Evaluation of blood pressure through home monitoring in brazilian primary care: a feasibility study

Abstract Blood pressure measurements taken in a clinical setting are subject to errors, therefore there are advantages to monitoring blood pressure at home, especially in in patients diagnosed with hypertension. The study describes the feasibility of home monitoring to assess blood pressure in primary care and compares blood pressure measured at home and during a medical consultation. This cross-sectional study was carried out with patients whose used home blood pressure in the morning and evening, thrice for seven consecutive day sat home. Participants included patients older than 18 years with suspected whitecoat hypertension, taking antihypertensives, or those intolerant of ambulatory blood pressure monitoring, and excluded patients who did not follow the protocol, suffered from an irregular heart rate, and pregnant women. Of the 134 patients who participated in the study, 63.3% had altered blood pressure when measured at health facilities and 48% had higher blood pressure at home. The mean difference between the methods was 10.1 mmHg for systolic and 4.3 mmHg for diastolic. The prevalence of whitecoat hypertension was 19.4%. Blood pressure monitoring at home is a practicable strategy in the Brazilian healthcare system.

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Influence of ethnicity on acceptability of method of blood pressure monitoring: a cross-sectional study in primary care

British Journal of General Practice ◽

10.3399/bjgp16x685717 ◽

2016 ◽

Vol 66 (649) ◽

pp. e577-e586 ◽

Cited By ~ 14

Author(s):

Sally Wood ◽

Sheila M Greenfield ◽

M Sayeed Haque ◽

Una Martin ◽

Paramjit S Gill ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Blood Pressure Monitoring ◽

Cross Sectional Study ◽

Sectional Study ◽

Pressure Monitoring ◽

Cross Sectional

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HBPM to refine the diagnosis of hypertension in a Family Health Care Unit in RJ, Brazil - LapARC

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1118 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

T S Mello ◽

B G Botelho ◽

J V G Hollanda ◽

L A Antequera ◽

M A O Mourão ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

Blood Pressure Monitoring ◽

Adult Population ◽

Home Monitoring ◽

Home Blood Pressure ◽

Neck Circumference ◽

White Coat ◽

Cross Sectional ◽

Diagnosis Of Hypertension

Abstract Background The new hypertension (HT) guidelines recommend the use of out-of-office blood pressure (BP) measures for its diagnosis however, in the scope of public health in Brazil, it is still based on office BP (OBP) for logistical and financial reasons. Furthermore, in our country, it is not yet clear whether the use of out-of-office BP would really be more reliable for the diagnosis. Objective To evaluate the importance of using Home Blood Pressure Monitoring (HBPM) in diagnosing HT in a young adult population in primary care in Brazil. Methods A cross-sectional population study enrolled adults between 20 and 50 years in a primary healthcare unit in Rio de Janeiro. Office BP was the mean value of 2 measures, while the HBPM followed a 7-day protocol. It was considered normal a Home BP < 135x85 mmHg and OBP <140x90 mmHg. Patients were classified into 4 phenotypes: normotension (controlled OBP and HBPM); white coat HT (uncontrolled OBP and controlled HBPM); masked HT (controlled OBP and uncontrolled HBPM) and sustained HT (uncontrolled OBP and HBPM). Results A total of 462 individuals were enrolled [38% males; mean age 36±9 years]. Sedentary lifestyle (43%), dyslipidemia (38%) and obesity (28%) were the main CV risk factors. OBP, the prevalence of HT was 13%, HBPM it was 19%, with low concordance between them (kappa=0.472). After HBPM, 17% changed the diagnosis, being 6% of them white-coat HT and 11% masked HT. The variables that were independently associated with HT diagnosed by OBP were male gender (OR 1.83,CI95%:1.01-3.33,p=0.04) and increased neck circumference (OR 3.77,CI95%:1.59-8.93,p=0.003), whilst by HBPM they were obesity (OR 2.18,CI95%:1.27-3.76,p=0.005) and increased neck circumference (OR 2.37,CI95%:1.05-5.33,p=0.04). Conclusions If the diagnosis was based only in the office BP values, 17% of the subjects would've had an erroneous diagnosis of hypertension, suggesting the importance of implementing out-of-office BP measurements in primary care. Key messages Home monitoring blood pressure corrected the diagnosis of hypertension of 17% of patients, allocating them correctly into white-coat HT and masked HT. Increased neck circumference was independently associated with the diagnosis of hypertension by both methods.

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Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study

Journal of Clinical Medicine ◽

10.3390/jcm10091913 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1913

Author(s):

Tomonori Kimura ◽

Emi Ushigome ◽

Yoshitaka Hashimoto ◽

Naoko Nakanishi ◽

Masahide Hamaguchi ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Pulse Pressure ◽

Handgrip Strength ◽

Cross Sectional Study ◽

Home Blood Pressure ◽

Cross Sectional ◽

The Relationship ◽

At Home

The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength.

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