title: Evaluation of blood pressure measurements in first ambulatory neurological consultations: a missed part of the physical examination?
abstract: OBJECTIVE
  To obtain a blood pressure reading is mandatory during either the general or specialized physical examination. This study describes factors associated with the accomplishment of blood pressure measurement in the first neurological consultation.
  
  
  METHODS
  We studied first ambulatory neurology consultations in a Mexican referral hospital. Demographic characteristics, diagnostic category of referral, final diagnosis and data on physical examination were collected to establish a logistic regression analysis in order to identify factors associated with the accomplishment of blood pressure measurement.
  
  
  RESULTS
  Over 8 months 778 outpatients were studied. The most frequent diagnoses for first consultation were headache (26%), epilepsy (14%) and stroke (13%). Only in 39% (n=301) of the outpatients blood pressure was registered, among them, 30% had normal blood pressure, 43% had 121-139/81-89 mmHg, 20% had 140-159/90-99 mmHg and 7% had ≥ 160/100 mmHg. The independent factors that favored the practice of BP determination in multivariable analysis were >65 years of age (odds ratio: 2.26; 95% confidence interval: 1.52-3.36) and headache complaint (odds ratio: 1.81, 95% confidence interval: 1.30-2.53). Notably, only 43% of patients with stroke had blood pressure registration, even when these stroke patients had blood pressure readings, they had higher blood pressure than with other diagnoses (p<0.05).
  
  
  CONCLUSIONS
  Blood pressure registration was frequently omitted from the first neurological consultation, particularly in outpatients who might need it the most.
authors.affiliation: Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.
authors.forename: Angel
authors.initials: A
authors.lastname: Vargas-Sánchez
authors.affiliation: Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico.
authors.forename: Erwin
authors.initials: E
authors.lastname: Chiquete
authors.affiliation: Registered Nurse, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico.
authors.forename: Gabriela E
authors.initials: GE
authors.lastname: López-Corrales
authors.affiliation: Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.
authors.forename: Karina
authors.initials: K
authors.lastname: Carrillo-Loza
authors.affiliation: Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.
authors.forename: Santiago
authors.initials: S
authors.lastname: Núñez-Velasco
authors.affiliation: Department of Internal Medicine, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.
authors.forename: Sol
authors.initials: S
authors.lastname: Ramírez-Ochoa
authors.affiliation: Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico.
authors.forename: Ana
authors.initials: A
authors.lastname: Ochoa-Guzmán
authors.affiliation: Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Department of Neurosciences, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Mexico. Electronic address: jorulej-1nj@prodigy.net.mx.
authors.forename: José L
authors.initials: JL
authors.lastname: Ruiz-Sandoval
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001795:Blood Pressure Determination / Q000706:statistics & numerical data*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D055815:Young Adult
keywords: Blood pressure; Hipertensión; Hypertension; Medical practice; Mexico; México; Outpatient; Paciente ambulatorio; Presión arterial; Práctica médica