Ambulatory Blood Pressure Monitoring Could Unmask Hypertension in Patients with Psoriasis Vulgaris

Bacaksız, Ahmet; Erdoğan, Ercan; Sönmez, Osman; Sevgili, Emrah; Taşal, Abdurrahman; Onsun, Nahide; Topukcu, Buğçe; Kulac, Beytullah; Uysal, Ömer; Göktekín, Ömer

doi:10.1016/j.jacc.2013.08.292

Cited by 4 publications

(6 citation statements)

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“…Among 54 CBPM studies, 31 studies [9, 11, 19-34, 40, 58-66, 71-73] reported 2x2 table data which could be assessed for diagnostic performance, while 7 [35-39, 41, 42] and 16 [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]70] studies reported data for only positive and negative CBPM respectively (see Table 1). The mean age ranged from 28 to 62 years and percent male ranged from 35% to 100%.…”

Section: Pooling Cbpm Diagnostic Performancesmentioning

confidence: 99%

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Karnjanapiboonwong

Anothaisintawee

Chaikledkaew

et al. 2020

Preprint

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Abstract Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:69%, 87%), and 11.11(95%CI:6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%, 80%), 82%(95%CI:77%, 87%), and 11.60(95% CI: 8.98, 15.13), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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Section: Pooling Cbpm Diagnostic Performancesmentioning

confidence: 99%

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Karnjanapiboonwong

Anothaisintawee

Chaikledkaew

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Pooling CBPM diagnostic performances Among 54 CBPM studies, 31 studies [9, 11, 19-34, 40, 58-66, 71-73] reported 2x2 table data which could be assessed for diagnostic performance, while 7 [35-39, 41, 42] and 16 [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]70] studies reported data for only positive and negative CBPM respectively (see Table 1). The mean age ranged from 28 to 62 years and percent male ranged from 35% to 100% (see Table 1).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Seven [35-39, 41, 42] and 16 studies [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]64] reported only data of WCHT and MHT, see Table 1. These studies were then combined with 31 CBPM studies with 2x2 data above yielding a total of 38 and 47 studies for pooling proportions of WCHT and MHT, respectively.…”

Section: Pooling Prevalence Of Wcht and Mht By Cbpmmentioning

confidence: 99%

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Karnjanapiboonwong

Anothaisintawee

Chaikledkaew

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem of white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:61%-87%), and 11.11(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%-80%), 82%(95%CI:77%-87%), and 11.60(95%CI:8.55.0-22.03), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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“…Psoriasis appeared to be an important and life-threatening risk factor particularly when leading to cardiovascular as well as metabolic comorbidities and their acute manifestations (for example, myocardial infarction or sudden cardiac death) [ 8 , 9 , 10 , 11 , 12 , 13 ]. Patients with severe psoriasis have a higher prevalence of the classical cardiovascular risk factors such as diabetes mellitus, arterial hypertension, smoking, and obesity [ 10 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Psoriasis and Its Impact on In-Hospital Outcome in Patients Hospitalized with Acute Kidney Injury

Wild

Hobohm

Münzel

et al. 2020

JCM

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Background: Psoriasis is a chronic inflammatory disease which affects the body far beyond the skin. Whereas there is solid evidence that chronic skin inflammation in psoriasis drives cardiovascular disease, the impact on renal impairment and acute kidney injury (AKI) is still unclear. We aimed to analyze the impact of psoriasis on the in-hospital outcome of patients hospitalized with AKI. Methods: In this retrospective database study, we investigated data on characteristics, comorbidities, and in-hospital outcomes for all hospitalized patients with AKI stratified for concomitant psoriasis, which were collected by the Federal Office of Statistics in Germany between 2005 and 2016. Results: Among the 3,162,449 patients treated for AKI in German hospitals between 2005 and 2016, 11,985 patients (0.4%) additionally suffered from psoriasis. While the annual number of AKI patients with psoriasis increased significantly from 485 cases (4.0%) in 2005 to 1902 (15.9%) in 2016 (p < 0.001), the in-hospital mortality decreased substantially (from 24.9% in 2005 to 17.4% in 2016; p < 0.001). AKI patients with concomitant psoriasis were younger (70 (IQR; 60–78) vs. 76 (67–83) years; p < 0.001) and were more often treated with dialysis (16.3% vs. 13.6%, p < 0.001). Presence of psoriasis in AKI patients was associated with reduced prevalence of myocardial infarction (OR 0.62; p < 0.001), stroke (OR 0.85; p = 0.013), and in-hospital mortality (OR 0.75; p < 0.001). Conclusions: AKI patients with psoriasis were hospitalized in median 6 years earlier than those without. Despite younger age, we detected higher use of kidney replacement therapy in patients with psoriasis, indicating a more severe course of AKI. Our findings might improve management of these patients and contribute evidence for extracutaneous, systemic manifestations of psoriasis.

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Ambulatory Blood Pressure Monitoring Could Unmask Hypertension in Patients with Psoriasis Vulgaris

Cited by 4 publications

References 0 publications

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

Psoriasis and Its Impact on In-Hospital Outcome in Patients Hospitalized with Acute Kidney Injury

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