Characteristics of Individuals with Disagreement between Home and Ambulatory Blood Pressure Measurements for the Diagnosis of Hypertension.

Chee Hae Kim,Moo-Yong Rhee,Je Sang Kim

doi:10.3390/healthcare8040457

Chee Hae Kim, Moo-Yong Rhee + Show 1 more

Open Access

https://doi.org/10.3390/healthcare8040457

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Journal: Healthcare	Publication Date: Nov 3, 2020
Citations: 5	License type: CC BY 4.0

Affiliation: Dongguk University Ilsan Hospital, Dongguk University

Abstract

Home and ambulatory blood pressure (BP) measurements are recommended for the diagnosis of hypertension. However, the clinical characteristics of individuals showing a diagnostic disagreement between their home and ambulatory BP measurements are unclear. Of the 470 individuals who were not on antihypertensive drug treatment with a BP ≥140/90 mmHg at an outpatient clinic, 399 who had valid office, home, and ambulatory BP results were included. Hypertension was diagnosed based on an average home BP ≥135/85 mmHg and/or an average daytime ambulatory BP ≥135/85 mmHg. The participants were divided into three groups: Agree-NT (home and ambulatory BP normotension), Disagree (home BP normotension and ambulatory BP hypertension, or home BP normotension and ambulatory BP hypertension), and Agree-HT (home and ambulatory BP hypertension). Eighty-four individuals (21.1%) were classified as the Disagree group. The mean serum creatinine, triglycerides, and electrocardiogram voltage in the Disagree group were intermediate between those observed in the Agree-NT and the Agree-HT group. In the Disagree group, the mean levels of office and home diastolic BP, all of the components of ambulatory BP, the aortic systolic BP, and the BP variabilities were found to be intermediate between those of the Agree-NT and the Agree-HT groups. These results indicate that individuals showing a diagnostic disagreement between their home and ambulatory BP may have cardiovascular risks that are intermediate between those with sustained home and ambulatory normotension and hypertension.

Highlights

Accurate blood pressure (BP) measurements are essential for the diagnosis and treatment of hypertension [1]
These results indicate that individuals showing a diagnostic disagreement between their home and ambulatory BP may have cardiovascular risks that are intermediate between those with sustained home and ambulatory normotension and hypertension
Current guidelines recommend out-of-office blood pressure measurements for the optimal diagnosis and treatment of hypertension [1,3]. Both home and ambulatory BP measurements provide BP values based on multiple measurements, reflect BP variations, and have the ability to identify white-coat or masked hypertension, which are commonly misdiagnosed by using office BP only

Summary

Introduction

Accurate blood pressure (BP) measurements are essential for the diagnosis and treatment of hypertension [1]. Office BP measurements have been widely used to monitor BP because they are conveniently and rapidly obtained, but they are confounded by various factors [2]. Current guidelines recommend out-of-office blood pressure measurements for the optimal diagnosis and treatment of hypertension [1,3]. Both home and ambulatory BP measurements provide BP values based on multiple measurements, reflect BP variations, and have the ability to identify white-coat or masked hypertension, which are commonly misdiagnosed by using office BP only. Home and ambulatory BP measurements have similar advantages over office BP and ambulatory BP showed a better association with a future cardiovascular risk or target organ damage compared to office BP [4,5,6].

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