Validation of self reported diagnosis of hypertension in a cohort of university graduates in Spain

Alvaro Alonso,Miguel Angel Martínez-González,Miguel Delgado-Rodríguez,Juan José Beunza

doi:10.1186/1471-2458-5-94

Alvaro Alonso, Miguel Angel Martínez-González + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-5-94

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Abstract

BackgroundThe search for risk factors of hypertension requires the study of large populations. Sometimes, the only feasible way of studying these populations is to rely on self-reported data of the outcome. The objective of this study was to evaluate validity of self-reported diagnosis of hypertension in a cohort of university graduates in Spain.MethodsThe Seguimiento Universidad de Navarra (SUN) Study is a cohort of more than 15,000 university graduates in Spain. We selected a random sample of 79 cohort participants who reported a diagnosis of hypertension and 48 participants who did not report such diagnosis (76% participation proportion). Then, we compared information on the self-reported diagnosis of hypertension and hypertension status as assessed through two personal blood pressure measurements and an interview. Additionally, we compared self-reported and measured blood pressure levels with intraclass correlation coefficients and the survival-agreement plot.ResultsFrom those 79 reporting a diagnosis of hypertension, 65 (82.3%, 95% CI 72.8–92.8) were confirmed through conventional measurement of blood pressure and the interview. From those 48 that did not report a diagnosis of hypertension, 41 (85.4%, 95% CI 72.4–89.1) were confirmed as non hypertensives. Results were similar among men and women, but were worse for overweight and obese individuals, and for those with a family history of hypertension. The agreement between self-reported and measured blood pressure levels (as a continuous variable), as estimated by the intraclass correlation coefficient, was 0.35 for both systolic and diastolic blood pressure.ConclusionSelf-reported hypertension among highly educated participants in a cohort study is a relatively valid tool to assess the hypertensive status of participants. However, the investigators should be cautious when using self-reported blood pressure values.

Highlights

The search for risk factors of hypertension requires the study of large populations
Our objective was to assess the validity of self-reported diagnosis of HT in a random sample of the participants in the Seguimiento Universidad de Navarra (SUN, University of Navarra Follow-up) study, a cohort study in Spain
We considered a participant as true hypertensive when the average of both blood pressure (BP) measurements was ≥140 mmHg for systolic BP and/or ≥ 90 mmHg for diastolic BP, when s/he was currently using antihypertensive drug treatment or when s/he presented a medical report with a diagnosis of HT.[8]

Summary

Introduction

The search for risk factors of hypertension requires the study of large populations. The only feasible way of studying these populations is to rely on self-reported data of the outcome. The search for risk factors of incident HT requires the study of large populations. Recent BP measurement (choosing among the following categories, in mm Hg: lower than 100, 101–110, 111– 120, 121–130, 131–140, 141–150, 151–160, 161–175, greater than 175 for systolic BP; lower than 60, 61 to 70, 71 to 80, 81 to 90, 91 to 100, 101 to 110, 111 to 120, 121 to 130, greater than 130 for diastolic BP) This question did not differentiate between casual BP determinations or more formal BP measurements carried out according to diagnostic protocols

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