RT Journal Article
SR Electronic
T1 Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e033792
DO 10.1136/bmjopen-2019-033792
VO 9
IS 12
A1 Laura C Armitage
A1 Adam Mahdi
A1 Beth K Lawson
A1 Cristian Roman
A1 Thomas Fanshawe
A1 Lionel Tarassenko
A1 Andrew J Farmer
A1 Peter J Watkinson
YR 2019
UL http://bmjopen.bmj.com/content/9/12/e033792.abstract
AB Introduction A significant percentage of patients admitted to hospital have undiagnosed hypertension. However, present hypertension guidelines in the UK, Europe and USA do not define a blood pressure threshold at which hospital inpatients should be considered at risk of hypertension, outside of the emergency setting. The objective of this study is to identify the optimal in-hospital mean blood pressure threshold, above which patients should receive postdischarge blood pressure assessment in the community.Methods and analysis Screening for Hypertension in the INpatient Environment is a prospective diagnostic accuracy study. Patients admitted to hospital whose mean average daytime blood pressure after 24 hours or longer meets the study eligibility threshold for mean daytime blood pressure (≥120/70 mm Hg) and who have no prior diagnosis of, or medication for hypertension will be eligible. At 8 weeks postdischarge, recruited participants will wear an ambulatory blood pressure monitor for 24 hours. Mean daytime ambulatory blood pressure will be calculated to assess for the presence or absence of hypertension. Diagnostic performance of in-hospital blood pressure will be assessed by constructing receiver operator characteristic curves from participants’ in-hospital mean systolic and mean diastolic blood pressure (index test) versus diagnosis of hypertension determined by mean daytime ambulatory blood pressure (reference test).Ethics and dissemination Ethical approval has been provided by the National Health Service Health Research Authority South Central—Oxford B Research Ethics Committee (19/SC/0026). Findings will be disseminated through national and international conferences, peer-reviewed journals and social media.