Comparative study of home and office blood pressure in hypertensive patients treated with enalapril/HCTZ 20/6 mg: the ESPADA study

Blood Press. 2000;9(6):355-62. doi: 10.1080/080370500300000941.

Abstract

The introduction and generalization of 24-h ambulatory blood pressure (BP) monitoring has shown the clinical relevance of home BP. The aim of this study was to assess the validity of home-measured BP for monitoring and controlling patients with arterial hypertension while on a homogeneous treatment. An additional objective was to establish the degree of office BP control obtained. This was a prospective, longitudinal, observational and multicenter study in a cohort of 156 patients of both sexes, aged over 18 years and with essential hypertension. All of them received the fixed combination enalapril/HCTZ 20/6 mg as the only hypertensive agent for at least 4 weeks previously. Office BP was the average of three measurements. For home BP, a semi-automated device (OMRON HEM 705 CP) was used. The patients measured their BP twice a day for 2 consecutive days. The average differences between the two measuring methods were low, but significant: 3.99 mmHg for systolic BP (SBP; p < 0.05), 2.02 mmHg for diastolic BP (DBP; p < 0.05). Pearson's regression coefficient between the office and home values was highly significant (p < 0.0001) for SBP, DBP and heart rate. Home BP measurement was highly reproducible as shown by the high within-class correlation coefficient for individual measurements on the first day compared with the second: 0.88 (95% confidence interval, CI 0.82-0.92; p < 0.00001) for SBP and 0.89 for DBP (95% CI 0.83-0.93; p < 0.00001). The percentage of patients with strict office DBP and SBP control (< 140/90 mmHg) was 61.3% and with DBP control (<90 mmHg) 92%. In conclusion, in the ESPADA study, the application of home BP measurement is valid, reproducible and shows a high correlation with office BP.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Determination
  • Blood Pressure Monitoring, Ambulatory / standards*
  • Circadian Rhythm
  • Cohort Studies
  • Confidence Intervals
  • Drug Therapy, Combination
  • Enalapril / administration & dosage*
  • Enalapril / pharmacology
  • Enalapril / therapeutic use*
  • Female
  • Hemodynamics
  • Humans
  • Hydrochlorothiazide / administration & dosage*
  • Hydrochlorothiazide / pharmacology
  • Hydrochlorothiazide / therapeutic use*
  • Hypertension / drug therapy
  • Hypertension / physiopathology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Office Visits
  • Prospective Studies
  • Reproducibility of Results
  • Sex Factors

Substances

  • Antihypertensive Agents
  • Hydrochlorothiazide
  • Enalapril