Open AccessDiagnosis and Treatment of Resistant Hypertension: The Critical Role of Ambulatory Blood Pressure Monitoring
Author(s) -
Turner J. Rick,
O'Brien Eoin
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12200
Subject(s) - medicine , ambulatory blood pressure , intensive care medicine , ambulatory , blood pressure , clinical trial , psychological intervention , intervention (counseling) , inclusion and exclusion criteria , masked hypertension , diuretic , white coat hypertension , randomized controlled trial , alternative medicine , pathology , psychiatry
other settings). 7 Two arguments can reasonably be postulated. First, if participants in a clinical trial of a procedural intervention have been enrolled based on CBPM values that were indeed influenced by the white-coat phenomenon and then undergo the intervention, their true (lower) BP values are less likely to be reduced by that intervention, thereby lessening the likelihood of finding compelling evidence that the intervention is truly effective. Second, if familiarization (with or without regression to the mean) occurs during the trial, the beneficial reduction in BP may be erroneously attributed to the intervention. In addition, while some trials that employ CBPM may be very well conducted and may indeed show an effect on BP at the snapshot in time at which a measurement is taken (which may only be at one point in a 24-hour cycle, typically during daytime hours), they cannot provide information on the duration of an effect on BP throughout a 24-hour period or its effect during the nocturnal period.