신진호
2019-12-04T00:31:27Z
2019-12-04T00:31:27Z
2018-01
KOREAN JOURNAL OF INTERNAL MEDICINE, v. 33, no. 1, page. 113-120
1226-3303
2005-6648
http://kjim.org/journal/view.php?doi=10.3904/kjim.2016.161
https://repository.hanyang.ac.kr/handle/20.500.11754/116918
Background/Aims: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea.Methods: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP >= 140 mmHg and/or diastolic OBP >= 90 mmHg, and systolic ABP >= 130 mmHg and/or diastolic ABP >= 80 mmHg.Results: In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 +/- 17 mmHg vs. 123 +/- 13 mmHg, p < 0.001) and diastolic (84 +/- 12 mmHg vs. 78 +/- 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r(2) = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001).Conclusions: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.
The current work was supported by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea (Grant no. 2013-E63010-01). The electronic CRF development and data management for this study was performed using iCReaT (internet-based Clinical Research and Trial management system), a data management system established by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea.
en_US
KOREAN ASSOC INTERNAL MEDICINE
Manual office blood pressure
Ambulatory blood pressure
Diagnostic accuracy
Sex
Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
Article
1
33
10.3904/kjim.2016.161
113-120
KOREAN JOURNAL OF INTERNAL MEDICINE
Kim, Sehun
Park, Jin Joo
Lee, Seung-Ah
Cho, Youngjin
Yoon, Yeonyee E.
Oh, Il-Young
Yoon, Chang-Hwan
Suh, Jung-Won
Cho, Young-Seok
Shin, Jinho
2018006805
S
COLLEGE OF MEDICINE[S]
DEPARTMENT OF MEDICINE
jhs2003