Home Blood Pressure Monitoring as an Alternative to Confirm Diagnoses of Hypertension in Adolescents with Elevated Office Blood Pressure from a Brazilian State Capital

Background:  Regional differences of using home blood pressure monitoring (HBPM) as an alternative to ambulatory blood pressure monitoring (ABPM) in hypertensive adolescents are unknown.

Objectives:  Define if HBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian capital with elevated office blood pressure (BP).

Methods:  Adolescents (12-18years) from public and private schools with BP > 90th percentile were studied to compare and evaluate the agreement among office BP measurements, HBPM and ambulatory BP monitoring. Office BP measurements, HBPM and ABPM were performed according to guidelines recommendations. Semi-automatic devices were used for BP measurements. Values of p < 0.05 were considered significant.

Results:  We included 133 predominantly males (63.2%) adolescents with a mean age of 15±1.6 years. HBPM systolic blood pressure and diastolic blood pressure mean values were similar to the daytime ABPM values (120.3 ± 12.6 mmHg x 121.5 ± 9.8 mmHg - p = 0.111 and 69.4 ± 7.7 mmHg x 70.2 ± 6.6 mmHg - p = 0.139) and lower than the office measurement values (127.3 ± 13.8 mmHg over 74.4 ± 9.5 mmHg - p < 0,001). The Bland-Altman plots showed good agreement between HBPM and ABPM.

Conclusions:  HBPM is an option to confirm diagnoses of hypertension in adolescents from a Brazilian state capital with elevated office BP and can be used as an alternative to ABPM.

Keywords:
Hypertension; Blood Pressure Monitoring, Ambulatory; Adolescent; Risk Factors