title: Improved diagnostic accuracy of a 3-day protocol of home blood pressure monitoring for the diagnosis of arterial hypertension.
abstract: BACKGROUND
  The best protocol for home blood pressure monitoring (HBPM) is not well defined. In this study, we compare two protocols of HBPM considering 24 h ambulatory blood pressure monitoring (ABPM) as a reference standard for the diagnosis of hypertension.
  
  
  METHODS
  One hundred and fifty-eight patients were subjected to 24 h ABPM and to a 3-day (33 measurements) and a 5-day (27 measurements) HBPM protocol. Single-void urinary albumin concentration and echocardiographically determined left ventricular mass were also assessed. Hypertension was defined as blood pressure more than 135/85 mmHg for HBPM and more than 130/80 mmHg for ABPM.
  
  
  RESULTS
  Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were higher for the 3-day HBPM protocol than the 5-day protocol. The area under the ROC curve (95% confidence interval) was 0.82 (0.75-0.90) for the 3-day protocol and 0.69 (0.60-0.78) for the 5-day protocol. Bland-Altman plots showed smaller dispersion for the 3-day protocol. The values of κ statistics were better with the 3-day HBPM. There was a better association between the 3-day protocol and urinary albumin concentration and left ventricular hypertrophy.
  
  
  CONCLUSIONS
  A 3-day protocol of HBPM has better accuracy than a 5-day protocol for the diagnosis of hypertension considering ABPM as a reference standard.
authors: Cardiology Division, Hospital Universitário Lauro Wanderley, Federal University of Paraíba, Porto Alegre, Brazil.
authors: Antonio E M
authors: AE
authors: Almeida
authors: Ricardo
authors: R
authors: Stein
authors: Miguel
authors: M
authors: Gus
authors: João A
authors: JA
authors: Nascimento
authors: Jorge R G
authors: JR
authors: Arévalo
authors: Flávio D
authors: FD
authors: Fuchs
authors: Jorge P
authors: JP
authors: Ribeiro
mesh_terms: D000419:Albuminuria / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D019540:Area Under Curve; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012015:Reference Standards; D012680:Sensitivity and Specificity; D012890:Sleep / Q000502:physiology; D013997:Time Factors; D014463:Ultrasonography; D014851:Wakefulness / Q000502:physiology