ArticleJournal of hypertension2009
Preventing misdiagnosis of ambulatory hypertension: algorithm using office and home blood pressures.
Article in Journal of hypertension, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Options for the diagnosis of high blood pressure in primary care: a systematic review and economic model.Journal of human hypertension · 2021Pooled it
- Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis.BMC cardiovascular disorders · 2020Pooled it
- Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review.BMJ (Clinical research ed.) · 2011Pooled it
- Use of Different Blood Pressure Thresholds to Reduce the Number of Home Blood Pressure Monitoring Days Needed for Detecting Hypertension.Hypertension (Dallas, Tex. : 1979) · 2023Article
- The Association between Diverticular Rebleeding and Early-Morning Blood Pressure and Surge: A Prospective Observational Trial.Digestion · 2023Observational
- Agreement between attended home and ambulatory blood pressure measurements in adolescents with chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2022Observational
- Algorithm for diagnosing hypertension using out-of-office blood pressure measurements.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Measurement of blood pressure for the diagnosis and management of hypertension in different ethnic groups: one size fits all.BMC cardiovascular disorders · 2017Article
- Evaluation of Criteria to Detect Masked Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2016Article
- Differences in night-time and daytime ambulatory blood pressure when diurnal periods are defined by self-report, fixed-times, and actigraphy: Improving the Detection of Hypertension study.Journal of hypertension · 2016Article
- Home blood pressure monitoring: primary role in hypertension management.Current hypertension reports · 2014Review
- Masked hypertension and prehypertension: diagnostic overlap and interrelationships with left ventricular mass: the Masked Hypertension Study.American journal of hypertension · 2012Article
- Within-visit variability of blood pressure and all-cause and cardiovascular mortality among US adults.Journal of clinical hypertension (Greenwich, Conn.) · 2012Article
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6 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesAn algorithm for making a differential diagnosis between sustained and white coat hypertension (WCH) has been proposed - patients with office hypertension undergo home blood pressure monitoring (HBPM) and those with normal HBP levels undergo ambulatory blood pressure monitoring (ABPM). We tested whether incorporating an upper office blood pressure (OBP) cut-off in the algorithm, higher than the traditional 140/90 mmHg, reduces the need for HBPM and ABPM.
methodsTwo hundred twenty-nine normotensive and untreated mildly hypertensive participants (mean age 52.5 +/- 14.6 years, 54% female participants) underwent OBP measurements, HBPM, and 24-h ABPM. Using the algorithm, sensitivity, specificity, and positive and negative predictive values (PPV, NPV) for sustained hypertension and WCH were assessed. We then modified the algorithm utilizing a systolic and diastolic OBP cut-off at a specificity of 95% for ambulatory hypertension - those with office hypertension but OBP levels below the upper cut-off underwent HBPM and subsequent ABPM, if appropriate.
resultsUsing the original algorithm, sensitivity and PPV for sustained hypertension were 100% and 93.8%, respectively. Despite a specificity of 44.4%, NPV was 100%. These values correspond to specificity, NPV, sensitivity, and PPV for WCH, respectively. Using the modified algorithm, the diagnostic accuracy for sustained hypertension and WCH did not change. However, far fewer participants needed HBPM (29 vs. 84) and ABPM (8 vs. 15).
conclusionIn this sample, the original and modified algorithms are excellent at diagnosing sustained hypertension and WCH. However, the latter requires far fewer participants to undergo HBPM and ABPM. These findings have important implications for the cost-effective diagnosis of sustained hypertension and WCH.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.