[Identification of overtreated hypertension with statistical analysis of 100 consecutive ambulatory blood pressure monitoring].
The data obtained from 100 consecutive ambulatory blood pressure (BP) recordings performed in treated hypertensive patients (60 men, 40 women, mean age 52 +/- 14 years) were analysed to make a choice between several possible definitions of overtreatment and to evaluate the prevalence of patients thus defined as overtreated. Recordings were studied over two periods: diurnal from 9 a.m. to 7 p.m. (100 patients, 37 +/- 5 measurements/patient), and nocturnal from 11 p.m. to 7 a.m. (98 patients, 19 +/- 2 measurements/patient). The patients were first classified on the basis of reference ambulatory BP values according to sex and age. Subnormal levels were found in 25 patients for diurnal SBP, 25 for nocturnal SBP, 13 for diurnal DBP and 33 for nocturnal DBP. Several criteria of overtreatment were then tested, based on the percentile method and on the number of subnormal values: the median DBP was below the 30th reference percentile in 16 patients, and the percentage of subnormal DBP values was above 80% in 18 patients. Clinically, there was little to differentiate these patients from the rest of the population treated. The goal of treatment which, in terms of BP values, is to normalize the ambulatory BP was therefore overshot in 1 out of 5 or 6 patients depending on the criteria adopted. The significance and consequences of overtreatment cannot yet be evaluated.
Herpin
D
D
Service de Cardiologie B, CHU, Poitiers.
Raud-Raynier
P
P
Amiel
A
A
Boijoux
C
C
Demange
J
J
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001795:Blood Pressure Determination; D002940:Circadian Rhythm; D003627:Data Interpretation, Statistical; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents
Identification des hypertendus surtraités par analyse statistique de 100 enregistrements tensionnels ambulatoires consécutifs.