High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55–64 Years in Holstebro County

• Published in: American journal of hypertension 2016-04, Vol.29 (4), p.439-447
• Main Authors: Hoffmann-Petersen, Nikolai, Lauritzen, Torsten, Bech, Jesper Nørgaard, Pedersen, Erling Bjerregaard
• Format: Article
• Language: English
• Subjects: Age Distribution; Blood Pressure; Blood Pressure Determination - methods; BP Measurement; Comorbidity; Denmark; Female; Humans; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - physiopathology; Male; Masked Hypertension - diagnosis; Masked Hypertension - epidemiology; Masked Hypertension - physiopathology; Middle Aged; Original; Predictive Value of Tests; Prevalence; Registries; Reproducibility of Results; Risk Factors; Telemedicine - methods; White Coat Hypertension - diagnosis; White Coat Hypertension - epidemiology; White Coat Hypertension - physiopathology
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpv116

BACKGROUND Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). METHODS Using the Civil Registration System, we invited citizens aged 55–64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. RESULTS We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. CONCLUSIONS This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55–64 years had an abnormally high HBP, and one fourth either had WCH or MH. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number: NCT02355392