Is there a need to redo many of the diagnoses of hypertension?
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000300007 |
Resumo: | CONTEXT AND OBJECTIVE: Most hypertensive subjects undergoing treatment were diagnosed solely through measurements made in the consultation office. The objective of this study was to redo the diagnosis of treated patients after new clinical measurements and ambulatory blood pressure monitoring (ABPM). DESIGN AND SETTING: Cross-sectional study conducted in an outpatient specialty clinic. METHODS: Patients with mild-to-moderate hypertension or undergoing anti-hypertensive treatment, without target organ damage or diabetes, were included. After drug withdrawal lasting 2-3 weeks, new blood pressure (BP) measurements were made during two separate visits. ABPM was performed blindly, in relation to clinical measurements. The BP thresholds used for diagnosing hypertension, white-coat hypertension, normotension and masked hypertension were: 140 (systolic) and 90 (diastolic) mmHg for office measurements and 135 (systolic) and 85 (diastolic) mmHg for mean awake ABPM (MAA). RESULTS: Evaluations were done on 101 subjects (70% women); mean age 51 ± 10 years. The clinical BP was 155 ± 18/97 ± 10 mmHg (first visit) and 150 ± 16/94 ± 11 mmHg (second visit); MAA was 137 ± 13/ 86 ± 10 mmHg. Sixty-four patients (63%) were confirmed as hypertensive, 28 (28%) as white-coat hypertensive, nine (9%) as normotensive and none as masked hypertensive. After ABPM, 37% of the presumed hypertensive patients did not fit into this category. CONCLUSION: This study showed that hypertension was overdiagnosed among hypertensive subjects undergoing treatment. New diagnostic procedures should be performed after drug withdrawal, with the aid of BP monitoring. |
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Is there a need to redo many of the diagnoses of hypertension?Blood pressure determinationHypertensionDiagnostic techniques, cardiovascularBlood pressure monitoring, ambulatoryHeadacheCONTEXT AND OBJECTIVE: Most hypertensive subjects undergoing treatment were diagnosed solely through measurements made in the consultation office. The objective of this study was to redo the diagnosis of treated patients after new clinical measurements and ambulatory blood pressure monitoring (ABPM). DESIGN AND SETTING: Cross-sectional study conducted in an outpatient specialty clinic. METHODS: Patients with mild-to-moderate hypertension or undergoing anti-hypertensive treatment, without target organ damage or diabetes, were included. After drug withdrawal lasting 2-3 weeks, new blood pressure (BP) measurements were made during two separate visits. ABPM was performed blindly, in relation to clinical measurements. The BP thresholds used for diagnosing hypertension, white-coat hypertension, normotension and masked hypertension were: 140 (systolic) and 90 (diastolic) mmHg for office measurements and 135 (systolic) and 85 (diastolic) mmHg for mean awake ABPM (MAA). RESULTS: Evaluations were done on 101 subjects (70% women); mean age 51 ± 10 years. The clinical BP was 155 ± 18/97 ± 10 mmHg (first visit) and 150 ± 16/94 ± 11 mmHg (second visit); MAA was 137 ± 13/ 86 ± 10 mmHg. Sixty-four patients (63%) were confirmed as hypertensive, 28 (28%) as white-coat hypertensive, nine (9%) as normotensive and none as masked hypertensive. After ABPM, 37% of the presumed hypertensive patients did not fit into this category. CONCLUSION: This study showed that hypertension was overdiagnosed among hypertensive subjects undergoing treatment. New diagnostic procedures should be performed after drug withdrawal, with the aid of BP monitoring.Associação Paulista de Medicina - APM2012-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000300007Sao Paulo Medical Journal v.130 n.3 2012reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/S1516-31802012000300007info:eu-repo/semantics/openAccessThalenberg,José MarcosLuna Filho,BráulioBombig,Maria Teresa NogueiraFrancisco,Yoná AfonsoPóvoa,Rui Manuel dos Santoseng2012-07-12T00:00:00Zoai:scielo:S1516-31802012000300007Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2012-07-12T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Is there a need to redo many of the diagnoses of hypertension? |
title |
Is there a need to redo many of the diagnoses of hypertension? |
spellingShingle |
Is there a need to redo many of the diagnoses of hypertension? Thalenberg,José Marcos Blood pressure determination Hypertension Diagnostic techniques, cardiovascular Blood pressure monitoring, ambulatory Headache |
title_short |
Is there a need to redo many of the diagnoses of hypertension? |
title_full |
Is there a need to redo many of the diagnoses of hypertension? |
title_fullStr |
Is there a need to redo many of the diagnoses of hypertension? |
title_full_unstemmed |
Is there a need to redo many of the diagnoses of hypertension? |
title_sort |
Is there a need to redo many of the diagnoses of hypertension? |
author |
Thalenberg,José Marcos |
author_facet |
Thalenberg,José Marcos Luna Filho,Bráulio Bombig,Maria Teresa Nogueira Francisco,Yoná Afonso Póvoa,Rui Manuel dos Santos |
author_role |
author |
author2 |
Luna Filho,Bráulio Bombig,Maria Teresa Nogueira Francisco,Yoná Afonso Póvoa,Rui Manuel dos Santos |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Thalenberg,José Marcos Luna Filho,Bráulio Bombig,Maria Teresa Nogueira Francisco,Yoná Afonso Póvoa,Rui Manuel dos Santos |
dc.subject.por.fl_str_mv |
Blood pressure determination Hypertension Diagnostic techniques, cardiovascular Blood pressure monitoring, ambulatory Headache |
topic |
Blood pressure determination Hypertension Diagnostic techniques, cardiovascular Blood pressure monitoring, ambulatory Headache |
description |
CONTEXT AND OBJECTIVE: Most hypertensive subjects undergoing treatment were diagnosed solely through measurements made in the consultation office. The objective of this study was to redo the diagnosis of treated patients after new clinical measurements and ambulatory blood pressure monitoring (ABPM). DESIGN AND SETTING: Cross-sectional study conducted in an outpatient specialty clinic. METHODS: Patients with mild-to-moderate hypertension or undergoing anti-hypertensive treatment, without target organ damage or diabetes, were included. After drug withdrawal lasting 2-3 weeks, new blood pressure (BP) measurements were made during two separate visits. ABPM was performed blindly, in relation to clinical measurements. The BP thresholds used for diagnosing hypertension, white-coat hypertension, normotension and masked hypertension were: 140 (systolic) and 90 (diastolic) mmHg for office measurements and 135 (systolic) and 85 (diastolic) mmHg for mean awake ABPM (MAA). RESULTS: Evaluations were done on 101 subjects (70% women); mean age 51 ± 10 years. The clinical BP was 155 ± 18/97 ± 10 mmHg (first visit) and 150 ± 16/94 ± 11 mmHg (second visit); MAA was 137 ± 13/ 86 ± 10 mmHg. Sixty-four patients (63%) were confirmed as hypertensive, 28 (28%) as white-coat hypertensive, nine (9%) as normotensive and none as masked hypertensive. After ABPM, 37% of the presumed hypertensive patients did not fit into this category. CONCLUSION: This study showed that hypertension was overdiagnosed among hypertensive subjects undergoing treatment. New diagnostic procedures should be performed after drug withdrawal, with the aid of BP monitoring. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000300007 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802012000300007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S1516-31802012000300007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.130 n.3 2012 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209263392129024 |