Influence of self-measurement of blood pressure on the responder rate in hypertensive patients treated with losartan: results of the SVATCH Study

Home measurement of blood pressure (BP) can improve compliance. The aim of this study was to evaluate if the efficacy of losartan in hypertension coul d be enhanced by providing patients with a device for home BP measurement. In this open, randomised, prospective, multi-centre study in 244 Swiss prac tices, patients with mild-to-moderate hypertension were randomised to a gro up receiving a home BP measuring device (OMRON) (group 2), or to a group wh ere this device was not provided (group 1). After 8 weeks of treatment with losartan, the responder rates between subjects performing home measurement of BP were compared with those without self-measurement, whereby exclusive ly sphygmomanometric office BP values were considered. A total of 622 subje cts completed the study. Treatment with losartan significantly reduced dias tolic (DBP) and systolic BP (SBP) (P < 0.0001). Overall, the group with hom e BP measurement showed an increased responder rate (DBP less than or equal to 90 mm Hg) by 6.4% (59.8% vs 66.2%; 0.05 < P < 0.1). This difference was mainly due to female patients (64.1% vs 73.2%), where it reached statistic al significance (P < 0.01). Pretreated patients showed a 9.0% improvement o f response in the home measurement group as well (0.05 < P < 0.1). The resp onder rate in newly treated subjects was relatively high, reaching 79.5% (D BP less than or equal to 90 mm Hg or reduction greater than or equal to 10 mm Hg DBP from baseline). However, home measurement did not significantly i mprove BP control in these new patients (81.4% vs 77.7%). Overall, home mea surement can lead to a slight improvement of BP control. This improvement w as most evident in females, reaching significance.