Effect of verapamil on home self-measurement of blood pressure and heart rate in hypertensive patients

Fernández-González, Ricardo; Gomez-Pajuelo, Casimiro; Gabriel, Rafael; Figuera, Mariano de la; Moreno, Elan

doi:10.1097/00126097-200002000-00005

Cited by 5 publications

(5 citation statements)

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“…In 6 articles 121617, 253541 , the effects of calcium channel blockers (taken in the morning) on the reduction of CBP and HBP were 17.5 ± 0.10 / 12.4 ± 0.13 mmHg and 14.1 ± 0.07 / 9.1 ± 0.08 mmHg, and the differences between clinic and home BP were 3.3 mmHg (95%CI 3.1 to 3.5 mmHg, P<0.001) for systolic and 3.0 mmHg (95%CI 2.8 to 3.3 mmHg). The BP reductions corrected for the level of BPs by using the Oldham's correction were 11.4 % for clinic systolic BP, 13.5 % for clinic diastolic BP, 9.5 % for home systolic BP, and 10.2 % for home diastolic BP.…”

Section: Resultsmentioning

confidence: 99%

“…We included 2 articles in which home BPs were measured only in the morning 31, 36 (the morning home BPs were used as the average home BPs in these studies) and one article where BP was measured in the morning, at noon, and in the evening. 16 We included some articles in which the method of clinic BP measurements was not clearly described, 15, 19, 24, 30, 31, 33, 35-37 and/or in which clinic BP was measured only once per clinic visit, 31 but we repeated our analyses excluding these articles. Rater differences in the selection of articles were discussed, and the last author (TGP) resolved any remaining discrepancies concerning article eligibility.…”

Section: Methodsmentioning

confidence: 99%

“…12-15, 18, 20, 23, 25, 30, 37, 38, 40, 41 We also evaluated the changes in clinic, morning, and evening BP depending on whether the antihypertensive medication was taken in the morning 12-15, 18, 20, 23, 25, 30, 41 or in the evening. 12, 37, 38, 40 The effects of different antihypertensive drug classes on the changes in clinic and home BP (using morning dosing) were evaluated for calcium channel blockers (6 studies), 12, 16, 17, 25, 35, 37 angiotensin converting enzyme inhibitors (5 studies), 13, 14, 18, 21, 22 and angiotensin II receptor blockers (7 studies). 18, 20-22, 24, 33, 41 Finally, we were able to compare the reductions of home BP with those of 24-hr BP in 7 articles 18, 20, 22, 25, 26, 32, 39 , and with daytime BP and nighttime BP in 5 articles.…”

Section: Methodsmentioning

confidence: 99%

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Changes in Home Versus Clinic Blood Pressure With Antihypertensive Treatments

et al. 2008

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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 BP (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 (± standard error) in CBP and HBP (systolic/diastolic) were -15.2±0.03/-10.3±0.03 mmHg and -12.2±0.04/-8.0±0.04 mmHg 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-hr BP in systolic (HBP; -12.6±0.06 mmHg, 24-hr BP; -11.9±0.04 mmHg, 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 about 20% less than CBP with antihypertensive treatments. Daytime systolic BP falls 15% less and nighttime systolic BP falls 30% less than home systolic BP.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Changes in Home Versus Clinic Blood Pressure With Antihypertensive Treatments

et al. 2008

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“…HBPM and assessment of drug efficacy. The possibility of HBPM to obtain multiple measurements within a relatively short period of time makes the technique particularly useful to determine drug efficacy (21,30,32). As an index of efficacy, the morning-to-evening ratio has been introduced as an alternative for the "trough-to-peak ratio," which is used with ABPM (55).…”

Section: Discussionmentioning

confidence: 99%

Home Blood Pressure Measurement

Verberk

Kroon

Kessels

et al. 2005

Journal of the American College of Cardiology

182

145

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The purpose of this research was to review the literature on home blood pressure measurement (HBPM) and to provide recommendations regarding HBPM assessment. Observational studies on HBPM, published after 1992, as identified by PubMed, EMBASE, and Cochrane literature searches were reviewed. Studies were selected if they met the following criteria: 1) self-measurements had been performed with validated devices; 2) measurement procedures were described in sufficient detail; and 3) papers clearly explained how final HBPM results were calculated upon which conclusions and/or treatment decisions were based. Office blood pressure measurement (OBPM) yields higher blood pressure values than HBPM. For systolic blood pressure, differences between OBPM and HBPM increase with age and the height of office pressure. Differences also tend to be greater in men than in women and greater in patients without than in those with antihypertensive treatment. Furthermore, HBPM can diagnose normotension with almost absolute certainty; it correlates better with target organ damage and cardiovascular mortality than OBPM, it enables prediction of sustained hypertension in patients with borderline hypertension, and it proves to be an appropriate tool for assessing drug efficacy. Despite some limitations and although more data are needed, HBPM is suitable for routine clinical practice.

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“…However, according to recent Poor performance of the device in some patients Lack of standardization of activities Unsuitability for tracking blood pressure over prolonged periods Discomfort in some patients Impaired quality of sleep Increase in cost meta-analyses, the cut-off point between normal and abnormal self-measured BP is around 135/85 mm Hg, a threshold currently adopted for ambulatory BP [47]. Recent reports have demonstrated that at-home self-measurement of BP can be profitably used in large-scale trials [48]. To determine whether self-measurement of BP using strictly standardized procedures may provide a valid and less expensive alternative to ABPM in clinical trials, the THOP study (Treatment of Hypertension Acccording to Home or Office Blood Pressure) has been initiated [49].…”

Section: Self-measurement Of Blood Pressurementioning

confidence: 99%

Importance of various methods of blood pressure measurement in clinical trials

Palatini

2000

Current Science Inc

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Ambulatory blood pressure (ABP) monitoring and self-measurement of blood pressure (BP) are more reproducible than clinic BP measurement, minimize the white coat effect, and can reduce the sample size necessary to demonstrate the efficacy of a drug in clinical trials. For many years, the trough:peak ratio has been considered the key index for demonstrating the efficacy of antihypertensive agents. However, several potential problems are associated with the use of this index, and ABP monitoring makes it possible to examine changes in BP over the entire 24-hour period, not only at a preset time of peak effect and at the end of the dosing interval. The smoothness index provides more comprehensive information on the 24-hour BP control with treatment and avoids part of the problems encountered with the trough:peak ratio. One simple way to summarize the results of ABP monitoring in clinical trials is to provide the mean 24-hour BP difference from placebo and the BP decrease at trough. The numerous advantages summarized above make ABP monitoring an accepted method of BP measurement in hypertension therapy trials. Self-measurement of BP may be a valid and less expensive alternative to ABP monitoring.

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Effect of verapamil on home self-measurement of blood pressure and heart rate in hypertensive patients

Cited by 5 publications

References 0 publications

Changes in Home Versus Clinic Blood Pressure With Antihypertensive Treatments

Changes in Home Versus Clinic Blood Pressure With Antihypertensive Treatments

Home Blood Pressure Measurement

Importance of various methods of blood pressure measurement in clinical trials

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