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Ambulatory blood pressure is more sensitive than office blood pressure to detect antihypertensive treatment effects in hypertensive patients
148A
ASH XIV ABSTRACTS
A005
1999-VOL.
12, NO. 4, PART 2
A006
EFFECT OF ALCOHOL CESSATION ON BLOOD PRESSURE. ASSESSMENT BY 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING MT Aauilcra,A dc la Siam*, A. Coca*, R. Estruch, J. Fekmdez-Sol& E Gbnez-Angelats, C. Sierra, E. Brag&t, V. Giner, MT Ammo, A Urbane-tvbkquez Hype&w.wonand Alcohol Unilr.De,,arfmenroflnternal Melcine. Hospital Clinx. Barcelona.Spain The aim of the present study was to assessthe effect of one month of proven abstkoce from alcohol on 24-hour blood pressure profile in
heavy alcohol drinkers. Forty-two male heavy drinkers (more than 1OOgof pure ethanol per day) were admitted in a general ward for voluntary alcohol detoxification. On the day of admission they received a total dose of 2 g/Kg of ethanol diluted in orange juice in five divided doses and a 24-hour ambulatory blood pressure monitoring was performed After one month of proven alcohol abstinence, a new 24-hour blood pressure monitoring was paformed in the same conditions, while receiving the same amount of fluid, without the addition of alcohol After one month of proven alcohol abstinence, blood pressure and heart rate decreased. The reduction was 7.2 mmHg for 24-hour systolic blood pressure (95% CI: 4.5-9.9), 6.6 mmHg for 24-hour diastolic blood pressure (95% Cl: 4.2-9.0) and 7.9 bpm for heart rate (95% CI: 5.1-10.7). The proportion of alcoholic patients considered hypertensive based on 24-hour blood pressure criteria (daytime systolic blood pressure L 135 mmHg or daytime diastolic blood pressure 2 85 mmHg) fell from 42% during alcohol drinking to 12% after one month of complete alcohol abstinence Alcohol cessation did not modify either the long-term blood pressure variability, assessed by standard deviations of 24-hour blood pressure, or its circadiao profile. We conch& that alcohol cessation in heavy alcohol drinkers reduces blood pressure assessed by 24-hour ambulatory blood pressure monitoring, this reduction being clinically relevant. These results demonstrate that heavy alcohol consumption has an important effect on blood pressure, and thus alcohol cessation must be recommendedas a priority for hypertensive alcohol drinkers. Key Words: alcohol drinking, alcoholism, ABPM
orevious /schemic transient patients. merwly
AJH-APRIL
hour&Twenty&o patients (46.8%) had hislorv of CT scannino demonstrated an (throhbotiij stroke in 39 patie& (4 patients had ischemic altacks) and hemorrhage in 8 Clinic BP values obtained al the emergency mom with sphygmomanometer
monitorization (ABPM) in essential Eighty-six patients regularly visited in hypertension units of county hospitals ware included in the study. Participants had not received anti-hypertensive
monlorizations was greater for the sleeping period (DBP = _ 1.27 f 7.05 mmHg and SBP = -1.25 f 10.1 I) than during adivity (DBP = -0.98 i 6.53 and SBP = -0.43 r 10.51) or the 24-hr period (DBP = -0.95 f 6.21 and SBP = -0.34 f 9.93). These differences were not significant. Diagnosis of HT varied by ABPM in 24.42% of Ten patients (11.6%) considered HT in the first ABPM were not in the second and 11 patients (12.6%) considered HT in the second ABPM did not meet criteria for HT in the second ABPM. We wndude that average values of BP obtained by Iwo ABPMs within one month of each other showed a good correlation although SBP correlated better than DBP. diagnosis of HT varied by ABPM for almosi one-fourth of the participants although almost half of them wuld be attributed to life-style attributed 10the knowledge of a hypertension diagnosis. Key Words: ambulatory blood pressure monitoring, repmdudbility.
(endothelin-1 antagonist Ro 47-0203, enalapril or placebo; for the pvrposes of this study treated as one treatment group). The OBP and ASP measurements correlated dosely during both the placebo-run in and active treatment (systolic r r 0.74, diastolic r 2 0.60, p < 0.0001). but the ASP was systematically sig’nificantly blood press& compared to placebo run-in as detected by both methods (p < 0.02). However, the antihypertensive significantly greater than that detected by OBP afler 3 weeks (-2.7 * 6.3 mmHg. p -z 0.0001) and 4 weeks (-0.7 f 6.0 mmHg, p = 0.02) of treatment. The drag-induced decrease in systolic blood pressure deieded by the two methods did not differ significantly. systematically higher values than ASP. For diastolic pressure, the antihypertensive significantly greater than that detected by OBP The greater treatment effect observed by using ASP measurements demands four times more oatients lo be studied with OBP measurements lo achieve the same statistical power. Our results suggesl that ABP may be more sensitive and therefore more cost-effective statistically and clinically significant blood pressure changes in clinical trials. ambulatory blood p~~.~ure. office blood pressure. Key vuwrls: antihypertensive
ASH XIV ABSTRACTS
A005
1999-VOL.
