This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Hypertension  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 144 words of the full text and any section headings.

To the Editor: Dr Staessen and colleagues¹ reported that patients whose antihypertensive therapy was guided by home measurements of blood pressure (BP) were more likely to have therapy discontinued after 1 year, and to have poorer BP control, than were those who underwent office monitoring of their BP. In both groups, therapy was adjusted to maintain a target diastolic BP between 80 and 89 mm Hg. However, the expert panel of American Society of Hypertension² recommends a stricter target value of 135/85 mm Hg for both ambulatory and home meaurements of BP. This difference is comparable to the final difference of 5.9 mm Hg in daytime ambulatory systolic BP between the groups whose treatment was guided by home BP and office BP in the trial by Staessen et al. A target cutoff value of 135/85 mm Hg or lower may have been more appropriate.

Kazuomi Kario, MD
kkario@jichi.ac.jp
Department of Medicine
Jichi Medical School
Tochigi, Japan

Thomas Pickering, MD, DPhil
Behavioral Cardiovascular Health and Hypertension Program
Columbia University College of Physicians and Surgeons
New York, NY

1. Staessen JA, Den Hond E, Celis H, et al, Treatment of Hypertension Based on Home or Office Blood Pressure (THOP) Trial Investigators. Antihypertensive treatment based on blood pressure measurement at home or in the physician's office: a randomized controlled trial. JAMA. 2004;291:955-964. FREE FULL TEXT 2. Pickering TG, Kaplan NM, Krakoff L, et al. American Society of Hypertension Expert Panel: conclusions and recommendations on the clinical use of home (self) and ambulatory BP monitoring. Am J Hypertens. 1996;9:1-11. FULL TEXT | ISI | PUBMED

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:2315.

RELATED ARTICLES

Guidelines for Home- and Office-Based Blood Pressure Monitoring—Reply
Jan A. Staessen, Elly Den Hond, and Eoin T. O'Brien
JAMA. 2004;291(19):2315-2316.
EXTRACT | FULL TEXT  

Antihypertensive Treatment Based on Blood Pressure Measurement at Home or in the Physician's Office: A Randomized Controlled Trial
Jan A. Staessen, Elly Den Hond, Hilde Celis, Robert Fagard, Louis Keary, Guy Vandenhoven, and Eoin T. O'Brien
JAMA. 2004;291(8):955-964.
ABSTRACT | FULL TEXT