Document Detail


Indication-specific 6-h systolic blood pressure thresholds can approximate 24-h determination of blood pressure control.
MedLine Citation:
PMID:  20574446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ambulatory blood pressure monitoring (ABPM) is an accurate method for evaluating hypertension, yet its use in clinical practice may be limited by availability, cost and patient inconvenience. The objective of this study was to investigate the ability of a 6-h ABPM window to predict blood pressure control, judging by that of the full 24-h ABPM session across several clinical indications in a cohort of 486 patients referred for ABPM. Sensitivities and specificities of the 6-h systolic blood pressure mean to accurately classify patients as hypertensive were determined using a fixed reference point of 130 mm Hg for the 24-h mean. For four common indications, in which ABPM was ordered, prediction tables were constructed varying the thresholds for the 6-h mean to find the optimal value that best predicted the 24-h hypertensive status as determined from the full 24-h interval. Using a threshold of 137 mm Hg for the indications of borderline hypertension, evaluation of current antihypertensive regimen and suspected white-coat hypertension, sensitivity and specificity ranged from 0.83-0.88 to 0.80-0.88, respectively, for the ability of 6-h ABPM to correctly categorize hypertensive status. Using 133 mm Hg as the threshold for treatment resistance resulted in a sensitivity and specificity of 0.93 and 0.83, respectively. We conclude that a shortened ABPM session of 6 h can be used to accurately classify blood pressure as controlled or not, based on the results of a 24-h session. The optimal 6-h threshold for comparison depends upon indication for referral.
Authors:
M E Ernst; G S Sezate; W Lin; C A Weber; J D Dawson; B L Carter; G R Bergus
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-06-24
Journal Detail:
Title:  Journal of human hypertension     Volume:  25     ISSN:  1476-5527     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-17     Completed Date:  2011-07-07     Revised Date:  2012-04-27    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  250-5     Citation Subset:  IM    
Affiliation:
Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA. michael-ernst@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / therapeutic use
Blood Pressure* / drug effects
Blood Pressure Monitoring, Ambulatory*
Circadian Rhythm*
Female
Humans
Hypertension / diagnosis*,  drug therapy,  physiopathology
Iowa
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
1R01HL069801-01A1/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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