Interest of home blood pressure measurements (HBPM) to establish degree of hypertensive control.
OBJECTIVE
To establish the validity and clinical value of home blood pressure measurements (HBPM) in the treatment follow-up of patients with essential hypertension to rule out or to confirm poor control of blood pressure obtained in the doctor's office with a mercury sphygmomanometer.


METHODS
Observational, cross-sectional study was carried out to validate HBPM in treated hypertensive patients poorly controlled by office-based casual blood pressure measurements. Measurements were made on 2 consecutive days with six readings taken per day. To do this, 2 x 2 tables were drawn up to validate the HBPM using ABPM as the reference method. Sensitivity (S), specificity (Sp), positive probability quotient (+PQ) and negative probability quotient (-PQ) were calculated. The study population (n = 149) was selected by consecutive sampling of the hypertensive patients seen in the Vallada Health Centre. Only 124 patients could be evaluated.


RESULTS
Values obtained with HBPM were: S 97.3% (95% CI 90.4-99.7%), Sp 62.7% (48.1-75.9%), +PQ 2.61 (1.82-3.73) and -PQ 0.04 (0.01-0.71).


CONCLUSIONS
Home monitoring of blood pressure is a useful alternative to ABPM to rule out office-based poor control of hypertensive patients, but not to confirm it.
Llisterri
José Luis
JL
Vallada Health Centre, Valencia, Spain.
Gil
Vicente Francisco
VF
Rodríguez
Gustavo
G
Orozco
Domingo
D
García
Alberto
A
Merino
Jaime
J
D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D015924:Blood Pressure Monitors; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009819:Office Visits; D018579:Patient Selection; D015203:Reproducibility of Results; D018401:Sample Size; D012648:Self Care; D012680:Sensitivity and Specificity; D013030:Spain