[Home self-monitoring of arterial pressure: identification of the white coat reaction].
OBJECTIVE
To validate the reliability of a standard protocol for self-measurement at home of blood pressure (SMBP) in terms of its sensitivity and specificity for the diagnosis of the white-coat phenomenon (WCP), by comparing it with out-clinic monitoring of blood pressure (OMBP) and examining the effect on the two methods' concordance of blood pressure (BP) levels, the intensity of the WCP, age and the body mass index.


METHODS
Crossover descriptive study.


METHODS
Two health centres in Asturias.


METHODS
58 patients with hypertension, whose BP was not monitored in the clinic, were taught to take 30 SMBP readings in 10 days with a previously calibrated digital sphygmanometer. In the 15 days immediately following, a 24-hour OMBP session took place. Sensitivity, specificity, predictive values and the analysis of individual differences between the variables were assessed.


RESULTS
SMBP sensitivity was 84.21%. Specificity was 82.05%. For the estimated prevalence of white-coat hypertension in our area (22.7%), positive predictive value was 58%, and negative 95%. The graphic analysis of individual differences did not show that the consistency between the two methods was affected in a relevant way by any variable analysed.


CONCLUSIONS
The SMBP protocol presented is a valid instrument, especially for confirming sustained hypertension. It enables the WCP to be suspected, though, if possible, this should be confirmed by means of OMBP.
Comas
A
A
Centros de Salud Otero, Oviedo. acomasf@meditex.es
González-Nuevo
J P
JP
Plaza
F
F
Barreda
M J
MJ
Madiedo
R
R
Pajón
P
P
Marin
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis*
Automedición domiciliaria de la presión arterial: identificación del fenómeno de bata blanca.