How often do we measure blood pressure in the office? Results of the Hungarian Hypertension Registry

János Nemcsik, Johanna Takács, Csaba Farsang, Attila Simon, Dénes Páll, Péter Torzsa, Szilveszter Dolgos, Akos Koller, Zoltán Járai

Background:

Hypertension is a major public health problem and its proper diagnosis and treatment are crucial to reduce the cardiovascular morbidity and mortality.

Research questions:

The aim of the new Hungarian Hypertension Registry was to evaluate the features of blood pressure measurement practice of family physicians and hypertension care specialists and to register the blood pressure values measured during everyday practice.

Method:

Omron M3 IT devices were distributed for four-months periods to family physician practices and to hypertension outpatient clinics between October 2018 and April 2023. Blood pressure data were transmitted online from the cuff of the monitors to the central database using the Medistance system of Omron.

Results:

Family physicians n=2 385), internists (n=988) and cardiologists (n=232) participated in the study. During 10 four-months long evaluation periods altogether 4 804 821 blood pressure measurements were registered. The daily average number of the measurements in the ten periods were between 3.0 and 5.6. Following the ESH diagnostic criteria, the proportion of subjects in optimal, normal and high-normal blood pressure categories were 14%, 13.4% and 16.7%, respectively. Altogether 56% of the measurements belonged to stage 1, stage 2 and stage 3 hypertension categories (31.6%, 17.1% and 7.4%, respectively). The average systolic blood pressure values in family physician practices with more than 2500 patients were higher compared with practices with less, than 1500 patients (141.8 mmHg versus 139.84 mmHg, respectively).

Conclusions:

In conclusions, the low daily average number of blood pressure measurements refers for limited blood pressure screening capacity of the Hungarian family physicians. In practices with more patients the blood pressure is generally less controlled. These results suggest the need for reconsideration of the blood pressure measurement guidelines and for the further promotion of home blood pressure measurement.

Points for discussion:

Office blood pressure measurement practice in real life, the importance of home blood pressure monitoring.

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