[The influence of correct blood pressure measurement on the diagnostic decisions in hypertensive patients. MEDIDA study].
OBJECTIVE
We aimed to assess the influence of correct blood pressure (BP) measurement, following the recommendations of the Spanish Guideline of Hypertension 2005 (SGH), on the diagnostic decisions in hypertensive patients.


METHODS
Prospective, longitudinal, observational, multicenter study conducted in hypertensive patients with stable pharmacologic therapy in primary care units. 4040 patients were included, in whom BP was measured following current clinical practice at the first visit (visit 1). After 7 days no therapeutic changes could be made and BP was measured following the criteria of good BP measurement from the SGH (visit 2). Control rate was assessed both, following the investigators opinion and the SGH algorithm, at visits 1 and 2. Differences in therapeutic recommendations between visits were assessed.


RESULTS
3436 patients were evaluable (48.9% women), with mean age (standard deviation) of 63.4 (11.4) years. Decreases in systolic/diastolic BP of 4.8 mmHg (95% confidence interval [CI], 4.5-5.1) and 2.8 mmHg (95% CI, 2.6-3.0) between visits were observed. The control rate following the investigators opinion was of 59.1% (95% CI, 57.4-60.8%) at visit 1 and 76.4% (95% CI, 75.0-77.9%) at visit 2, and the one following the criteria of the SGH was 32.2% (95% CI, 30.6-33.7%) at visit 1 and 46.6% (95% CI, 44.9-48.3%) at visit 2. The rate of patients in which therapeutic recommendations were changed was of 54.1% (95% CI, 52.4-55.7%).


CONCLUSIONS
Applying the recommendations of the SHG for correct BP measurement led to increased control rate in relation to a previous measurement, prompting changes in the therapeutic attitude.
Márquez-Contreras
Emilio
E
Centro de Salud La Orden. Huelva. España. emarquezc@papps.org
de la Figuera Von Wichmann
Mariano
M
Aguilera de la Fuente
María Teresa
MT
Garrido García
Jesús
J
D001795:Blood Pressure Determination / Q000592:standards*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies