The role first-day readings play in a three-day schedule of self-monitoring home blood pressure based on prognostic data. VAMPAHICA Study

Abstract

Abstract BACKGROUND The optimal schedule for self-monitoring home BP (SMHBP) readings is enormously important in the diagnosis of different phenotypes related to hypertension. The aim of this study was to determine the prognostic capacity of a three-day SMHBP schedule when using or suppressing the first-day measurements in compiling the results. METHODS A total of 767 newly diagnosed, non-treated patients with no history of cardiovascular disease (CVD) were followed for 6.2 years. As a baseline, office BP measurements were taken for all the patients who then went on to follow a three-day SMHBP schedule, taking two readings in the morning and two in the evening. The prognostic calculation was performed with CVD variables. The prognostic capacity of the three-day schedule was evaluated with and without the first-day readings (12 and 8 readings). RESULTS A total of 223 normotensive subjects (NT), 271 subjects with sustained hypertension (SHT) and 184 white-coat hypertensive subjects (WCH) were followed. The distribution of 98 (14.4%) non-fatal CV events during the follow-up was as follows: WCH 21 (11.4%), NT 9 (4.0%) and SHT 68 (25.1%). No statistically significant differences were observed in the risk of CV events (OR) for the two groups of hypertensives, irrespective of the schedule of readings used (SHT with vs without first-day readings: 8.81 (4.28-18.15) vs 8.61 (4.15-17.85) and WCH with vs without first-day readings: 2.71(1.13-6.47) vs 3.40 (1.49-7.78)). CONCLUSIONS Our findings show that first-day readings do not need to be discarded in order to calculate the final value of an SMHBP schedule.