Background The limits of level of hypertension are being established arbitrarily. The increase in arterial blood pressure by a few mm Hg within values recognized by clinicians as normal is associated with the increase of the global risk. One should take into account in treatment procedure a personal variability of blood pressure, white coat phenomenon, and asses global risk to bring more benefits to patients.
In this study the variability of arterial blood pressure in ambulatory measurements was assessed.
Material and methods A multicenter screening study took place in outpatient clinics all over the country. Three hundred and fourty general practitioners included 100 consecutive patients each. A total of 31 131 patients were examined. Patients in whom the hypertension was not detected earlier and whose blood pressure was ≥ 140/90 mm Hg at the first visit were invited to the next two visits within 6–15 days. The patients whose mean value of 2 measurements of blood pressure at all 3 visits was within the range of hypertensive values were classified to the group with hypertension.
Results From 13 762 patients with elevated blood pressure 3318 (24%) were diagnosed for the first time. In this group of patients there was high percentage of young persons with newly diagnosed hypertension. The group of patients with newly diagnosed elevated blood pressure differed in terms of risk factors and commorbid disorders from the group of patients with known hypertension. Blood pressure measurements at 3 consecutive visits differed significantly. Each of consecutive measurements was lower than the preceding one. Blood pressure measurement was considered valid at all the 3 visits in 1136 patients. The hypertension was confirmed in 65% patients after 3 visits. The group of patients with confirmed hypertension at all the 3 visits was significantly older and had higher diastolic and systolic pressure than the group with non-confirmed hypertension.
Conclusions Only one third of patients with newly diagnosed elevated blood pressure came for the second and the third visit. Newly diagnosed elevated blood pressure values were within the hypertensive limits during 3 visits in 65% of persons.