Threshold for diagnosing hypertension by automated office blood pressure using random sample population data
| Authors | |
|---|---|
| Year of publication | 2016 |
| Type | Article in Periodical |
| Magazine / Source | Journal of Hypertension |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1097/HJH.0000000000001076 |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | automated office blood pressure measurement; blood pressure; masked hypertension; mercury sphygmomanometer; white coat hypertension |
| Description | Objective:Manual office blood pressure (BP) is still recommended for diagnosing hypertension. However, its predictive value is decreased by errors in measurement technique and the white-coat effect. The errors can be eliminated by automated office BP (AOBP) measurement taking multiple readings with the participant resting quietly alone. Therefore, use of AOBP in clinical practice requires a threshold value for hypertension diagnosis. The aim of the present study was to determine an AOBP threshold corresponding to the 140/90mmHg manual office BP using data from a large random population sample.Methods:In 2145 participants (mean age 47.311.3 years) randomly selected from a Brno population aged 25-64 years, BP was measured using manual mercury and automated office sphygmomanometers.Results:Manual SBP (mean difference 6.39 +/- 9.76mmHg) and DBP (mean difference 2.50 +/- 6.54mmHg) were higher than the automated BP. According to polynomial regression, automated systole of 131.06 (95% confidence interval 130.43-131.70) and diastole of 85.43 (95% confidence interval 85.03-85.82) corresponded to the manual BP of 140/90mmHg. Using this cut-off, the white-coat hypertension was present in 24% of participants with elevated manual BP, whereas 10% had masked hypertension and 11% masked uncontrolled hypertension. In individuals with masked uncontrolled hypertension, only AOBP was associated with the urinary albumin-creatinine ratio, whereas there was no association with manual BP.Conclusion:AOBP of 131/85mmHg corresponds to the manual BP of 140/90mmHg. This value may be used as a threshold for diagnosing hypertension using AOBP. However, outcome-driven studies are required to confirm this threshold. |