Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients
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...
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BMJ Publishing Group
2019-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/12/e033792.full |
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| author | Peter J Watkinson Andrew J Farmer Lionel Tarassenko Laura C Armitage Adam Mahdi Beth K Lawson Cristian Roman Thomas Fanshawe |
| author_facet | Peter J Watkinson Andrew J Farmer Lionel Tarassenko Laura C Armitage Adam Mahdi Beth K Lawson Cristian Roman Thomas Fanshawe |
| author_sort | Peter J Watkinson |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7d44bd2f93e047d4b93243d615f95043 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-7d44bd2f93e047d4b93243d615f950432025-08-20T02:50:38ZengBMJ Publishing GroupBMJ Open2044-60552019-12-0191210.1136/bmjopen-2019-033792Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patientsPeter J Watkinson0Andrew J Farmer1Lionel Tarassenko2Laura C Armitage3Adam Mahdi4Beth K Lawson5Cristian Roman6Thomas Fanshawe7Oxford University Hospitals NHS Foundation Trust, Oxford, UK4 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK3 Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, Oxfordshire, UK1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK2 Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, Oxfordshire, UK1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKDepartment of Engineering Science, Institute of Biomedical Engineering, University of Oxford Mathematical, Physical and Life Sciences Division, Oxford, UK1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKIntroduction 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.https://bmjopen.bmj.com/content/9/12/e033792.full |
| spellingShingle | Peter J Watkinson Andrew J Farmer Lionel Tarassenko Laura C Armitage Adam Mahdi Beth K Lawson Cristian Roman Thomas Fanshawe Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients BMJ Open |
| title | Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| title_full | Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| title_fullStr | Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| title_full_unstemmed | Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| title_short | Screening for Hypertension in the INpatient Environment(SHINE): a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| title_sort | screening for hypertension in the inpatient environment shine a protocol for a prospective study of diagnostic accuracy among adult hospital patients |
| url | https://bmjopen.bmj.com/content/9/12/e033792.full |
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