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Characterization of Antihypertensive Therapy by Whole-Day Blood Pressure Monitoring
Michael A. Weber, MD;
Deanna G. Cheung, MD;
William F. Graettinger, MD;
Jodi L. Lipson, MPH
JAMA. 1988;259(22):3281-3285.
Abstract
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Whole-day ambulatory monitoring is used for diagnosing hypertension and for judging response to treatment. We evaluated both of these properties in an antihypertensive trial with the calcium channel blocker diltiazem hydrochloride. Measured by a conventional sphygmomanometer, systolic and diastolic blood pressures fell significantly in patients who received diltiazem, whereas no consistent changes occurred in those who received placebo. Administration of the drug also decreased systolic and diastolic blood pressures evenly throughout the day, as determined by automated monitoring. The 15 diltiazem-treated patients were subdivided into those whose clinically diagnosed hypertension was confirmed by pretreatment blood pressure monitoring (24-hour average diastolic blood pressure,  90 mm Hg; n=9) and those whose 24-hour blood pressures failed to meet this criterion (n=6). Diltiazem therapy decreased average whole-day blood pressures by 18/13 mm Hg in the hypertensives but by only 0/1 mm Hg in the others. Thus, whole-day blood pressure monitoring strengthens antihypertensive trials by documenting efficacy and duration of treatment. In addition, it enhances the diagnosis of hypertension, thereby identifying those patients in whom treatment seems justified.
(JAMA 1988;259:3281-3285)
Author Affiliations
From the Hypertension Center, Veterans Administration Medical Center, Long Beach, Calif; and the University of California, Irvine.
Footnotes
Reprint requests to Veterans Administration Medical Center, W130, 5901 E Seventh St, Long Beach, CA 90822 (Dr Weber).
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