Fortuna Health Centre, Murcia, Spain.
Faculty of Medicine (University of Murcia) - Instituto Murciano de Biosanitaria - Arrixaca (IMIB-Arrixaca), Murcia, Spain.
BMC Cardiovasc Disord. 2019 Jul 17;19(1):171. doi: 10.1186/s12872-019-1145-9.
Improving clinical practice aimed at controlling hypertension is a pending issue in health systems. One of the methods currently used for this purpose is self blood pressure measurement (SBPM) whose use increases every day. The aims of this study are to establish the optimal cut-off point for the 3-day SMBP protocol and to identify factors that could affect the precision of the 3-day SMBP protocol using 24-h ambulatory blood pressure monitoring (ABPM) as a reference.
This is a cross-sectional descriptive study to validate a diagnostic test performed by a primary care team in Murcia, Spain. A total of 153 hypertensive patients under 80 years of age who met the inclusion criteria were evaluated. ABPM was performed for 24 h. The SBPM protocol consisted of recording 2 measurements in the morning and 2 at night for 3 days.
The cut-off point for SBP was set at 135 mmHg (sensitivity: 80.39%, specificity: 74.19%), and for DBP, it was set at 83 mmHg (sensitivity: 76.48%, specificity: 84.89%), which yielded the highest combined sensitivity and specificity. After carrying out the validation study with the new figures, we proceeded to establish which socio-demographic factors prevented a correct classification of patients. These errors were more common in male patients for the assessments of both DBP (OR = 2.4) and SBP (OR = 2.5); hypertensive patients with age < 67,5 years (OR = 1,5); having no work activity (OR = 3,6) and with concomitant chronic kidney disease (CKD) (OR = 5.0).
Being male, older than 67.5 years, with CKD or with no work activity increases the probability of being misclassified for hypertension during follow-up as assessed by SBPM over 3 days.
This study was approved by the research ethics committee of the University of Murcia under registration number 1018/2015.
提高旨在控制高血压的临床实践是卫生系统中的一个待解决问题。目前用于此目的的方法之一是自我血压测量（SBPM），其使用频率日益增加。本研究的目的是确定 3 天 SBPM 方案的最佳截止点，并确定使用 24 小时动态血压监测（ABPM）作为参考可能影响 3 天 SBPM 方案精度的因素。
这是一项在西班牙穆尔西亚进行的初级保健团队进行的横断面描述性研究，旨在验证诊断测试。共评估了 153 名符合纳入标准的 80 岁以下高血压患者。进行了 24 小时 ABPM。SBPM 方案包括连续 3 天记录早晨 2 次和晚上 2 次测量值。
收缩压的截止点设定为 135mmHg（敏感性：80.39%，特异性：74.19%），舒张压的截止点设定为 83mmHg（敏感性：76.48%，特异性：84.89%），得出最高的敏感性和特异性组合。在使用新数据进行验证研究后，我们着手确定哪些社会人口因素会导致患者分类错误。这些错误在男性患者中更为常见，无论是舒张压（OR=2.4）还是收缩压（OR=2.5）的评估；年龄<67.5 岁的高血压患者（OR=1.5）；无工作活动（OR=3.6）和合并慢性肾脏病（CKD）（OR=5.0）的患者。
男性、年龄>67.5 岁、合并 CKD 或无工作活动会增加在随访中通过 3 天 SBPM 评估高血压时被误诊的可能性。
这项研究得到了穆尔西亚大学研究伦理委员会的批准，注册号为 1018/2015。
