scholarly journals Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Auttakiat Karnjanapiboonwong ◽  
Thunyarat Anothaisintawee ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Diagnostic Performance ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Reference Standard ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM, reporting sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-h ABPM as the reference standard, were 74% (95% CI: 65–82%), 79% (95% CI: 69%, 87%), and 11.11 (95% CI: 6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI 0.19, 0.29) and 0.29 (95% CI 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71% (95% CI 61%, 80%), 82% (95% CI 77%, 87%), and 11.60 (95% CI 8.98, 15.13), respectively. Conclusions Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-h ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

scholarly journals Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Auttakiat Karnjanapiboonwong ◽  
Thunyarat Anothaisintawee ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Diagnostic Performance ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Reference Standard ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem of white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:61%-87%), and 11.11(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%-80%), 82%(95%CI:77%-87%), and 11.60(95%CI:8.55.0-22.03), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

scholarly journals Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Auttakiat Karnjanapiboonwong ◽  
Thunyarat Anothaisintawee ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Diagnostic Performance ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Reference Standard ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:69%, 87%), and 11.11(95%CI:6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%, 80%), 82%(95%CI:77%, 87%), and 11.60(95% CI: 8.98, 15.13), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

scholarly journals Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Auttakiat Karnjanapiboonwong ◽  
Thunyarat Anothaisintawee ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Measurement ◽  
Odds Ratio ◽  
Diagnostic Performance ◽  
Blood Pressure Measurement ◽  
Diagnostic Odds Ratio ◽  
Home Blood Pressure ◽  
Masked Hypertension ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background: Currently, clinic blood pressure measurement(CBPM) is most commonly used for screening hypertension, but it is facing with white coat hypertension(WCHT) and masked hypertension(MHT). Home blood pressure measurement(HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline and Scopus databases were searched up to 23 rd January 2020. Studies having diagnostic test as CBPM or HBPM, reference standard as ABPM, and reported sensitivity and specificity of either or both tests and/or proportion of white coat or masked hypertension were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 70%(95%CI:63%-76%), 81%(95%CI:73%-81%), and 9.84(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 28%(95%CI:25%-32%) and 27%(95%CI:22%-31%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 74%(95%CI:66%-80%), 83%(95%CI:76%-89%), and 13.73(95%CI:8.55.0-22.03), respectively. Pooled WCHT and MHT were 17%(95%CI:11%-22%) and 30%(95%CI:19%-42%), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of MHT was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.

Abstract 10357: The Usefulness of Home Blood Pressure Measurement in the Diagnosis of Hypertension: A Prospective Multicenter Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Deuk-Young Nah ◽  
Jin-Wook Chung ◽  
Jun-Ho Bae ◽  
Dong-Seok Lee ◽  
Moo-Yong Rhee
Keyword(s):  
Blood Pressure ◽  
Diagnostic Accuracy ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Predictive Value ◽  
Blood Pressure Measurement ◽  
Home Blood Pressure ◽  
Current Guideline ◽  
Guideline Values ◽  
Diagnosis Of Hypertension

Introduction: The major hypertension guidelines suggest methods for diagnosing hypertension by measuring the 24-hour ambulatory blood pressure (ABP) or home blood pressure (HBP) if hypertension is suspected. Hypothesis: there is no consensus of cut off values for HBP as the criterion for hypertension and also optimal duration of home blood pressure measurement (HBPM). Methods: 319 suspected hypertension patients (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg, average value of three times measurements of blood pressure in the office) were included in four university hospital. The blood pressure (BP) measurement taken by patients in his/her home with HBPM device (Watch BP Home, Microlife, Swiss) and measured three times with one minute interval at morning and evening for 7 days. The 24-hour ambulatory blood pressure measurement (ABPM) was performed by Mobil-O-Graph (IEM. GmbH, Germany). The device was set to obtain BP readings at 30-minute intervals during the day and night. The definition of hypertension was as follows, SBP ≥135 mmHg or DBP ≥85 mmHg for HBPM and SBP ≥130 mmHg or DBP ≥85 mmHg for ABPM. For the analysis for diagnostic accuracy of HBPM, we used ABPM as a reference standard for the diagnosis of hypertension. Results: We decided to exclude 53 patients due to dropout or lack of valid BP measurement (valid leadings <70% of tried measurements of ABPM and less than 5-days HBPM). Finally we analyzed BP measurement data of 266 patients. Dropout or invalid BP measurement was more common in ABPM than HBPM. HBP was measured at least 6 days in more than 90% patients and white coat hypertension was diagnosed more frequently in the HBPM. HBPM had a more than 98.6% positive predictive value and 46.8% negative predictive value for the diagnosis of hypertension when put the criteria on ABPM. There are no difference of diagnostic accuracy for the diagnosis of hypertension according to the 5-day, 6-day and 7-day HBPM. Conclusions: A 5-day HBPM is enough for the diagnosis of hypertension considering ABPM as a reference. The cut off value of hypertension in HBPM is same to the current guideline values (135/85 mmHg) in this study. HBPM is an effective and available method for the diagnosis of hypertension in suspected hypertensive patients.

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