Rhythm / physiology
Hypertension / drug therapy*,  physiopathology*
Reproducibility of Results
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Antihypertensive Agents
Comment In:
Hypertension. 2008 Nov;52(5):795-6   [PMID:  18809788 ]

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