Key result
One-hour automated office blood pressure measurement demonstrated a diagnostic accuracy of 72.1% (95% CI 67.7-76.3) for diagnosing hypertension in undiagnosed patients.
Why the study?
The validity of 1 h automated office blood pressure measurement for diagnosing hypertension needed to be examined.
Does 1-h automated office blood pressure measurement accurately diagnose hypertension compared to ambulatory blood pressure monitoring in patients requiring a diagnostic test?
Cross-Sectional (n=562)
Does 1-h automated office blood pressure measurement accurately diagnose hypertension compared to ambulatory blood pressure monitoring in patients requiring a diagnostic test?
One-hour automated office blood pressure measurement provides valid and reliable diagnostic accuracy for hypertension, outperforming conventional office measurements and enabling detection of white-coat and masked hypertension.
AIMS: The objective of this study was to examine the validity of 1 h automated office blood pressure measurement for the diagnosis of hypertension. METHODS: We included patients requiring a hypertension diagnostic test. Participants underwent ambulatory blood pressure monitoring, 1 h automated office blood pressure measurement, office blood pressure measurement and home blood pressure monitoring. The prevalence of hypertension and subtypes were calculated. Mean values of ambulatory blood pressure monitoring were compared with 1 h automated office blood pressure measurement using the correlation coefficient and Bland-Altman graphs. The Kappa concordance index, sensitivity, specificity and diagnostic accuracy were calculated, and the area under the receiver operating characteristic curve was used to establish the diagnostic threshold of the 1-h measurement. RESULTS: Of 562 participants, 438 (87.6%) completed the four diagnostic methods. The 1-h method had a sensitivity of 76.6 [95% confidence interval (95% CI): 71.1-81.5], a specificity of 64.8% (95% CI: 57-72.1) and the best diagnostic accuracy (72.1%, 95% CI: 67.7-76.3) compared with the office and home measurements. Moderate-high correlations were observed between DBP (r = 0.73) and SBP (r = 0.58) readings. The 1-h method classified more patients as normotensive (24.4%) and fewer patients with white-coat hypertension (13.3%). A diagnostic threshold of at least 133/83 mmHg for the 1-h method could improve diagnostic accuracy by 2.3%. CONCLUSION: One-hour automated blood pressure measurement is a valid, reliable method for the diagnosis of hypertension in undiagnosed patients. The diagnostic accuracy permits detection of white-coat and masked hypertension. To diagnose hypertension, the 1-h method or conventional home blood pressure monitoring should be used rather than office measurements. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03147573.
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A 2021 study conducted a cross-sectional in Hypertension (n=562). 1-h automated office blood pressure measurement vs. Ambulatory, office, and home blood pressure monitoring was evaluated on diagnostic accuracy (95% CI 67.7-76.3). One-hour automated office blood pressure measurement demonstrated a diagnostic accuracy of 72.1% (95% CI 67.7-76.3) for diagnosing hypertension in undiagnosed patients.
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