Incidental blood pressure elevations: a MIRNET project
C R Trembath1, J M Hickner, S W Bishop
1Providence Family Health Center, South Lyon, MI 48178.
Insights
Elevated diastolic blood pressure readings in office patients often indicate hypertension. Sixty percent of patients with incidental high diastolic pressure were diagnosed with hypertension, highlighting the need for medical attention.
Area of Science:
- Cardiology
- Public Health
- Clinical Medicine
Background:
- Investigated the prevalence of hypertension in primary care settings.
- Focused on patients with incidental diastolic blood pressure (DBP) ≥ 90 mm Hg.
Purpose of the Study:
- To determine the prevalence of hypertension among office patients with incidentally elevated DBP.
- To assess the diagnostic value of initial DBP readings for hypertension.
Main Methods:
- Prospective study involving routine screening of 14,890 patients.
- Identified 174 patients with elevated DBP and no prior hypertension diagnosis.
- 115 patients (64%) completed follow-up readings over 3 months.
Main Results:
- 60% of returning patients met hypertension criteria (JNC criteria).
- Hypertension prevalence was 69% in men and 49% in women.
- Patients with initial DBP > 105 mm Hg had a 90% hypertension rate.
Conclusions:
- Incidental elevations in DBP warrant serious clinical consideration.
- High prevalence of confirmed hypertension in this patient group necessitates further evaluation.
- Physicians should not overlook elevated DBP during routine screenings.
Background:
A prospective study was undertaken to determine the prevalence of hypertension in office patients with an incidental diastolic blood pressure greater than or equal to 90 mm Hg.
Methods:
During routine screening of 14,890 patients, 174 patients with elevated diastolic blood pressures but no previous diagnosis of hypertension were identified over a 3-month period. Only 115 (64%) returned as requested for two subsequent blood pressure readings.
Results:
Sixty percent of those returning fit the definition for hypertension using the criteria of the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension. Sixty-nine percent (43/62) of the men and 49% (26/53) of the women were hypertensive. Women under 40 years old were less likely to be hypertensive, but age did not predict hypertension in men. Among those patients with a diastolic pressure reading below 105 mm Hg, progressively higher diastolic readings on the first visit did not predict a higher probability of hypertension. Among those patients with a diastolic pressure reading above 105 mm Hg, however, 90% (9/10) were hypertensive.
Conclusions:
Physicians should take incidental elevation of diastolic pressure seriously because of the high prevalence of confirmed hypertension in this group of patients.
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