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1/ We would like to announce the primary results of the Improving the Detection of Hypertension Study from a @NIH @nih_nhlbi PPG published today in @JACCJournals.
https://www.jacc.org/doi/10.1016/j.jacc.2020.10.039#.X9fIOjCKAR0.twitter
https://www.jacc.org/doi/10.1016/j.jacc.2020.10.039#.X9fIOjCKAR0.twitter
2/ This a study that we ran with Drs. Thomas Pickering and J. Thomas Bigger, two giants in hypertension and CV field.
3/ For a long time, ABPM has been considered to be the de facto reference standard for out-of-office BP monitoring.
4/ For office BP, adult hypertension guidelines recommend measuring and averaging BP across multiple visits. For HBPM, these guidelines also recommend performing 2 AM and 2 PM readings for a preferred period of 7 days (and a minimum of 3 days).
5/ Our study compared the reliability of office BP, ABPM, and HBPM and their associations with target-organ damage, when ALL BP measurement methods are performed using guideline-recommended approaches.
6/ Results: (a) HBPM was more reliable than ABPM and office BP measured at 3 visits, (b) office BP measured at 3 visits was more reliable than ABPM, (c) Higher BP on HBPM was associated with higher left ventricular mass index (LVMI), independent of office BP and ABPM.
7/ (d) Neither office BP nor ABPM was associated with LVMI, independent of HBPM, and (e) the results were similar when using awake BP, asleep BP, and 24-hour BP on ABPM.
8/ Therefore. HBPM may be the best approach for measuring BP. Office BP measurement, when done over 3 visits, may be a better approach than ABPM. And ABPM may not be needed if office BP measurement and HBPM are conducted using guideline-recommended approaches.
9/ These results support HBPM as a reference standard for out-of-office BP monitoring for diagnosing hypertension.
10/ Here is our proposal of why HBPM may have been superior to ABPM.
