Home blood pressure normalcy: the Didima study.

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Home blood pressure (HBP) monitoring is increasingly used for hypertension management.
• Establishing reliable reference values for HBP is crucial for accurate diagnosis and treatment.
• Previous studies have shown discrepancies between clinic blood pressure (CBP) and HBP.

Purpose of the Study:

• To evaluate reference values for home blood pressure (HBP) in an adult community population.
• To compare HBP measurements with clinic blood pressure (CBP) measurements.
• To propose interpretative thresholds for HBP based on multiple criteria.

Main Methods:

• A cross-sectional community study involving 694 adult subjects in Didima, Greece.
• Blood pressure was measured using both clinic (mercury sphygmomanometer) and home (oscillometric devices) methods.
• Three distinct criteria (distribution, correspondence, regression) were used to determine HBP normality thresholds.

Main Results:

• Average HBP (120.0/72.6 mm Hg) was strongly correlated with CBP (118.7/73.8 mm Hg).
• Systolic CBP was slightly lower than HBP, while diastolic CBP was slightly higher.
• The three criteria suggested HBP < 137/82 mm Hg as probably normal and > 140/86 mm Hg as probably abnormal.

Conclusions:

• Reference values for HBP were established using distribution, correspondence, and regression criteria.
• Proposed interpretative thresholds for HBP are <137/82 mm Hg (normal), 137-140/82-86 mm Hg (borderline), and >140/86 mm Hg (abnormal).
• These HBP reference values can aid in clinical practice for interpreting home blood pressure readings pending further prospective data.