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Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon

BACKGROUND: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM). Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressur...

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Autores principales: de Almeida, Antonio Eduardo Monteiro, Stein, Ricardo, Gus, Miguel, Nascimento, João Agnaldo, Belli, Karlyse Claudino, Arévalo, Jorge Rene Garcia, Fuchs, Flávio Dani, Ribeiro, Jorge Pinto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cardiologia 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206365/
https://www.ncbi.nlm.nih.gov/pubmed/25352508
http://dx.doi.org/10.5935/abc.20140139
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author de Almeida, Antonio Eduardo Monteiro
Stein, Ricardo
Gus, Miguel
Nascimento, João Agnaldo
Belli, Karlyse Claudino
Arévalo, Jorge Rene Garcia
Fuchs, Flávio Dani
Ribeiro, Jorge Pinto
author_facet de Almeida, Antonio Eduardo Monteiro
Stein, Ricardo
Gus, Miguel
Nascimento, João Agnaldo
Belli, Karlyse Claudino
Arévalo, Jorge Rene Garcia
Fuchs, Flávio Dani
Ribeiro, Jorge Pinto
author_sort de Almeida, Antonio Eduardo Monteiro
collection PubMed
description BACKGROUND: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM). Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressure monitoring (wakefulness ABPM) as gold-standard and measurements taken before morning micturition (BM) and in the afternoon (AM), for the best diagnosis of systemic arterial hypertension (SAH), and their association with prognostic markers. METHODS: After undergoing 24-hour wakefulness ABPM, 158 participants (84 women) were randomized for 3- or 5-day HBPM. Two variations of the 3-day protocol were considered: with measurements taken before morning micturition and in the afternoon (BM+AM); and with post-morning-micturition and evening measurements (PM+EM). All patients underwent echocardiography (for left ventricular hypertrophy - LVH) and urinary albumin measurement (for microalbuminuria - MAU). RESULT: Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard 3-day HBPM, 3-day HBPM (BM+AM) and (PM+EM), and 5-day HBPM were 0.660, 0.638, 0.348 and 0.387, respectively. The values of sensitivity of (BM+AM) versus (PM+EM) were 82.6% × 71%, respectively, and of specificity, 84.8% × 74%, respectively. The positive and negative predictive values were 69.1% × 40% and 92.2% × 91.2%, respectively. The comparisons of intraclass correlations for the diagnosis of LVH and MAU between (BM+AM) and (PM+EM) were 0.782 × 0.474 and 0.511 × 0.276, respectively. CONCLUSIONS: The 3 day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers.
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spelling pubmed-42063652014-10-23 Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon de Almeida, Antonio Eduardo Monteiro Stein, Ricardo Gus, Miguel Nascimento, João Agnaldo Belli, Karlyse Claudino Arévalo, Jorge Rene Garcia Fuchs, Flávio Dani Ribeiro, Jorge Pinto Arq Bras Cardiol Original Articles BACKGROUND: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM). Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressure monitoring (wakefulness ABPM) as gold-standard and measurements taken before morning micturition (BM) and in the afternoon (AM), for the best diagnosis of systemic arterial hypertension (SAH), and their association with prognostic markers. METHODS: After undergoing 24-hour wakefulness ABPM, 158 participants (84 women) were randomized for 3- or 5-day HBPM. Two variations of the 3-day protocol were considered: with measurements taken before morning micturition and in the afternoon (BM+AM); and with post-morning-micturition and evening measurements (PM+EM). All patients underwent echocardiography (for left ventricular hypertrophy - LVH) and urinary albumin measurement (for microalbuminuria - MAU). RESULT: Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard 3-day HBPM, 3-day HBPM (BM+AM) and (PM+EM), and 5-day HBPM were 0.660, 0.638, 0.348 and 0.387, respectively. The values of sensitivity of (BM+AM) versus (PM+EM) were 82.6% × 71%, respectively, and of specificity, 84.8% × 74%, respectively. The positive and negative predictive values were 69.1% × 40% and 92.2% × 91.2%, respectively. The comparisons of intraclass correlations for the diagnosis of LVH and MAU between (BM+AM) and (PM+EM) were 0.782 × 0.474 and 0.511 × 0.276, respectively. CONCLUSIONS: The 3 day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers. Sociedade Brasileira de Cardiologia 2014-10 /pmc/articles/PMC4206365/ /pubmed/25352508 http://dx.doi.org/10.5935/abc.20140139 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
de Almeida, Antonio Eduardo Monteiro
Stein, Ricardo
Gus, Miguel
Nascimento, João Agnaldo
Belli, Karlyse Claudino
Arévalo, Jorge Rene Garcia
Fuchs, Flávio Dani
Ribeiro, Jorge Pinto
Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title_full Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title_fullStr Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title_full_unstemmed Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title_short Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First-Morning Micturition and in the Afternoon
title_sort relevance to home blood pressure monitoring protocol of blood pressure measurements taken before first-morning micturition and in the afternoon
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206365/
https://www.ncbi.nlm.nih.gov/pubmed/25352508
http://dx.doi.org/10.5935/abc.20140139
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