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Reference Values for Self-recorded Blood Pressure

1998; American Medical Association; Volume: 158; Issue: 5 Linguagem: Inglês

10.1001/archinte.158.5.481

1538-3679

Lutgarde Thijs, Jan A. Staessen, Hilde Celis, R. De Gaudemaris, Yutsuka Imai, Stevo Julius, R. Fagard,

Hemodynamic Monitoring and Therapy

Background:The widespread clinical use of selfrecorded blood pressure measurement is limited by the lack of generally accepted reference values.The purpose of this study was therefore to perform a metaanalysis of summary data in an attempt to determine an operational threshold for self-recorded blood pressures. Studies and Methods:Seventeen studies, including a total of 5422 subjects, were reviewed.Eight of these 17 studies included both normotensive and untreated hypertensive subjects, while the other 9 reports included normotensive subjects only.Within each study an operational cutoff point between normotension and hypertension was derived by means of the mean+2 SDs and the 95th percentiles of the self-recorded blood pressure in normotensive subjects.These 2 methods were contrasted with 2 other techniques that have been applied in the literature to calculate (1) the self-recorded pressures equivalent to a conventional pressure of 140 mm Hg systolic and 90 mm Hg diastolic by means of regression analysis and (2) the self-recorded blood pressures at the percentiles corresponding to a conventional pressure of 140/90 mm Hg.The latter 2 methods were applied in un-treated subjects not selected on the basis of their blood pressure.Results: With weighting for the number of subjects included in the various studies, the self-recorded blood pressure averaged 115/71 mm Hg in normotensive persons and 119/74 mm Hg in untreated subjects not selected on the basis of their blood pressure.The reference values for selfrecorded blood pressures determined by the mean+2 SDs (137/89 mm Hg) or the 95th percentile (135/86 mm Hg) of the distribution in normotensive subjects were concordant within 2/3 mm Hg, whereas the cutoff points derived with the regression and percentile methods were considerably lower, ie, 125/79 and 129/84 mm Hg, respectively.Conclusions: Until the relationship between selfrecorded pressure and the incidence of cardiovascular morbidity and mortality is further clarified by prospective studies, a mean self-recorded blood pressure above 135 mm Hg systolic or 85 mm Hg diastolic may be considered hypertensive.