Successive blood pressure measurements to evaluate suspected and treated hypertension

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art_SILVA_Successive_blood_pressure_measurements_to_evaluate_suspected_and_2016.PDF (315.38 KB)
Citações na Scopus
4
Tipo de produção
article
Data de publicação
2016
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
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Scopus
Web of Science
PubMed
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Título do Volume
Autores
SILVA, Marco A. Vieira da
SILVA, Ana P. Mendes da
Autor de Grupo de pesquisa
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Citação
BLOOD PRESSURE MONITORING, v.21, n.2, p.69-74, 2016
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
IntroductionAccording to the published literature, blood pressure (BP) measurements performed in the outpatient clinical setting are often inaccurate. The white coat effect and improper technique are the main causes of this imprecision. Construction of a set of readings without them could improve the accuracy of BP measurement.ObjectiveTo evaluate the accuracy and agreement of successive office BP measurements using the awake blood pressure average (ABPa) as the gold standard.MethodsBP was measured in 852 patients using three techniques: in office (OBPa); seven successive measurements performed by a nurse using an automatic device; and 24h of ambulatory BP monitoring. BP averages (BPa) were obtained from the nurse's measurements: 1-2BPa (first and second), 3-7BPa (third to seventh), and 1-7BPa (first to seventh). OBPa and successive measurements were tested against ABPa by calculating the following: average difference in BP of 1-2BPa, 3-7BPa and OBPa, and the area under the curve.ResultsAmong the 834 patients eligible, 374 (43.9%) were considered to be hypertensive on the basis of the ABPa (135/85mmHg). 3-7BPa showed the lowest average difference (4/3mmHg). By contrast, OBPa showed the highest result (21/11mmHg). The mean difference with 1-2BPa was 8/4mmHg. The areas under the curve were better with 3-7BPa (0.82-0.85) and 1-2BPa (0.82-0.83) than OBPa (0.67-0.71) for both systolic and diastolic BP.ConclusionAll means from successive measurements showed a better precision than OBPa, even the two first readings. However, more research needs to be carried out before recommendation of the use of this technique in routine practice.
Palavras-chave
blood pressure ambulatory monitoring, blood pressure determination, diagnosis, hypertension
URI
https://observatorio.fm.usp.br/handle/OPI/14515
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Coleções
Artigos e Materiais de Revistas Científicas - HC/InCor