[Diagnosis of systemic hypertension: evidences that current criteria should be revised].
It has been recommended to take the average of several blood pressure (BP) determinations with a sphygmomanometer to diagnose hypertension, but there is no agreement on the reading numbers.


OBJECTIVE
Describing the behavior of BP readings taken in three different days to establish the classificatory BP in an outpatient hypertension clinic.


METHODS
In the outpatient hypertension clinic of the Clinical Pharmacology Division of the Hospital de Clínicas de Porto Alegre, we use the mean of six readings taken in three different days to establish the classificatory blood pressure, except for those with very high or low values in the first day. In this report we describe the behavior of BP in 58 patients submitted to this routine.


RESULTS
The mean of systolic (SBP) and diastolic (DBP) blood pressures decreased from the first to the 6th reading (ANOVA for repeated measurements: F = 4.45, P = 0.001 for SBP and F = 5.54, P < 0.001 for DBP). Afterward, the patients were classified into two groups according their first SBP and DBP reading. The decreasing in both SBP and DBP was confined to those with the first measurement in the upper half of the entire group (ANOVA: F = 8.03; P < 0.0001 for SBP and F = 6.33, P < 0.0001 for DBP). Regression to the mean and some reactiveness in the first day are possible explanations for this.


CONCLUSIONS
These data corroborate that the hypertension diagnosis should not be based in an single blood pressure determination and suggest that the recommendation to diagnose severe hypertension based on high values in the first two readings could misclassify some patients.
Fuchs
F D
FD
Unidade de Farmacologia Clínica, Hospital de Clínicas de Porto Alegre, RS.
Lubianca Neto
J
J
Moraes
R S
RS
Jotz
J C
JC
Wannmacher
L
L
Rosito
G A
GA
de Paoli
C L
CL
Moreira
L B
LB
D000704:Analysis of Variance; D001795:Blood Pressure Determination / Q000639:trends*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
Diagnóstico de hipertensão arterial sistêmica: evidências de que os critérios contemporâneos devem ser revistos.