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document
A comparison of home measurement and ambulatory monitoring of blood pressure in the adjustment of antihypertensive treatment . BACKGROUND The purpose of this study was to compare home and ambulatory blood pressure ( BP ) in the adjustment of antihypertensive treatment . METHODS After a 4-week washout period , patients whose untreated daytime diastolic ambulatory BP averaged > or = 85 mm Hg were randomized to be treated according to their ambulatory or home BP . Antihypertensive treatment was adjusted at 6-week intervals according to the mean daytime ambulatory diastolic BP or the mean home diastolic BP , depending on the patient 's randomization group . If the diastolic BP stayed above 80 mm Hg , the physician blinded to randomization intensified hypertensive treatment . RESULTS Ninety-eight patients completed the study . During the 24-week follow-up period both systolic and diastolic BP decreased significantly within both groups ( P < .001 ) . At the end of the study , the systolic/diastolic differences between ambulatory ( n = 46 ) and home ( n = 52 ) BP groups in home , daytime ambulatory , night-time ambulatory , and 24-h ambulatory BP changes averaged 2.6/2.6 mm Hg , 0.6/1.7 mm Hg , 1.0/1.4 mm Hg , and 0.6/1.5 mm Hg , respectively ( P range .06 to .75 ) A nonsignificant trend to more intensive drug therapy in the ambulatory BP group and a nonsignificant trend to larger share of patients reaching ( 57.7 % v 43.5 % , P = .16 ) the target pressure in the home BP group was observed due to the 3.8 mm Hg difference in ambulatory and home diastolic BP at randomization . CONCLUSIONS The adjustment of antihypertensive treatment based on either ambulatory or home BP measurement led to good BP control . No significant between-group differences in BP changes were seen at the end of the study . Additional research is needed to provide more conclusive results .
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Intervention_Educational
home measurement
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Intervention_Physical
ambulatory monitoring
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Intervention_Other
ambulatory or home BP .
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Intervention_Control
intensified hypertensive treatment .
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Intervention_Educational
ambulatory or home BP measurement
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Outcome_Physical
daytime ambulatory diastolic BP
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Outcome_Physical
home diastolic BP
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Outcome_Physical
systolic and diastolic BP
26015
Outcome_Physical
systolic/diastolic differences between ambulatory
26016
Outcome_Physical
BP
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Outcome_Physical
home , daytime ambulatory , night-time ambulatory , and 24-h ambulatory BP changes
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Outcome_Physical
ambulatory BP
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Outcome_Physical
ambulatory and home diastolic BP
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Outcome_Physical
BP