[Efficiency between the different measurement patterns of home blood pressure monitoring in the follow-up of hypertensive patients in primary care].

OBJECTIVE

To identify the most efficient measurement pattern of home blood pressure monitoring (HBPM) for the follow-up of hypertensive patients in primary care.

DESIGN

Validation study of a diagnostic test.

SETTING

Primary care team in Murcia, Spain.

POPULATION

One hundred and fifty three hypertensive patients younger than 80 years who met the inclusion criteria, who used HBPM and ambulatory blood pressure monitoring.

MAIN MEASUREMENTS

Performing HBPM for 24hours. The HBPM protocol consisted of recording 2 measurements in the morning and 2 in the evening for 7 days. With the records obtained, the different HBPM patterns were established (7, 6, 5, 4, 3 days). The ROC curves were used for the analysis, together with the correlation coefficients and the Bland-Altman plots.

RESULTS

The best areas under the curve for the systolic pressure of the different HBPM patterns corresponded to the 4-day pattern: 0.837 (0.77-0.90); and the 3 day one: 0.834 (0.77-0.90). As for diastolic pressure, the 7-day pattern had an area under the curve of 0.889 (0.84-0.94); followed by the 3 and 4 days patterns, which had the same statistical result both: 0.834 (0.83-0.94). There were no significant differences between correlation coefficients for systolic and diastolic blood pressures. The 3-day pattern showed a lower dispersion in the Bland-Altman plots.

CONCLUSION

The 3 days HBPM pattern is proposed for the follow-up of the hypertensive patient, since it does not have an inferior efficiency to the other patterns.