A randomized and controlled study of noninvasive hemodynamic monitoring as a guide to drug treatment of uncontrolled hypertensive patients
| Autor: | Eliza Miszkowska-Nagórna, Marika Heinpalu-Kuum, Sverre E. Kjeldsen, Anne Cecilie K Larstorp, Krzysztof Narkiewicz, Xiaoqiu Liu, Fadl Elmula M. Fadl Elmula, Paola Rebora, Morten Rostrup, Gianfranco Parati, Margus Viigimaa, S. Salerno, Tommaso Comotti, Stéphane Laurent, Anneli Talvik, Ewa Świerblewska, Maria Grazia Valsecchi |
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| Přispěvatelé: | Elmula, F, Rebora, P, Talvik, A, Salerno, S, Miszkowska Nagórna, E, Liu, X, Heinpalu Kuum, M, Comotti, T, Larstorp, A, Rostrup, M, ͆wierblewska, E, Valsecchi, M, Kjeldsen, S, Viigimaa, M, Narkiewicz, K, Parati, G, Laurent, S |
| Rok vydání: | 2015 |
| Předmět: |
Blood pressure control
Adult Male integrated hemodynamic monitoring medicine.medical_specialty Ambulatory blood pressure Physiology Clinical Decision-Making Hemodynamics Blood Pressure Decision Support Techniques Drug treatment Clinical decision making Internal medicine Internal Medicine medicine Humans Prospective Studies Prospective cohort study Diuretics Antihypertensive Agents business.industry blood pressure control uncontrolled hypertension Blood Pressure Monitoring Ambulatory Middle Aged System study ambulatory blood pressure monitoring Blood pressure Hypertension Cardiology antihypertensive drug Female Cardiology and Cardiovascular Medicine business Algorithms |
| Zdroj: | Journal of hypertension. 33(12) |
| ISSN: | 1473-5598 |
| Popis: | In the BEtter control of BP in hypertensive pAtients monitored Using the HOTMAN sYstem study, we investigated whether utilizing noninvasive monitoring of hemodynamic parameters combined with a drug selection algorithm (integrated hemodynamic management - IHM) compared with conventional drug selection may improve uncontrolled hypertension in European Hypertension Excellence centers.Uncontrolled (office SBP140 mmHg and ambulatory daytime SBP135 mmHg while taking ≥2 antihypertensive drugs) essential hypertensive patients were referred to five European Hypertension Excellence centers and, if eligible, were randomized to IHM-guided (n = 83) vs. conventional (control, n = 84) treatment adjustment in an investigator-initiated multicenter prospective randomized parallel groups controlled study.The average number of antihypertensive drugs increased from 3.1 to 4.1 in both groups and differed only in a rise of the use of diuretics in the IHM groups (from 13 to 31%). Daytime SBP, defined as the primary endpoint, decreased markedly and to the same extent from baseline to 6 months in IHM (-15.8 ± 14.8 mmHg) and control (-15.4 ± 14.5 mmHg) groups (P = 0.87), with a similar behavior of office SBP (no between group differences, P = 0.18). Average number of adverse events was significantly lower in IHM than in controls (P = 0.008) but of the more general type and not necessarily related to drug treatment.Thus, noninvasive hemodynamic monitoring associated with a drug selection algorithm induced similar reductions in ambulatory daytime and office SBP compared with conventional drug selection in uncontrolled hypertensive patients referred to European Hypertension Excellence centers.Clinical Trial Registration - URL: http://www.clinicaltrials.gov. Unique identifier: NCT01482364. |
| Databáze: | OpenAIRE |
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