Effect of antihypertensive treatment on office and self-measured blood pressure: the Autodil study

OBJECTIVE: To examine prospectively the effects of antihypertensive therapy on office blood pressure (BP) and home BP, in a large-scale hypertensive population followed by their general practitioners. PATIENTS: A total of 760 hypertensive patients either never treated or after a 2-week washout period, aged 18-75 years, with a diastolic office BP between 95 and 110 mm Hg and a systolic office BP below 180 mm Hg. METHODS: Patients measured their BP at home using an automated printer-equipped oscillometric device (OMRON-HEM 705 CP) twice daily for 8 days before the visit to their general practitioner who recorded three office BP. These measurements were performed before and after 8 weeks of antihypertensive therapy with sustained-release diltiazem 300 mg once daily. RESULTS: Diltiazem reduced systolic and diastolic office BP and home BP and heart rate (P < 0.01). Systolic and diastolic office BP were higher than home BP before (P < 0.01) but not during treatment. Correlation coefficients between the two methods before and during therapy were 0.6 and 0.7 for systolic BP and 0.4 and 0.6 for diastolic BP (P < 0. 01). Both methods did not agree equally throughout the range of BP: home BP was higher than office BP for high values and lower for low values. CONCLUSION: The results show that BP measured at home by patients can be higher than office BP in the highest range of BP. Journal of Human Hypertension (2000) 14, 525-529