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Using central – not cuff – BP controls hypertension at lower doses


Treatment decisions based on central, rather than arm cuff, blood pressures result in patients being controlled at lower doses of antihypertensives, suggests a paper published today in Hypertension.

Australian researchers randomised 286 patients with hypertension to treatment decisions guided by best-practice usual care (which could be office, home or 24-hour ambulatory BP) or usual care plus central BP measurement using a SphygmoCor device.  In the latter group treatment decisions were based on the central BP measurement.

For usual care alone, there was no change in daily defined dose (DDD) of antihypertensive but there was a significant stepwise decrease in DDD from baseline to three months and at two subsequent three monthly reviews in those in the central BP group.

But there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness.

The researchers conclude that hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.