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Abstract Number: 2059

Usage of Predicting Out-of-Office Blood Pressure Calculator in Hispanic Patients with Rheumatic Diseases

Dionicio Galarza-Delgado 1, Jose Azpiri-Lopez 1, Iris Colunga-Pedraza 1, Carolina Marlene Martinez-Flores1, Marielva Castro-Gonzalez 1, Ileana Cecilia Reynosa-Silva 1, Karla Paola Cuellar-Calderon 1 and Raymundo Vera-Pineda 2, 1Universidad Autonoma de Nuevo Leon, Hospital Universitario "Dr Jose Eleuterio Gonzalez", Monterrey, Nuevo Leon, Mexico, 2Universidad Autonoma de Nuevo Leon, Hospital Universitario "Dr. Jose Eleuterio Gonzalez", Monterrey, Nuevo Leon, Mexico

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: arthritis and clinical research, Cardiovascular disease, hypertension, Rheumatic disease

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Session Information

Date: Tuesday, November 12, 2019

Title: Epidemiology & Public Health Poster III: OA, Gout, & Other Diseases

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose:

Subjects with rheumatic diseases have an increased risk of cardiovascular (CV) morbimortality. Hypertension (HTN) is a key modifiable risk factor for CV events. A recently published and validated prediction model (Predicting Out-of-Office Blood Pressure, PROOF-BP) has been proposed as a tool to improve diagnosis of HTN, and detection of out-of-office HTN in subjects with a previous diagnosis, with a c-statistic (AUC) of 0.86 in non-rheumatic subjects. This model has not been explored in rheumatic patients. Therefore, the objective of this study was to evaluate the diagnostic performance of the PROOF-BP algorithm for the prediction of HTN in subjects with/without rheumatic diseases.

Methods: A cross-sectional, observational trial was designed. Subjects with/without rheumatologic conditions were recruited at a rheumatology outpatient clinic. Complete history with somatometry of each subject was registered. BP was measured by a physician 3 times to each participant using current recommendations, with an OMRON HEM-7121 BP monitor. Calculations using the PROOF-BP online site were done, and risk categories were assigned to each subject: low (< 130/80 mmHg), medium (130/80-145/90 mmHg) and high risk ( >145/90 mmHg). Subjects in the medium and high risk strata were then asked to return for further evaluation and additional BP measurement, to define each diagnosis of HTN. We used frequencies (%) and median (q25-q75) for descriptive analysis. Diagnostic accuracy of each category was determined using 2 x 2 tables.

Results:

A total of 217 subjects were included. The most frequent rheumatic disease was RA (35.9%), followed by OA, SLE and Sjögren syndrome (13.4%, 2.8% and 2.3%, respectively). Using PROOF-BP, 84 (38.7%) subjects were stratified as medium or high risk. Of these, only 36 (42.8%) returned for evaluation. A final diagnosis of HTN was attained in 14 (38.8%) of those who returned. In 21 (67.7%) cases of the medium risk category the diagnosis of HTN was finally discarded, and in the remaining 10 (32.2%) diagnosis of HTN was finally ascertained. The high risk category had a specificity of 95% and a PPV of 80% for the diagnosis of HTN.

Conclusion: In a cohort of Mexican-mestizo subjects with rheumatic diseases, 38.7% were classified as medium or high-risk for HTN. Only 42.8% of patients that required further evaluation followed medical recommendations. More than 30% of patients in the medium-risk category had a final diagnosis of HTN. Using the BP-PROOF algorithm, none of the patients in the low-risk stratum had a final diagnosis of HTN (sensitivity= 100%); the high-risk category had a high specificity (95%) for the diagnosis of HTN.


Predicting Out-of-Office Blood Pressure calculator.TABLE

PPV- Positive predictive value; NPV- Negative predictive value.


Disclosure: D. Galarza-Delgado, None; J. Azpiri-Lopez, None; I. Colunga-Pedraza, None; C. Martinez-Flores, None; M. Castro-Gonzalez, None; I. Reynosa-Silva, None; K. Cuellar-Calderon, None; R. Vera-Pineda, None.

To cite this abstract in AMA style:

Galarza-Delgado D, Azpiri-Lopez J, Colunga-Pedraza I, Martinez-Flores C, Castro-Gonzalez M, Reynosa-Silva I, Cuellar-Calderon K, Vera-Pineda R. Usage of Predicting Out-of-Office Blood Pressure Calculator in Hispanic Patients with Rheumatic Diseases [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/usage-of-predicting-out-of-office-blood-pressure-calculator-in-hispanic-patients-with-rheumatic-diseases/. Accessed .
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