A series of self-measurements by the patient is a reliable alternative to ambulatory blood pressure measurement.
BACKGROUND
Several studies have reported overdiagnosis and overtreatment of hypertensive patients, especially in borderline hypertensives.


OBJECTIVE
To find a blood pressure measurement procedure that reduces the risk of misclassification to an acceptable level.


METHODS
Comparative, prospective study over seven months of primary care patients with elevated initial blood pressures. Blood pressure measurements made by general practitioners (GPs), practice nurses, and patients were compared with ambulatory blood pressure measurements.


RESULTS
Ninety-nine patients completed the study. Mean differences (systolic blood pressure) between different measurement procedures and ambulatory measurement ranged from +10 mmHg (doctor) to -1 mmHg (patient), and (diastolic) from +4 mmHg (doctor) to -2 mmHg (patient). Standard deviations of mean differences ranged from 12 mmHg (doctor/systolic) to 10 mmHg (patient/systolic), and from 8 mmHg (doctor/diastolic) to 7 mmHg (patient/diastolic).


CONCLUSIONS
Self-measurements by the patient appear to be a reliable alternative to ambulatory blood pressure measurement. In diagnosing and managing mild hypertension, we recommend the use of a valid self-measuring device.
Brueren
M M
MM
Department of General Practice, Maastricht University.
Schouten
H J
HJ
de Leeuw
P W
PW
van Montfrans
G A
GA
van Ree
J W
JW
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000451:nursing; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies