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Eur J Public Health. 2014 Oct;24(5):776-81. doi: 10.1093/eurpub/ckt144. Epub 2013 Oct 1.

Home blood pressure measurement as a screening tool for hypertension in a web-based worksite health promotion programme.

Author information

1
1 NIPED Research Foundation, Amsterdam, The Netherlands.
2
1 NIPED Research Foundation, Amsterdam, The Netherlands 2 Departments of Internal and Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands n.v.vanderhoeven@amc.nl.
3
2 Departments of Internal and Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.

Abstract

BACKGROUND:

Guidelines on home blood pressure measurement (HBPM) recommend taking at least 12 measurements. For screening purposes, however, it is preferred to reduce this number. We therefore derived and validated cut-off values to determine hypertension status after the first duplicate reading of a HBPM series in a web-based worksite health promotion programme.

METHOD:

Nine hundred forty-five employees were included in the derivation and 528 in the validation cohort, which was divided into a normal (n = 297) and increased cardiometabolic risk subgroup (n = 231), and a subgroup with a history of hypertension (n = 98). Six duplicate home measurements were collected during three consecutive days. Systolic and diastolic readings at the first duplicate measurement were used as predictors for hypertension in a multivariate logistic model. Cut-off values were determined using receiver operating characteristics analysis.

RESULTS:

Upper (≥ 150 or ≥ 95 mmHg) and lower limit (<135 and <80 mmHg) cut-off values were derived to confirm or reject presence of hypertension after one duplicate reading. The area under the curve was 0.94 (standard error 0.01, 95% confidence interval 0.93-0.95). In 62.5% of participants, hypertension status was determined, with 1.1% false positive and 4.7% false negatives. Performance was similar in participants with high and low cardiometabolic risk, but worse in participants with a history of hypertension (10.4% false negatives).

CONCLUSION:

One duplicate home reading is sufficient to accurately assess hypertension status in 62.5% of participants, leaving 37.5% in which the whole HBPM series needs to be completed. HBPM can thus be reliably used as screening tool for hypertension in a working population.

PMID:
24088704
DOI:
10.1093/eurpub/ckt144
[Indexed for MEDLINE]

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