Related Experiment Videos
Home blood pressure normalcy: the Didima study
G S Stergiou1, G C Thomopoulou, I I Skeva
1Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece.
Insights
This study establishes reference values for home blood pressure (HBP) in a Greek community, suggesting HBP below 137/82 mm Hg is likely normal. These findings aid in interpreting HBP readings for better clinical practice.
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.
Abstract:
To evaluate reference values of home blood pressure (HBP) a cross-sectional community study was conducted on 694 adult subjects (aged > or = 18 years) of the village Didima in southern Greece (participation rate 76.4%). Clinic blood pressure (CBP) was measured on two visits (triplicate measurements, mercury sphygmomanometer) and HBP on 3 workdays (duplicate morning and evening measurements, oscillometric devices; Omron HEM 705CP). After exclusion of 132 subjects (103 treated hypertensives and 29 with incomplete data), 562 subjects were analyzed (mean +/- SD aged 51.2 +/- 17.2 years, 42.7% men). Average HBP (120.0 +/- 17.8/72.6 +/- 8.8 mm Hg, systolic/diastolic) was strongly correlated (P < .0001) with CBP (118.7 +/- 17.7/73.8 +/- 10.5 mm Hg). Systolic CBP was 1.3 mm Hg lower than HBP (P < .01, 95% confidence interval 0.4, 2.2), whereas diastolic CBP was 1.2 mm Hg higher than HBP (P < .0001, 95% confidence interval 0.6, 1.7). The threshold of HBP normality determined using three different approaches was 1) 139.7/83.0 mm Hg (systolic/diastolic) using the distribution criterion (95th percentile of the HBP distribution among 476 normotensive subjects); 2) 139.7/85.8 mm Hg using the correspondence criterion (the percentiles of the CBP distribution that correspond to CBP > or = 140/90 mm Hg were estimated, and the levels of BP that correspond to these same percentiles on the HBP distribution were calculated); and 3) 137.4/82.7 mm Hg using the regression criterion (calculation of the levels of HBP that correspond to CBP of 140/90 mm Hg using the regression equation between HBP and CBP). Overall, the findings of the three criteria suggest that average HBP < 137/82 mm Hg might be considered as probably normal, > 140/86 mm Hg as probably abnormal, and within these limits as borderline. Until mortality-based prospective data are available, this approach might be useful in the interpretation of HBP in clinical practice.