Document Detail


Reproducibility of masked hypertension in adults with untreated borderline office blood pressure: comparison of ambulatory and home monitoring.
MedLine Citation:
PMID:  20671718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined short-term reproducibility of masked hypertension (MH) among adults with recent "borderline" office blood pressure (BP) and compared agreement of ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) in detecting MH.
METHODS: Fifty participants underwent repeated office BP measurements, 24-h ABPM, and HBPM sessions 1-week apart. Participants with office average <140/90 mm Hg were considered to have MH if daytime ABPM average was ≥135/85 mm Hg; they were considered to have MH by HBPM if the average was ≥135/85 mm Hg. Agreements were quantified using κ. We calculated sensitivity and specificity of daytime ABPM-office average pairing and HBPM session-office average pairing for diagnosing MH using a "standard" of two pairings of office and 24-h average ABPM (using a cutoff ≥130/80 mm Hg).
RESULTS: Prevalence rates of MH based on office-daytime ABPM pairings were 54 and 53%, with agreement of 73% (κ = 0.47; 95% confidence interval (CI) 0.21-0.72). MH was less prevalent (43 and 35%) using HBPM-office pairings, with agreement of 69% (κ = 0.34; 95% CI 0.06-0.62). Office-HBPM pairings and office-daytime ABPM pairings had poor agreement on MH classification on both occasions, with κ of -0.06 and 0.10. Sensitivity and specificity of daytime ABPM-office pairing were 93 and 83%. Sensitivity and specificity of HBPM-office pairing were 23 and 67%.
CONCLUSIONS: MH appears to have fair-to-moderate reproducibility, favoring the hypothesis that office BP measurement systematically fails to identify some patients who should be treated as hypertensive. HBPM may not be adequate for detecting MH, or may identify a different "type" of MH than ABPM.
Authors:
Anthony J Viera; Alan L Hinderliter; Abhijit V Kshirsagar; Jason Fine; Rosalie Dominik
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Validation Studies     Date:  2010-07-29
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-31     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1190-7     Citation Subset:  IM    
Affiliation:
Department of Family Medicine, University of North Carolina at Chapel Hill, USA. anthony_viera@med.unc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure*
Blood Pressure Monitoring, Ambulatory / standards*,  statistics & numerical data
Female
Humans
Hypertension / diagnosis*,  epidemiology,  therapy
Male
Middle Aged
Physicians' Offices*
Prevalence
Reproducibility of Results
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
K12 RR 17667/RR/NCRR NIH HHS; KL2RR 025746/RR/NCRR NIH HHS; RR 00046/RR/NCRR NIH HHS; U54RR 024383/RR/NCRR NIH HHS

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


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