Key result
A 3-day self-monitoring home blood pressure schedule including first-day readings showed similar prognostic capacity for cardiovascular events compared to excluding them (SHT OR 8.81 vs 8.61).
Why the study?
The optimal schedule for self-monitoring home blood pressure readings is important for diagnosing hypertension phenotypes, but the prognostic impact of including versus discarding first-day measurements remained unclear.
Does including first-day readings in a 3-day self-monitoring home blood pressure schedule alter its prognostic capacity for cardiovascular events in newly diagnosed, nontreated patients?
Cohort (n=767)
Does including first-day readings in a 3-day self-monitoring home blood pressure schedule alter its prognostic capacity for cardiovascular events in newly diagnosed, nontreated patients?
First-day readings do not need to be discarded when calculating the final value of a 3-day self-monitoring home blood pressure schedule for prognostic purposes.
May support simplified 3-day home BP monitoring without discarding first-day readings; hypothesis-generating pending randomized confirmation.
BACKGROUND: The optimal schedule for self-monitoring home BP (SMHBP) readings is enormously important in the diagnosis of different phenotypes related to hypertension. The aim of this study was to determine the prognostic capacity of a 3-day SMHBP schedule when using or suppressing the first-day measurements in compiling the results. METHODS: A total of 767 newly diagnosed, nontreated patients with no history of cardiovascular disease (CVD) were followed for 6.2 years. As a baseline, office BP measurements were taken for all the patients who then went on to follow a 3-day SMHBP schedule, taking 2 readings in the morning and 2 in the evening. The prognostic calculation was performed with CVD variables. The prognostic capacity of the 3-day schedule was evaluated with and without the first-day readings (12 and 8 readings). RESULTS: A total of 223 normotensive subjects (NT), 271 subjects with sustained hypertension (SHT), and 184 white-coat hypertensive subjects (WCH) were followed. The distribution of 98 (14.4%) nonfatal CV events during the follow-up was as follows: WCH 21 (11.4%), NT 9 (4.0%), and SHT 68 (25.1%). No statistically significant differences were observed in the risk of CV events (OR) for the 2 groups of hypertensives, irrespective of the schedule of readings used (SHT with vs. without first-day readings: 8.81 (4.28-18.15) vs. 8.61 (4.15-17.85) and WCH with vs. without first-day readings: 2.71(1.13-6.47) vs. 3.40 (1.49-7.78)). CONCLUSIONS: Our findings show that first-day readings do not need to be discarded in order to calculate the final value of an SMHBP schedule.
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Bayó et al. (2019) conducted a cohort in Newly diagnosed hypertension (n=767). 3-day self-monitoring home blood pressure including first-day readings vs. Excluding first-day readings was evaluated on Nonfatal cardiovascular events (OR 8.81 (with first-day) vs 8.61 (without) for sustained hypertension, 95% CI 4.28-18.15 vs 4.15-17.85). A 3-day self-monitoring home blood pressure schedule including first-day readings showed similar prognostic capacity for cardiovascular events compared to excluding them (SHT OR 8.81 vs 8.61).
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