Home blood pressure monitoring in an ethnically diverse inner-city cardiology practice.

OBJECTIVES

To evaluate home blood pressure monitoring (HBPM) in an inner city cardiology practice.

DESIGN

Retrospective study.

SETTING

Inner city cardiology practice.

PATIENTS

Consecutive patients were evaluated for hypertension and had > or = 8 home blood pressure recordings during 2-4 weeks while clinically stable on a medical regimen.

MAIN OUTCOME MEASURES

Blood pressure differences, blood pressure load, defined as %HBPM systolic blood pressure readings > 140 and/or diastolic blood pressure readings > 90 mm Hg.

RESULTS

55 patients, (33 female, age 62 +/- 12.5 years). Office systolic, diastolic and mean BPs were higher than HBPM values (147 +/- 19 mmHg vs 139 +/- 17 mmHg, P = < .0001), (86 +/- 10 mm Hg vs 79 +/- 10 mm Hg, P < .0001), and (106 +/- 11 mm Hg vs 99 +/- 10 mmHg, P < .0001) respectively. Office and home pulse pressure (PPs) were similar (61 +/- 17 mm Hg vs 60 +/- 17 mm Hg, P = .42). Office and home PPs were more strongly correlated (r = .78, P < .0001) than were systolic (r = .51, P < .0001), diastolic (r = .51, P < .0001). Blood pressure load increased in a step-wise manner with increasing office blood pressure, 7.5% for patients with office blood pressure < 120/80 mm Hg to 73.5% in patients with office blood pressure > 160/100 mm Hg (P = .02). Office BPs showed 10/55 patients were normal or controlled (blood pressure < 140/ 90 mmHg) and 45 were high or uncontrolled (blood pressure > or = 140/90 mmHg). HBPM reclassified 2/10 patients as high/uncontrolled whereas 17/45 patients became normal/controlled.

CONCLUSIONS

Office systolic and diastolic BPs are 7-8 mm Hg higher than home recordings in ethnically diverse patients. Office and home PPs are more strongly correlated than systolic, diastolic or mean arterial BPs. Blood pressure load is related to office BPs. HBPM reclassified approximately one third of the patients. HBPM appears useful in managing minority populations with hypertension.