ABC | Volume 113, Nº5, November 2019

Original Article Barroso et al. Telemedicine in hypertension diagnosis Arq Bras Cardiol. 2019; 113(5):970-975 that of patients with sustained hypertension. 4,17 It is worth mentioning that this prevalence is high in adults, but it is also significant in adolescents. 6 In the sample of the present study, among the prehypertensive patients (n = 703), we found a prevalence of MH of 20.6%; this value is even higher when we analyze the highest BP strata in this group. In PH patients with SBP ≥130 mmHg and/or DBP ≥ 85 mmHg, this prevalence is 27.8%, significantly higher (p < 0.001) than PH patients with BP levels lower than 130/85 mmHg. Our findings are in agreement with the trend seen at the last guidelines and statements, 1,2,5,18-21 which dedicate special attention to prehypertensive individuals, since some of these individuals will show a significant increase in cardiovascular outcomes. It is also justifiable recommending the American and European guidelines regarding the performance of ABPM or HBPM whenever possible when casual BP is ≥ 130/85 mmHg. 2,19 Finally, when we evaluated the individuals diagnosed as stage 1 hypertension (n = 570), we found a prevalence of WCH of 48.9%, which could result inmisdiagnosis and use of inadequate therapeutic strategies in almost half of these individuals. Most of this sample consisted of individuals from the Northeast region of the country (67.7%); this may be considered a limitation; however, as the analysis refers to AH phenotypes, it seems to us that the geographic region distribution would have little or no effect on the results. The TelemedicineMRPA (TeleMRPA) platform is an extremely useful, low-cost, easy-to-perform and wide-ranging modality, allowing a systematic evaluation of home-based BP measures, in accordance with the DBHA recommendations. In addition to the individual evaluation in clinical practice, the accumulation of information on this platform represents an important database for analyses on the diagnosis and treatment of AH in several regions of Brazil, both in public and private institutions. Conclusion The casual BP measurement is a method used for AH screening, but it is necessary to take into account that home measurements are more accurate for the diagnosis. We found high prevalence rates of MH and white-coat hypertension in individuals diagnosed with prehypertension or stage-1 hypertension. The TeleMRPA platform allowed the reclassification of 33.3% of the assessed individuals. National Co-Investigators Adriana C. Oliveira (Clínica Vittá, Goiânia), Adriana Serpa (Clínica SAVE, Recife), Andresson W. Andrade (Icordis, Caruaru), Ana C. Arantes (Universidade Federal de Goiás, Goiânia), Annelise M. G. Paiva (Centro Universitário CESMAC, Alagoas), Ant nio A. M. A. Braga (Clínica Ant nio Almeida, Recife), Carlos A. Machado (Núcleo de Apoio à Estratégia Saúde da Família. Secretaria Municipal de Saúde de Campos do Jordão), Cláudia F. Gonçalves (Universidade Federal de Goiás, Goiânia), Cleuriberto V. Pereira (Cardiocity, Guarulhos), Danielle B. L. Melo (Cardiologia IMIP, Recife), Ederaldo B. Leite (Cárddio - Hospital Anchieta, Taguatinga), Elder G. A. Cruz (Clínica Santa Louise, Salgueiro), Fábio Argenta (Clínica Mediodonto, Lucas do Rio Verde), Fábio S. Silveira (Clinica do Coração, Sergipe), Fernando M. F. França (Clínica Cardiovasf, Petrolina), Gustavo A. C. S. Barros (MCor, Recife), Jadil F. F. Júnior (Clínica CardioService, Porto Velho), João A. C. Berigó (Universidade Federal de Goiás, Goiânia), Josafá O. Costa (Clínica Vitta, Igarassu), Luiz H. Thompson (Prev-Saúde, Recife), Luiz Kencis Jr (Centro de Medicina Avançada Dr Luiz Kencis, São Paulo), Marcelo De’ Carli (Clínica Ipado, Petrolina), Marcelo J. Oliveira (Cardiográficos - Diagnóstico em Cardiologia, Ribeirão Preto), Marco A. M. Alves (Escada Clinical Center, Escada), Marcos A. P.Meira Junior (Clincar, João Pessoa), Mariana B. C. Sepulvida (Universidade Federal de São Paulo, São Paulo), Nelson Dinamarco (Laboratório de Hipertensão Arterial-UESC, Salvador), Renné G. Busnello (Clinicordis - Diagnóstico em Cardiologia, Porto Alegre), Stephan Barisic Junior (Clínica do Coração, Mossoró), Valdir L. Schwerz (Clínica Fares, São Paulo). Author contributions Conception and design of the research and Acquisition of data: Souza WKSB, Feitosa ADM, Barbosa ECD; Analysis and interpretation of the data: Souza WKSB, Feitosa ADM, Barbosa ECD, Miranda RD, Brandão AA, Gomes MM; Statistical analysis:Vitorino PVO; Obtaining financing: Souza WKSB; Writing of the manuscript: Souza WKSB, Feitosa ADM, Barbosa ECD, Brandão AA; Critical revision of the manuscript for intellectual content: Souza WKSB, Feitosa ADM, Barbosa ECD, Miranda RD, Brandão AA, Vitorino PVO, Gomes MM; Platform development and support (www.telemrpa.com ): Ribeiro LPS. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by Indústria Farmac utica E.M.S. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Human Research Ethics Committee of Hospital das Clínicas da Universidade Federal de Goiás under theprotocol number CAEE99691018.7.0000.5078. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. 974