Ambulatory blood pressure monitoring in the evaluation of antihypertensive treatment: Additional information from a large data base

Giuseppe Mancia, Stefano Omboni, Antonella Ravogli, Gianfranco Parati, Alberto Zanchetti

Research output: Contribution to journalArticle

Abstract

Aims of our study were i) to compare in a large number of hypertensive subjects the relative effect of antihypertensive treatment on clinic (C) blood pressure (BP) and various ambulatory (A) BP components, and ii) to determine whether antihypertensive treatment affects BP variability. In 266 mild essential hypertensive outpatients (age: 18-78 years) CBP (trough measurements) and ABP (Spacelabs 90202 or 90207) were measured after 3 to 4 weeks of wash-out and after 4 to 8 weeks of treatment with an ACE-inhibitor (n = 135) or a calcium-antagonist (n = 131). ABP recordings were analyzed to obtain average 24h, day-time (6 a.m. to midnight) and night-time (midnight to 6 a.m.) systolic and diastolic BP values and standard deviations (BP variabilities). Treatment reduced both CBP and ABP. Treatment-induced changes in CBP showed a poor correlation with those in 24 h, day- and night-time BP (r never > 0.23) and the correlation was poor also when trough ABP (mean of last 2h) was considered. Twenty-four hour, day- and night-time BP were similarly reduced by treatment with a direct relationship between the initial BP values and the subsequent BP falls. BP standard deviations were also reduced by treatment in relation to the pretreatment values but the overall reduction was small, limited to the day-time and proportional or less than proportional to the reduction in mean values, with no change or an increase in variation coefficients. The effects of ACE-inhibitor and calcium-antagonist treatments were superimposable. Our results from a large data base show that antihypertensive treatment effectively reduces all ABP components. The reduction cannot be predicted by the concomitant fall in CBP but it relates to the initial ABP values. Treatment has a limited effect on BP variability, this being the case both for ACE-inhibitors and calcium-antagonists.

Original languageEnglish
Pages (from-to)148-156
Number of pages9
JournalBlood Pressure
Volume4
Issue number3
DOIs
Publication statusPublished - 1995

Keywords

  • ACE-inhibitors
  • Ambulatory blood pressure monitoring
  • Antihypertensive treatment
  • Blood pressure variability
  • Calcium-antagonists
  • Clinic blood pressure

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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