Exploring blood pressure associations: home and office measurements in stroke, myocardial infarction, and diabetes outcomes

Objective: Evaluate the association of blood pressure (BP) with home and office measurements and the outcomes of stroke, acute myocardial infarction, and diabetes Design and method: Cross-sectional study, utilizing variables such as age, gender, office systolic blood pressure (OSBP), office diastolic blood pressure (ODBP), and home blood pressure measurements (HBPM). Other variables include time since the diagnosis of arterial hypertension, and outcomes: stroke (AVC), acute myocardial infarction (AMI), and diabetes. The criteria for hypertension are office BP 140/90mmHg and HBPM 130/80mmHg. Data collected from participants and medical records. Data analysis conducted using the chi-square test and Student's t-test. Blood pressure (BP) values were adjusted based on the time since the diagnosis of arterial hypertension (HA), with a significance level of p<0.05. Results: 240 patients were evaluated, with average age of 63.4 years (±11.8), and 73.3% were female, 62.5% had diabetes, and 76.7% had dyslipidemia. The incidence of MI was 7.9%, and AVC was 11.7%. The average time of arterial hypertension was 19.1 years (±11.9). Uncontrolled BP, according HBPM criteria, was observed in 54.2% (n=130); according to the casual measurement criteria (office), it was 42.1% (n=101). Men exhibited higher rates of uncontrolled BP by HBPM (65.6% - 42) compared to women (50.0% - 88; p-value = 0.032). Average ODBP were significantly higher (138.1 (22.9) /81.6(±12.2) than home values (129.0 (±15.2) /79.4(±10.0). Average diastolic BP (DBP) values were lower among women, both in office (80.6 ±11.8 and 86.0 ±12.8; p=0.001) and home measurements (78.7 ±9.4 and 83.6 ±10.7; p=0.001). The average systolic/diastolic BP values, by HBPM, were significantly higher (132.1 ±14.0/84.2 ±12.8 mmHg) among those with a history of stroke (124.2 ±14.5/79.5±9.5 mmHg); average HBPM systolic BP values (132.4 ±17.0 and 124.5 ±14.3) were significantly higher among those with a history of myocardial infarction. Office measurements did not show the same association. Conclusions: The average BP values were lower at home, as were the control rates. The association of blood pressure (HBPM) with outcomes such as acute myocardial infarction (AMI) and stroke (AVC) demonstrated higher values when assessed at home, with no association observed with office measurements.