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Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

Title
Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea
Author
신진호
Keywords
Manual office blood pressure; Ambulatory blood pressure; Diagnostic accuracy; Sex
Issue Date
2018-01
Publisher
KOREAN ASSOC INTERNAL MEDICINE
Citation
KOREAN JOURNAL OF INTERNAL MEDICINE, v. 33, no. 1, page. 113-120
Abstract
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.
URI
http://kjim.org/journal/view.php?doi=10.3904/kjim.2016.161http://repository.hanyang.ac.kr/handle/20.500.11754/116918
ISSN
1226-3303; 2005-6648
DOI
10.3904/kjim.2016.161
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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