Blood pressure and variability responses to the down-titration of antihypertensive drugs.

Autor: Kim BS; Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri., Lee Y; Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri., Shin JH; Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri., Heo R; Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea., Kim HJ; Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri., Shin J; Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
Jazyk: angličtina
Zdroj: Journal of hypertension [J Hypertens] 2024 May 01; Vol. 42 (5), pp. 809-815. Date of Electronic Publication: 2024 Jan 16.
DOI: 10.1097/HJH.0000000000003668
Abstrakt: Objectives: Several recent guidelines have proposed the gradual reduction of antihypertensive drugs for patients with well controlled blood pressure (BP). However, no studies have examined alterations in BP variability (BPV) during the down-titration of antihypertensives. This study aims to investigate changes in home BPV during the down-titration of antihypertensives.
Methods: We analyzed 83 hypertensive patients who underwent down-titration of antihypertensives and had available home BP data during the down-titration. Down-titration was performed when home SBP was less than 120 mmHg, regardless of the clinic SBP. Primary exposure variable was the standard deviation (SD) of home BP.
Results: Among 83 patients (mean age 66.3 ± 11.9 years; 45.8% men), down-titration led to increase home SBP (from 110.5 to 118.7 mmHg; P  < 0.001), and home DBP (from 68.8 to 72.8 mmHg; P  = 0.001) significantly. There were no significant differences in SDs of SBP [from 6.02 ± 3.79 to 5.76 ± 3.09 in morning, P  = 0.570; from 6.13 ± 3.32 to 6.63 ± 3.70 in evening, P  = 0.077; and from 6.54 (4.80, 8.31) to 6.37 (4.65, 8.76) in home SBP, P  = 0.464] and SDs of DBP during the down-titration of antihypertensive drugs.
Conclusion: Down-titration of antihypertensive drugs did not have notable impact on clinic BP and home BPV, while significantly increasing home BP. These findings provide important insights indicating that the potential concern related to an increase in BPV in the planned strategy of reducing antihypertensive drugs is not substantial.
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Databáze: MEDLINE
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