Office blood pressure and 24-hour ambulatory blood pressure measurements: high proportion of disagreement in resistant hypertension

Journal of Clinical Epidemiology
Cláudia Soares RodriguesArmando da Rocha Nogueira

Abstract

To evaluate the accuracy and quantify the agreement between office blood pressure (BP) and daytime ambulatory BP monitoring in the assessment of BP control of patients with a clinical diagnosis of resistant hypertension. Office BP measurements were done in a cohort of 228 true resistant (TR) or white-coat resistant (WCR) hypertensives classified by ambulatory BP in a hypertension clinic in Rio de Janeiro in this validity study. The agreement between the daytime ambulatory BP and office BP was analyzed using the graphic methods of Altman -- Bland and survival -- agreement plots. The likelihood ratio of a positive test result of office BP was 1.99 for the assessment of uncontrolled BP in TR patients and 1.05 for the WCR hypertensive patients. The Altman and Bland plot showed a significant difference between the two methods, and the presence of a fixed and a proportional bias. The survival-agreement plot showed that a tolerance limit of 20 mm Hg of difference between systolic office BP and systolic daytime ambulatory BP would generate a proportion of disagreement equal to 57.5%. The office BP is still an important tool to monitor BP control of patients with TR hypertension, whereas the monitoring of patients with WCR hypertension ...Continue Reading

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Citations

Nov 26, 2010·Journal of Internal Medicine·A BurgazA Wolk
Nov 21, 2009·Expert Opinion on Pharmacotherapy·Maria Czarina AcelajadoSuzanne Oparil
Dec 20, 2011·Journal of Hypertension·Geoffrey A HeadAlison Wilson
Oct 13, 2010·Cardiology Clinics·Maria Czarina Acelajado, David A Calhoun

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