(HealthDay News) — Mean blood pressure (BP) is significantly lower with clinic-based measurement, significantly higher for kiosk-based measurement, and not significantly different for home-based measurement compared with 24-hour ambulatory BP monitoring (ABPM), according to a study published online March 3 in the Journal of General Internal Medicine.
Beverly B. Green, M.D., M.P.H., from the Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues conducted a diagnostic study in 12 Washington state primary care centers involving participants aged 18 to 85 years without diagnosed hypertension to compare clinic-, home- and kiosk-based BP measurements with ABPM for diagnosing hypertension. The primary analysis included 434 participants who were randomly assigned to clinic-, home- or kiosk-based BP measurements; at three weeks, all participants completed ABPM.
The researchers found that the adjusted mean differences in systolic BP were −4.7, −0.1 and 9.5 mm Hg for clinic-, home-, and kiosk-based measurements, respectively, compared with ABPM. For diastolic BP, the corresponding differences were −7.2, −0.4 and 5.0 mm Hg. The sensitivities for detecting hypertension for clinic-, home- and kiosk-based BP measurement compared with ABPM were 31.1, 82.2, and 96% respectively, and the corresponding specificities were 79.5, 53.3, and 28.2%.
“Home had higher sensitivity than clinic for detecting hypertension, but at the expense of specificity,” the authors write. “However, as most participants had hypertension, false positive rates were relatively low.”