Compared with office or 24-hour ambulatory measurements, one week of home blood pressure monitoring was more reliable and more strongly associated with left ventricular mass index.
Observational (n=408)
Does home blood pressure monitoring provide better reliability and correlation with left ventricular mass index compared to office or ambulatory blood pressure monitoring in untreated individuals?
One week of home blood pressure monitoring is more reliable and more strongly associated with left ventricular mass index than office or 24-hour ambulatory blood pressure monitoring.
Effect estimate: 5.07 g/m2 higher LVMI per 10 mm Hg higher systolic HBP
Background. Determining the reliability and predictive validity of office blood pressure (OBP), ambulatory BP (ABP), and home BP (HBP) can inform which is best for diagnosing hypertension and estimating cardiovascular disease risk. Objectives: To assess the reliability of OBP, HBP and ABP, and evaluate their associations with left ventricular mass index (LVMI) in untreated individuals. Methods: The Improving the Detection of Hypertension (IDH) study, a community-based observational study, enrolled 408 participants who had OBP assessed at three visits, and completed three weeks of HBP, two 24-hour ABP recordings and a 2D echocardiogram. Mean±SD age was 41.2±13.1 years, 59.5% were women, 25.5% African American, and 64.0% Hispanic. Results. The reliability of one week of HBP, three office visits with mercury sphygmomanometry, and 24-hr ABP were 0.938, 0.894, and 0.846 for systolic and 0.918, 0.847, and 0.843 for diastolic BP, respectively. The correlations among OBP, HBP, and ABP, corrected for regression dilution bias, were 0.74–0.89. After multivariable adjustment including OBP and 24-hr ABP, 10 mm Hg higher systolic and diastolic HBP was associated with 5.07 (standard error SE: 1.48) and 3.92 (SE: 2.14) g/m2 higher LVMI, respectively. After adjustment for HBP, neither systolic or diastolic OBP nor ABP were associated with LVMI. Conclusion: OBP, HBP and ABP assess somewhat distinct parameters. Compared with OBP (3 visits) or 24-hour ABP, systolic and diastolic HBP (1 week) were more reliable and more strongly associated with LVMI. These data suggest one week of HBP monitoring may be the best approach for diagnosing hypertension.
Schwartz et al. (2020) conducted an observational in Hypertension (n=408). Home blood pressure (HBP) monitoring vs. Office blood pressure (OBP) and 24-hour ambulatory blood pressure (ABP) was evaluated on Left ventricular mass index (LVMI) (5.07 g/m2 higher LVMI per 10 mm Hg higher systolic HBP). Compared with office or 24-hour ambulatory measurements, one week of home blood pressure monitoring was more reliable and more strongly associated with left ventricular mass index.