Document Detail


Nurse-recorded and ambulatory blood pressure predicts treatment-induced reduction of left ventricular hypertrophy equally well in hypertension: results from the Swedish irbesartan left ventricular hypertrophy investigation versus atenolol (SILVHIA) study.
MedLine Citation:
PMID:  12172314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the relationships of treatment-induced reductions of left ventricular hypertrophy to the changes in clinic and ambulatory blood pressure (BP). DESIGN: Double-blind and randomized treatment with irbesartan or atenolol for 48 weeks. PATIENTS: Patients with hypertension and left ventricular hypertrophy (n = 66) with a seated diastolic BP 90-115 mmHg (average of three measurements one minute apart by nurses). MAIN OUTCOME MEASURES: Registrations of echocardiographic left ventricular (LV) mass. Clinic and ambulatory BP. RESULTS: In the total material, nurse-measured BP was reduced by 23 +/- 15/16 +/- 7.7 mmHg and 24-h ambulatory BP fell 20 +/- 15/14 +/- 8.5 mmHg by treatment. The correlation between the change in nurse-measured BP and LV mass index (LVMI) induced by treatment was r = 0.35, P = 0.004 for systolic BP and r = 0.26, P = 0.03 for diastolic BP. Corresponding values for 24-h ambulatory BP were r = 0.29, P = 0.02 and r = 0.35, P = 0.004, respectively, with similar correlations for day- and night-time ambulatory BP. The nurse-recorded BP was slightly higher than ambulatory BP (systolic clinic - systolic 24-h ambulatory BP = 5 mmHg). Using 130/80 mmHg as a cut-off value for normal 24-h ambulatory BP, eight subjects had normal diastolic or systolic ambulatory BP, or both. Interestingly, these patients also experienced LVMI regression following treatment (low/normal ABP, -13 +/- 21 g/m2; remaining patients, -18 +/- 22 g/m2, P > 0.5). CONCLUSIONS: In patients with hypertension and left ventricular hypertrophy, ambulatory BP is not superior to carefully standardized nurse-recorded seated BP in terms of associations with treatment-induced changes in LV mass.
Authors:
Fredrik Nyström; Karin Malmqvist; K Peter Ohman; Thomas Kahan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  20     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-12     Completed Date:  2003-02-06     Revised Date:  2010-10-19    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1527-33     Citation Subset:  IM    
Affiliation:
Department of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden. Fredrik.Nystrom@lio.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / therapeutic use*
Atenolol / therapeutic use*
Biphenyl Compounds / therapeutic use*
Blood Pressure / drug effects
Blood Pressure Determination / nursing
Blood Pressure Monitoring, Ambulatory
Double-Blind Method
Echocardiography
Female
Humans
Hypertension / complications,  drug therapy*,  physiopathology
Hypertrophy, Left Ventricular / complications,  drug therapy*,  ultrasonography
Male
Middle Aged
Prognosis
Sweden
Tetrazoles / therapeutic use*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Tetrazoles; 138402-11-6/irbesartan; 29122-68-7/Atenolol

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


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