Cargando…

Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved

BACKGROUND: Improving clinical practice aimed at controlling hypertension is a pending issue in health systems. One of the methods currently used for this purpose is self blood pressure measurement (SBPM) whose use increases every day. The aims of this study are to establish the optimal cut-off poin...

Descripción completa

Detalles Bibliográficos
Autores principales: De León-Robert, Arleen, Gascón-Cánovas, Juan José, Antón-Botella, José Joaquín, Hidalgo-García, Isabel María, López-Alegría, Carmen, Pérez-Cabrera, Yoalys Dilvani, Campusano-Castellanos, Heidy Merari
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637525/
https://www.ncbi.nlm.nih.gov/pubmed/31315567
http://dx.doi.org/10.1186/s12872-019-1145-9
_version_ 1783436257705066496
author De León-Robert, Arleen
Gascón-Cánovas, Juan José
Antón-Botella, José Joaquín
Hidalgo-García, Isabel María
López-Alegría, Carmen
Pérez-Cabrera, Yoalys Dilvani
Campusano-Castellanos, Heidy Merari
author_facet De León-Robert, Arleen
Gascón-Cánovas, Juan José
Antón-Botella, José Joaquín
Hidalgo-García, Isabel María
López-Alegría, Carmen
Pérez-Cabrera, Yoalys Dilvani
Campusano-Castellanos, Heidy Merari
author_sort De León-Robert, Arleen
collection PubMed
description BACKGROUND: Improving clinical practice aimed at controlling hypertension is a pending issue in health systems. One of the methods currently used for this purpose is self blood pressure measurement (SBPM) whose use increases every day. The aims of this study are to establish the optimal cut-off point for the 3-day SMBP protocol and to identify factors that could affect the precision of the 3-day SMBP protocol using 24-h ambulatory blood pressure monitoring (ABPM) as a reference. METHOD: This is a cross-sectional descriptive study to validate a diagnostic test performed by a primary care team in Murcia, Spain. A total of 153 hypertensive patients under 80 years of age who met the inclusion criteria were evaluated. ABPM was performed for 24 h. The SBPM protocol consisted of recording 2 measurements in the morning and 2 at night for 3 days. RESULTS: The cut-off point for SBP was set at 135 mmHg (sensitivity: 80.39%, specificity: 74.19%), and for DBP, it was set at 83 mmHg (sensitivity: 76.48%, specificity: 84.89%), which yielded the highest combined sensitivity and specificity. After carrying out the validation study with the new figures, we proceeded to establish which socio-demographic factors prevented a correct classification of patients. These errors were more common in male patients for the assessments of both DBP (OR = 2.4) and SBP (OR = 2.5); hypertensive patients with age < 67,5 years (OR = 1,5); having no work activity (OR = 3,6) and with concomitant chronic kidney disease (CKD) (OR = 5.0). CONCLUSION: Being male, older than 67.5 years, with CKD or with no work activity increases the probability of being misclassified for hypertension during follow-up as assessed by SBPM over 3 days. TRIAL REGISTRATION: This study was approved by the research ethics committee of the University of Murcia under registration number 1018/2015.
format Online
Article
Text
id pubmed-6637525
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-66375252019-07-25 Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved De León-Robert, Arleen Gascón-Cánovas, Juan José Antón-Botella, José Joaquín Hidalgo-García, Isabel María López-Alegría, Carmen Pérez-Cabrera, Yoalys Dilvani Campusano-Castellanos, Heidy Merari BMC Cardiovasc Disord Research Article BACKGROUND: Improving clinical practice aimed at controlling hypertension is a pending issue in health systems. One of the methods currently used for this purpose is self blood pressure measurement (SBPM) whose use increases every day. The aims of this study are to establish the optimal cut-off point for the 3-day SMBP protocol and to identify factors that could affect the precision of the 3-day SMBP protocol using 24-h ambulatory blood pressure monitoring (ABPM) as a reference. METHOD: This is a cross-sectional descriptive study to validate a diagnostic test performed by a primary care team in Murcia, Spain. A total of 153 hypertensive patients under 80 years of age who met the inclusion criteria were evaluated. ABPM was performed for 24 h. The SBPM protocol consisted of recording 2 measurements in the morning and 2 at night for 3 days. RESULTS: The cut-off point for SBP was set at 135 mmHg (sensitivity: 80.39%, specificity: 74.19%), and for DBP, it was set at 83 mmHg (sensitivity: 76.48%, specificity: 84.89%), which yielded the highest combined sensitivity and specificity. After carrying out the validation study with the new figures, we proceeded to establish which socio-demographic factors prevented a correct classification of patients. These errors were more common in male patients for the assessments of both DBP (OR = 2.4) and SBP (OR = 2.5); hypertensive patients with age < 67,5 years (OR = 1,5); having no work activity (OR = 3,6) and with concomitant chronic kidney disease (CKD) (OR = 5.0). CONCLUSION: Being male, older than 67.5 years, with CKD or with no work activity increases the probability of being misclassified for hypertension during follow-up as assessed by SBPM over 3 days. TRIAL REGISTRATION: This study was approved by the research ethics committee of the University of Murcia under registration number 1018/2015. BioMed Central 2019-07-17 /pmc/articles/PMC6637525/ /pubmed/31315567 http://dx.doi.org/10.1186/s12872-019-1145-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
De León-Robert, Arleen
Gascón-Cánovas, Juan José
Antón-Botella, José Joaquín
Hidalgo-García, Isabel María
López-Alegría, Carmen
Pérez-Cabrera, Yoalys Dilvani
Campusano-Castellanos, Heidy Merari
Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title_full Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title_fullStr Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title_full_unstemmed Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title_short Validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
title_sort validity of self blood pressure measurement in the control of the hypertensive patient: factors involved
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637525/
https://www.ncbi.nlm.nih.gov/pubmed/31315567
http://dx.doi.org/10.1186/s12872-019-1145-9
work_keys_str_mv AT deleonrobertarleen validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT gasconcanovasjuanjose validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT antonbotellajosejoaquin validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT hidalgogarciaisabelmaria validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT lopezalegriacarmen validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT perezcabrerayoalysdilvani validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved
AT campusanocastellanosheidymerari validityofselfbloodpressuremeasurementinthecontrolofthehypertensivepatientfactorsinvolved