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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
|
| pubmed:dateCreated |
1997-1-9
|
| pubmed:abstractText |
The SMART study (Self Measurement for the Assessment of the Response to Trandolapril) was a large scale trial conducted by general practitioners in order to assess the informative value of home self-measured blood pressure (BP) for the evaluation of therapeutic intervention. After a 2-week wash-out period, patients with office diastolic blood pressure (DBP) between 95 and 120 mm Hg received trandolapril, 2 mg once daily for 4 weeks. Four days of self-recorded BP were performed both at the end of the wash-out period and at the end of the treatment period with an automatic printerequipped device using the oscillometric method (A&D UA 751). Every day, a series of three consecutive measurements was planned in the morning before drug intake and repeated in the evening. A total of 1710 patients (946 men, 764 women) aged 56 +/- 11 entered the study. In the 816 patients who correctly performed self-measured blood pressure (SMBP) during both periods and followed the protocol schedule, office BP (SBP/DBP) decreased from 166.4 +/- 15/101.4 +/- 6 mm Hg to 144.7 +/- 14/86.1 +/- 8 mm Hg while SMBP decreased from 153 +/- 18/94 +/- 10 mm Hg to 139 +/- 16/85 +/- 10 mm Hg. A weak correlation was found between the two methods with regard to systolic (r = 0.47, P < 0.0001) and diastolic (r = 0.36, P < 0.0001) BP lowering. Individual response to therapy varied between the two methods: 633 patients (77.6%) exhibited at least a 10 mm Hg office DBP decrease while 493 (60.4%) presented at least a 6 mm Hg self measured DBP decrease in the evening; 65% of patients were considered as responders with both methods. The 24-h therapeutic coverage was assessed by the morning to evening BP decrease ratio (M/E ratio) which represents the ratio of the trough effect to the 12-h post dosing efficacy. Both population and individual M/E ratios ranged between 73% and 86% thus confirming the long duration of action of trandolapril. In conclusion: (1) discrepancies between office and self-measured BP evaluation of therapeutic response have been pointed out: agreement between the two methods is obtained in only 65% of patients, mainly due to intra-individual BP variability and recording conditions; and (2) self-measured BP could be a potential tool to explore the 24-h therapeutic coverage.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jun
|
| pubmed:issn |
0950-9240
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
10
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
341-7
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:8872795-Adolescent,
pubmed-meshheading:8872795-Adult,
pubmed-meshheading:8872795-Aged,
pubmed-meshheading:8872795-Angiotensin-Converting Enzyme Inhibitors,
pubmed-meshheading:8872795-Antihypertensive Agents,
pubmed-meshheading:8872795-Blood Pressure Determination,
pubmed-meshheading:8872795-Female,
pubmed-meshheading:8872795-Humans,
pubmed-meshheading:8872795-Hypertension,
pubmed-meshheading:8872795-Indoles,
pubmed-meshheading:8872795-Male,
pubmed-meshheading:8872795-Middle Aged
|
| pubmed:year |
1996
|
| pubmed:articleTitle |
Assessment of drug efficacy using home self-blood pressure measurement: the SMART study. Self Measurement for the Assessment of the Response to Trandolapril.
|
| pubmed:affiliation |
Hôpital Central, Nancy, France.
|
| pubmed:publicationType |
Journal Article
|