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Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

BACKGROUND/AIMS: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. METHODS: In retrospective and prosp...

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Autores principales: Kim, Sehun, Park, Jin Joo, Lee, Seung-Ah, Cho, Youngjin, Yoon, Yeonyee E., Oh, Il-Young, Yoon, Chang-Hwan, Suh, Jung-Won, Cho, Young-Seok, Youn, Tae-Jin, Cho, Goo-Yeong, Chae, In-Ho, Lee, Hae-Young, Shin, Jinho, Park, Sungha, Choi, Dong-Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Association of Internal Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768545/
https://www.ncbi.nlm.nih.gov/pubmed/28602060
http://dx.doi.org/10.3904/kjim.2016.161
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author Kim, Sehun
Park, Jin Joo
Lee, Seung-Ah
Cho, Youngjin
Yoon, Yeonyee E.
Oh, Il-Young
Yoon, Chang-Hwan
Suh, Jung-Won
Cho, Young-Seok
Youn, Tae-Jin
Cho, Goo-Yeong
Chae, In-Ho
Lee, Hae-Young
Shin, Jinho
Park, Sungha
Choi, Dong-Ju
author_facet Kim, Sehun
Park, Jin Joo
Lee, Seung-Ah
Cho, Youngjin
Yoon, Yeonyee E.
Oh, Il-Young
Yoon, Chang-Hwan
Suh, Jung-Won
Cho, Young-Seok
Youn, Tae-Jin
Cho, Goo-Yeong
Chae, In-Ho
Lee, Hae-Young
Shin, Jinho
Park, Sungha
Choi, Dong-Ju
author_sort Kim, Sehun
collection PubMed
description BACKGROUND/AIMS: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. METHODS: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. RESULTS: In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r(2) = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). CONCLUSIONS: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.
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spelling pubmed-57685452018-01-19 Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea Kim, Sehun Park, Jin Joo Lee, Seung-Ah Cho, Youngjin Yoon, Yeonyee E. Oh, Il-Young Yoon, Chang-Hwan Suh, Jung-Won Cho, Young-Seok Youn, Tae-Jin Cho, Goo-Yeong Chae, In-Ho Lee, Hae-Young Shin, Jinho Park, Sungha Choi, Dong-Ju Korean J Intern Med Original Article BACKGROUND/AIMS: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. METHODS: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. RESULTS: In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r(2) = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). CONCLUSIONS: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients. The Korean Association of Internal Medicine 2018-01 2017-06-07 /pmc/articles/PMC5768545/ /pubmed/28602060 http://dx.doi.org/10.3904/kjim.2016.161 Text en Copyright © 2018 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Sehun
Park, Jin Joo
Lee, Seung-Ah
Cho, Youngjin
Yoon, Yeonyee E.
Oh, Il-Young
Yoon, Chang-Hwan
Suh, Jung-Won
Cho, Young-Seok
Youn, Tae-Jin
Cho, Goo-Yeong
Chae, In-Ho
Lee, Hae-Young
Shin, Jinho
Park, Sungha
Choi, Dong-Ju
Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title_full Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title_fullStr Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title_full_unstemmed Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title_short Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
title_sort diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768545/
https://www.ncbi.nlm.nih.gov/pubmed/28602060
http://dx.doi.org/10.3904/kjim.2016.161
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