Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Staessen and colleagues1 reported that patients whose antihypertensive therapy
was guided by home measurements of blood pressure (BP) were more likely to
have therapy discontinued after 1 year, and to have poorer BP control, than
were those who underwent office monitoring of their BP. In both groups, therapy
was adjusted to maintain a target diastolic BP between 80 and 89 mm Hg. However,
the expert panel of American Society of Hypertension2 recommends
a stricter target value of 135/85 mm Hg for both ambulatory and home meaurements
of BP. This difference is comparable to the final difference of 5.9 mm Hg
in daytime ambulatory systolic BP between the groups whose treatment was guided
by home BP and office BP in the trial by Staessen et al. A target cutoff value
of 135/85 mm Hg or lower may have been more appropriate.
Kario K, Pickering T. Guidelines for Home- and Office-Based Blood Pressure Monitoring. JAMA. 2004;291(19):2315. doi:10.1001/jama.291.19.2315-a