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Diagnostic thresholds for ambulatory blood pressure moving lower: a review based on a meta-analysis-clinical

Tine W Hansen1, Masahiro Kikuya, Lutgarde Thijs

  • 1Research Center for Prevention and Health and Department of Clinical Physiology, Hvidovre University Hospital, Copenhagen, Denmark.

Journal of Clinical Hypertension (Greenwich, Conn.)
|May 6, 2008
PubMed

Insights

New outcome-driven thresholds for ambulatory blood pressure (ABP) are proposed. These findings from the IDACO database offer updated guidance for diagnosing hypertension, considering 24-hour, daytime, and nighttime readings.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Public Health

Background:

  • Defining normal ambulatory blood pressure (ABP) remains a challenge, with current thresholds based on statistical norms.
  • Previous diagnostic criteria for ABP lacked direct correlation with cardiovascular outcomes.
  • The International Database of Ambulatory Blood Pressure in Relation to Cardiovascular Outcome (IDACO) initiative aims to establish evidence-based thresholds.

Purpose of the Study:

  • To establish outcome-driven diagnostic thresholds for ambulatory blood pressure (ABP).
  • To provide updated reference values for optimal, normal, and hypertensive ABP levels across different time periods.
  • To inform clinical practice regarding the interpretation of ABP measurements.

Main Methods:

  • Analysis of data from the International Database of Ambulatory Blood Pressure in Relation to Cardiovascular Outcome (IDACO).
  • Identification of systolic and diastolic blood pressure thresholds associated with cardiovascular outcomes.
  • Calculation of recommended values for 24-hour, daytime, and nighttime ABP.

Main Results:

  • Outcome-driven thresholds for optimal ABP: 115/75 mm Hg (24h), 120/80 mm Hg (day), 100/65 mm Hg (night).
  • Outcome-driven thresholds for normal ABP: 125/75 mm Hg (24h), 130/85 mm Hg (day), 110/70 mm Hg (night).
  • Outcome-driven thresholds for ambulatory hypertension: 130/80 mm Hg (24h), 140/85 mm Hg (day), 120/70 mm Hg (night).

Conclusions:

  • The IDACO findings provide evidence-based thresholds for ambulatory hypertension.
  • Clinical interpretation of ABP should integrate these new thresholds with patient risk profiles.
  • Future updates to the IDACO database will enable multifactorial risk score charts incorporating ABP.

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