Ambulatory Blood Pressure Monitoring for Antihypertensive Treatment Guidance

• Difference in mean 24-hour systolic blood pressure at 1 year
• Difference in mean 24-hour diastolic blood pressure at 1 year

• Change in 24-hour diastolic blood pressure from baseline to 1 year
• Primary outcome measure in patients with treated hypertension at baseline

• Proportion of patients with controlled hypertension at 1 year
• Mean number of blood pressure lowering drugs per patient at 1 year
• Difference in mean office systolic blood pressure at 1 year
• Difference in mean office diastolic blood pressure at 1 year

The purpose of this study is to determine whether in patients with arterial hypertension, treatment guidance using 24-hour blood pressure measurement results in better blood pressure control compared to treatment guidance using office blood pressure measurement.

Blood pressure control in arterial hypertension remains poor, despite the availability of effective drug treatment. Therefore, strategies to increase blood pressure control are urgently needed. 24 hour blood pressure is a better predictor of cardiovascular morbidity and mortality than office blood pressure. Furthermore, the lower variability of measurements over time of 24 hour blood pressure could allow better adjustment of antihypertensive therapy. However, there are only scarce data about antihypertensive treatment adjustment using 24 hour blood pressure instead of office blood pressure.

Aim: To test the hypothesis that a 24 hour blood pressure guided therapy is is more effective in reaching blood pressure control when compared to conventional office blood pressure guided therapy.

Inclusion Criteria:

• Uncontrolled hypertension (office BP >139/89mmHg AND 24h BP >129/79mmHg)

Exclusion Criteria:

• Severe concomitant illness including heart failure, significant valvular heart disease or malignancy