Study to Evaluate Blood Pressure Diagnostics

(Wikimedia Commons)

21 July 2016. A health care system in Seattle is assessing three different techniques for confirming newly found cases of hypertension, or high blood pressure. A research team from Group Health Research Institute, the research arm of Group Health Cooperative, a network of health care providers, is conducting the study, funded by a $2.8 million grant from Patient-Centered Outcomes Research Institute, or PCORI.

The team directed by Group Health researcher Beverly Green is seeking easy and reliable ways of confirming an initial diagnosis of high blood pressure, a condition affecting some 70 million people in the U.S., about 1 in 3 adults. However, only about half (52%) of people with high blood pressure have their condition under control, according to Centers for Disease Control and Prevention. Without controlling high blood pressure, the condition increases the risk of heart disease and stroke, among the leading causes of death in the U.S.

Confirming the initial screening is an important next step, however, since about 3 in 10 people first found with high blood pressure in the clinic turn out to have normal levels outside the clinic, a phenomenon known as “white coat hypertension,” often a result of the stress of being tested. To confirm the initial diagnosis, the U.S. Preventive Services Task Force recommends monitoring an individual’s blood pressure for 24 hours, with readings taken every 30 minutes during the day and every 60 minutes at night. Home monitoring with a blood-pressure cuff for several days is offered by the task force as an option.

Green and colleagues note that continuous, ambulatory blood pressure monitoring is rarely requested of patients, although monitoring at home is more accurate and practical with today’s technology, and kiosks with equipment to check blood pressure are found more often in drug stores and supermarkets. The team plans to evaluate these measurement options in its study.

The researchers expect to recruit 510 adult Group Health patients found with high blood pressure in their initial screening, and randomly assign them to 1 of 3 methods for confirmation: testing at a clinic, at home, or with a public testing kiosk. Each of these methods will then be compared to continuous ambulatory blood-pressure monitoring.

“Correct diagnosis of hypertension is important to prevent strokes, heart attacks, and heart failure,” says Green in a Group Health statement, “and also to avoid making people worry or take medicines when they don’t need to.”

Group Health says the formal award announcement will be made after a review by PCORI of the study’s business plan. On Tuesday, PCORI announced awards of nearly $153 million for 28 comparative clinical effectiveness research projects.

The Group Health researchers may not be aware of the latest innovations in ambulatory blood pressure monitoring. In June, Science & Enterprise reported on development of a wristband device for continuous blood pressure monitoring called Slapband, by recent graduates from University of California in Irvine.

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