Effect of antihypertensive treatment on office and self-measured blood pressure: The Autodil Study

Abstract

Objective: To examine prospectively the effects of antihypertensive therapy on office blood pressure (BP) and home BP, in a large-scale hypertensive population followed by their general practitioners.Patients: A total of 760 hypertensive patients either never treated or after a 2-week washout period, aged 18–75 years, with a diastolic office BP between 95 and 110 mm Hg and a systolic office BP below 180 mm Hg.Methods: Patients measured their BP at home using an automated printer-equipped oscillometric device (OMRON-HEM 705 CP) twice daily for 8 days before the visit to their general practitioner who recorded three office BP. These measurements were performed before and after 8 weeks of antihypertensive therapy with sustained-release diltiazem 300 mg once daily.Results: Diltiazem reduced systolic and diastolic office BP and home BP and heart rate (P < 0.01). systolic and diastolic office bp were higher than home bp before (P < 0.01) but not during treatment. correlation coefficients between the two methods before and during therapy were 0.6 and 0.7 for systolic bp and 0.4 and 0.6 for diastolic bp (P < 0.01). both methods did not agree equally throughout the range of bp: home bp was higher than office bp for high values and lower for low values.Conclusion: The results show that BP measured at home by patients can be higher than office BP in the highest range of BP.