Home blood pressure measurement in prehypertension and untreated hypertension: comparison with ambulatory blood pressure monitoring and office blood pressure

OBJECTIVES: (i) To explore blood pressure (BP) baseline characteristics in prehypertension (PH) and untreated essential hypertension (HT), and (ii) to evaluate whether simple home blood pressure (HBP) measurement can provide more reliable BP information than office blood pressure (OBP) in PH and untreated essential HT, and (iii) to investigate whether HBP measurement can also satisfactorily screen out masked hypertension (MH) and white-coat hypertension (WCH) by comparing with ambulatory blood pressure (ABP) monitoring. METHODS: We recruited 122 Beijing community volunteers. According to OBP measurement, they were divided into three groups, including PH group (n=51), stage 1 HT group (HT-1, n=51) and stage 2 HT group (HT-2, n=20). We calculated average OBP, HBP, and ABP, detection rate of MH, WCH, and nondipper status percentage in each group. RESULTS: Nondipper status percentage of PH, HT-1, and HT-2 was 54.9, 45.1, and 75%, respectively. Except for diastolic blood pressure difference between HBP and ABP, the others did not reach statistical significance. ABP correlated more strongly with HBP than OBP. Detection rate of MH in PH participants by HBP and ABP was 49.0 and 52.9% (P=0.56), respectively, and MH diagnostic agreement between ABP and HBP was moderate (kappa=0.53, 95% confidence interval: 0.30-0.76). Detection rate of WCH in stage 1 HT participants by HBP and ABP was 9.8 and 11.8% (P=0. 65), respectively, and WCH diagnostic agreement between ABP and HBP was moderate (kappa=0.49, 95% confidence interval: 0.10-0.87). CONCLUSION: Nondipper status percentage was higher in PH and untreated HT, and detection rate of MH in PH participants was also higher. The simple HBP measurement can provide more reliable and actual BP information and may be a feasibility of screening out MH and WCH for the clinical practice.