Feasibility of Home Blood Pressure Measurement in Elderly Individuals: Cross-Sectional Analysis of a Population-Based Sample

Background: Hypertension and cognitive impairment often coexist in older people. Office blood pressure measurement is a poor indicator for diagnosing hypertension in the general population. However, its diagnostic accuracy has not been substantially studied in patients with cognitive impairment. Aim: The aim of this study was to determine the proportion of misdiagnosis of hypertension in patients with mild cognitive impairment and dementia compared to no cognitive impairment, by comparing office blood pressure measurement with home blood pressure measurement. Methods: A cross-sectional study including consecutive patients visiting a memory clinic between 2014 and 2017. Home blood pressure was measured for one week according to the European guidelines. Office blood pressure was assessed during routine clinical practice. Using guideline definitions for normal blood pressure and hypertension, we investigated the proportion of disagreement between office blood pressure measurement and home blood pressure measurement. Univariable and multivariable logistic regression compared disagreement in diagnosis between patients with dementia, mild cognitive impairment and no cognitive impairment. Results: Of 213 patients (aged 73.4±9.0 years, 42% women) 82 had dementia, 65 had mild cognitive impairment and 66 had no cognitive impairment. Mean office blood pressure was 156/84±23/11 mmHg and mean home blood pressure was 139/79±16/10 mmHg. In 31% of patients, there was disagreement in hypertension diagnosis. This proportion was higher for mild cognitive impairment (38.5%) and dementia (35.4%) compared to no cognitive impairment (18.2%), with adjusted odds ratios of 3.7 (95% confidence interval 1.5–9.0), P=0.005 for mild cognitive impairment and 3.4 (1.3–8.6), P=0.011 for dementia. Conclusions: In memory clinic patients with dementia and mild cognitive impairment, the diagnostic accuracy of office blood pressure measurement is lower compared to patients without cognitive impairment. To avoid the risk of making improper treatment decisions in this vulnerable group, a diagnosis of hypertension should be based on home blood pressure measurement, not office blood pressure measurement.

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Current status of home blood pressure measurement and relevant demographics and lifestyle characteristics of individuals with periodic measurement: a cross-sectional study in a worksite population

SANGYO EISEIGAKU ZASSHI ◽

10.1539/sangyoeisei.2020-016-b ◽

2020 ◽

Author(s):

Yukako Tatsumi ◽

Azusa Shima ◽

Atsuko Kawamura ◽

Ayumi Morino ◽

Yuichiro Kawatsu ◽

...

Keyword(s):

Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Cross Sectional Study ◽

Home Blood Pressure ◽

Current Status ◽

Sectional Study ◽

Cross Sectional

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Home blood-pressure measurement for the diagnosis and monitoring of arterial hypertension by French general practitioners: a cross-sectional survey in the Auvergne region

BMC Family Practice ◽

10.1186/s12875-020-01358-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mangiavillano Xavier ◽

Tréfond Jéromine ◽

Plaquevent-Hostache Guillaume ◽

Tanguy Gilles ◽

Bœuf-Gibot Sylvaine ◽

...

Keyword(s):

Blood Pressure ◽

General Practitioners ◽

Pressure Measurement ◽

Urban Areas ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Frequent Use ◽

Self Reporting Questionnaire

Abstract Background Home blood-pressure measurement (HBPM) is recommended for the diagnosis of hypertension and monitoring of patients with hypertension. Since 2013, the French National Health Insurance Body (FNHIB) has promoted HBPM to general practitioners (GPs). The objective of the study was to evaluate the practice of HBPM by French GPs to diagnose and monitor hypertension, 3 years after the beginning of the FNHIB campaign. Methods We conducted a postal survey from 7 March to 31 May 2016. All of the 1040 GPs practising in the Auvergne region in France were invited to participate, using a self-reporting questionnaire. We obtained information on the characteristics of the GPs, and their practice regarding the use of HBPM. Use of HBPM was reported as “never, occasionally, regularly and systematically”. Frequency of HBMP use was analysed using multivariate ordered logistic regression model. Results A total of 569 (54.7%) GPs responded to the survey. They were 50.3 (± 11.5) years old, 241 (43.0%) were female, and 352 (62.7%) worked in urban areas. Among them, 530 (94.5%) reported the use of HBPM for diagnosis and 519 (92.5%) for monitoring hypertension. To diagnose hypertension, younger GPs (OR = 0.97; 95% CI: 0.95–0.98), GPs practising in a group (OR = 1.45; 95% CI: 1.00–2.10) and in an MHC (OR = 2.09; 95% CI: 1.15–3.78), as compared to GPs with individual practices, and Clinical Tutors, as compared to non-Clinical Tutors, (OR = 1.92; 95% CI: 1.33–2.79) reported more frequent use of HBPM. To manage hypertension, female GPs, as compared to male GPs, (OR=1.47; 95% CI: 1.04–2.06), younger GPs (OR = 0.98; 95% CI: 0.97–0.99), and Clinical Tutors (OR = 1.90; 95% CI: 1.31–2.75) reported more frequent use of HBPM. Conclusions Our survey reveals that 3 years after the introduction of the FNHIB incentives, the use of HBPM by participating GPs to diagnose and manage hypertension is well established. A larger survey of GPs from other regions would make it possible to verify whether our results can be extrapolated to France as a whole.

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Prevalence of Home Blood Pressure Measurement Among Selected Hypertensive Patients

High Blood Pressure & Cardiovascular Prevention ◽

10.2165/00151642-200512030-00031 ◽

2005 ◽

Vol 12 (3) ◽

pp. 156

Author(s):

C. Cuspidi ◽

S. Meani ◽

L. Lonati ◽

V. Fusi ◽

G. Magnaghi ◽

...

Keyword(s):

Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Hypertensive Patients

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The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01948-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jiajing Jia ◽

Ying Yang ◽

Fangchao Liu ◽

Minjin Zhang ◽

Qin Xu ◽

...

Keyword(s):

Alanine Aminotransferase ◽

Elevated Serum ◽

Population Based ◽

Reproductive Age ◽

Chinese Adults ◽

Cross Sectional ◽

Serum Alanine Aminotransferase ◽

Cross Sectional Analysis ◽

Registration Data ◽

Sectional Analysis

Abstract Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.

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