Relationship Between the Frequency of Blood Pressure Self-measurement and Blood Pressure Reduction with Antihypertensive Therapy : Results of the OLMETEL (OLMEsartan TELemonitoring Blood Pressure) Study

Overview

Journal Clin Drug Investig

Date 2006 Dec 14

PMID 17163276

Citations 6

Authors

Silke Ewald

Johannes Vor dem Esche

Sakir Uen

Fabian Neikes

Hans Vetter

Thomas Mengden

Affiliations

Soon will be listed here.

Abstract

Objectives: This subanalysis of the OLMETEL (OLMEsartan TELemonitoring blood pressure) study in patients with essential hypertension assessed the relationship between the frequency of blood pressure self-measurement (BPSM) and the response to blood pressure (BP)-lowering therapy with olmesartan medoxomil, and the number of BP readings per week necessary to detect a mean systolic or diastolic BP reduction > or =5mm Hg.

Methods: A total of 53 patients with essential hypertension received treatment with olmesartan medoxomil 10, 20 or 40 mg daily for 12 weeks. BPSM was performed for the first 9 weeks using a TensioPhone TP2 device. Patients were instructed to measure BP at least twice daily (morning and evening).

Results: After the first 9 weeks of the 12-week treatment period, the extent of BP reduction correlated with the number of BPSMs. Systolic/diastolic BP reductions in patients with a 100% adherence to at least two BP measurements daily were -16.6/-8.0mm Hg compared with -0.2/-3.3mm Hg in patients with only a 75% adherence to at least one BP measurement daily. Obtaining five home BP readings per week resulted in a sensitivity of 94.8% and a specificity of 90.0% to detect a BP reduction of > or =5mm Hg.

Conclusion: Patients adhering to the instructions for BPSM (at least two measurements daily) had a better response to antihypertensive treatment with olmesartan medoxomil. Whether BPSM per se resulted in an improved adherence to therapy or whether the number of recordings was an indicator of already existing adherence remains to be determined. Obtaining at least five home BP readings per week was identified as the threshold for correctly predicting response to olmesartan medoxomil treatment.

Citing Articles

User engagement with home blood pressure monitoring: a multinational cohort using real-world data collected with a connected device.

Rech J, Postel-Vinay N, Vercamer V, de Villele P, Steichen O J Hypertens. 2024; 43(1):90-97.

PMID: 39315540 PMC: 11608629. DOI: 10.1097/HJH.0000000000003861.

Recommendations for home blood pressure monitoring in Latin American countries: A Latin American Society of Hypertension position paper.

Villar R, Sanchez R, Boggia J, Penaherrera E, Lopez J, Barroso W J Clin Hypertens (Greenwich). 2020; 22(4):544-554.

PMID: 32049425 PMC: 8029829. DOI: 10.1111/jch.13815.

Self-blood pressure monitoring in an urban, ethnically diverse population: a randomized clinical trial utilizing the electronic health record.

Yi S, Tabaei B, Angell S, Rapin A, Buck M, Pagano W Circ Cardiovasc Qual Outcomes. 2015; 8(2):138-45.

PMID: 25737487 PMC: 4366280. DOI: 10.1161/CIRCOUTCOMES.114.000950.

[Possibilities of telemedicine in arterial hypertension].

Sehnert W, Mengden T Med Klin (Munich). 2009; 104(4):314-22.

PMID: 19399391 DOI: 10.1007/s00063-009-1053-3.

Changes in home versus clinic blood pressure with antihypertensive treatments: a meta-analysis.

Ishikawa J, Carroll D, Kuruvilla S, Schwartz J, Pickering T Hypertension. 2008; 52(5):856-64.

PMID: 18809791 PMC: 4593654. DOI: 10.1161/HYPERTENSIONAHA.108.115600.

References

Imai Y, Ohkubo T, Hozawa A, Tsuji I, Matsubara M, Araki T . Usefulness of home blood pressure measurements in assessing the effect of treatment in a single-blind placebo-controlled open trial. J Hypertens. 2001; 19(2):179-85. DOI: 10.1097/00004872-200102000-00003. View

OBrien E, Beevers G, Lip G . ABC of hypertension: Blood pressure measurement. Part IV-automated sphygmomanometry: self blood pressure measurement. BMJ. 2001; 322(7295):1167-70. PMC: 1120288. DOI: 10.1136/bmj.322.7295.1167. View

