Comparing office-based and ambulatory blood pressure monitoring in clinical trials

Vollmer, William M.; Appel, Lawrence J.; Svetkey, Laura P.; Moore, Thomas J.; Vogt, Thomas; Conlin, Paul R.; Proschan, Michael A.; Harsha, David W.

doi:10.1038/sj.jhh.1001772

Cited by 37 publications

(33 citation statements)

References 30 publications

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“…Indeed, the increasingly valuable role of ambulatory blood pressure monitoring in risk assessment, prognostic and therapeutic guidance is well recognized. [15][16][17][18] This same principle is surprisingly not been tested in biomarkers and is long overdue. Simply, the temporal pattern of repeated measures over a set time interval might define disease progression, stability or pending instability, for the individual regardless of symptomatic state (or potentially despite it!).…”

Section: Could Repeated Measures Of Biomarkers or The Variance Thereomentioning

confidence: 99%

Intraindividual temporal variance of biomarkers and the definition of individualized prognosis in cardiovascular patients

MacFadyen

2006

J Hum Hypertens

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Section: Could Repeated Measures Of Biomarkers or The Variance Thereomentioning

confidence: 99%

Intraindividual temporal variance of biomarkers and the definition of individualized prognosis in cardiovascular patients

MacFadyen

2006

J Hum Hypertens

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“…ABP treatment differences usually agree well with the result from clinic measures, and treatment was effective when measured by both methods. [26][27][28] The difference between the groups was 8/4 mm Hg for night-time ABP and even higher in the 52 participants with ABP measurements at baseline and during follow-up (online-only Data Supplement). Over 65 years of age, night-time ABP is a better predictor of cardiovascular events than the CBP and other measures of ABP.…”

Section: -25mentioning

confidence: 99%

Does White Coat Hypertension Require Treatment Over Age 80?

et al. 2013

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A ccurate measurement of blood pressure (BP) is an essential feature of any trial aiming to determine the relationship between BP reduction and outcome. BP control was the source of a controversy surrounding the results of the Heart Outcomes Prevention Evaluation (HOPE) trial, which claimed additional benefits from the use of an angiotensin-converting enzyme inhibitor (ramipril) versus placebo, because the between-group difference in clinic BP (CBP) was only 3/2 mm Hg.1 The beneficial effect was estimated to be 3 times that expected for this small difference in BP, 2 however, the possibility of a greater difference in BP was suggested by a small substudy of HOPE that measured ambulatory BP (ABP) and found a between-group difference of 10/4 mm Hg. 3ABP does not exactly mirror CBP, even if a fixed correction factor is used and the timing of the CBP measurement during the day is taken into account, for example, by comparing morning ABP values with morning CBP. The difference between CBP and ABP also depends on the degree of the alarm response induced in the office and varies from person to person, method of measurement, and the observer. This office or alarm response tends to increase with age 4,5 and decrease with the familiarity with the measurement. Furthermore, the machine used to measure ABP or CBP may over-or underestimate BP. When CBP is above normal and ABP is judged to be normal, then white coat hypertension (WCH) is said to be present. Importantly, it has long been considered desirable to avoid pharmaceutical treatment in those with WCH, because it has been suggested that active treatment does not lower ABP in this condition and also does not reduce cardiovascular events. Abstract-White coat hypertension is considered to be a benign condition that does not require antihypertensive treatment.Ambulatory blood pressure (ABP) was measured in 284 participants in the Hypertension in the Very Elderly Trial (HYVET), a double-blind randomized trial of indapamide sustained release 1.5 mg±perindopril 2 to 4 mg versus matching placebo in hypertensive subjects (systolic blood pressure 160-199 mm Hg) aged >80 years. ABP recordings (Diasys Integra II) were obtained in 112 participants at baseline and 186 after an average follow-up of 13 months. At baseline, clinic blood pressure (CBP) exceeded the morning ABP by 32/10 mm Hg. Fifty percent of participants fulfilled the established criteria for white coat hypertension. The highest ABP readings were in the morning (average 140/80 mm Hg), the average night-time pressure was low at 124/72 mm Hg, and the average 24-hour blood pressure was 133/77 mm Hg. During follow-up, the systolic/diastolic blood pressure placebo-active differences averaged 6/5 mm Hg for morning ABP, 8/5 mm Hg for 24-hour ABP, and 13/5 mm Hg for CBP. The lowering of blood pressure over 24 hours supports the reduction in blood pressure with indapamide sustained release±perindopril as the explanation for the reduction in total mortality and cardiovascular events observed in the main HYVET study. Because we es...

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“…5 As 24-h ambulatory BP monitoring (ABPM) can now be easily performed with reliable monitoring devices, a number of studies have shown the inadequacy of evaluating BP control from clinical measurements alone. 6,7 Recent studies have indicated that home BP (HBP) measured in the morning has a stronger predictive power for mortality than does office BP measurement. 8,9 These reports suggest the importance of monitoring morning HBP, in addition to office BP, to evaluate BP control and to adjust antihypertensive therapy.…”

Section: Introductionmentioning

confidence: 99%

Morning home blood pressure may be a significant marker of nephropathy in Japanese patients with type 2 diabetes: ADVANCED-J study 1

et al. 2009

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A 3-year multicenter, prospective, randomized, open-label trial (ADVANCED-J) compared the effect of an increased dose of angiotensin-II receptor blocker (ARB) with that of a maintenance dose of ARB plus calcium channel blocker (amlodipine) on blood pressure (BP) control, nephropathy and atherosclerosis in patients with type 2 diabetes and hypertension in whom the usual ARB dose failed to control BP. A cross-sectional analysis using baseline data was conducted. Of 316 patients (recruited between September 2004 and December 2005), 228 patients were evaluated by multiple regression analysis using two models after randomization and exclusions. Model 1 assessed 13 baseline variables (age, sex, estimated diabetes duration, estimated hypertension duration, HbA1c, brain natriuretic peptide (BNP), high-sensitive C-reactive protein (hsCRP), triglycerides (TGs), total cholesterol (TCHO), diabetic retinopathy (DMR), systolic morning home BP (HBP), diastolic morning HBP and brachialankle pulse wave velocity (baPWV)) for correlation with the urinary albumin creatinine excretion rate (UACR). In model 2, systolic and diastolic morning HBP was replaced by systolic and diastolic office BP. The systolic morning HBP and systolic office BP or diastolic morning HBP and diastolic office BP correlations were weak, but significant (r¼0.43 and 0.48, respectively). BNP, HbA1c, DMR and estimated diabetes duration were significantly correlated with UACR in both models 1 and 2. Although systolic office BP did not show a significant correlation with UACR in model 2, systolic morning HBP showed a significant correlation with UACR in model 1. Morning HBP, but not office BP, may be a significant marker of nephropathy in Japanese patients with type 2 diabetes.

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Comparing office-based and ambulatory blood pressure monitoring in clinical trials

Cited by 37 publications

References 30 publications

Intraindividual temporal variance of biomarkers and the definition of individualized prognosis in cardiovascular patients

Intraindividual temporal variance of biomarkers and the definition of individualized prognosis in cardiovascular patients

Does White Coat Hypertension Require Treatment Over Age 80?

Morning home blood pressure may be a significant marker of nephropathy in Japanese patients with type 2 diabetes: ADVANCED-J study 1

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