Diagnostic Accuracy
Background
Using awake high blood pressure (BP; ≥130/80 mm Hg) in ambulatory BP monitoring (ABPM), the purpose of this study was to determine the accuracy of office high BP (≥130/80 mm Hg). 80 mm Hg) at a baseline visit and confirmatory high office BP (≥130/80 mm Hg), and separately, high home BP ( ≥130/80 mm Hg) among participants with high office BP (≥130/80 mm Hg) at an initial office visit.
Methods and results
The accuracy of office BP measurements using the oscillometric method to detect high BP in ABPM was determined among 379 participants with complete office BP and ABPM data in the IDH (Improving Hypertension Detection) study.
To detect high BP on ABPM, the accuracy of confirmatory high office BP was also determined using the oscillometric method and, separately, high home BP among the subgroup of 122 participants with high office BP in an initial visit and complete home BP monitoring data.
High office BP had moderate sensitivity (0.61 [95% CI, 0.53–0.68]) and high specificity (0.85 [95% CI, 0.80–0.90 ]) for high awake BP.
Confirmatory high office BP and high home BP had moderate sensitivity (0.69 [95% CI, 0.59–0.79] and 0.79 [95% CI, 0.71–0. 87], respectively) and a low and moderate specificity (0.44 [95% CI, 0.27–0.79]). 0.61] and 0.72 [95% CI, 0.56–0.88], respectively).
Conclusions Many people with high ABPM BP do not have high office BP. Confirmatory office BP monitoring and home blood pressure also had limited ability to identify individuals with high BP on ABPM. |
Clinical perspective
What’s new?
High office blood pressure (BP) based on a single baseline visit had high specificity but only moderate sensitivity for identifying high awake BP in ambulatory BP monitoring.
To identify high awake BP in ambulatory BP monitoring among people with high office BP at a baseline visit, confirmatory high office BP had moderate sensitivity but low specificity, and high awake BP in Home BP monitoring had moderate sensitivity and moderate specificity.
What are the clinical implications?
Single-visit office BP, confirmatory office BP, and home BP monitoring had limited ability to identify elevated awake BP in ambulatory BP monitoring.
