Time-weighted vs conventional quantification of 24 H average systolic and diastolic ambulatory blood pressures

Octavio, José; Contreras, Jesús Ruíz; Octavio, Bernardo; Moleiro, Federico; Parati, Gianfranco; Omboni, Stefano; Mancia, Giuseppe

doi:10.1016/j.amjhyper.2004.03.084

Cited by 12 publications

(14 citation statements)

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“…However, it was suggested that sampling rate and different measurements during the daytime and nighttime may lead to bias of mean ABP. 29,30 Third, as mentioned above, our results showed a difference in degree of agreement limits with Agarwal's. 4 Whether and how the agreement limits vary across different ethnic groups remain elusive.…”

Section: Study Limitationssupporting

confidence: 46%

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Liu

Niu

Dai

et al. 2014

J of Clinical Hypertension

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Although ambulatory blood pressure (ABP) monitoring (ABPM) is often considered to have an advantage over dialysis unit blood pressure (BP) in dialysis patients, the exact relationship between these two measurements of BP has not been well determined. In a cohort of 90 Chinese dialysis patients, agreement between dialysis unit BP (predialysis and postdialysis BP) and interdialytic ABP was evaluated using Bland-Altman plots and Lin's concordance correlation coefficient for quantitative analysis, and inter-rater agreement (j) for qualitative analysis. Limits of agreement between dialysis unit BP and ABP were wide (predialysis systolic BP: À33.5 to 20.9 mm Hg; predialysis diastolic BP: À22.2 to 11.9 mm Hg; postdialysis systolic BP: À25.4 to 26.5 mm Hg; postdialysis diastolic BP: À18.4 to 12.3 mm Hg). Lin's concordance correlation coefficient exhibited a poor agreement with concordance correlation coefficients of 0.75, 0.81, 0.64, and 0.75 for predialysis systolic BP, postdialysis systolic BP, predialysis diastolic BP, and postdialysis diastolic BP, respectively. When BP level was classified into quartiles, an increasing trend for incorrect classification rate was observed with deleterious hypertension, with the highest value in grade 3 hypertension (100% and 75.0% for predialysis and postdialysis BP, respectively). Therefore, these data suggest that agreement between dialysis unit BP and interdialytic ABP is poor in Chinese dialysis patients, and the bias for patients with higher degree of hypertension is more prominent. J Clin Hypertens (Greenwich). 2014;16:701-706. ª

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Section: Study Limitationssupporting

confidence: 46%

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Liu

Niu

Dai

et al. 2014

J of Clinical Hypertension

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“…Time weighting was applied in calculating average BP values for all time periods. 22 We defined screen positives for hypertension as individuals whose mean of the last 2 clinic BP measurements was above the 95th percentile for their age, sex, and height. 15 Confirmed hypertensives were those whose 24 hours systolic (SBP) and/or diastolic BP (DBP) averages, respectively, were above the 95th percentile for their sex, age, and height.…”

Section: Methodsmentioning

confidence: 99%

Blood Pressure and Arterial Stiffness in Kenyan Adolescents With α ⁺ Thalassemia

Etyang

Khayeka–Wandabwa

Kapesa

et al. 2017

JAHA

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BackgroundRecent studies have discovered that α‐globin is expressed in blood vessel walls where it plays a role in regulating vascular tone. We tested the hypothesis that blood pressure (BP) might differ between normal individuals and those with α+thalassemia, in whom the production of α‐globin is reduced.Methods and ResultsThe study was conducted in Nairobi, Kenya, among 938 adolescents aged 11 to 17 years. Twenty‐four‐hour ambulatory BP monitoring and arterial stiffness measurements were performed using an arteriograph device. We genotyped for α+thalassemia by polymerase chain reaction. Complete data for analysis were available for 623 subjects; 223 (36%) were heterozygous (−α/αα) and 47 (8%) were homozygous (−α/−α) for α+thalassemia whereas the remaining 353 (55%) were normal (αα/αα). Mean 24‐hour systolic BP ±SD was 118±12 mm Hg in αα/αα, 117±11 mm Hg in −α/αα, and 118±11 mm Hg in −α/−α subjects, respectively. Mean 24‐hour diastolic BP ±SD in these groups was 64±8, 63±7, and 65±8 mm Hg, respectively. Mean pulse wave velocity (PWV)±SD was 7±0.8, 7±0.8, and 7±0.7 ms−1, respectively. No differences were observed in PWV and any of the 24‐hour ambulatory BP monitoring‐derived measures between those with and without α+thalassemia.ConclusionsThese data suggest that the presence of α+thalassemia does not affect BP and/or arterial stiffness in Kenyan adolescents.

