Is there a need to redo many of the diagnoses of hypertension?

Detalhes bibliográficos
Autor(a) principal: Thalenberg,José Marcos
Data de Publicação: 2012
Outros Autores: Luna Filho,Bráulio, Bombig,Maria Teresa Nogueira, Francisco,Yoná Afonso, Póvoa,Rui Manuel dos Santos
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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spelling 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
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