Abstract T2: Agreement Between Attended Home Blood Pressure Measurements And Ambulatory Blood Pressure Monitoring

Abstract

Objectives: Compare attended home blood pressure (BP) measurements (HBPM) with ambulatory BP monitor (ABPM) readings and examine if level of agreement between the measurement approaches differ overall and by subgroup. Methods: This was a secondary analysis of data from a 2-yr observational study of children 11-19 yrs (mean 15, SD=2.69) with chronic kidney disease. Participants had 3 standardized resting oscillometric home BPs taken by staff followed by 24-hr ABPM within 2 weeks of home BP. BP indices (measured BP/95%ile BP) were calculated for the mean triplicate attended HBPM and mean daytime ABPM readings. All paired HBPM and ABPM measurements taken during any of 5 study visits were compared using linear regression with robust standard errors. Generalized estimating equations-based logistic regression determined the sensitivity, specificity, negative, and positive predictive values with ABPM as the gold standard. Analyses were conducted for the group overall and by subgroup. Results: There were 103 participants who contributed 251 paired measurements. Indexed systolic BP did not differ between modalities (mean difference -0.002; 95% CI: -0.006, 0.003), and the difference in indexed diastolic BP was minimal (mean difference -0.033; 95% CI: -0.040, -0.025). The overall agreement between HBPM and ABPM in identifying abnormal BP was high (88.5%), and findings were consistent in each subgroup (Table). Conclusions: Attended HBPM may be a reasonable substitute for ABPM when monitoring BP. The greater accessibility and feasibility of attended HBPM has the potential to improve BP control among at-risk youth.