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National Registry of Hypertension Control Evaluated by Office and Home Measurements: The LHAR National Registry
Roberto Dischinger Miranda1, Andréa Araujo Brandão2, Weimar Kunz Sebba Barroso3
1Serviço de Cardiologia, Disciplina de Geriatria e Gerontologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP - Brasil.
Insights
Home blood pressure monitoring (HBPM) revealed better hypertension control rates (61%) compared to office measurements (56.3%) in Brazilian cardiology practices. Overall control considering both settings was 46.4%.
Area of Science:
- Cardiology
- Hypertension Management
- Epidemiology
Background:
- Elevated blood pressure (BP) in clinical settings is common, affecting approximately 30% of patients.
- Globally, only 35% of hypertensive patients achieve their target BP levels with current treatments.
Purpose of the Study:
- To assess BP control rates among Brazilian cardiology patients using both office and home BP measurements.
- To provide epidemiological data on hypertension management effectiveness in a Brazilian context.
Main Methods:
- A cross-sectional study involving 2540 patients diagnosed with hypertension and on antihypertensive treatment.
- Office BP measurements were taken by a medical professional, alongside home BP monitoring (HBPM).
- Statistical analysis included the chi-square test to assess associations between categorical variables.
Main Results:
- Office BP control was 56.3%, while home BP control reached 61%.
- 46.4% of patients achieved controlled BP in both office and home settings.
- Prevalence of uncontrolled white coat hypertension was 15%, and uncontrolled masked hypertension was 10%.
Conclusions:
- Office BP measurement alone may overestimate hypertension control rates.
- Home BP monitoring provides a more comprehensive assessment of BP control.
- Targeted interventions considering both office and home BP readings are crucial for effective hypertension management.
Background:
It is known that around 30% of patients have higher blood pressure (BP) values when examined at the office than at home. Worldwide, only 35% of patients with hypertension undergoing treatment have reached their BP targets.
Objective:
To provide epidemiological data on BP control in the offices of a sample of Brazilian cardiologists, considering office and home BP measurement.
Methods:
This is a cross-sectional analysis of patients with a hypertension diagnosis and undergoing antihypertensive treatment, with controlled BP or not. BP was assayed in the office by a medical professional and at home using home BP monitoring (HBPM). The association between categorical variables was verified using the chi-square test (p<0.05).
Results:
The study included 2540 patients, with a mean age of 59.7 ± 15.2 years. Most patients were women (62%; n=1575). Prevalence rates of 15% (n=382) for uncontrolled white coat hypertension and 10% (n=253) for uncontrolled masked hypertension were observed. The rate of BP control in the office was 56.3% and at home, 61%. Meanwhile, 46.4% of the patients had controlled BP in and outside of the office. Greater control was observed in women and in the 49-61 years age group. Considering the new DBHA 2020 threshold for home BP control, the control rate was 42.4%.
Conclusion:
BP control in the offices of a sample of Brazilian cardiologists was 56.3%; this rate was 61% when BP was measured at home and 46.4% when considering both the office and home.
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