ArticleAmerican journal of hypertension2025
The Diagnostic Accuracy of Using Borderline High Office Blood Pressure Thresholds to Diagnose Masked Hypertension According to the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline.
Article in American journal of hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline recommends ambulatory BP monitoring (ABPM) for diagnosing masked hypertension among adults not taking antihypertensive medication with borderline office BP (i.e., office systolic BP [SBP] 120 to < 130 mm Hg or diastolic BP [DBP] 75 to < 80 mm Hg).
methodsUsing data from the Improving the Detection of Hypertension Study, sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios for a positive and negative test of having borderline office BP (i.e., office SBP 120 to < 130 mm Hg or DBP 75 to < 80 mm Hg) for diagnosing masked hypertension (i.e., mean awake SBP ≥ 130 mm Hg or mean awake DBP ≥ 80 mm Hg) were determined among 263 participants who had a mean office SBP < 130 mm Hg and mean DBP < 80 mm Hg. Likelihood ratios for a positive test > 10, 5-10, and < 5 were considered strong, moderate, and weak, respectively. Likelihood ratios for a negative test < 0.1, 0.1-0.2, and > 0.2 were considered strong, moderate, and weak, respectively.
resultsAmong the 263 participants, mean ± SD age was 39.2 ± 12.8 years, 62.4% were female, 38.4% had borderline office BP, and 26.2% had masked hypertension. SN, SP, PPV, and NPV were 0.754, 0.747, 0.515, and 0.895, respectively. The likelihood ratios for a positive and negative test were 2.984 (weak) and 0.330 (weak), respectively.
conclusionsThe use of borderline office BP thresholds recommended in the 2017 ACC/AHA BP guideline did not sufficiently rule in or rule out masked hypertension.
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