A SINGLE CASUAL BLOOD PRESSURE MEASUREMENT IN PRIMARY CARE CAN OPTIMIZE SCREENING FOR HYPERTENSION AND CONTROL

Objective: Worldwide, only ∼50% of hypertensives are diagnosed and ∼30% controlled. The few studies investigating how regularly Primary Care Unit (PCU) physicians measure blood pressure (BP) in real-life settings showed disappointing numbers due to increased workload and limited visit time, with doctors finding it impossible to measure BP according to guidelines in all patients, even often not measuring BP at all. Finally, a substantial proportion of people never visit a physician to measure their BP, feeling healthy without any symptoms. In this setting, the involvement of trained healthcare professionals (HCPs) in BP measurements has been proposed lately as a potential solution. The aim of this study was to evaluate the role a single casual BP measurement (SCBPM) could play in PCU as a screening tool to increase awareness and control of hypertension.Design and method: In this two-phase study, HCPs performed BP measurements. All measurements were obtained using validated automated upper-arm BP monitors with appropriate cuff size. Any adult who attended the PCUs (patients, attendants or working staff) could be recruited. During the protocol, an SCBPM was taken in the waiting room (1st_phase) and then moved out for a 3-BP measurement course according to ESH 2023 Guidelines (2nd_phase). Results: A total of 1,188 individuals, age 63.0 (18-95), 58.7% females of 64 PCUs all over Greece (7/7 health districts) participated. Among the participants 69.9% were patients, 85.2% visited the PHU for a regular visit and 14.8% as an emergency. Figure 1 depicts the BP distribution in the total population (a) and in individuals not receiving antihypertensive treatment (b). Among 650 who didn’t receive any antihypertension medication and might not otherwise measured their BP, 187 (28.8%) had increased BP in the 2nd phase. The validity metrics are shown in Table 1. Conclusions: This study shows for the first time that implementing a feasible protocol with a SCBPM can potentially increase diagnosis and control of hypertension. The very high Negative predictive value of this method suggests that a SRMBP can be implemented as a screening tool for the detection of individuals requiring further investigation with more BP measurements.