{"id":"ef03c1032830","type":"article","url":"https://hartvaat.nl/2023/03/01/korttermijn-bloeddrukmetingen-voorspellen-langetermijneffect-van-behandeling/","title":"Korttermijn bloeddrukmetingen voorspellen langetermijneffect van behandeling","title_en":"Clinical Utility of Short-Term Blood Pressure Measures to Inform Long-Term Blood Pressure Management.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling","lipidenverlaging"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.122.20458","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.122.20458","authors":["Nelson Wang","Katie Harris","Mark Woodward","Stephen Harrap","Giuseppe Mancia","Neil Poulter","John Chalmers","Anthony Rodgers"],"significance":6,"published":"2023-03-01","source_date":"2023-03-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/bloeddrukmeting-thuismeting-abpm/","https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/"],"congress":"","summary_en":"This study showed that blood pressure measurements taken shortly after starting antihypertensive therapy reliably predict long-term effects, supporting early assessment to guide medication adjustments.","created":"2026-07-03T10:30:15Z","updated":"2026-07-03T18:39:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie toonde dat bloeddrukmetingen kort na start van antihypertensieve therapie het langetermijneffect betrouwbaar voorspellen. Vroege respons helpt de juiste medicatie te selecteren en onnodige wisseling te voorkomen.","abstract_original":"BACKGROUND: Decisions about hypertension management are substantially influenced by blood pressure (BP) levels measured before and soon after starting BP lowering drugs. We aimed to assess the utility of short-term BP changes in individuals in terms of long-term treatment response. METHODS: Post hoc analyses of 2 randomized trials with 4-to-6 weeks active run-in for all participants, followed by randomization to active BP lowering treatment (combination perindopril±indapamide) or placebo. We categorized individuals by degree of systolic BP (SBP) change during active run-in treatment and assessed associations with subsequent postrandomization placebo-corrected BP reduction, cardiovascular events, and tolerability. We included individuals with baseline BP ≥140/90 mm Hg from the PROGRESS trial (Perindopril Protection Against Recurrent Stroke Study; 4275 individuals with cerebrovascular disease) and ADVANCE trial (The Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation; 6610 individuals with diabetes). RESULTS: During the active run-in period, the proportion of participants with initial SBP changes in 4 categories (SBP increase, 0-9.9 mm Hg decrease, 10-19.9 mm Hg decrease, and ≥20 mm Hg decrease) were 17%, 27%, 28%, and 28% in PROGRESS and 21%, 22%, 24%, and 33% in ADVANCE. Randomization to active therapy achieved similar placebo-corrected long-term BP reductions across the 4 initial SBP change groups in both trials (P-values for heterogeneity >0.1). There was no significant difference in achieving BP <140/90 mm Hg at follow-up, major cardiovascular events, nor treatment tolerability according to the SBP change during active run-in period (all P-values >0.1). CONCLUSIONS: An individual's apparent BP change immediately after commencing therapy has limited clinical utility. Therefore, more emphasis should be given to use of evidence-based regimens and measures over the long-term to ensure sustained BP control. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT00145925."}