[Critical analysis of the response to antihypertensive therapy. Report of 102 cases].

UNLABELLED: One hundred and two patients with mild to moderate hypertension, non responding to a placebo therapy, were given an antihypertensive drug for a mean period of 6 weeks (range: 3-12 weeks). Their blood pressure (BP) was measured before and after active treatment by both a mercury manometer at the clinic and an ambulatory apparatus (Spacelabs 5200 or 90202). The clinic BP figures were poorly correlated with the 24 hour ambulatory BP levels, as well as the magnitude of decrease in clinic BP with the reduction in ambulatory BP. Twenty eight patients who were considered as "clinic responders" had in fact not significantly lowered their ambulatory DBP and, conversely, 16 patients were "clinic non responders" whereas they were "ambulatory responders". The patients were divided into 2 groups, according to White's and Morgan Roth's recommendations: group I (n = 61) with a percentage of pathological DBP readings (greater than 90 mmHg) during daytime as high as 50% or more, and group II (n = 41) with a percentage less than 50%. The correlations between the 2 methods of BP measurement were closer within the group I than within the group II and the rate of discrepancies between the "clinic" and "ambulatory responders" was lower. On the other hand, we identified the group II patients as being often "clinic responders" but rarely "ambulatory responders", whereas the inverse trend was observed in the group I.

IN CONCLUSION: even in non placebo responding hypertensive patients the clinic BP measurement might be not sufficient for proper evaluation of an antihypertensive drug.(ABSTRACT TRUNCATED AT 250 WORDS)