Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2014;67:717-23 - Vol. 67 Num.09 DOI: 10.1016/j.rec.2013.12.017

Validity and Applicability of a New Recording Method for Hypertension

Minerva Mas-Heredia a, Eloisa Molés-Moliner a, Luis González-de Paz a,b, Belchin Kostov b, Jacinto Ortiz-Molina a, Vanesa Mauri-Vázquez a, Ignacio Menacho-Pascual a, Daniel Cararach-Salami a, Cristina Sierra-Benito c, Antoni Sisó-Almirall a,b,

a Centro de Salud Les Corts, Consorci d’Atenció Primària de Salut Eixample (CAPSE), Barcelona, Spain
b Grup Transversal de Recerca en Atenció Primària, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
c Unidad de Hipertensión Arterial, Servicio de Medicina Interna, Institut Clínic de Medicina Interna i Dermatologia (ICMID), Hospital Clínic de Barcelona, Barcelona, Spain

Keywords

Ambulatory blood pressure monitoring. Primary care. White coat hypertension.

Abstract

Introduction and objectives

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.

1885-5857/© 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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