Blood Pressure

Home BP Diagnostic Accuracy Improved With Lower Thresholds

Lowering the diagnostic thresholds of home blood pressure (HBP) measurements from 135/85 mm Hg to 130/80 mm Hg may improve its diagnostic accuracy for hypertension, according to a recent study.

For their study, the researchers identified 319 patients with confirmed high blood pressure (BP), defined as having BP levels of at least 140/90 mm Hg. Of these patients, 256 who had valid HBP measurements and 24-hour ambulatory blood pressure (ABP) measurements were included in the present analysis. Mean patient age was 51.8 years, and 119 patients were men.
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HBP measurements were recorded in triplicates every morning and evening for 7 days, and the 24-hour ABP measurement was recorded on day 8. The researchers assessed HBP diagnostic thresholds at 135/85 mm Hg, 130/85 mm Hg, and 130/80 mm Hg, using 24-hour ABP measurements as a reference.

Findings from the study showed that the threshold of 130/80 mm Hg had the highest diagnostic sensitivity with diagnostic agreement by Kappa statistics. Furthermore, the prevalence of masked hypertension was significantly lower when using 130/80 mm Hg (7.8%) as a diagnostic threshold for hypertension, compared with 130/85 mm Hg (15.2%) and 135/85 mm Hg (18.4%).

“The present study suggests that lowering the diagnostic thresholds of HBP measurement from 135/85 mm Hg to 130/80 mm Hg may improve diagnostic accuracy for hypertension,” the researchers concluded.

—Christina Vogt

Reference:

Park JS, Rhee MY, Namgung J, et al. Comparison of optimal diagnostic thresholds of hypertension with home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring. Am J Hypertens. 2017;30(12):1170-1176. https://doi.org/10.1093/ajh/hpx115.