PS-C07-4: COST EFFECTIVE SCREENING FOR BLOOD PRESSURE IN A LMIC: COMPARISON OF STANDARD AND RANDOM METHODS FOR HOME BLOOD PRESSURE MONITORING

Abstract

Background: Hypertension is a leading risk factor for worldwide mortality and has become an important public health concern. Globally one billion people are suffering from hypertension and this rate may reach up to 1.56 billion by 2025. The prevalence of hypertension in Pakistani adults is upto 50%. The National Institute for Clinical Excellence and Pakistan Hypertension League guidelines recommend home blood pressure monitoring (HBPM) for screening and diagnosis of hypertension in Pakistan; whereas, the current gold standard of hypertension diagnosis is still ABPM. However, the utility of HBPM is restricted due to the cumbersome standard method for HBPM, which requires timed blood pressure measurements pre-breakfast & pre dinner.. We need pragmatic ways of measuring home blood pressure which will lead to higher patient compliance. Objective: To compare the limits of agreement between standard and random methods for HBPM in patients with or without hypertension. Design & Method: A cross sectional study with n = 345 participants will be conducted in The Aga Khan University Hospital. After receiving due ethical approvals, participants 18 80 years of age will be recruited with or without hypertension. A HBPM device (OMRON M7 Intelli) will be provided to each participant for 14 days. In first week, BP readings will be taken as per standard method (2 readings pre breakfast & 2 pre-dinner) and random method (6 readings anytime during a day) will be followed in subsequent week. Besides demographics, history of comorbid, medications status and BP charting, international physical activity questionnaire short form will be filled. SPSS software will be used for data management and analyses. Pearson correlation coefficients, Bland Altman plots and ROC curve will be used to determine the correlation limits of agreement and level of accuracy in predicting hypertension for both methods.