Impact on Hypertension Reclassification by Ambulatory Blood Pressure Monitoring (ABPM) according to the V Brazilian Guidelines on ABPM

Grezzana, Guilherme Brasil; Stein, Airton Tetelbom; Pellanda, Lúcia Campos

doi:10.5935/abc.20130197

Cited by 2 publications

(6 citation statements)

References 2 publications

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“…The present study, however, sought to prospectively assess the impact of adopting different thresholds of normality for ABPM in comparison with measures performed by PHC physicians. The results, in terms of accuracy, were similar to those of other studies that indicated a low accuracy of BP obtained by conventional measures compared with that obtained by ABPM, 8 but with unique results when comparing different guidelines for 24-hour mean pressure thresholds.…”

Section: Discussionsupporting

confidence: 86%

“…Patients were assessed by their own PHC physicians during routine visits to the hypertension outpatient clinic from January 2013 to October 2014. Patients who had participated in a previous cross-sectional study, 8 which included an assessment with 24-hour ABPM, were contacted by phone and/or letter to participate in this new study. Those who were not able to answer the questionnaire, pregnant women, individuals with a non-sinus rhythm electrocardiogram, residents from outside the coverage area of the UBSs, patients who switched cities or who were not found, and those who did not tolerate the use of ABPM or who presented some technical difficulty in the application of the method were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…The screening questionnaire also included validated instruments for the evaluation of smoking and nicotine dependence (Fagerström test), abusive alcohol consumption (Alcohol Use Disorders Identification Test, AUDIT), and adherence to treatment using the Morisky Medication Adherence Scale. 8 …”

Section: Methodsmentioning

confidence: 99%

“…8 These inquiries arise from a need for prospective studies and elaboration of databases, preferably national ones, to allow a more adequate assessment of the ABPM normality thresholds for the hypertensive population, especially those attended by the primary health care (PHC) system.…”

Section: Introductionmentioning

confidence: 99%

“…Two questions of application in clinical practice regarding the care of the hypertensive patient remain little explored: the applicability and the importance of more rigorous thresholds as criteria of normality for BP, and the prospective evaluation of the diagnostic accuracy between the different methods of BP measurement. 8 These inquiries arise from a need for prospective studies and elaboration of databases, preferably national ones, to allow a more adequate assessment of the ABPM normality thresholds for the hypertensive population, especially those attended by the primary health care (PHC) system.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

Grezzana

Moraes

Stein

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundHypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC) physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP) remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM) can lead to different medical decisions in PHC.ObjectiveTo evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines.MethodsA cross-sectional study including 569 hypertensive patients. The BP was initially measured by the PHC physicians and, later, by 24-hour ABPM. The BP measurements were obtained independently between the two methods. The therapeutic targets for the conventional BP followed the guidelines by the Eighth Joint National Committee (JNC 8), the V ABPM Brazilian Guidelines, and the 2013 European Hypertension Guidelines.ResultsThere was an accuracy of 54.8% (95% confidence interval [95%CI] 0.51 - 0.58%) for the BP measured with the conventional method when compared with the 24-hour ABPM, with a sensitivity of 85% (95%CI 80.8 - 88.6%), specificity of 31.9% (95%CI 28.7 - 34.7%), and kappa value of 0.155, when considering the European Hypertension Guidelines. When using more stringent thresholds to characterize the BP as "normal" by ABPM, the accuracy was 45% (95%CI 0.41 - 0.47%) for conventional measurement when compared with 24-hour ABPM, with a sensitivity of 86.7% (95%CI 0.81 - 0.91%), specificity of 29% (95%CI 0.26 - 0.30%), and kappa value of 0.103.ConclusionThe BP measurements obtained by PHC physicians showed low accuracy when compared with those obtained by 24-hour ABPM, regardless of the threshold set by the different guidelines.

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Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

Grezzana

Moraes

Stein

et al. 2016

Arquivos Brasileiros De Cardiologia

Self Cite

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Analysis of systolic and diastolic blood pressure variability in frail, pre-frail, and non-frail elderly patients: The relationship between frailty syndrome and blood pressure variability in the elderly

Wang

Ren

et al. 2023

Medicine

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Frailty can change the prognosis and treatment approach of chronic diseases. We, therefore, conducted this study to explore the relationship between frailty syndrome and blood pressure variability in the elderly. The clinical data of 150 elderly patients with debilitating syndrome admitted to the neurology department of our hospital from May 2021 to May 2022 were selected, and they were grouped according to Fried debilitation scale and divided into 50 cases each in the debilitation group, pre-debilitation group, and no-debilitation group. The general data, co-morbidities, medications, and biochemical indexes were collected. The 24-hour ambulatory blood pressure monitoring was performed in each group, and the mean systolic blood pressure, diastolic blood pressure, nocturnal systolic load value, and diastolic load value were analyzed to determine the relationship between blood pressure variability and senile frailty. Serum albumin (ALB) and high-density lipoprotein were significantly lower in the debilitated and pre-debilitated groups than in the non-debilitated group (P < .05). Multivariate logistic regression analysis revealed that age (odds ratio [OR]: 3.910, 95% confidence intervals [CI]: 2.021–5.402) was a risk factor for frailty in the elderly, and serum ALB (OR: 0.656, 95% CI: 0.110–0.960) and HDL (OR: 0.581, 95% CI: 0.237–0.944) were protective factors for frailty in the elderly. Age, type of medication taken, co-morbidities, serum ALB, and HDL are influencing factors of debilitating syndrome. Serum ALB and HDL are protective factors against debilitating syndrome in the elderly. Age is an independent risk factor of debilitation in the elderly and increased fluctuation of blood pressure in the elderly can increase their risk of developing debilitating syndrome.

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Impact on Hypertension Reclassification by Ambulatory Blood Pressure Monitoring (ABPM) according to the V Brazilian Guidelines on ABPM

Cited by 2 publications

References 2 publications

Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

Analysis of systolic and diastolic blood pressure variability in frail, pre-frail, and non-frail elderly patients: The relationship between frailty syndrome and blood pressure variability in the elderly

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