THE EVALUATION OF ANTIHYPERTENSIVE PROCEDURES, WITH PARTICULAR REFERENCE TO THEIR EFFECTS ON BLOOD PRESSURE

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Abstract
Essential data used in evaluating clinical trials in patients with essential hypertension are conveniently grouped in a single graphic chart and can be summarized, for purposes of comparison, as a numerical "Severity Index." Casual readings of blood pressure are not representative data for such purposes. They are usually 20/10 mm Hg higher than means of the week''s pressures as measured either by nurses in hospital or by the patient or his family at home. Hydralazine and reserpine treatment does not diminish this variability. Weekly means of pressures group to provide representative data. In hospitalized patients, the means stabilize usually after 1 week, so that the 2d or 3d week''s mean is a satisfactory control level. Means of home pressures usually correspond well with means of hospital pressures. They show narrow ranges of variation from week to week and, like hospital means, provide representative, reproducible data. Our experience does not support the arbitrary belief that the taking of home pressures is psychologically damaging. Rather, it is often reassuring to the patient, while also useful to the therapist. Recording of weekly means of hospital or home pressures is part of the program of evaluation of antihypertensive procedures.

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