ArticleJournal of the American Heart Association2016
Clinical and Epidemiological Implications of 24-Hour Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Kenyan Adults: A Population-Based Study.
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- 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
- Prevalence of target organ damage in rural Kenya and The Gambia: a cross-sectional study.The Lancet regional health. Africa · 2026Article
- Article
- Understanding what factors influence community health worker involvement in hypertension service delivery in Kenya: applying a community health system lens.Health policy and planning · 2026Article
- Access to hypertension services and health-seeking experiences in rural Coastal Kenya: A qualitative study.PLOS global public health · 2025Article
- Isolated Nocturnal Hypertension in People Living With HIV: Do We Need HIV-Specific Guidelines for Hypertension Diagnosis?American journal of hypertension · 2024Article
- Association Between Systolic Blood Pressure and in-Hospital Mortality Among Congestive Heart Failure Patients with Chronic Obstructive Pulmonary Disease in the Intensive Care Unit: A Retrospective Cohort Study.International journal of chronic obstructive pulmonary disease · 2024Article
- Head-to-head comparison of the WHO STEPwise approach with immediate unattended and delayed unattended automated blood pressure measurements during household-based screening: a diagnostic accuracy study in Lesotho.EClinicalMedicine · 2023Article
- Determining the optimal diagnostic and risk stratification approaches for people with hypertension in two rural populations in Kenya and The Gambia: a study protocol for IHCoR-Africa Work Package 2.NIHR open research · 2023Article
- Six-month incidence of hypertension and diabetes among adults with HIV in Tanzania: A prospective cohort study.PLOS global public health · 2023Article
- Mapping the Current and Future Noncommunicable Disease Burden in Kenya by Human Immunodeficiency Virus Status: A Modeling Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Blood pressure, T cells, and mortality in people with HIV in Tanzania during the first 2 years of antiretroviral therapy.Journal of clinical hypertension (Greenwich, Conn.) · 2020Article
- Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania.Integrated blood pressure control · 2020Article
- Prevalence of white coat and masked hypertension in Africa: A systematic review and meta-analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2018Review
- Evaluation of the Accuracy of a New Cuffless Magnetoplethysmography Blood Pressure Monitor in Hypertensive Patients.Pulse (Basel, Switzerland) · 2018Article
- Scaling up the use of home blood pressure monitoring in the management of hypertension in low-income countries: A step towards curbing the burden of hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2017Article
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundThe clinical and epidemiological implications of using ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension have not been studied at a population level in sub-Saharan Africa. We examined the impact of ABPM use among Kenyan adults. METHODS AND
resultsWe performed a nested case-control study of diagnostic accuracy. We selected an age-stratified random sample of 1248 adults from the list of residents of the Kilifi Health and Demographic Surveillance System in Kenya. All participants underwent a screening blood pressure (BP) measurement. All those with screening BP ≥140/90 mm Hg and a random subset of those with screening BP <140/90 mm Hg were invited to undergo ABPM. Based on the 2 tests, participants were categorized as sustained hypertensive, masked hypertensive, "white coat" hypertensive, or normotensive. Analyses were weighted by the probability of undergoing ABPM. Screening BP ≥140/90 mm Hg was present in 359 of 986 participants, translating to a crude population prevalence of 23.1% (95% CI 16.5-31.5%). Age standardized prevalence of screening BP ≥140/90 mm Hg was 26.5% (95% CI 19.3-35.6%). On ABPM, 186 of 415 participants were confirmed to be hypertensive, with crude prevalence of 15.6% (95% CI 9.4-23.1%) and age-standardized prevalence of 17.1% (95% CI 11.0-24.4%). Age-standardized prevalence of masked and white coat hypertension were 7.6% (95% CI 2.8-13.7%) and 3.8% (95% CI 1.7-6.1%), respectively. The sensitivity and specificity of screening BP measurements were 80% (95% CI 73-86%) and 84% (95% CI 79-88%), respectively. BP indices and validity measures showed strong age-related trends.
conclusionsScreening BP measurement significantly overestimated hypertension prevalence while failing to identify ≈50% of true hypertension diagnosed by ABPM. Our findings suggest significant clinical and epidemiological benefits of ABPM use for diagnosing hypertension in Kenyan adults.
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