Decisiones clínicas en los pacientes hipertensos según la técnica de toma de la presión arterial

Abstract

Introduction High blood pressure is a very frequent disease that affects one out of every four persons. Increases in blood pressure levels increases the risk of cardiovascular events and is the first cause of morbidity-mortality in our population. Thus, blood pressure levels must be measured as correctly as possible in order to achieve better control. Design A descriptive, cross-sectional and validity study of diagnostic tests in patients over 18 years diagnosed of high blood pressure. The main variable was blood pressure (BP), measured using three methods. The following were also studied: gender, age, diabetes, left ventricular hypertrophy, creatinine, glomerular filtration rate, smoking, obesity, abdominal perimeter and time of the treatment. Results The grade of BP control was adequate after the first measurement of BP in the doctor's office in 15.7% (CI: 7.6–23. 8). The mean value of the 3 measurements was 20.2% (11–29), that of the second and third ones 25.8% (CI: 16.2–35.5), the self-monitoring of blood pressure at home (SMBPH) at 28.1% (CI: 18.2–38) and the ambulatory monitoring of blood pressure (AMBP) at 51.7% (CI: 40.7–62.6). The sensitivity (S) and specificity (sp) indexes were: first measurement S: 95.3, sp: 26.1; the second and third measurements with a mean S: 79.1 and sp: 30; the mean of all three measurements was S: 86 and sp: 26.1 and SMBPH S: 86 and sp: 41.3. Conclusions A greater grade of control of high blood pressure is observed when AMBP is used versus other methods. Decision-making in the daily practice should not be based only on the measurement of BP in the doctor's office due to its low specificity.