Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice
yes === Abstract Background: Blood pressure (BP) measurement is increasingly carried out through home or ambulatory monitoring, yet existing cardiovascular risk scores were developed for use with measurements obtained in clinic. Aim: To describe differences in cardiovascular risk estimates obtaine...
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ndltd-BRADFORD-oai-bradscholars.brad.ac.uk-10454-165882019-08-31T03:04:57Z Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice Stevens, S.L. Stevens, R.J. de Leeuw, P. Kroon, A.A. Greenfield, S. Mohammed, Mohammed A. Gill, P. Verberk, W.J. McManus, R.J. Blood pressure Risk Myocardial infarction Stroke Primary health care Ambulatory monitoring Measurements Accuracy Blood Pressure (BP) measurement yes Abstract Background: Blood pressure (BP) measurement is increasingly carried out through home or ambulatory monitoring, yet existing cardiovascular risk scores were developed for use with measurements obtained in clinic. Aim: To describe differences in cardiovascular risk estimates obtained using ambulatory or home BP measurements instead of clinic readings. Design and setting: Secondary analysis of data from adults aged 30-84 without prior history of cardiovascular disease (CVD) in two BP monitoring studies (BP-Eth and HOMERUS). Method: The primary comparison was Framingham risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements. The QRISK2 and SCORE risk equations were also studied. Statistical and clinical significance were determined using the Wilcoxon signed-rank test and scatter plots respectively. Results: In 442 BP-Eth patients (mean age = 58 years, 50% female) the median absolute difference in 10-year Framingham cardiovascular risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements was 1.84% (interquartile range 0.65 to 3.63, p=0.67). Only 31/ 442 (7.0%) of patients were reclassified across the 10% risk treatment threshold. In 165 HOMERUS patients (mean age = 56 years, 46% female) the median difference in 10-year risk was 2.76% (IQR 1.19 to 6.39, p<0.001) and only 8/165 (4.8%) of patient were reclassified. Conclusion: Estimates of cardiovascular risk are similar when calculated using BP measurements obtained as in the risk score derivation study or through ambulatory monitoring. Further research is required to determine if differences in estimated risk would meaningfully influence risk score accuracy. The full text will be available at the end of the publisher's embargo period, 12 months after publication. 2018-09-28T15:32:57Z 2018-09-28T15:32:57Z 2018 2018-09-09 2019-11-30 Article published version paper Stevens SL, Stevens RJ, de Leeuw P, Kroon AA, Greenfield S, Mohammed MA et al (2018) Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice. British Journal of General Practice. Accepted for publication. http://hdl.handle.net/10454/16588 en https://bjgp.org/ © 2018 Royal College of General Practitioners. Reproduced in accordance with the publisher's self-archiving policy. |
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NDLTD |
language |
en |
sources |
NDLTD |
topic |
Blood pressure Risk Myocardial infarction Stroke Primary health care Ambulatory monitoring Measurements Accuracy Blood Pressure (BP) measurement |
spellingShingle |
Blood pressure Risk Myocardial infarction Stroke Primary health care Ambulatory monitoring Measurements Accuracy Blood Pressure (BP) measurement Stevens, S.L. Stevens, R.J. de Leeuw, P. Kroon, A.A. Greenfield, S. Mohammed, Mohammed A. Gill, P. Verberk, W.J. McManus, R.J. Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
description |
yes === Abstract
Background: Blood pressure (BP) measurement is increasingly carried out through home or ambulatory monitoring, yet existing cardiovascular risk scores were developed for use with measurements obtained in clinic.
Aim: To describe differences in cardiovascular risk estimates obtained using ambulatory or home BP measurements instead of clinic readings.
Design and setting: Secondary analysis of data from adults aged 30-84 without prior history of cardiovascular disease (CVD) in two BP monitoring studies (BP-Eth and HOMERUS).
Method: The primary comparison was Framingham risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements. The QRISK2 and SCORE risk equations were also studied. Statistical and clinical significance were determined using the Wilcoxon signed-rank test and scatter plots respectively.
Results: In 442 BP-Eth patients (mean age = 58 years, 50% female) the median absolute difference in 10-year Framingham cardiovascular risk calculated using BP measured as in the Framingham study or daytime ambulatory BP measurements was 1.84% (interquartile range 0.65 to 3.63, p=0.67). Only 31/ 442 (7.0%) of patients were reclassified across the 10% risk treatment threshold. In 165 HOMERUS patients (mean age = 56 years, 46% female) the median difference in 10-year risk was 2.76% (IQR 1.19 to 6.39, p<0.001) and only 8/165 (4.8%) of patient were reclassified.
Conclusion: Estimates of cardiovascular risk are similar when calculated using BP measurements obtained as in the risk score derivation study or through ambulatory monitoring. Further research is required to determine if differences in estimated risk would meaningfully influence risk score accuracy. === The full text will be available at the end of the publisher's embargo period, 12 months after publication. |
author |
Stevens, S.L. Stevens, R.J. de Leeuw, P. Kroon, A.A. Greenfield, S. Mohammed, Mohammed A. Gill, P. Verberk, W.J. McManus, R.J. |
author_facet |
Stevens, S.L. Stevens, R.J. de Leeuw, P. Kroon, A.A. Greenfield, S. Mohammed, Mohammed A. Gill, P. Verberk, W.J. McManus, R.J. |
author_sort |
Stevens, S.L. |
title |
Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
title_short |
Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
title_full |
Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
title_fullStr |
Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
title_full_unstemmed |
Using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
title_sort |
using out-of-office blood pressure measurements in established cardiovascular risk scores: implications for practice |
publishDate |
2018 |
url |
http://hdl.handle.net/10454/16588 |
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