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Office blood pressure threshold of 130/80 mmHg better predicts uncontrolled out-of-office blood pressure in apparent treatment-resistant hypertension

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Author(s)
Chan Joo LeeJeong-Ha HaJang Young KimIn-Cheol KimSung Kee RyuMoo-Yong RheeJu-Hee LeeJung-Hee LeeHae-Young LeeSang-Hyun IhmJoong Wha ChungJung Hyun ChoiJinho ShinSungha ParkKazuomi Kario
Keimyung Author(s)
Kim, In Cheol
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of Clinical Hypertension
Issued Date
2021
Volume
23
Issue
3
Abstract
The objective of this study was to compare the diagnostic accuracy of office blood pressure (BP) threshold of 140/90 and 130/80 mmHg for correctly identifying uncontrolled out‐of‐office BP in apparent treatment‐resistant hypertension (aTRH). We analyzed 468 subjects from a prospectively enrolled cohort of patients with resistant hypertension in South Korea (clinicaltrials.gov: NCT03540992). Resistant hypertension was defined as office BP ≥ 130/80 mmHg with three different classes of antihypertensive medications including thiazide‐type/like diuretics, or treated hypertension with four or more different classes of antihypertensive medications. We conducted different types of BP measurements including office BP, automated office BP (AOBP), home BP, and ambulatory BP. We defined uncontrolled out‐of‐office BP as daytime BP ≥ 135/85 mmHg and/or home BP ≥ 135/85 mmHg. Among subjects with office BP < 140/90 mmHg and subjects with office BP < 130/80 mmHg, 66% and 55% had uncontrolled out‐of‐office BP, respectively. The prevalence of controlled and masked uncontrolled hypertension was lower, and the prevalence of white‐coat and sustained uncontrolled hypertension was higher, with a threshold of 130/80 mmHg than of 140/90 mmHg, for both office BP and AOBP. The office BP threshold of 130/80 mmHg was better able to diagnose uncontrolled out‐of‐office BP than 140/90 mmHg, and the net reclassification improvement (NRI) was 0.255. The AOBP threshold of 130/80 mmHg also revealed better diagnostic accuracy than 140/90 mmHg, with NRI of 0.543. The office BP threshold of 130/80 mmHg showed better than 140/90 mmHg in terms of the correspondence to out‐of‐office BP in subjects with aTRH.
Keimyung Author(s)(Kor)
김인철
Publisher
School of Medicine (의과대학)
Citation
Chan Joo Lee et al. (2021). Office blood pressure threshold of 130/80 mmHg better predicts uncontrolled out-of-office blood pressure in apparent treatment-resistant hypertension. Journal of Clinical Hypertension, 23(3), 595–605. doi: 10.1111/jch.14113
Type
Article
ISSN
1751-7176
Source
https://onlinelibrary.wiley.com/doi/10.1111/jch.14113
DOI
10.1111/jch.14113
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43454
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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