Clinic-based measures significantly lower than ABPM and had low sensitivity for detecting hypertension
THURSDAY, March 17, 2022 (HealthDay News) — Mean blood pressure (BP) is significantly lower with clinic-based measurement, significantly higher for kiosk-based measurement, and not significantly different for home-based measurement compared with 24-hour ambulatory BP monitoring (ABPM), according to a study published online March 3 in the Journal of General Internal Medicine.
Beverly B. Green, M.D., M.P.H., from the Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues conducted a diagnostic study in 12 Washington state primary care centers involving participants aged 18 to 85 years without diagnosed hypertension to compare clinic-, home-, and kiosk-based BP measurements with ABPM for diagnosing hypertension. The primary analysis included 434 participants who were randomly assigned to clinic-, home-, or kiosk-based BP measurements; at three weeks, all participants completed ABPM.
The researchers found that the adjusted mean differences in systolic BP were −4.7, −0.1, and 9.5 mm Hg for clinic-, home-, and kiosk-based measurements, respectively, compared with ABPM. For diastolic BP, the corresponding differences were −7.2, −0.4, and 5.0 mm Hg. The sensitivities for detecting hypertension for clinic-, home-, and kiosk-based BP measurement compared with ABPM were 31.1, 82.2, and 96 percent, respectively, and the corresponding specificities were 79.5, 53.3, and 28.2 percent.
“Home had higher sensitivity than clinic for detecting hypertension, but at the expense of specificity,” the authors write. “However, as most participants had hypertension, false positive rates were relatively low.”
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