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Is there a need to redo many of the diagnoses of hypertension?

José Marcos Thalenberg1, Bráulio Luna Filho, Maria Teresa Nogueira Bombig

  • 1Blood Pressure Monitoring Service, Hypertensive Cardiopathy Clinic, Universidade Federal de São Paulo, Rua Tupi 397, São Paulo, Brazil. jm@thalenberg.com

Sao Paulo Medical Journal = Revista Paulista De Medicina
|July 14, 2012
PubMed

Insights

Overdiagnosis of hypertension is common in treated patients. Ambulatory blood pressure monitoring after drug withdrawal accurately reclassifies many presumed hypertensive individuals.

Area of Science:

  • Cardiology
  • Clinical Hypertension Research
  • Diagnostic Accuracy Studies

Background:

  • Hypertension diagnosis often relies on office blood pressure (BP) measurements.
  • This can lead to overdiagnosis, particularly in patients undergoing treatment.

Purpose of the Study:

  • To re-evaluate the diagnosis of treated hypertensive patients using new clinical measurements and ambulatory blood pressure monitoring (ABPM).
  • To assess the accuracy of traditional BP measurement methods versus ABPM in a treated hypertensive cohort.

Main Methods:

  • A cross-sectional study involving 101 patients undergoing antihypertensive treatment.
  • Patients underwent drug withdrawal for 2-3 weeks, followed by repeated office BP measurements and ABPM.
  • Standardized BP thresholds were used for diagnosing hypertension, white-coat hypertension, and normotension.

Main Results:

  • Of 101 subjects, 63% were confirmed hypertensive, 28% had white-coat hypertension, and 9% were normotensive.
  • Ambulatory blood pressure monitoring revealed that 37% of initially presumed hypertensive patients were not confirmed as such after re-evaluation.
  • No cases of masked hypertension were identified.

Conclusions:

  • Hypertension is frequently overdiagnosed in patients undergoing treatment.
  • Implementing new diagnostic procedures, including drug withdrawal and BP monitoring, is crucial for accurate hypertension diagnosis.
Abstract

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