12, NO. 4, PART 2
A006
EFFECT OF ALCOHOL CESSATION ON BLOOD PRESSURE. ASSESSMENT BY 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING MT Aauilcra,A dc la Siam*, A. Coca*, R. Estruch, J. Fekmdez-Sol& E Gbnez-Angelats, C. Sierra, E. Brag&t, V. Giner, MT Ammo, A Urbane-tvbkquez Hype&w.wonand Alcohol Unilr.De,,arfmenroflnternal Melcine. Hospital Clinx. Barcelona.Spain The aim of the present study was to assessthe effect of one month of proven abstkoce from alcohol on 24-hour blood pressure profile in
heavy alcohol drinkers. Forty-two male heavy drinkers (more than 1OOgof pure ethanol per day) were admitted in a general ward for voluntary alcohol detoxification. On the day of admission they received a total dose of 2 g/Kg of ethanol diluted in orange juice in five divided doses and a 24-hour ambulatory blood pressure monitoring was performed After one month of proven alcohol abstinence, a new 24-hour blood pressure monitoring was paformed in the same conditions, while receiving the same amount of fluid, without the addition of alcohol After one month of proven alcohol abstinence, blood pressure and heart rate decreased. The reduction was 7.2 mmHg for 24-hour systolic blood pressure (95% CI: 4.5-9.9), 6.6 mmHg for 24-hour diastolic blood pressure (95% Cl: 4.2-9.0) and 7.9 bpm for heart rate (95% CI: 5.1-10.7). The proportion of alcoholic patients considered hypertensive based on 24-hour blood pressure criteria (daytime systolic blood pressure L 135 mmHg or daytime diastolic blood pressure 2 85 mmHg) fell from 42% during alcohol drinking to 12% after one month of complete alcohol abstinence Alcohol cessation did not modify either the long-term blood pressure variability, assessed by standard deviations of 24-hour blood pressure, or its circadiao profile. We conch& that alcohol cessation in heavy alcohol drinkers reduces blood pressure assessed by 24-hour ambulatory blood pressure monitoring, this reduction being clinically relevant. These results demonstrate that heavy alcohol consumption has an important effect on blood pressure, and thus alcohol cessation must be recommendedas a priority for hypertensive alcohol drinkers. Key Words: alcohol drinking, alcoholism, ABPM
orevious /schemic transient patients. merwly
AJH-APRIL
hour&Twenty&o patients (46.8%) had hislorv of CT scannino demonstrated an (throhbotiij stroke in 39 patie& (4 patients had ischemic altacks) and hemorrhage in 8 Clinic BP values obtained al the emergency mom with sphygmomanometer
monitorization (ABPM) in essential Eighty-six patients regularly visited in hypertension units of county hospitals ware included in the study. Participants had not received anti-hypertensive
monlorizations was greater for the sleeping period (DBP = _ 1.27 f 7.05 mmHg and SBP = -1.25 f 10.1 I) than during adivity (DBP = -0.98 i 6.53 and SBP = -0.43 r 10.51) or the 24-hr period (DBP = -0.95 f 6.21 and SBP = -0.34 f 9.93). These differences were not significant. Diagnosis of HT varied by ABPM in 24.42% of Ten patients (11.6%) considered HT in the first ABPM were not in the second and 11 patients (12.6%) considered HT in the second ABPM did not meet criteria for HT in the second ABPM. We wndude that average values of BP obtained by Iwo ABPMs within one month of each other showed a good correlation although SBP correlated better than DBP. diagnosis of HT varied by ABPM for almosi one-fourth of the participants although almost half of them wuld be attributed to life-style attributed 10the knowledge of a hypertension diagnosis. Key Words: ambulatory blood pressure monitoring, repmdudbility.
(endothelin-1 antagonist Ro 47-0203, enalapril or placebo; for the pvrposes of this study treated as one treatment group). The OBP and ASP measurements correlated dosely during both the placebo-run in and active treatment (systolic r r 0.74, diastolic r 2 0.60, p < 0.0001). but the ASP was systematically sig’nificantly blood press& compared to placebo run-in as detected by both methods (p < 0.02). However, the antihypertensive significantly greater than that detected by OBP afler 3 weeks (-2.7 * 6.3 mmHg. p -z 0.0001) and 4 weeks (-0.7 f 6.0 mmHg, p = 0.02) of treatment. The drag-induced decrease in systolic blood pressure deieded by the two methods did not differ significantly. systematically higher values than ASP. For diastolic pressure, the antihypertensive significantly greater than that detected by OBP The greater treatment effect observed by using ASP measurements demands four times more oatients lo be studied with OBP measurements lo achieve the same statistical power. Our results suggesl that ABP may be more sensitive and therefore more cost-effective statistically and clinically significant blood pressure changes in clinical trials. ambulatory blood p~~.~ure. office blood pressure. Key vuwrls: antihypertensive