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The Journal of Clinical Hypertension
Article . 2019 . Peer-reviewed
License: Wiley Online Library User Agreement
Data sources: Crossref
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Reproducibility of masked uncontrolled hypertension detected through home blood pressure monitoring

Authors: Jessica Barochiner; María Lourdes Posadas Martínez; Rocío Martínez; Diego Giunta;

Reproducibility of masked uncontrolled hypertension detected through home blood pressure monitoring

Abstract

AbstractMasked uncontrolled hypertension (MUCH) is an entity described in treated hypertensive subjects, where office blood pressure (BP) is well controlled and out‐of‐office BP is elevated. It has been related to a higher cardiovascular risk. However, the reproducibility of MUCH has been scarcely studied. In this study, we aimed to determine the reproducibility of MUCH detected through home blood pressure monitoring (HBPM). Two sets of measurements were performed in hypertensive adults under stable treatment with a 1‐week interval. Each set of measurements included three office BP readings and a 4‐day HBPM with duplicate readings in the morning, afternoon, and evening (the same validated oscillometric device was employed in both settings). We determined the percentage of agreement regarding the presence of MUCH in the two sets of measurements and quantified such agreement through the Cohen's kappa coefficient (κ), its 95% confidence interval, andPvalue. We included 105 patients (median age 58.6 [IQR 45.6‐67.2] years old, 53.4% men). MUCH prevalence on at least one occasion was 22.3% (95% CI: 15.2‐31.5). The reproducibility of MUCH was scant:κ = 0.19 (95% CI: 0.0002‐0.38),P = 0.02, due to the poor reproducibility of the office BP component of MUCH in comparison with the home BP component:κ = 0.21 (95% CI: 0.03‐0.39),P = 0.01 vsκ = 0.48 (95% CI 0.29‐0.67),P < 0.001, respectively. In conclusion, the reproducibility of MUCH detected through HBPM is minimal, mainly due to the poor reproducibility of office BP measurements. An HBPM‐based strategy for the management of patients with MUCH may be more adequate in terms of cardiovascular morbidity and mortality.

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Keywords

Male, Office Visits, Argentina, Reproducibility of Results, Blood Pressure Monitoring, Ambulatory, Middle Aged, Cardiovascular Diseases, Risk Factors, Masked Hypertension, Prevalence, Humans, Female, Antihypertensive Agents

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Average
Published in a Diamond OA journal