ABSTRACT
OBJETIVO: Determinar los valores de punto de corte óptimos para la determinación de la presión arterial en consulta (PAC) como prueba de seguimiento en la consulta de Atención Primaria (AP). MATERIAL Y MÉTODO: A 153 hipertensos menores de 80años que cumplieran con criterios de inclusión y exclusión se les realizó una monitorización ambulatoria de su presión arterial durante 24h (MAPA), tras lo cual se obtuvieron dos medidas de PAC. Con los registros obtenidos de PAC, y tomándose la MAPA como referencia, se procedió a realizar la curva ROC para elegir el punto de corte óptimo. El acuerdo entre ambas mediciones fue determinado por el coeficiente de correlación intraclase y el método de Bland-Altman, tras lo cual se realizó un estudio de validación con el objetivo de diagnosticar el control o no del hipertenso. RESULTADOS: Los valores óptimos de corte fueron 137mmHg para la PA sistólica (sensibilidad: 89,3%; especificidad: 72,2%) y de 84mmHg para la diastólica (sensibilidad: 79,4%; especificidad: 72,3%). El acuerdo en el diagnóstico de control entre PAC y MAPA fue de 58,9% (kappa: 0,418). CONCLUSIÓN: El valor de corte óptimo de la PA diastólica para el seguimiento es menor a las cifras establecidas en la actualidad
AIM: This study seeks to determine the optimal cut-off values for the determination of the blood pressure in the clinic as a follow-up test in Primary Care practice. DESIGN: A total of 153 hypertensive patients under 80years of age who met inclusion and exclusion criteria for the study, were subjected to ambulatory monitoring of their blood pressure for 24hours (ABPM). After which two clinic-based measurements were obtained. With the results obtained from the clinic, and taking the ABMP as a reference, the ROC curve was calculated choose the optimal cut-off point. The agreement between both measurements was determined by the intraclass correlation coefficient and the Bland-Altman equation. A validation study was then carried out with the objective of diagnosing whether or not the hypertensive patient was in control. RESULTS: The optimal cut-off values were 137mmHg for systolic BP (sensitivity: 89.3%; specificity: 72.2%) and 84mmHg for diastolic blood pressure (sensitivity: 79.4%; specificity: 72.3%). The agreement in the diagnosis of control between clinic-based measurement and ABPM was 58.9% (Kappa: 0.418). CONCLUSION: The optimal cut-off value of the diastolic BP for follow-up is lower than the values currently established
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Arterial Pressure/physiology , Blood Pressure Monitoring, Ambulatory/methods , Hypertension/diagnosis , Primary Health Care/methods , Cross-Sectional Studies , Sensitivity and SpecificityABSTRACT
AIM: This study seeks to determine the optimal cut-off values for the determination of the blood pressure in the clinic as a follow-up test in Primary Care practice. DESIGN: A total of 153 hypertensive patients under 80years of age who met inclusion and exclusion criteria for the study, were subjected to ambulatory monitoring of their blood pressure for 24hours (ABPM). After which two clinic-based measurements were obtained. With the results obtained from the clinic, and taking the ABMP as a reference, the ROC curve was calculated choose the optimal cut-off point. The agreement between both measurements was determined by the intraclass correlation coefficient and the Bland-Altman equation. A validation study was then carried out with the objective of diagnosing whether or not the hypertensive patient was in control. RESULTS: The optimal cut-off values were 137mmHg for systolic BP (sensitivity: 89.3%; specificity: 72.2%) and 84mmHg for diastolic blood pressure (sensitivity: 79.4%; specificity: 72.3%). The agreement in the diagnosis of control between clinic-based measurement and ABPM was 58.9% (Kappa: 0.418). CONCLUSION: The optimal cut-off value of the diastolic BP for follow-up is lower than the values currently established.
