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Using out-of-office blood pressure measurements in established cardiovascular risk scores : a secondary analysis of data from two blood pressure monitoring studies
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Stevens, S. L., Stevens, R. J., de Leeuw, P., Kroon, A. A., Greenfield, S., Mohammed, M. A., Gill, Paramjit, Verberk, W. J. and McManus, R. J. (2019) Using out-of-office blood pressure measurements in established cardiovascular risk scores : a secondary analysis of data from two blood pressure monitoring studies. British Journal of General Practice, 69 (683). e381-e388. doi:10.3399/bjgp19X702737 ISSN 0960-1643.
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Official URL: https://doi.org/10.3399/bjgp19X702737
Abstract
Background
Blood pressure (BP) measurement is increasingly carried out through home or ambulatory monitoring, yet existing cardiovascular risk scores were developed for use with measurements obtained in clinics.
Aim
To describe differences in cardiovascular risk estimates obtained using ambulatory or home BP measurements instead of clinic readings.
Design and setting
Secondary analysis of data from adults aged 25–84 years in the UK and the Netherlands without prior history of cardiovascular disease (CVD) in two BP monitoring studies: the Blood Pressure in different Ethnic groups (BP-Eth) study and the Home versus Office blood pressure MEasurements: Reduction of Unnecessary treatment Study (HOMERUS).
Method
The primary comparison was Framingham risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements. Statistical significance was determined using non-parametric tests.
Results
In 442 BP-Eth patients (mean age = 58 years, 50% female [n = 222]) the median absolute difference in 10-year Framingham cardiovascular risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements was 1.84% (interquartile range [IQR] 0.65–3.63, P = 0.67). In 165 HOMERUS patients (mean age = 56 years, 46% female) the median absolute difference in 10-year risk for daytime ambulatory BP was 2.76% (IQR 1.19–6.39, P<0.001) and only 8 out of 165 (4.8%) of patients were reclassified.
Conclusion
Estimates of cardiovascular risk are similar when calculated using BP measurements obtained as in the risk score derivation study or through ambulatory monitoring. Further research is required to determine if differences in estimated risk would meaningfully influence risk score accuracy.
| Item Type: | Journal Article | ||||||||
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| Subjects: | Q Science > QP Physiology | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Cardiovascular system -- Diseases -- Risk factors, Blood pressure | ||||||||
| Journal or Publication Title: | British Journal of General Practice | ||||||||
| Publisher: | Royal College of General Practitioners | ||||||||
| ISSN: | 0960-1643 | ||||||||
| Official Date: | June 2019 | ||||||||
| Dates: |
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| Volume: | 69 | ||||||||
| Number: | 683 | ||||||||
| Page Range: | e381-e388 | ||||||||
| DOI: | 10.3399/bjgp19X702737 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 11 September 2018 | ||||||||
| Date of first compliant Open Access: | 7 May 2020 | ||||||||
| RIOXX Funder/Project Grant: |
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