Τίτλος:
Ambulatory versus home blood pressure monitoring: Frequency and determinants of blood pressure difference and diagnostic disagreement
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objectives:Out-of-office blood pressure evaluation assessed using ambulatory (ABP) or home (HBP) monitoring is currently recommended for hypertension management. We evaluated the frequency and determinants of diagnostic disagreement between ABP and HBP measurements.Methods:Cross-sectional data from 1971 participants (mean age 53.8±11.4 years, 52.6% men, 32% treated) from Greece, Finland and the United Kingdom were analyzed. The diagnostic disagreement between HBP and daytime ABP was regarded as certain when (i) the two methods diagnosed a different blood pressure phenotype, (ii) the absolute HBP-ABP difference was more than 10/5mmHg (systolic/diastolic) and (iii) ABP and HBP had a more than 5mmHg difference from the respective hypertension threshold.Results:In 1574 participants (79.9%), there was agreement between HBP and ABP in diagnosing hypertensive phenotypes (kappa 0.70). Of the remaining 397 participants (20.1%) with diagnostic disagreement, 95 had clinically irrelevant HBP-ABP differences, which reduced the disagreement to 15.3%. When cases with ABP and/or HBP differing ≤5mmHg from the respective hypertension threshold were excluded, the certain disagreement between the two methods was reduced to 8.2%. Significant determinants of the HBP-ABP difference were age, sex, study center, BMI, cardiovascular disease history, office hypertension and antihypertensive treatment. Antihypertensive drug treatment, alcohol consumption and office normotension independently increased the odds of diagnostic disagreement.Conclusion:These data suggest that there is considerable diagnostic agreement between HBP and ABP, and that these methods are interchangeable for clinical decisions in most patients. However, considerable disagreement between the two methods occurs in an appreciable minority, most likely due to methodological and patient-related factors. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Ntineri, A.
Niiranen, T.J.
McManus, R.J.
Lindroos, A.
Jula, A.
Schwartz, C.
Kollias, A.
Andreadis, E.A.
Stergiou, G.S.
Περιοδικό:
JOURNAL OF HYPERTENSION
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
antihypertensive agent, adult; aged; alcohol consumption; antihypertensive therapy; Article; blood pressure measurement; blood pressure monitoring; clinical decision making; cross-sectional study; diastolic blood pressure; evaluation study; female; home monitoring; human; hypertension; intermethod comparison; major clinical study; male; phenotype; priority journal; systolic blood pressure; blood pressure; blood pressure monitoring; cardiovascular disease; clinical trial; comparative study; diastole; Finland; Greece; hypertension; middle aged; multicenter study; procedures; systole; United Kingdom, Adult; Aged; Antihypertensive Agents; Blood Pressure; Blood Pressure Determination; Blood Pressure Monitoring, Ambulatory; Cardiovascular Diseases; Cross-Sectional Studies; Diastole; Female; Finland; Greece; Humans; Hypertension; Male; Middle Aged; Systole; United Kingdom
DOI:
10.1097/HJH.0000000000002148
