Indication-specific 6-h systolic blood pressure thresholds can approximate 24-h determination of blood pressure control

M E Ernst; G S Sezate; W Lin; C A Weber; J D Dawson; B L Carter; G R Bergus

doi:10.1038/jhh.2010.66

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Indication-specific 6-h systolic blood pressure thresholds can approximate 24-h determination of blood pressure control

Journal article

Open access

Peer reviewed

Indication-specific 6-h systolic blood pressure thresholds can approximate 24-h determination of blood pressure control

M E Ernst, G S Sezate, W Lin, C A Weber, J D Dawson, B L Carter and G R Bergus

Journal of human hypertension, Vol.25(4), pp.250-255

04/2011

DOI: 10.1038/jhh.2010.66

PMCID: PMC2946963

PMID: 20574446

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https://www.ncbi.nlm.nih.gov/pmc/articles/2946963View

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Abstract

Ambulatory blood pressure monitoring (ABPM) is an accurate method for evaluating hypertension, yet its use in clinical practice may be limited by availability, cost and patient inconvenience. The objective of this study was to investigate the ability of a 6-h ABPM window to predict blood pressure control, judging by that of the full 24-h ABPM session across several clinical indications in a cohort of 486 patients referred for ABPM. Sensitivities and specificities of the 6-h systolic blood pressure mean to accurately classify patients as hypertensive were determined using a fixed reference point of 130 mm Hg for the 24-h mean. For four common indications, in which ABPM was ordered, prediction tables were constructed varying the thresholds for the 6-h mean to find the optimal value that best predicted the 24-h hypertensive status as determined from the full 24-h interval. Using a threshold of 137 mm Hg for the indications of borderline hypertension, evaluation of current antihypertensive regimen and suspected white-coat hypertension, sensitivity and specificity ranged from 0.83-0.88 to 0.80-0.88, respectively, for the ability of 6-h ABPM to correctly categorize hypertensive status. Using 133 mm Hg as the threshold for treatment resistance resulted in a sensitivity and specificity of 0.93 and 0.83, respectively. We conclude that a shortened ABPM session of 6 h can be used to accurately classify blood pressure as controlled or not, based on the results of a 24-h session. The optimal 6-h threshold for comparison depends upon indication for referral.

Predictive Value of Tests

Humans

Middle Aged

Hypertension - drug therapy

Male

Treatment Outcome

Antihypertensive Agents - therapeutic use

Circadian Rhythm

Hypertension - physiopathology

Iowa

Time Factors

Sensitivity and Specificity

Adult

Female

Aged

Blood Pressure - drug effects

Blood Pressure Monitoring, Ambulatory

Hypertension - diagnosis

Details

Title: Subtitle: Indication-specific 6-h systolic blood pressure thresholds can approximate 24-h determination of blood pressure control
Creators: M E Ernst - Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA. michael-ernst@uiowa.edu
G S Sezate
W Lin
C A Weber
J D Dawson
B L Carter
G R Bergus
Resource Type: Journal article
Publication Details: Journal of human hypertension, Vol.25(4), pp.250-255
DOI: 10.1038/jhh.2010.66
PMID: 20574446
PMCID: PMC2946963
NLM abbreviation: J Hum Hypertens
ISSN: 0950-9240
eISSN: 1476-5527
Publisher: England
Grant note: R01 HL069801 / NHLBI NIH HHS 1R01HL069801-01A1 / NHLBI NIH HHS R01 HL069801-01A1 / NHLBI NIH HHS
Language: English
Date published: 04/2011
Academic Unit: Physician Assistant Studies; Public Health Administration; Psychiatry; Biostatistics; Family and Community Medicine; Pharmacy Practice and Science
Record Identifier: 9983997486102771

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