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

2019 ◽  
Author(s):  
Thunyarat Anothaisintawee ◽  
Auttakiat Karnjanapiboonwong ◽  
Usa Chaikledkaew ◽  
Charungthai Dejthevaporn ◽  
John Attia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Odds Ratio ◽  
Diagnostic Odds Ratio ◽  
Home Blood Pressure ◽  
White Coat ◽  
Masked Hypertension ◽  
Pressure Measurements ◽  
Pooled Prevalence ◽  
Sensitivity Specificity ◽  
Pool Prevalence

Abstract Background This systematic review aimed to estimate the performance of clinic(CBPM) and home blood pressure measurements(HBPM) compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of white coat and masked hypertension.Methods Medline and Scopus databases were searched up to 11th June 2018. 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 white coat and masked hypertension.Results Forty-six studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio of CBPM were 66%(95%CI:58%-73%), 83%(95%CI:75%-89%), and 9.75(95%CI:6.45-14.74), respectively. Pooled prevalence of white coat and masked hypertension were 31%(95%CI:26%-35%) and 25%(95%CI:22%-28%). Pooled sensitivity, specificity, and diagnostic odds ratio of HBPM were 71%(95%CI:58%-80%), 84%(95%CI:73%-91%), and 12.47(95%CI:6.13-25.37), respectively. Pooled prevalence of white coat and masked hypertension were 19%(95%CI:10%-27%) and 31%(95%CI:10%-52%).Conclusions Diagnostic performances of HBPM were slightly higher than performance of CBPM. However, prevalence of masked hypertension was high in both negative CBPM and HBPM. Therefore, ABPM is still necessary for hypertension diagnosis, especially in people suspected with masked hypertension.

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.

P0149PREVALENCE OF MASKED HYPERTENSION IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ekaterina Borodulina ◽  
Alexander M Shutov
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Home Blood Pressure ◽  
Office Blood Pressure ◽  
White Coat ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Pressure Measurements

Abstract Background and Aims Arterial hypertension is main cause of left ventricular hypertrophy (LVH) in hemodialysis patients. Masked hypertension is associated with asymptomatic organ damage, including the development of LVH. The aim of this study was to investigate the prevalence of white-coat hypertension and masked hypertension in hemodialysis patients. Method Hemodialysis patients (n=88; 42 males, 46 females, mean age was 51.7±13.3 years) were studied. Office blood pressure measurements were performed before and after hemodialysis within 30 days. Home Blood Pressure Measurements (HBPM) was collected in the morning and in the evening during 4 weeks including hemodialysis session days. 24 hours blood pressure monitoring (ABPM) was performed in the next day after hemodialysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP) were analyzed. White-coat hypertension was diagnosed when blood pressure elevated in the office, but was normal when was measured by ABPM, HBPM, or both. Masked hypertension was determined when blood pressure was normal in the office, but increased when was measured by HBPM or ABPM. The definitions of the European Society of Cardiology (2018 ESC/ESH Guidelines for the management of arterial hypertension) were used for the diagnosis of hypertension according to office, ambulatory, and home blood pressure levels. Echocardiographic evaluation was performed on the day after dialysis and left ventricular mass index (LVMI) was calculated. Results Arterial hypertension was diagnosed by office blood pressure measurements in 39 (44.3%) patients. Arterial hypertension was defined by ABPM (mean 24h BP > or = 130 and 80 mmHg) in 48 (54.5%) patients. The number of non-dipper patients was 59 (67.0%). According to HBPM arterial hypertension was observed in 61 (69.3%) patients. Left ventricular hypertrophy was detected in 71 (80.7%) patients. Mean LVMI was 140.5±43.0 g/m2. According to the results of three methods of blood pressure measuring arterial hypertension was diagnosed in 53 (60.2%) patients, white-coat hypertension was observed in 5 (5.7%) patients, masked hypertension – in 19 (21.6%) patients. Conclusion According to office blood pressure measurements arterial hypertension was diagnosed in 44.3% hemodialysis patients. Masked hypertension was often observed in hemodialysis patients and when using not only ABPM, but also HBPM was detected in 21.6% of patients. The results indicate the importance of using not only ABPM, but also HBPM in hemodialysis patients.

scholarly journals Impact of 2017 ACC/AHA hypertension guidelines on the prevalence of white‐coat and masked hypertension: A home blood pressure monitoring study

2018 ◽  
Vol 20 (12) ◽  
pp. 1745-1747 ◽  
Author(s):  
Audes D. M. Feitosa ◽  
Marco A. Mota‐Gomes ◽  
Roberto D. Miranda ◽  
Weimar S. Barroso ◽  
Eduardo C. D. Barbosa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Home Blood Pressure ◽  
White Coat ◽  
Masked Hypertension ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Hypertension Guidelines ◽  
Monitoring Study

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.

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