Mengden T, Chamontin B, Phong Chau N, Luis Palma Gamiz J, Chanudet X . User procedure for self-measurement of blood pressure. First International Consensus Conference on Self Blood Pressure Measurement. Blood Press Monit. 2000; 5(2):111-29. View

Mengden T, Uen S, Baulmann J, Vetter H . Significance of blood pressure self-measurement as compared with office blood pressure measurement and ambulatory 24-hour blood pressure measurement in pharmacological studies. Blood Press Monit. 2003; 8(4):169-72. DOI: 10.1097/00126097-200308000-00008. View

Stumpe K, Ludwig M . Antihypertensive efficacy of olmesartan compared with other antihypertensive drugs. J Hum Hypertens. 2002; 16 Suppl 2:S24-8. DOI: 10.1038/sj.jhh.1001395. View

Ashida T, Sugiyama T, Okuno S, Ebihara A, Fujii J . Relationship between home blood pressure measurement and medication compliance and name recognition of antihypertensive drugs. Hypertens Res. 2000; 23(1):21-4. DOI: 10.1291/hypres.23.21. View

Warner G, Jarvis B . Olmesartan medoxomil. Drugs. 2002; 62(9):1345-53; discussion 1354-6. DOI: 10.2165/00003495-200262090-00005. View

Chatellier G, Vaur L, Zannad F, Genes N, Elkik F, Menard J . Home self blood pressure measurement in general practice. The SMART study. Self-measurement for the Assessment of the Response to Trandolapril. Am J Hypertens. 1996; 9(7):644-52. DOI: 10.1016/0895-7061(96)00018-0. View

Ball K, Williams P, Stumpe K . Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents. Olmesartan medoxomil versus antihypertensives. J Hypertens Suppl. 2001; 19(1):S49-56. DOI: 10.1097/00004872-200106001-00007. View

10.

Mengden T, Ewald S, Kaufmann S, Vor dem Esche J, Uen S, Vetter H . Telemonitoring of blood pressure self measurement in the OLMETEL study. Blood Press Monit. 2004; 9(6):321-5. DOI: 10.1097/00126097-200412000-00010. View

11.

Denolle T, Waeber B, Kjeldsen S, Parati G, Wilson M, Asmar R . Self-measurement of blood pressure in clinical trials and therapeutic applications. Blood Press Monit. 2000; 5(2):145-9. View

12.

Illyes M, Mengden T, Tisler A . The virtual hypertension clinic. Blood Press Monit. 2002; 7(1):67-8. DOI: 10.1097/00126097-200202000-00014. View

13.

Williams B, Poulter N, Brown M, Davis M, McInnes G, Potter J . British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary. BMJ. 2004; 328(7440):634-40. PMC: 381142. DOI: 10.1136/bmj.328.7440.634. View

14.

OBrien E, Fitzgerald D . The history of blood pressure measurement. J Hum Hypertens. 1994; 8(2):73-84. View

15.

Rogers M, Small D, Buchan D, Butch C, Stewart C, Krenzer B . Home monitoring service improves mean arterial pressure in patients with essential hypertension. A randomized, controlled trial. Ann Intern Med. 2001; 134(11):1024-32. DOI: 10.7326/0003-4819-134-11-200106050-00008. View

16.

Brueren M, Schouten H, de Leeuw P, van Montfrans G, Van Ree J . A series of self-measurements by the patient is a reliable alternative to ambulatory blood pressure measurement. Br J Gen Pract. 1998; 48(434):1585-9. PMC: 1313222. View

17.

Mengden T, Vetter H, Tisler A, Illyes M . Tele-monitoring of home blood pressure. Blood Press Monit. 2002; 6(4):185-9. DOI: 10.1097/00126097-200108000-00004. View

18.

Chalmers J, Macmahon S, Mancia G, Whitworth J, Beilin L, Hansson L . 1999 World Health Organization-International Society of Hypertension Guidelines for the management of hypertension. Guidelines sub-committee of the World Health Organization. Clin Exp Hypertens. 1999; 21(5-6):1009-60. DOI: 10.3109/10641969909061028. View

19.

Ragot S, Genes N, Vaur L, Herpin D . Comparison of three blood pressure measurement methods for the evaluation of two antihypertensive drugs: feasibility, agreement, and reproducibility of blood pressure response. Am J Hypertens. 2000; 13(6 Pt 1):632-9. DOI: 10.1016/s0895-7061(99)00258-7. View

20.

Mengden T, Battig B, Vetter W . Self-measurement of blood pressure improves the accuracy and reduces the number of subjects in clinical trials. J Hypertens Suppl. 1991; 9(6):S336-7. View