Comparison of patients' confidence in office, ambulatory, and home blood pressure measurements as methods of assessing for hypertension.
OBJECTIVE
Uncertainty exists when relying on office (clinic) blood pressure (BP) measurements to diagnose hypertension. Home BP monitoring and ambulatory BP monitoring (ABPM) provide measurements that are more strongly associated with cardiovascular disease. The degree to which patients exhibit uncertainty about office BP measurements is unknown, as is whether they would have less uncertainty about other BP measurement methods. We therefore assessed people's confidence in methods of BP measurement, comparing perceptions about office BP monitoring, home BP monitoring, and ABPM techniques.


METHODS
We surveyed adults who were 30 years or older (n=193), all whom had undergone office BP measurements, two sessions of 24-h ABPM, and two 5-day periods of home BP monitoring. Respondents were asked to indicate their level of confidence on a 1 to 9 scale that BP measurements represented their 'usual' BP.


RESULTS
Respondents had least confidence that assessments of BP made by office measurements (median 6) represented usual BP and greater confidence that assessments made by home BP monitoring (median 7, P<0.0001 vs. office) and ABPM (median 8, P<0.0001 vs. office) did so. Confidence levels did not vary significantly by BP levels, age, sex, race, or education level.


CONCLUSIONS
The finding that patients do not have a great deal of confidence in office BP measurements, but have a higher degree of confidence in home BP and ambulatory BP assessment methods may be helpful in guiding strategies to diagnose hypertension and improve antihypertensive medication adherence.
aDepartment of Family Medicine, University of North Carolina School of Medicine bHypertension Research Program cDepartment of Medicine, Division of Nephrology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Anthony J
AJ
Viera
Laura A
LA
Tuttle
Raven
R
Voora
Emily
E
Olsson
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction
D000959:Antihypertensive Agents