Validity of ambulatory blood pressure monitoring in daily primary healthcare practice in France
Résumé
Objective
The objective of the study was to assess 24-h ambulatory blood pressure monitoring (ABPM) validity in daily primary healthcare practice in France.
Patients and methods
An observational, longitudinal, prospective, multicenter study was performed in the Burgundy region, France. Participants were patients who had been prescribed ABPM by their general practitioner (GP), whatever its indication. ABPM was performed by employees of the healthcare providers group, which is publicly funded. The validity of ABPM was established according to the European Society of Cardiology (ESC) criteria. GPs interpretation of the ABPM results was collected and compared with the ESC recommendations. Determinants of ABPM validity were identified using logistic regression models.
Results
Among the 531 patients included, 357 (67.23%) had a valid ABPM measurement. Multivariate analyses showed that ABPM validity was associated with nonmanual worker status [odds ratio (OR)=1.14; 95% confidence interval (CI)=1.04–1.23], participant’s age of at least 65 years (OR=0.88; 95% CI=0.81–0.95) and participant’s BMI above 30 kg/m2 (OR=0.90; 95% CI=0.81–0.99). GPs’ interpretation of ABPM results was consistent with the ESC recommendation in 508 (95.67%) cases.
Conclusion
ABPM is feasible in daily primary healthcare practice in the studied condition, that is to say relying on trained employees. GPs should be careful when prescribing ABPM to patients aged 65 years and older, to those with BMI over 30 or to manual workers.