Document Detail

Lack of agreement between office and ambulatory blood pressure responses to hydrochlorothiazide.
MedLine Citation:
PMID:  15797660     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Differences between the antihypertensive responses to drug therapy measured by office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM) techniques have been noted but rarely analyzed. We studied whether the OBP and 24-h ABPM responses to hydrochlorothiazide differ and, if so, the relevance of these differences. METHODS: The OBP and ABPM responses to hydrochlorothiazide (25 mg/d, for 4 weeks) were measured in 228 subjects with essential hypertension, and mean responses were compared between methods using the Student paired t test. To assess variation in the agreement between OBP and ABPM responses among subjects, the limits of agreement were calculated as the mean difference between OBP and ABPM responses +/-2 standard deviations. RESULTS: The mean systolic OBP response was 4.8 mm Hg greater than the response measured by ABPM (-14.3 v -9.5 mm Hg, P < .001), and the mean diastolic OBP response was 2.1 mm Hg greater than the response measured by ABPM (-7.5 v -5.5, P < .001). The limits of agreement between the OBP and ABPM responses ranged from -18.7 to +28.2 mm Hg for systolic response and from -12.9 to +17.1 mm Hg for diastolic response. The systolic and diastolic OBP and ABPM responses were in opposite directions in 22.8% and 23.7% of the subjects, respectively. CONCLUSIONS: Compared to ABPM, OBP overestimates the mean systolic and mean diastolic blood pressure responses to hydrochlorothiazide. Variation among subjects in the magnitude and direction of responses renders OBP an unreliable predictor of ABPM responses.
Javier Daniel Finkielman; Gary L Schwartz; Arlene B Chapman; Eric Boerwinkle; Stephen T Turner
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of hypertension     Volume:  18     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-30     Completed Date:  2005-06-28     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  398-402     Citation Subset:  IM    
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, USA.
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MeSH Terms
Antihypertensive Agents / administration & dosage*
Blood Pressure / drug effects
Blood Pressure Monitoring, Ambulatory
Hydrochlorothiazide / administration & dosage*
Hypertension / diagnosis*,  drug therapy*
Middle Aged
Physicians' Offices
Grant Support
Reg. No./Substance:
0/Antihypertensive Agents; 58-93-5/Hydrochlorothiazide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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