Diagnosing Hypertension in Primary Care: A Comparison of Three Methods

Özet

Objective: The aim of this study was to compare the office and home blood pressure measurements with 24 hours ambulatory blood pressure measurements, and to decide which method could be used for the diagnosis of hypertension inprimary care.Materials and Methods: Patients who had blood pressure measurements of 140/90 mm Hg and over were included in thisstudy. Subjects with an initial high blood pressure were evaluated by using three office measurements, seven days homeblood pressure measurements, and 24 hours ambulatory blood pressure measurements. Bland–Altman plots and Passing–Bablok regression analysis were performed to find the compliance of the office, home, and ambulatory blood pressuremeasurements.Results: Office measurements revealed 48.2% systolic and 62.0% diastolic hypertensive values, whereas home and ambulatory measurements showed 48.2% and 37.9% and 24.1% and 51.7% of systolic and diastolic hypertensive values, respectively. The intraclass correlation of ambulatory and home measurements (r=0.620) was higher compared to the ambulatoryand office measurements (r=0.478).Conclusion: The results of this study demonstrate that the home measurements were more compliant with the ambulatory blood pressure measurements than the mean value of three office measurements in the diagnosis of hypertension.