Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

Sehun Kim; Jin Joo Park; Seung Ah Lee; Youngjin Cho; Yeonyee E. Yoon; Il Young Oh; Chang Hwan Yoon; Jung Won Suh; Young Seok Cho; Tae Jin Youn; Goo Yeong Cho; In Ho Chae; Hae Young Lee; Jinho Shin; Sungha Park; Dong Ju Choi

doi:10.3904/kjim.2016.161

Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

Sehun Kim, Jin Joo Park, Seung Ah Lee, Youngjin Cho, Yeonyee E. Yoon, Il Young Oh, Chang Hwan Yoon, Jung Won Suh, Young Seok Cho, Tae Jin Youn, Goo Yeong Cho, In Ho Chae, Hae Young Lee, Jinho Shin, Sungha Park, Dong Ju Choi

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background/Aims: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. Methods: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. Results: In the retrospective cohort (n = 903), the mean OBP1 (before ABP mea-surement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r ² = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). Conclusions: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.

Original language	English
Pages (from-to)	113-120
Number of pages	8
Journal	Korean Journal of Internal Medicine
Volume	33
Issue number	1
DOIs	https://doi.org/10.3904/kjim.2016.161
Publication status	Published - 2018 Jan

Bibliographical note

Funding Information:
The current work was supported by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea (Grant no. 2013-E63010-01). The electronic CRF development and data management for this study was performed using iCReaT (internet-based Clinical Research and Trial management system), a data management system established by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea.

Publisher Copyright:
© 2018 The Korean Association of Internal Medicine.

All Science Journal Classification (ASJC) codes

Internal Medicine

Access to Document

10.3904/kjim.2016.161

Cite this

Kim, S., Park, J. J., Lee, S. A., Cho, Y., Yoon, Y. E., Oh, I. Y., Yoon, C. H., Suh, J. W., Cho, Y. S., Youn, T. J., Cho, G. Y., Chae, I. H., Lee, H. Y., Shin, J., Park, S., & Choi, D. J. (2018). Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea. Korean Journal of Internal Medicine, 33(1), 113-120. https://doi.org/10.3904/kjim.2016.161

@article{54483e6caf7a4edf9e9cc0051d3bfaff,

title = "Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea",

abstract = " Background/Aims: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. Methods: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. Results: In the retrospective cohort (n = 903), the mean OBP1 (before ABP mea-surement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r 2 = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). Conclusions: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.",

author = "Sehun Kim and Park, {Jin Joo} and Lee, {Seung Ah} and Youngjin Cho and Yoon, {Yeonyee E.} and Oh, {Il Young} and Yoon, {Chang Hwan} and Suh, {Jung Won} and Cho, {Young Seok} and Youn, {Tae Jin} and Cho, {Goo Yeong} and Chae, {In Ho} and Lee, {Hae Young} and Jinho Shin and Sungha Park and Choi, {Dong Ju}",

note = "Funding Information: The current work was supported by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea (Grant no. 2013-E63010-01). The electronic CRF development and data management for this study was performed using iCReaT (internet-based Clinical Research and Trial management system), a data management system established by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea. Publisher Copyright: {\textcopyright} 2018 The Korean Association of Internal Medicine.",

year = "2018",

month = jan,

doi = "10.3904/kjim.2016.161",

language = "English",

volume = "33",

pages = "113--120",

journal = "Korean Journal of Internal Medicine",

issn = "1226-3303",

publisher = "Korean Association of Internal Medicine",

number = "1",

}

TY - JOUR

T1 - Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

AU - Kim, Sehun

AU - Park, Jin Joo

AU - Lee, Seung Ah

AU - Cho, Youngjin

AU - Yoon, Yeonyee E.

AU - Oh, Il Young

AU - Yoon, Chang Hwan

AU - Suh, Jung Won

AU - Cho, Young Seok

AU - Youn, Tae Jin

AU - Cho, Goo Yeong

AU - Chae, In Ho

AU - Lee, Hae Young

AU - Shin, Jinho

AU - Park, Sungha

AU - Choi, Dong Ju

N1 - Funding Information: The current work was supported by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea (Grant no. 2013-E63010-01). The electronic CRF development and data management for this study was performed using iCReaT (internet-based Clinical Research and Trial management system), a data management system established by the Centers for Disease Control and Prevention, Ministry of Health and Welfare, Republic of Korea. Publisher Copyright: © 2018 The Korean Association of Internal Medicine.

PY - 2018/1

Y1 - 2018/1

N2 - Background/Aims: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. Methods: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. Results: In the retrospective cohort (n = 903), the mean OBP1 (before ABP mea-surement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r 2 = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). Conclusions: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.

AB - Background/Aims: Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. Methods: In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. Results: In the retrospective cohort (n = 903), the mean OBP1 (before ABP mea-surement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p < 0.001) and diastolic (84 ± 12 mmHg vs. 78 ± 11 mmHg, p < 0.001) measurements. Interestingly, there was only a weak correlation between OBP and ABP (r 2 = 0.038, p < 0.001). The overall discordance rate of OBP compared to ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p < 0.001). Conclusions: The diagnostic accuracy of manual OBP is low in reference to ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.

UR - http://www.scopus.com/inward/record.url?scp=85040945455&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040945455&partnerID=8YFLogxK

U2 - 10.3904/kjim.2016.161

DO - 10.3904/kjim.2016.161

M3 - Article

C2 - 28602060

AN - SCOPUS:85040945455

VL - 33

SP - 113

EP - 120

JO - Korean Journal of Internal Medicine

JF - Korean Journal of Internal Medicine

SN - 1226-3303

IS - 1

ER -

Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this