Key result
Outcome-driven thresholds for ambulatory hypertension were established as 130/80 mm Hg for 24 hours, 140/85 mm Hg for daytime, and 120/70 mm Hg for nighttime.
Why the study?
What are the outcome-driven diagnostic thresholds for ambulatory blood pressure?
What are the outcome-driven diagnostic thresholds for ambulatory blood pressure?
Outcome-driven thresholds for ambulatory blood pressure suggest lower targets than traditional reference populations, with optimal 24-hour ABP at 115/75 mm Hg.
Outcome-driven ABP thresholds may refine diagnosis; leaves open prospective validation before clinical adoption.
Upper limits of normal ambulatory blood pressure (ABP) have been a matter of debate in recent years. Current diagnostic thresholds for ABP rely mainly on statistical parameters derived from reference populations. Recent findings from the International Database of Ambulatory Blood Pressure in Relation to Cardiovascular Outcome (IDACO) provide outcome-driven thresholds for ABP. Rounded systolic/diastolic thresholds for optimal ABP were found to be 115/75 mm Hg for 24 hours, 120/80 mm Hg for daytime, and 100/65 mm Hg for nighttime. The corresponding rounded thresholds for normal ABP were 125/75 mm Hg, 130/85 mm Hg, and 110/70 mm Hg, respectively, and those for ambulatory hypertension were 130/80 mm Hg, 140/85 mm Hg, and 120/70 mm Hg. However, in clinical practice, any diagnostic threshold for blood pressure needs to be assessed in the context of the patient's overall risk profile. The IDACO database is therefore being updated with additional population cohorts to enable the construction of multifactorial risk score charts, which also include ABP.
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Hansen et al. (2008) conducted a review in Hypertension. Ambulatory blood pressure thresholds was evaluated on Outcome-driven thresholds for ambulatory blood pressure. Outcome-driven thresholds for ambulatory hypertension were established as 130/80 mm Hg for 24 hours, 140/85 mm Hg for daytime, and 120/70 mm Hg for nighttime.
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