Accuracy of home and clinic-based blood pressure monitoring

January 01, 0001

Accuracy of home and clinic-based blood pressure monitoring

These UK researchers compared the accuracy of clinic home blood pressure monitoring vis-à-vis ambulatory blood pressure monitoring to diagnose hypertension. They performed a systematic review with meta-analysis with of Medline, Embase, Cochrane Database of Systematic Reviews, DARE, Medion, ARIF, and TRIP.

The researchers found: "The 20 eligible studies used various thresholds for the diagnosis of hypertension, and only seven studies (clinic) and three studies (home) could be directly compared with ambulatory monitoring. Compared with ambulatory monitoring thresholds of 135/85 mm Hg, clinic measurements over 140/90 mm Hg had mean sensitivity and specificity of 74.6% and 74.6%, respectively, whereas home measurements over 135/85 mm Hg had mean sensitivity and specificity of 85.7% and 62.4%."

The researchers concluded: "Neither clinic nor home measurement had sufficient sensitivity or specificity to be recommended as a single diagnostic test. If ambulatory monitoring is taken as the reference standard, then treatment decisions based on clinic or home blood pressure alone might result in substantial overdiagnosis. Ambulatory monitoring before the start of lifelong drug treatment might lead to more appropriate targeting of treatment, particularly around the diagnostic threshold."

This study suggests neither home or office based blood pressure monitoring is sufficiently accurate to diagnose hypertension compared to ambulatory blood pressure monitoring.

For the full abstract, click here.

BMJ 342:d3621, 24 June 2011 © 2011 BMJ Publishing Group Ltd.
Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. J Hodgkinson, J Mant, U Martin, et al. Correspondence to R J McManus: [email protected]

Category: K. Circulatory. Keywords: blood pressure, hypertension, home, office, ambulatory, systematic review with meta-analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 12 July 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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