Helen Andersson1,2, Lennart Hedström3, Stefan Bergman2, Håkan Bergh2,4. 1. 1 Hallands Hospital Varberg, Sweden. 2. 2 Primary Health Care Unit, The Sahlgrenska Academy, University of Gothenburg, Sweden. 3. 3 Public Dental Services, Västra Vall, Varberg, Sweden. 4. 4 Department of Research and Development Unit, Region Halland, Sweden.
Abstract
AIM: The purpose of this study was to evaluate a two-step screening method for hypertension in dentistry regarding the number needed to screen (NNS) and positive predictive value (PPV) and to risk-classify those with newly diagnosed hypertension. METHODS: In connection with their regular dental care check-up, 2025 subjects aged 40-75 years were screened for high blood pressure. Via a health questionnaire, data were collected concerning risk factors. Blood pressure was screened comprehensively in two steps, which included screening in a dental clinic and home measurements for one week. Recently discovered hypertensive participants were assessed for 10-year risk of cardiovascular mortality according to the guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). RESULTS: A total of 170 new hypertensive participants were found (NNS = 12; 95% confidence interval (CI): 11-13). The method yielded a PPV of 0.73 (95% CI: 0.68-0.78) and eliminated 84.8% of the false-positive participants. The results also showed that based on ESH/ESC risk estimation, 76.5% of those newly diagnosed hypertensive participants had a moderate or high risk of cardiovascular mortality within 10 years. CONCLUSIONS: The study shows that a two-step method for blood pressure screening in a dental setting including home measurement resulted in a high PPV and eliminated most of those with a false high blood pressure reading. The findings also show that two-step screening for hypertension is feasible in a larger population with more screening providers involved.
AIM: The purpose of this study was to evaluate a two-step screening method for hypertension in dentistry regarding the number needed to screen (NNS) and positive predictive value (PPV) and to risk-classify those with newly diagnosed hypertension. METHODS: In connection with their regular dental care check-up, 2025 subjects aged 40-75 years were screened for high blood pressure. Via a health questionnaire, data were collected concerning risk factors. Blood pressure was screened comprehensively in two steps, which included screening in a dental clinic and home measurements for one week. Recently discovered hypertensiveparticipants were assessed for 10-year risk of cardiovascular mortality according to the guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). RESULTS: A total of 170 new hypertensiveparticipants were found (NNS = 12; 95% confidence interval (CI): 11-13). The method yielded a PPV of 0.73 (95% CI: 0.68-0.78) and eliminated 84.8% of the false-positive participants. The results also showed that based on ESH/ESC risk estimation, 76.5% of those newly diagnosed hypertensiveparticipants had a moderate or high risk of cardiovascular mortality within 10 years. CONCLUSIONS: The study shows that a two-step method for blood pressure screening in a dental setting including home measurement resulted in a high PPV and eliminated most of those with a false high blood pressure reading. The findings also show that two-step screening for hypertension is feasible in a larger population with more screening providers involved.