Document Detail

Diagnosis of hypertension using home or ambulatory blood pressure monitoring: comparison with the conventional strategy based on repeated clinic blood pressure measurements.
MedLine Citation:
PMID:  11132597     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate whether measurement of blood pressure at home (HBP) and by ambulatory monitoring (ABP) are reliable alternatives to the traditional strategy for the diagnosis of hypertension based on blood pressure measurement on repeated clinic visits (CBP). DESIGN: Comparison of the diagnosis of hypertension based on HBP (on six workdays) or ABP monitoring (two occasions) with that based on CBP (five visits within 3 months). SETTING: Outpatient hypertension clinic. PARTICIPANTS: We enrolled 133 individuals with a diastolic CBP of 90-115 mmHg on the initial visit. MAIN OUTCOME MEASURES: CBP, HBP and ABP values, and the diagnosis of hypertension. RESULTS: Hypertension was diagnosed in 70, 63 and 56% of individuals using the CBP, ABP and HBP methods respectively (P = 0.04). Agreement in the diagnosis of hypertension between all three methods was found in 59% of individuals. Disagreement between CBP and ABP was found in 27%, between CBP and HBP in 29% and between ABP and HBP in 26% of individuals. The sensitivity, specificity and positive and negative predictive values of ABP to diagnose hypertension correctly were 76, 67, 85 and 53% respectively; for HBP the respective values were 69, 77, 88 and 51%. The same parameters for HBP compared with ABP in the detection of white-coat hypertension were 61, 79, 48 and 86% respectively. CONCLUSIONS: Indiscriminate use of HBP or ABP monitoring in the evaluation of all individuals with high blood pressure will probably result in confusion and therefore should be discouraged. However, in the detection of white-coat hypertension, HBP appears to be useful as a screening test, which, if positive, requires confirmation with ABP monitoring.
G S Stergiou; I I Skeva; N M Baibas; C B Kalkana; L G Roussias; T D Mountokalakis
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  18     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-29     Completed Date:  2001-03-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1745-51     Citation Subset:  IM    
Hypertension Centre, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
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MeSH Terms
Ambulatory Care Facilities
Blood Pressure Determination*
Blood Pressure Monitoring, Ambulatory*
Hypertension / diagnosis*,  physiopathology
Middle Aged
Self Care

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