Comparison of optimal diagnostic thresholds of hypertension with home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring

Jin Sun Park, Moo Yong Rhee, June Namgung, Sung Yun Lee, Deok Kyu Cho, Tae Young Choi, Seok Yeon Kim, Jang Young Kim, Sang Min Park, Jae Hyuk Choi, Jae Hang Lee, Hae-Young Kim

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Abstract

BACKGROUND Differences between the recently suggested outcome-driven diagnostic threshold of home blood pressure (HBP) measurements and the currently recommended diagnostic threshold of HBP measurements may cause a disagreement between 24-hour ambulatory blood pressure (ABP) and HBP measurements in the diagnosis of hypertension. We evaluated the agreement of various HBP diagnostic thresholds (135/85, 130/85, and 130/80 mm Hg) to ABP measurements, as a reference method. METHODS Patients who were confirmed to have high BP (≥140/90 mm Hg) at the outpatient clinic were referred. HBP measurement was performed for 7 days in triplicates every morning and evening. The 24-hour ABP measurement was performed on the 8th day. Using 24-hour ABP measurement as a reference method, we analyzed HBP diagnostic thresholds at 135/85, 130/85, and 130/80 mm Hg. RESULTS Among 319 patients, 256 patients (mean age, 51.8 ± 9.7 years; 119 men) with valid HBP measurements and 24-hour ABP measurements were enrolled. The threshold of 130/80 mm Hg showed the highest diagnostic sensitivity (P = 0.001) with diagnostic agreement by Kappa statistics. Using 130/80 mm Hg as a diagnostic threshold of hypertension, the prevalence of masked hypertension was significantly lower than 130/85 and 135/85 mm Hg (7.8, 15.2, and 18.4%, respectively, P = 0.002). CONCLUSIONS The present study suggests that lowering the diagnostic thresholds of HBP measurement from 135/85 mm Hg to 130/80 mm Hg may improve diagnostic accuracy for hypertension.

Original languageEnglish
Pages (from-to)1170-1176
Number of pages7
JournalAmerican Journal of Hypertension
Volume30
Issue number12
DOIs
Publication statusPublished - 2017 Dec 1

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Keywords

  • Ambulatory blood pressure measurement
  • Blood pressure
  • Home blood pressure measurement
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Park, J. S., Rhee, M. Y., Namgung, J., Lee, S. Y., Cho, D. K., Choi, T. Y., Kim, S. Y., Kim, J. Y., Park, S. M., Choi, J. H., Lee, J. H., & Kim, H-Y. (2017). Comparison of optimal diagnostic thresholds of hypertension with home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring. American Journal of Hypertension, 30(12), 1170-1176. https://doi.org/10.1093/ajh/hpx115