Diagnosis of hypertension in a family practice setting: a preliminary study of published protocol versus 24-hour ambulatory blood pressure monitoring.
Although there have been many recommendations in the medical literature regarding the proper evaluation of hypertensive patients, there have been few reports regarding physician compliance with such diagnostic protocols. To assess physician compliance with the diagnostic protocol published by the Joint National Committee for the Detection, Evaluation, and Treatment of High Blood Pressure (JNC), we reviewed the records of 181 hypertensive patients in the family practice clinic of a medical university. We found numerous discrepancies between the published protocol and actual practice. Antihypertensive medication was then discontinued in a small subset of the study group, and the diagnosis of hypertension was reevaluated by both JNC criteria and by 24-hour ambulatory blood pressure monitoring. As compared with 24-hour ambulatory measurements, the JNC criteria were ineffective in properly classifying hypertensive status of the patients in this small subset.
Pye
J
J
Department of Family Medicine, Medical College of Georgia, Augusta 30912.
Fletcher
J L
JL
Fischer
P M
PM
Miller
F E
FE
Prisant
L M
LM
Carr
A A
AA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012017:Referral and Consultation; D012189:Retrospective Studies; D012494:Sampling Studies; D013997:Time Factors
D000959:Antihypertensive Agents