Dataset Information

Antihypertensive drug effects according to the pretreatment self-measured home blood pressure: the HOMED-BP study.

ABSTRACT:

Objectives

To clarify whether or not the antihypertensive drug effect is proportional to the baseline pretreatment self-measured home blood pressure (HBP) in accordance with the law of initial value (Wilder's law).

Design

A post-hoc analysis of a multicentre clinical trial.

Setting

Outpatients across Japan with mild-to-moderate essential hypertension.

Participants

Among 3518 randomised participants, 2423 who self-measured HBP during the pretreatment drug-free period (10-28 days after starting fixed-dose antihypertensive monotherapy) with a mean 7.0 years follow-up were eligible.

Main outcome measures

We analysed individual HBP readings during pretreatment and monotherapy.

Results

The day-to-day HBP during both the pretreatment period and monotherapy period remains almost the same throughout each period; the results were consistent, regardless of the pretreatment HBP. Following monotherapy, the reduction in the HBP increased by 2.2 mm Hg (95% CI: 1.8 to 2.5 mm Hg) per 10 mm Hg pretreatment HBP increase, up to 11.0 mm Hg (95% CI: 9.9 to 12.0 mm Hg) among patients with an HBP ?165 mm Hg during pretreatment. Among the 1005 patients receiving low-dose monotherapy (defined daily dose: 0.5 units), the reduction peaked at 8.9-9.1 mm Hg in those with pretreatment HBP 155-164 mm Hg and ?165 mm Hg (p=0.88).

Conclusions

According to Wilder's law, the HBP reduction due to fixed-dose monotherapy was proportional to the pretreatment HBP without any regression to the mean phenomenon. With low-dose antihypertensive drugs, however, the HBP reduction peaked in patients with a high pretreatment HBP, indicating the need for such patients to receive a sufficient amount of antihypertensive drug medication at the initial treatment.

Trial registration

UMIN Clinical Trial Registry (http://www.umin.ac.jp/ctr), Unique identifier: C000000137.

SUBMITTER: Sano H

PROVIDER: S-EPMC7735093 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Antihypertensive drug effects according to the pretreatment self-measured home blood pressure: the HOMED-BP study.

Sano Hikari H Hara Azusa A Asayama Kei K Miyazaki Seiko S Kikuya Masahiro M Imai Yutaka Y Ohkubo Takayoshi T

BMJ open 20201212 12

<h4>Objectives</h4>To clarify whether or not the antihypertensive drug effect is proportional to the baseline pretreatment self-measured home blood pressure (HBP) in accordance with the law of initial value (Wilder's law).<h4>Design</h4>A post-hoc analysis of a multicentre clinical trial.<h4>Setting</h4>Outpatients across Japan with mild-to-moderate essential hypertension.<h4>Participants</h4>Among 3518 randomised participants, 2423 who self-measured HBP during the pretreatment drug-free period ...[more]

PMID: 33310801

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Dataset Information

Antihypertensive drug effects according to the pretreatment self-measured home blood pressure: the HOMED-BP study.

Objectives

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Trial registration

Publications

Antihypertensive drug effects according to the pretreatment self-measured home blood pressure: the HOMED-BP study.

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