Threshold for diagnosing hypertension by automated office blood pressure using random sample population data. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Wohlfahrt, Peter; Cífková, Renata; Movsisyan, Narine; Kunzová, Šárka; Lešovský, Jiří; Homolka, Martin; Soška, Vladimír; Bauerová, Hana; Lopez-Jimenez, Francisco; Sochor, Ondřej
• Is Part Of: Journal of hypertension. Volume 34:Issue 11(2016:Nov.)
• Page Start: 2180
• Page End: 2186
• Publication Date: 2016-11
• Subjects: automated office blood pressure measurement -- blood pressure -- masked hypertension -- mercury sphygmomanometer -- white coat hypertension; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000001076
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract : 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 140/90 mmHg manual office BP using data from a large random population sample. Methods: In 2145 participants (mean age 47.3 ± 11.3 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 ± 9.76 mmHg) and DBP (mean difference 2.50 ± 6.54 mmHg) 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 140/90 mmHg. 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 131/85 mmHg corresponds to the manual BP of 140/90 mmHg. This value may be used as a threshold for diagnosing hypertension using AOBP. However, outcome-driven studies are required to confirm this threshold.