In 1,988 adults, a single casual blood pressure measurement demonstrated high sensitivity and negative predictive value for hypertension diagnosis compared to guideline-based measurements.
Cross-Sectional (n=1,988)
Yes
Does a single casual blood pressure measurement accurately screen for hypertension compared to guideline-based measurements in adults attending primary care units?
A single casual blood pressure measurement in the waiting room is a feasible screening tool with high negative predictive value for hypertension diagnosis in primary care.
Objective: Worldwide, only ∼45% of hypertensive patients are diagnosed, and ∼30% controlled. We recently found that in real-world primary care (PC) settings, only 13.2% of PC physicians measure blood pressure (BP) in all patients, primarily due to heavy workloads. Furthermore, BP is usually measured only in patients, and not in visitors or accompanying persons in PC units (PCUs). Therefore, simple and practical screening tools are needed to address these limitations and improve the detection of hypertension in PC. In this setting, the involvement of trained healthcare professionals (HCPs) in BP measurements is a practical tool to increase hypertension diagnosis. The objective of the study was to evaluate the potential role of a single-casual blood pressure measurement (SCBPM) as a feasible screening tool to improve the diagnosis of hypertension in PCUs. Design and method: This is a diagnostic accuracy study. Adults attending PCUs (patients, accompanying persons, and visitors) were enrolled. On the 1st-visit, an SCBPM was performed in the waiting room, followed by 3 measurements according to guidelines in a quiet room. Additionally, participants underwent home BP monitoring (HBPM) and 2nd-visit measurements. Office BP measurements, including SCBPM, were performed using validated devices. Trained HCPs and medical students conducted measurements in 68 PCUs. Results: In this study, 1988 participants were included median age: 64 (interquartile-range: 52.0-74.0) years, 57.8% female; 73.5% patients, and 83.0% of them for a regular visit. Mean BP values across measurement methods are presented in Table-1a. The diagnostic performance of SCBPM is presented in Table-1b. SCBPM demonstrated high negative predictive value (NPV) and specificity in relation to guideline-based office BP measurements and HBPM. In Figures-1a,b, BP distributions in the total population and in untreated participants are presented. In multivariate logistic regression, older age and body-mass index were independently associated with more greater diagnostic disagreement between SCBPM and guideline-based measurements at the 1st-visit.Conclusions: This feasible SCBPM protocol demonstrated high sensitivity and NPV, confirmed by HBPM and 2nd-visit measurements, suggesting a potential role as an excellent screening tool for hypertension diagnosis.
Evangelidis et al. (Fri,) conducted a cross-sectional in Hypertension (n=1,988). Single casual blood pressure measurement (SCBPM) vs. Guideline-based office BP measurements and home BP monitoring (HBPM) was evaluated on Diagnostic accuracy (sensitivity, specificity, negative predictive value) for hypertension. In 1,988 adults, a single casual blood pressure measurement demonstrated high sensitivity and negative predictive value for hypertension diagnosis compared to guideline-based measurements.