Inconsistent Control Status of Office, Home, and Ambulatory Blood Pressure All Taken Using the Same Device: The...

Area of Science:

• Cardiology
• Hypertension Management
• Medical Device Validation

Background:

• Discrepancies between office and out-of-office blood pressure (BP) readings, known as white-coat hypertension or masked hypertension, may stem from using different BP monitoring devices.
• This study addresses the consistency of BP control classification across various measurement settings.

Purpose of the Study:

• To evaluate the consistency in classifying blood pressure (BP) control (well-controlled vs. uncontrolled) using office, home, and ambulatory BP measurements.
• To assess the impact of using a single, validated "all-in-one" BP monitoring device on BP classification consistency.

Main Methods:

• The HI-JAMP study involved 2,322 hypertensive patients treated with antihypertensive drugs.
• Patients underwent office BP measurements, followed by 24-hour ambulatory BP monitoring (ABPM) and 5-day home BP monitoring (HBPM) using a validated device.

Main Results:

• Patients with consistent well-controlled BP in office and home settings (n=970) largely showed well-controlled 24-hour BP (83.3%).
• Patients with consistent uncontrolled BP in office and home settings (n=579) predominantly had uncontrolled 24-hour BP (80.9%).
• Among 803 patients with inconsistent office vs. home BP control, 46.1% showed conflicting out-of-office BP control status between ABPM and HBPM.

Conclusions:

• Combined assessment of office and home BP is valuable in clinical practice.
• For patients with conflicting office and home BP classifications, complementary use of home BP monitoring (HBPM) and ambulatory BP monitoring (ABPM) is recommended.