Agreement Between Community Pharmacy and Ambulatory and Home Blood Pressure Measurement Methods to Assess the Effectiveness of Antihypertensive Treatment: The MEPAFAR Study

Abstract

The usefulness of the community pharmacy blood pressure (CPBP) method in the diagnosis or treatment of hypertension has not been adequately addressed in controlled studies. The authors' aim was to assess the agreement between awake ambulatory blood pressure (ABP), home blood pressure (HBP), and CPBP in treated hypertensive patients. This was a cross-sectional study carried out in 169 patients in which blood pressure (BP) was measured at the pharmacy (4 visits), at home (4days), and by 24-hour ABP monitoring. Lin correlation-concordance coefficient (CCC) and Bland-Altman plots were used to evaluate quantitative agreement. The qualitative agreement to establish the degree of BP control was evaluated using κ coefficient. The agreement was acceptable between HBP and CPBP (CCC=0.80 for systolic BP [SBP] and 0.80 for diastolic BP [DBP]; κ=0.62) and moderate between awake ABP and CPBP (CCC=0.74/0.67, respectively; κ=0.56). The Bland-Altman plots also showed lowest mean differences (0.5/0.3 for SBP and DBP, respectively) for the comparison between CPBP and HBP. The CPBP has a better agreement with HBP than with awake ABP. Thus, the CPBP measurement method could be a good alternative to HBP monitoring, whereas it cannot be used as a screening test to assess the degree of BP control by awake ABP. © 2012 Wiley Periodicals, Inc.