The Föllinge Hypertension and Lifestyle Intervention; a Comparative Study of Methods for Blood Pressure Measurement and Survey of Living Habits

Background: At present, both 24-hour ambulatory blood pressure and self-directed blood pressure measurement in self-care rooms, are services provided by most Swedish primary care clinics. Ambulatory measurement of blood pressure has the disadvantage of being more demanding with regard to the need for advanced technical equipment and trained staff.

Identification of modifiable cardiovascular risk factors and support for change, should be integrated into the treatment programs of hypertension. At study entry all study participants will be invited to an interview focused on identifying modifiable cardiovascular risk factors, with a follow-up interview after six months to consolidate good lifestyle choices.

Aim: If self-directed blood pressure measured in a designated self-care room gives results that are on average equivalent to ambulatory blood pressure daytime, diagnosis and follow-up of hypertensive patients in primary care could be simplified. The majority of patients could then be cared for through self-checks., and the technically more demanding ambulatory blood pressure measurement reserved for special cases. We therefore want to examine patients under treatment or investigated for hypertension in primary care with three different methods: conventional in-office blood pressure measurement by medical staff, ambulatory blood pressure and automated measurement of blood pressure in a special self-care room. Between study entry and after six months changes in modifiable risk factors are documented according to an interview guide covering use of tobacco, alcohol, physical activity and food preferences, with 4-6 fixed alternatives per item.

Demographics: Study patients are recruited among patients registered at Föllinge Health Centre (population 1500), of which about 1000 are in ages where investigation and treatment of hypertension could be relevant. The prevalence of hypertension in the adult population is estimated to about 30%.

Methods: We will recruit men and women from age 20 and older. Advanced age is not a criterion for exclusion if treatment of hypertension is judged to be important after clinical assessment.