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Discordance between ambulatory versus clinic blood pressure according to global cardiovascular risk group

Jinho Shin1, Sung Ha Park2, Ju Han Kim3

  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

The Korean Journal of Internal Medicine
|September 11, 2015
PubMed

Insights

Global cardiovascular risk influences blood pressure measurement discrepancies. Higher risk patients show less discordance between ambulatory and clinic readings, mainly due to lower white coat hypertension prevalence.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Diagnostic Accuracy

Background:

  • Accurate hypertension diagnosis is crucial for effective management.
  • Understanding discrepancies between ambulatory blood pressure (ABP) and clinic blood pressure (CBP) is key.
  • The impact of global cardiovascular risk (GCR) on ABP/CBP discordance remains unclear.

Purpose of the Study:

  • To investigate the relationship between GCR and discordance between ABP and CBP.
  • To analyze the prevalence of white coat hypertension (WCH), treated normalized hypertension, and masked hypertension (MH) in relation to GCR.

Main Methods:

  • Analysis of data from 1,916 subjects from the Korean Multicenter Registry for ABP monitoring.
  • Classification of subjects based on diagnostic and therapeutic thresholds for CBP (140/90 mmHg) and ABP (135/85 mmHg).
  • Assessment of GCR using European Society of Hypertension 2007 guidelines.

Main Results:

  • Discordancy between ABP and CBP was higher in untreated (32.5%) versus treated (26.5%) patients.
  • Prevalence of WCH/treated normalized hypertension was 14.4% and MH was 16.0%.
  • Lower discordance between ABP and CBP was observed in the very high GCR group (OR, 0.649; p=0.003) and lower WCH/treated normalized hypertension prevalence (OR, 0.451; p<0.001).

Conclusions:

  • ABP/CBP discordance is more common in untreated individuals.
  • Higher global cardiovascular risk is associated with less ABP/CBP discordance.
  • This association is primarily driven by a reduced prevalence of white coat hypertension in high-risk individuals.
Abstract

Keywords:
Blood pressure monitoring, ambulatoryHypertensionMasked hypertensionRisk assessmentWhite coat hypertension

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