Predictive value of ambulatory blood pressure shortly after withdrawal of antihypertensive drugs in primary care patients.
OBJECTIVE
To determine whether ambulatory blood pressure eight weeks after withdrawal of antihypertensive medication is a more sensitive measure than seated blood pressure to predict blood pressure in the long term.


METHODS
Patients with previously untreated diastolic hypertension were treated with antihypertensive drugs for one year; these were withdrawn in patients with well controlled blood pressure, who were then followed for one year.


METHODS
Primary care.


METHODS
29 patients fulfilling the criteria for withdrawal of antihypertensive drugs.


METHODS
Sensitivity, specificity, and positive and negative predictive value of seated and ambulatory blood pressure eight weeks after withdrawal of antihypertensive drugs.


RESULTS
Eight weeks after withdrawal of medication, mean diastolic blood pressure returned to the pretreatment level on ambulatory measurements but not on seated measurements. One year after withdrawal of medication, mean diastolic blood pressure had returned to the pretreatment level both for seated and ambulatory blood pressure. For ambulatory blood pressure, the sensitivity and the positive predictive value eight weeks after withdrawal of medication were superior to those for seated blood pressure; specificity and negative predictive value were comparable for both types of measurement. Receiver operating characteristic curves showed that the results were not dependent on the cut off values that were used.


CONCLUSIONS
Ambulatory blood pressure eight weeks after withdrawal of antihypertensive drugs predicts long term blood pressure better than measurements made when the patient is seated.
Beltman
F W
FW
Department of General Practice, University of Groningen, Netherlands.
Heesen
W F
WF
Kok
R H
RH
Smit
A J
AJ
May
J F
JF
de Graeff
P A
PA
Havinga
T K
TK
Schuurman
F H
FH
van der Veur
E
E
Lie
K I
KI
Meyboom-de Jong
B
B
D000328:Adult; D017311:Amlodipine / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000592:standards*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D017706:Lisinopril / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D000959:Antihypertensive Agents; D017311:Amlodipine; D017706:Lisinopril