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Home blood pressure self-monitoring: diagnostic performance in white-coat hypertension

Joan Bayó1, Francesc Xavier Cos, Carme Roca

  • 1PCT El Clot, ICS Consorci Sanitari Creu Roja d'Hospitalet, Faculty of Medicine, Biomedical Research Institute August Pi i Sunyer, University of Barcelona, Barcelona, Spain. 27515jbl@comb.es

Blood Pressure Monitoring
|March 15, 2006
PubMed

Insights

A 3-day home blood pressure self-monitoring program showed poor diagnostic accuracy for white-coat hypertension. Ambulatory blood pressure monitoring remains the preferred diagnostic tool for this condition.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Diagnostic Accuracy

Background:

  • White-coat hypertension (WCH) is a condition where blood pressure is elevated in a clinical setting but normal otherwise.
  • Accurate diagnosis of WCH is crucial to avoid unnecessary treatment and its associated side effects.

Purpose of the Study:

  • To evaluate the diagnostic performance of a 3-day home blood pressure self-monitoring (HBPSM) program for identifying white-coat hypertension.
  • To compare HBPSM with 24-hour ambulatory blood pressure monitoring (ABPM) in diagnosing WCH.

Main Methods:

  • A study involving 190 patients with newly diagnosed mild-moderate hypertension.
  • Patients performed 3-day HBPSM (morning and night, triplicate readings).
  • Comparison with 24-hour ABPM, using a normality cut-off of 135/85 mmHg for both methods.

Main Results:

  • HBPSM diagnosed WCH in 34.8% of patients, while ABPM identified it in 41.6%.
  • HBPSM demonstrated sensitivity of 50.0% and specificity of 75.7%.
  • Receiver operating characteristic curve analysis did not improve HBPSM's diagnostic performance.

Conclusions:

  • A 3-day HBPSM program exhibits poor diagnostic accuracy for white-coat hypertension.
  • 24-hour ABPM remains the gold standard and recommended diagnostic test for WCH.
Abstract

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