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Aten Primaria. 2006 Sep;38(4):212-8.

[Home blood pressure self-monitoring. Influence of the mean calculation used on the diagnosis of white-coat hypertension].

[Article in Spanish]

Author information

1
EAP El Clot, ICS, Barcelona, España. 27515jbl@comb.es

Abstract

OBJECTIVE:

To describe the variations in the diagnosis performance of home blood pressure self-monitoring (hBPSM) with different methods for mean calculation, in order to diagnose white-coat hypertension (WCH).

DESIGN:

Multi-centre, descriptive, and comparative study to assess the diagnosis performance of a test method.

SETTING:

Four primary health care centres.

PARTICIPANTS:

A total of 157 recently-diagnosed, untreated patients with mild-moderate hypertension took part in the study.

METHODS:

The results obtained with hBPSM (3 consecutive days with readings in triplicate, morning-night) were compared with a "gold standard" out-patient blood pressure reading (OutBP).

RESULTS:

Systolic and diastolic BP values of the first day and first reading (morning-night) were higher than the remaining days and readings (linear trend P< .001). Results in hBPSM diagnostic performance using all readings to calculate the mean were: sensitivity (S), 47.6%; specificity (Sp), 77.4%; positive and negative predictive values (PPV and NPV), 58.8% and 68.6%, with positive and negative probability coefficients (PPC and NPC), 2.10 and 0.67. When readings with greater patient alarm reaction (first day and first reading, morning-night) were removed, greater values of S (61.9%) were obtained, albeit at expense of an excessive loss in Sp (64.5%) and without improvement in PPC (1.74).

CONCLUSIONS:

The diagnostic performance of hBPSM in WCH was low and failed to improve with the use of different systems to calculate mean BP.

PMID:
16978558
[Indexed for MEDLINE]

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