Effect of placebo on ambulatory blood pressure monitoring in children. Pediatr Nephrol 2012 Oct;27(10):1937-42
Date
05/25/2012Pubmed ID
22623022Pubmed Central ID
PMC3423579DOI
10.1007/s00467-012-2191-zScopus ID
2-s2.0-84866986774 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
BACKGROUND: Ambulatory blood pressure monitoring (ABPM) has been proposed as a useful tool for more accurately diagnosing hypertension (HTN) and evaluating blood pressure (BP) response in pediatric anti-hypertensive trials. ABPM captures multiple BP measurements during routine daily activities and is thus an excellent method for identifying white-coat HTN. Additionally, ABPM measurements in adults do not demonstrate the placebo effect commonly seen with casual BP measurements, although this has yet to be evaluated in children. Therefore,, the aim of this study was to assess the effect of placebo on ABPM measurements in children.
METHODS: A total of 141 children aged 5-16 years with elevated BP were randomized into a multi-center, single-blind, cross-over trial. Subjects received a placebo pill prior to wearing a 24-h ABPM device at one of two visits separated by 1-2 weeks. Study procedures were otherwise identical at both visits.
RESULTS: Mean systolic and diastolic BP for all measured time periods were similar between visits, as was the number of children diagnosed with HTN at each visit.
CONCLUSION: Having confirmed HTN at baseline did not affect the impact of placebo on mean BP. If confirmed, this lack of placebo effect on ABPM measurements may allow for the design of direct comparison pediatric anti-hypertensive trials without a placebo arm.
Author List
Redwine K, Howard L, Simpson P, Li SH, Yan K, James L, Blumer J, Sullivan J, Ward R, Wells T, Network of Pediatric Pharmacology Research UnitsAuthors
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of WisconsinKe Yan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAge Factors
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Child
Child, Preschool
Cross-Over Studies
Female
Humans
Hypertension
Male
Office Visits
Placebo Effect
Predictive Value of Tests
Single-Blind Method
United States