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Setting Thresholds ...
Setting Thresholds to Varying Blood Pressure Monitoring Intervals Differentially Affects Risk Estimates Associated With White-Coat and Masked Hypertension in the Population
- Article/chapterEnglish2014
Publisher, publication year, extent ...
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-237287
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-237287URI
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https://doi.org/10.1161/HYPERTENSIONAHA.114.03614DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:129960106URI
Supplementary language notes
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Language:English
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Summary in:English
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Classification
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Outcome-driven recommendations about time intervals during which ambulatory blood pressure should be measured to diagnose white-coat or masked hypertension are lacking. We cross-classified 8237 untreated participants (mean age, 50.7 years; 48.4% women) enrolled in 12 population studies, using >= 140/>= 90, >= 130/>= 80, >= 135/>= 85, and >= 120/>= 70 mm Hg as hypertension thresholds for conventional, 24-hour, daytime, and nighttime blood pressure. White-coat hypertension was hypertension on conventional measurement with ambulatory normotension, the opposite condition being masked hypertension. Intervals used for classification of participants were daytime, nighttime, and 24 hours, first considered separately, and next combined as 24 hours plus daytime or plus nighttime, or plus both. Depending on time intervals chosen, white-coat and masked hypertension frequencies ranged from 6.3% to 12.5% and from 9.7% to 19.6%, respectively. During 91 046 person-years, 729 participants experienced a cardiovascular event. In multivariable analyses with normotension during all intervals of the day as reference, hazard ratios associated with white-coat hypertension progressively weakened considering daytime only (1.38; P=0.033), nighttime only (1.43; P=0.0074), 24 hours only (1.21; P=0.20), 24 hours plus daytime (1.24; P=0.18), 24 hours plus nighttime (1.15; P=0.39), and 24 hours plus daytime and nighttime (1.16; P=0.41). The hazard ratios comparing masked hypertension with normotension were all significant (P<0.0001), ranging from 1.76 to 2.03. In conclusion, identification of truly low-risk white-coat hypertension requires setting thresholds simultaneously to 24 hours, daytime, and nighttime blood pressure. Although any time interval suffices to diagnose masked hypertension, as proposed in current guidelines, full 24-hour recordings remain standard in clinical practice.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Thijs, Lutgarde
(author)
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Li, Yan
(author)
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Gu, Yu-Mei
(author)
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Hara, Azusa
(author)
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Liu, Yan-Ping
(author)
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Zhang, Zhenyu
(author)
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Wei, Fang-Fei
(author)
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Lujambio, Ines
(author)
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Mena, Luis J.
(author)
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Boggia, Jose
(author)
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Hansen, Tine W.
(author)
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Björklund-Bodegård, KristinaKarolinska Institutet,Uppsala universitet,Geriatrik(Swepub:uu)krisbjor
(author)
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Nomura, Kyoko
(author)
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Ohkubo, Takayoshi
(author)
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Jeppesen, Jorgen
(author)
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Torp-Pedersen, Christian
(author)
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Dolan, Eamon
(author)
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Stolarz-Skrzypek, Katarzyna
(author)
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Malyutina, Sofia
(author)
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Casiglia, Edoardo
(author)
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Nikitin, Yuri
(author)
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Lind, LarsUppsala universitet,Kardiovaskulär epidemiologi,Geriatrik(Swepub:uu)larslind
(author)
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Luzardo, Leonella
(author)
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Kawecka-Jaszcz, Kalina
(author)
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Sandoya, Edgardo
(author)
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Filipovsky, Jan
(author)
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Maestre, Gladys E.
(author)
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Wang, Jiguang
(author)
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Imai, Yutaka
(author)
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Franklin, Stanley S.
(author)
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O'Brien, Eoin
(author)
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Staessen, Jan A.
(author)
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Uppsala universitetGeriatrik
(creator_code:org_t)
Related titles
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In:Hypertension64:5, s. 935-9420194-911X1524-4563
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- By the author/editor
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Asayama, Kei
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Thijs, Lutgarde
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Li, Yan
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Gu, Yu-Mei
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Hara, Azusa
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Liu, Yan-Ping
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show more...
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Zhang, Zhenyu
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Wei, Fang-Fei
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Lujambio, Ines
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Mena, Luis J.
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Boggia, Jose
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Hansen, Tine W.
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Björklund-Bodegå ...
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Nomura, Kyoko
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Ohkubo, Takayosh ...
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Jeppesen, Jorgen
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Torp-Pedersen, C ...
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Dolan, Eamon
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Stolarz-Skrzypek ...
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Malyutina, Sofia
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Casiglia, Edoard ...
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Nikitin, Yuri
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Lind, Lars
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Luzardo, Leonell ...
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Kawecka-Jaszcz, ...
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Sandoya, Edgardo
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Filipovsky, Jan
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Maestre, Gladys ...
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Wang, Jiguang
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Imai, Yutaka
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Franklin, Stanle ...
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O'Brien, Eoin
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Staessen, Jan A.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Hypertension
- By the university
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Uppsala University
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Karolinska Institutet