Prevalence of home blood pressure measurement among selected hypertensive patients: results of a multicenter survey from six hospital outpatient hypertension clinics in Italy.
OBJECTIVE
The purpose of this study was to evaluate the prevalence of home blood pressure (BP) measurement, the type of devices and accuracy in a large sample of hypertensive patients referred to hospital outpatient hypertension clinics.


METHODS
Eight hundred and fifty-five consecutive treated hypertensive patients who attended six specialized centers during a period of 4 months were included. They underwent the following procedures: (i) detailed medical interview by a structured questionnaire; (ii) physical examination; (iii) standard 12-lead electrocardiogram; (iv) BP measurements taken by a validated mercury sphygmomanometer and patient's devices.


RESULTS
A total of 640 (74.7%) of 855 patients were regularly performing home BP measurement. These patients were on average younger than those not practising it (58 vs 60 years, p<0.01); men were more numerous than women (58 vs 44%, p=0.03) and had higher educational level. Electronic arm-cuff instruments were the most frequently used devices (58%) followed by wrist devices (19%) and mercury or aneroid sphygmomanometers (23%). Significant correlations were found between BPs measured by validated mercury sphygmomanometers and patients' devices [r=0.85, p<0.0001 for systolic BP (SBP) and r=0.78, p<0.0001 for diastolic BP (DBP)]. Differences 5 mmHg in SBP or DBP were found in 50 and 60% of patients, respectively.


CONCLUSIONS
Our findings indicate that: (i) home BP measurement is performed by a majority of treated hypertensives seen in specialized centers; (ii) male gender, age and educational level seem to influence the adoption of home BP monitoring; (iii) electronic arm-cuff devices are the most used instruments; (iv) a notable fraction of patient's devices do not meet the accuracy criteria recommended by US Association for the Advancement of Medical Instrumentation.
Cuspidi
Cesare
C
Istituto di Medicina Cardiovascolare and Centro Interuniversitario di Fisiologia Clinica e Ipertensione, Università di Milano e Ospedale Maggiore Policlinico IRCCS, Milano. dhipertensione@libero.it
Meani
Stefano
S
Lonati
Laura
L
Fusi
Veronica
V
Magnaghi
Gaia
G
Garavelli
Guido
G
Palumbo
Gaetana
G
Pini
Claudio
C
Vaccarella
Alvaro
A
Parati
Gianfranco
G
Leonetti
Gastone
G
Zanchetti
Alberto
A
D000368:Aged; D001795:Blood Pressure Determination / Q000295:instrumentation*; D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D010808:Physical Examination; D015995:Prevalence; D011795:Surveys and Questionnaires