title: Validity and applicability of a new recording method for hypertension.
abstract: OBJECTIVE
  Blood pressure measurement methods and conditions are determinants of hypertension diagnosis. A recent British guideline recommends systematic 24-h ambulatory blood pressure monitoring. However, these devices are not available at all health centers and they can only be used by 1 patient per day. The aim of this study was to test a new blood pressure recording method to see if it gave the same diagnostic results as 24-h blood pressure monitoring.
  
  
  METHODS
  One-hour blood pressure monitoring under routine clinical practice conditions was compared with standard method of day time recording by analyzing the coefficient of correlation and Bland-Altman plots. The Kappa index was used to calculate degree of agreement. Method sensitivity and specificity were also analyzed.
  
  
  RESULTS
  Of the 102 participants, 89 (87.3%) obtained the same diagnosis regardless of method, with high between-method agreement (κ= 0.81; 95% confidence interval, 0.71-0.91). We observed robust correlations between diastolic (r=0.85) and systolic blood pressure (r=0.76) readings. Sensitivity and specificity for the new method for diagnosing white coat hypertension were 85.2% (95% confidence interval 67.5%-94.1%) and 92% (95% confidence interval, 83.6%-96.3%), respectively.
  
  
  CONCLUSIONS
  One-hour blood pressure monitoring is a valid and reliable method for diagnosing hypertension and for classifying hypertension subpopulations, especially in white coat hypertension and refractory hypertension. This also leads to a more productive use of monitoring instruments.
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Minerva
authors.initials: M
authors.lastname: Mas-Heredia
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Molés-Moliner
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain; Grup Transversal de Recerca en Atenció Primària, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: González-de Paz
authors.affiliation: Grup Transversal de Recerca en Atenció Primària, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Belchin
authors.initials: B
authors.lastname: Kostov
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Jacinto
authors.initials: J
authors.lastname: Ortiz-Molina
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Mauri-Vázquez
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Menacho-Pascual
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cararach-Salami
authors.affiliation: Unidad de Hipertensión Arterial, Servicio de Medicina Interna, Institut Clínic de Medicina Interna i Dermatologia (ICMID), Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sierra-Benito
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain; Grup Transversal de Recerca en Atenció Primària, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain. Electronic address: asiso@clinic.ub.es.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó-Almirall
mesh_terms: D001795:Blood Pressure Determination / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
keywords: Ambulatory blood pressure monitoring; Atención primaria; Hipertensión de bata blanca; Monitorización ambulatoria de la presión arterial; Primary care; White coat hypertension