[Home blood pressure self-monitoring. Influence of the mean calculation used on the diagnosis of white-coat hypertension].
OBJECTIVE
To describe the variations in the diagnosis performance of home blood pressure self-monitoring (hBPSM) with different methods for mean calculation, in order to diagnose white-coat hypertension (WCH).


METHODS
Multi-centre, descriptive, and comparative study to assess the diagnosis performance of a test method.


METHODS
Four primary health care centres.


METHODS
A total of 157 recently-diagnosed, untreated patients with mild-moderate hypertension took part in the study.


METHODS
The results obtained with hBPSM (3 consecutive days with readings in triplicate, morning-night) were compared with a "gold standard" out-patient blood pressure reading (OutBP).


RESULTS
Systolic and diastolic BP values of the first day and first reading (morning-night) were higher than the remaining days and readings (linear trend P< .001). Results in hBPSM diagnostic performance using all readings to calculate the mean were: sensitivity (S), 47.6%; specificity (Sp), 77.4%; positive and negative predictive values (PPV and NPV), 58.8% and 68.6%, with positive and negative probability coefficients (PPC and NPC), 2.10 and 0.67. When readings with greater patient alarm reaction (first day and first reading, morning-night) were removed, greater values of S (61.9%) were obtained, albeit at expense of an excessive loss in Sp (64.5%) and without improvement in PPC (1.74).


CONCLUSIONS
The diagnostic performance of hBPSM in WCH was low and failed to improve with the use of different systems to calculate mean BP.
Bayó Llibre
Joan
J
EAP El Clot, ICS, Barcelona, España. 27515jbl@comb.es
Roca Saumell
Carmen
C
Dalfó Baqué
Antoni
A
Martín-Baranera
M Montserrat
MM
Naberan Toña
Karlos Xavier
KX
Botey Puig
Albert
A
D018660:Blood Pressure Monitoring, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D009819:Office Visits