School of Medicine Publications and Presentations
Document Type
Article
Publication Date
11-2014
Abstract
Outcome-driven recommendations about time intervals during which ambulatory blood pressure should be measured to diagnose white-coat or masked hypertension are lacking. We cross-classified 8237 untreated participants (mean age, 50.7 years; 48.4% women) enrolled in 12 population studies, using ≥140/≥90, ≥130/≥80, ≥135/≥85, and ≥120/≥70 mm Hg as hypertension thresholds for conventional, 24-hour, daytime, and nighttime blood pressure. White-coat hypertension was hypertension on conventional measurement with ambulatory normotension, the opposite condition being masked hypertension. Intervals used for classification of participants were daytime, nighttime, and 24 hours, first considered separately, and next combined as 24 hours plus daytime or plus nighttime, or plus both. Depending on time intervals chosen, white-coat and masked hypertension frequencies ranged from 6.3% to 12.5% and from 9.7% to 19.6%, respectively. During 91 046 person-years, 729 participants experienced a cardiovascular event. In multivariable analyses with normotension during all intervals of the day as reference, hazard ratios associated with white-coat hypertension progressively weakened considering daytime only (1.38; P=0.033), nighttime only (1.43; P=0.0074), 24 hours only (1.21; P=0.20), 24 hours plus daytime (1.24; P=0.18), 24 hours plus nighttime (1.15; P=0.39), and 24 hours plus daytime and nighttime (1.16; P=0.41). The hazard ratios comparing masked hypertension with normotension were all significant (P
Recommended Citation
Asayama, K., Thijs, L., Li, Y., Gu, Y.-M., Hara, A., Liu, Y.-P., Zhang, Z., Wei, F.-F., Lujambio, I., Mena, L. J., Boggia, J., Hansen, T. W., Björklund-Bodegård, K., Nomura, K., Ohkubo, T., Jeppesen, J., Torp-Pedersen, C., Dolan, E., Stolarz-Skrzypek, K., … International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes (IDACO) Investigators. (2014). Setting thresholds to varying blood pressure monitoring intervals differentially affects risk estimates associated with white-coat and masked hypertension in the population. Hypertension, 64(5), 935–942. https://doi.org/10.1161/HYPERTENSIONAHA.114.03614
First Page
935
Last Page
942
Publication Title
Hypertension
DOI
10.1161/HYPERTENSIONAHA.114.03614
Academic Level
faculty
Mentor/PI Department
Neuroscience
Comments
© 2014 American Heart Association, Inc. Original published version available at https://doi.org/10.1161/HYPERTENSIONAHA.114.03614