Feasibility of self blood pressure measurement in elderly hypertensives

The goal of the SHEAF study is to determine whether self blood pressure mea surement (SBPM) has a better cardiovascular prognostic value than office bl ood pressure (OBP) among French elderly (greater than or equal to 60 y) hyp ertensive patients (pts) followed-up by general practitioners. Baseline SBPM was performed over a 4-day period : every day a series of 3 c onsecutive measurements was requested in the morning (8:00 am) and in the e vening (8:00 pm), using a validated device OMRON 705 CP. Measurements perfo rmed out of predefined morning and evening time (outside the 4:00-12:00 am range or the 4:00-12:00 pm range) were discarded as well as aberrant values . Pts were included in the study only if they exhibited at least 15 valid m easurements with at least 6 in the morning and 6 in the evening. 5649 pts were selected. 186 pts were excluded for age <60 years. Thus SBPM analysis was performed for 5463 pts: 2687 men (49%) and 2776 women (51%) ag ed 70+/-7 years, Only 252 pts (5%) were excluded for non valid SBPM (207 pt s <15 measurements, 106 pts<6 measurements in the morning and 205 pts<6 mea surements in the evening). 5211 pts (95%) with valid SBPM were included. Th e distribution of pts according to the number of measurements performed is the following: [GRAPHICS] The number of measurements performed in the morning is highly related to th e number of measurements performed in the evening. None of the following va riables is significantly associated with the poor compliance of measurement protocol: age, gender, CV history, CV risk factors, hypertension duration. In a large cohort of elderly hypertensive living in the community, SBPM is easily performed both in the morning and in the evening by most of the pts. If the SHEAF study demonstrates the prognostic value of SBPM, this would p rovide the basis for the use of this measurement method by a majority of el derly hypertensives.