K.M. Amosova, Іu.V. Rudenko. Interrelation of office and home blood pressure levels in patients with uncomplicated hypertension under algorithmic antihypertensive treatment in real clinical practice

The aim – to evaluate long-term results of antihypertensive treatment using simplified step-by-step algorithm for the control of office and home blood pressure (BP) depending on their interrelation after one month of therapy in patients with uncomplicated arterial hypertension (AH) in real clinical practice.
Material and methods. We analyzed data of 440 patients with uncomplicated uncontrolled AH. Step-by-step algorithmized treatment included initial appointment of the fixed drug combination of perindopril and amlodipine, and, if needed, additional indapamide-retard, spironolactone, moxonidine or doxazosin to achieve target office BP. Office and home BP was measured by certified automatic oscillometric device.
Results. According to the interrelation of office and home blood pressure control after 1 month of treatment all patients were divided into 4 groups: 120 (27.3 %) patients with controlled AH (group 1), 73 (16.6 %) with masked uncontrolled AH (group 2), 17 (3.8 %) with white-coat AH (group 3) and 230 (52.3 %) with uncontrolled AH (group 4). Patients of group 4 compared with patients of the 1st and 2nd groups had higher baseline office SBP, DBP, heart rate and more individuals with baseline SBP ≥180 mm Hg and heart rate ≥ 75 bpm, with concomitant diabetes and stable angina (Р<0.05). Patients of 4th group had higher office and home BP compared to the patients of the 1st and 2nd groups during entire period of treatment. After 2 months of therapy patients of 2nd group compared to 1st group had worse control of the office and home BP (Р<0,01; Р<0,0001, respectively). In the 4th group, the level of control of the office and home BP during the entire observation period remained lower compared to the 1st and 2nd groups. Conclusions. Among patients treated for hypertension frequency of masked uncontrolled AH at 1 month of therapy was 16.6 %, and among patients with target office BP – 37 %. Patients with masked uncontrolled AH compared to patients with uncontrolled office and home BP at 6 months were more likely to attain target office and home BP.

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