Factors influencing the difference between office and ambulatory blood pressure measurements

Aim. То identify psychological predictors and quality of life (QoL) indicators affecting the difference between office and ambulatory blood pressure (BP), as well as the effects of long-term antihypertensive treatment on this difference.

Material and methods. The database for 8 studies with similar design was analysed, including the data on 204 patients with arterial hypertension (AH), who took diltiazem, amlodipine, betaxolol, moxonidine, enalapril, lisinopril, metopro-lol, ortelmisartanfor 1—3 months. Mean age ofthe participants was 53,2±8,7 years, mean AH duration — 10,6±8,6 years. At baseline and after the treatment end, 24-hour BP monitoring (BPM), QoL and psychological status (PS) assessment were performed.

Results. All medications significantly reduced systolic and diastolic BP (SBP, DBP). The office-ambulatory BP difference negatively correlated with QoL scales IV and H, as well as with PS scales F and 6, being positively correlated with PS scales 3, 4, F, and 7. Metoprolol therapy reduced the office ambulatory BP difference: for SBP — from 12,6±2,8 to 0,8±2,8 mm Hg, for DBP — from 10,4±1,8 to 3,0±1,8 mm Hg. Amlodipine reduced this parameter for SBP from 11,9±3,0 to 3,8±3,0 mm Hg.

Conclusion. The office-ambulatory BP difference increased when PS scales 3, 4, K, and 7 increased, and decreased when PS scales F and 6 or QoL scales IV and H decreased. Out of all antihypertensive medications studied, only metoprolol and amlodipine monotherapy significantly reduced the office-ambulatory BP difference.

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