Key result
24-hour ABPM reclassifies ~28% of patients compared to standardized office blood pressure measurement.
Why the study?
The impact of using 24-hour ambulatory blood pressure monitoring on hypertension prevalence, awareness, treatment, and control in a community sample was unclear.
Does 24-hour ABPM improve the accuracy of hypertension classification compared to study blood pressure in a community sample?
Cross-Sectional (n=931)
Does 24-hour ABPM improve the accuracy of hypertension classification compared to study blood pressure in a community sample?
Absolute Event Rate: 61% vs 60%
While 24-hour ABPM does not substantially change population-level hypertension prevalence estimates, it significantly reduces individual misclassification, facilitating more appropriate clinical management.
We aimed to examine hypertension prevalence, awareness, treatment and control in a community sample and investigate the impact of using 24 hour ABPM. Office blood pressure (BP) was taken from the electronic health record. Study BP was measured by standardised methods. Participants were invited to undergo ABPM. Hypertension was defined by accepted thresholds or anti-hypertensive use. Standardised questions assessed awareness and treatment. Control was defined as anti-hypertensive use with BP below normal threshold. There were 931 (45%) participants with office BP, study BP and ABPM. By study BP, hypertension prevalence was 60%, awareness 59%, 60% were treated and 46% controlled. By daytime ABPM threshold, prevalence was 61%, awareness 59%, 59% were treated and 54% controlled. ABPM reclassified 13.5% from normotensive to hypertensive and 14.5% from hypertensive to normotensive. ABPM may not hugely impact population hypertension prevalence but at an individual level it reduces misclassification and facilitates more appropriate management.
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O’Flynn et al. (2015) conducted a cross-sectional in Hypertension (n=931). 24-hour Ambulatory Blood Pressure Monitoring (ABPM) vs. Study blood pressure was evaluated on Hypertension prevalence. 24-hour ambulatory blood pressure monitoring yielded a 61% hypertension prevalence versus 60% by study BP, reclassifying 13.5% to hypertensive and 14.5% to normotensive.
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