Rapid Responses from bmj.com

doi:10.1136/bmjusa.02100004

BMJ, doi: 10.1136/bmjusa.02100004, (Published 26 January 2003)

Letters

Rapid Responses from bmj.com

Use the sphygmomanometers more, not less

Ambulatory blood pressure monitoring: really a gold standard?

The first 150 words of the full text of this article appear below.

From BMJ USA 2002;October:553

As of September 19, 2002, this article had generated 11 Rapid Responses, which can be read in their entirety at http://bmj.com/cgi/eletters/325/7358/254.Edited excerpts from two responses are presented here. $---$ Editor

Use the sphygmomanometers more, not less

EDITOR $---$ The conclusion by Little et al $---$ that conventional measurements by general practitioners may be misleading $---$ runs aheadof the evidence. The chain of evidence that is required to makethis conclusion has three links: The first is a reliable methodof measuring blood pressure, the second is demonstrating thatraised blood pressure diagnosed by the chosen method increasesthe patient's cardiovascular risk, and the third is that treatmentreduces the risk. As part of the last link it is valuable to knowthe absolute benefits of treatment, and what target blood pressureto aimfor.

The research evidence for treatment decisions based on newer methods is not available for the last link. We know from well-conducted. . . [Full text of this article]