Diagnostic accuracy of blood pressure measurement methods for hypertension screening in obesity: does one fit all?

OBJECTIVE

The aim of this study was to identify which blood pressure (BP) measurement method - ambulatory (ABPM), home (HBPM), office (OBPM) - provides the highest accuracy according to the categorization of patients across different obesity assessment tools.

METHODS

All participants performed ABPM, HBPM and OBPM. Participants were categorized based on BMI: underweight, normal, overweight, obese, waist circumference: as having normal waist circumference, increased and greatly increased, and waist to hip ratio: normal and increased.

RESULTS

The study population consisted of 281 participants (39.9% men), 56.9 ± 15.8 years old. OBPM presented the best accuracy (78.9%), sensitivity (86%) and specificity (72.9%) in obese BMI, in greatly increased waist circumference (accuracy 79%, sensitivity 80.6% and specificity 77.1%) and increased waist to hip ratio (accuracy 78.4%, sensitivity 80.2% and specificity 76%), while the accuracy was reduced as BMI, waist circumference and waist to hip ratio were lowered. HBPM presented the best accuracy in overweight BMI (accuracy 75.8%, sensitivity 86%, specificity 58.8%) and in increased waist circumference (accuracy 81.5%, sensitivity 91.7%, specificity 73.3%), while the accuracy was reduced in the other categories. HBPM presents same accuracy, sensitivity and specificity in both waist to hip ratio categories.

CONCLUSION

This study shows a different accuracy of BP measurement methods across different categories of obesity assessment tools. OBPM emerges as an alternative to ABPM in patients with obesity, greatly increased waist circumference and increased waist to hip ratio, while HBPM in patients overweight or with increased waist circumference.