High levels of discordance between office-based and ambulatory blood pressure measurements for diagnosing optimal blood pressure control in high-risk diabetic populations from a developing country

Diabetes Metab. 2012 Jun;38(3):271-2. doi: 10.1016/j.diabet.2012.02.004. Epub 2012 May 30.

Abstract

This study investigated the concordance between office-based blood pressure (BP) readings and ambulatory BP monitoring (ABPM) in 51 consenting type 2 diabetes patients (25 males) in Cameroon with hypertension who had been receiving stable treatment for at least 3 months. The prevalence of optimal BP control was 63% based on office measurements and 23% based on ABPM. Agreement between the two methods was poor (kappa statistic: 0.15; 95% confidence interval: -0.08 to 0.29). Using ABPM as the standard, office BP was helpful for ruling out optimal BP control (specificity: 75%), but not for ruling it in (sensitivity: 41%). Our results suggest that ABPM should be recommended in such settings as ours only for those patients who have already achieved stable optimal BP control according to office measurements.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Determination / methods*
  • Blood Pressure Monitoring, Ambulatory / economics
  • Blood Pressure* / drug effects
  • Cameroon
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Humans
  • Hypertension / drug therapy
  • Hypertension / economics
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Young Adult

Substances

  • Antihypertensive Agents