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Is "Isolated Home" Hypertension as Opposed to "Isolated Office" Hypertension a Sign of Greater Cardiovascular Risk?
Guillaume Bobrie, MD;
Nathalie Genès, MD;
Laurent Vaur, MD;
Pierre Clerson, MD;
Bernard Vaisse, MD;
Jean-Michel Mallion, MD;
Gilles Chatellier, MD
Arch Intern Med. 2001;161:2205-2211.
Background The SHEAF (Self-Measurement of Blood Pressure at Home in the Elderly:
Assessment and Follow-up) study is an observational study (from February 1998
to early 2002) designed to determine whether home blood pressure (BP) measurement
has a greater cardiovascular prognostic value than office BP measurement among
elderly ( 60 years) French patients with hypertension. The objective of
this present work is to describe the baseline characteristics of the treated
patients in the SHEAF study from February 1998 to March 1999, placing special
emphasis on "isolated office" and "isolated home" hypertension.
Methods Baseline office BP measurement was assessed using a mercury sphygmomanometer.
Home BP measurement was performed over a 4-day period. A 140/90–mm Hg
threshold was chosen to define office hypertension, and a 135/85–mm
Hg threshold to define home hypertension.
Results Of the 5211 hypertensive patients in the SHEAF study with a valid home
BP measurement, 4939 received treatment with at least 1 antihypertensive drug.
Patients with isolated office hypertension represented 12.5% of this population,
while patients with isolated home hypertension represented 10.8%. The characteristics
of the patients with isolated office hypertension were similar to those of
patients with controlled hypertension. However, patients with isolated office
hypertension had fewer previous cardiovascular complications. In contrast,
rates of cardiovascular risk factors and history of cardiovascular disease
in patients with isolated home hypertension resembled those in patients with
uncontrolled hypertension.
Conclusions This retrospective analysis suggests that patients with isolated home
hypertension belong to a high-risk subgroup. The 3-year follow-up of these
patients will provide prospective data about the cardiovascular prognosis
of these subgroups.
From the Service d'Hypertension Artérielle, Hôpital Européen
Georges Pompidou, Paris, France (Dr Bobrie); Laboratoire Aventis, Paris (Dr
Genès and Vaur); Orgamétrie, Wasquehal, France (Dr Clerson);
Médecine Interne, Hôpital de la Timone, Marseille, France (Dr
Vaisse); Médecine Interne et Cardiologie, Centre Hospitalier Universitaire,
Grenoble, France (Dr Mallion); and the Département d'Information Hospitalière,
Hôpital Européen Georges Pompidou, Paris (Dr Chatellier).
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