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“…Time weighting was applied in calculating average BP values for all time periods. 20 We defined screen-positive participants as those whose last 2 screening BP measurements had a mean ≥140/ 90 mm Hg, and confirmed hypertensive participants were defined as those who met any of the following 3 criteria: 24hour BP average ≥130/80 mm Hg, isolated daytime hypertension (daytime BP average ≥135/85 mm Hg and nighttime BP average <120/70 mm Hg), and isolated nocturnal hypertension (nighttime BP average ≥120/70 mm Hg and daytime BP average <135/85 mm Hg). 7 Validity measures were computed using data from participants who were not taking antihypertensive medications.…”

Section: Methodsmentioning

confidence: 99%

Clinical and Epidemiological Implications of 24‐Hour Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Kenyan Adults: A Population‐Based Study

Etyang

Warne

Kapesa

et al. 2016

JAHA

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BackgroundThe clinical and epidemiological implications of using ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension have not been studied at a population level in sub‐Saharan Africa. We examined the impact of ABPM use among Kenyan adults.Methods and ResultsWe performed a nested case–control study of diagnostic accuracy. We selected an age‐stratified random sample of 1248 adults from the list of residents of the Kilifi Health and Demographic Surveillance System in Kenya. All participants underwent a screening blood pressure (BP) measurement. All those with screening BP ≥140/90 mm Hg and a random subset of those with screening BP <140/90 mm Hg were invited to undergo ABPM. Based on the 2 tests, participants were categorized as sustained hypertensive, masked hypertensive, “white coat” hypertensive, or normotensive. Analyses were weighted by the probability of undergoing ABPM. Screening BP ≥140/90 mm Hg was present in 359 of 986 participants, translating to a crude population prevalence of 23.1% (95% CI 16.5–31.5%). Age standardized prevalence of screening BP ≥140/90 mm Hg was 26.5% (95% CI 19.3–35.6%). On ABPM, 186 of 415 participants were confirmed to be hypertensive, with crude prevalence of 15.6% (95% CI 9.4–23.1%) and age‐standardized prevalence of 17.1% (95% CI 11.0–24.4%). Age‐standardized prevalence of masked and white coat hypertension were 7.6% (95% CI 2.8–13.7%) and 3.8% (95% CI 1.7–6.1%), respectively. The sensitivity and specificity of screening BP measurements were 80% (95% CI 73–86%) and 84% (95% CI 79–88%), respectively. BP indices and validity measures showed strong age‐related trends.ConclusionsScreening BP measurement significantly overestimated hypertension prevalence while failing to identify ≈50% of true hypertension diagnosed by ABPM. Our findings suggest significant clinical and epidemiological benefits of ABPM use for diagnosing hypertension in Kenyan adults.

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Time-weighted vs conventional quantification of 24 H average systolic and diastolic ambulatory blood pressures

Cited by 12 publications

References 0 publications

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Blood Pressure and Arterial Stiffness in Kenyan Adolescents With α ⁺ Thalassemia

Clinical and Epidemiological Implications of 24‐Hour Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Kenyan Adults: A Population‐Based Study

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Time-weighted vs conventional quantification of 24 H average systolic and diastolic ambulatory blood pressures

Cited by 12 publications

References 0 publications

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Poor Agreement Between Dialysis Unit Blood Pressure and Interdialytic Ambulatory Blood Pressure

Blood Pressure and Arterial Stiffness in Kenyan Adolescents With α + Thalassemia

Clinical and Epidemiological Implications of 24‐Hour Ambulatory Blood Pressure Monitoring for the Diagnosis of Hypertension in Kenyan Adults: A Population‐Based Study

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Product

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Blood Pressure and Arterial Stiffness in Kenyan Adolescents With α ⁺ Thalassemia