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Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline.

Publication ,  Journal Article
Vongpatanasin, W; Ayers, C; Lodhi, H; Das, SR; Berry, JD; Khera, A; Victor, RG; Lin, F-C; Viera, AJ; Yano, Y; de Lemos, JA
Published in: Hypertension
December 2018

Most guidelines have recommended lower home blood pressure (BP) threshold when clinic BP threshold of 140/90 mm Hg is used for diagnosis of hypertension. However, home BP thresholds to define hypertension have never been determined in the general population in the United States. We identified home BP thresholds for stage 1 (BP ≥130/80 mm Hg) hypertension using a regression-based approach in the DHS (Dallas Heart Study; n=5768) and the NCMH study (North Carolina Masked Hypertension; n=420). Home BP thresholds were also assessed using outcome-derived approach based on the composite of all-cause mortality or cardiovascular events in the DHS cohort. For this approach, BP thresholds were identified only for systolic BP because diastolic BP was not associated with the outcome. Among untreated participants, the regression-derived thresholds for home BP corresponding to clinic BP for stage 1 hypertension were 129/80 mm Hg in blacks, 130/80 mm Hg in whites, and 126/78 mm Hg in Hispanics, respectively. The results are similar in the North Carolina cohort. The 11-year composite cardiovascular and mortality events corresponding to clinic systolic BP >130 mm Hg were higher in blacks than in whites and Hispanics (13.3% versus 5.98% versus 5.52%, respectively). Using a race/ethnicity-specific composite outcome in the untreated DHS participants, the outcome-derived home systolic BP thresholds corresponding to stage 1 hypertension were 130 mm Hg in blacks, 129 mm Hg in whites, and 131 mm Hg in Hispanics, respectively. Our data based on both regression-derived and outcome approach support home BP threshold of 130/80 mm Hg for diagnosis of hypertension in blacks, whites, and Hispanics.

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Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

December 2018

Volume

72

Issue

6

Start / End Page

1312 / 1319

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Prospective Studies
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Blood Pressure Monitoring, Ambulatory
 

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Vongpatanasin, W., Ayers, C., Lodhi, H., Das, S. R., Berry, J. D., Khera, A., … de Lemos, J. A. (2018). Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline. Hypertension, 72(6), 1312–1319. https://doi.org/10.1161/HYPERTENSIONAHA.118.11657
Vongpatanasin, Wanpen, Colby Ayers, Hamza Lodhi, Sandeep R. Das, Jarett D. Berry, Amit Khera, Ronald G. Victor, et al. “Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline.Hypertension 72, no. 6 (December 2018): 1312–19. https://doi.org/10.1161/HYPERTENSIONAHA.118.11657.
Vongpatanasin W, Ayers C, Lodhi H, Das SR, Berry JD, Khera A, et al. Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline. Hypertension. 2018 Dec;72(6):1312–9.
Vongpatanasin, Wanpen, et al. “Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline.Hypertension, vol. 72, no. 6, Dec. 2018, pp. 1312–19. Pubmed, doi:10.1161/HYPERTENSIONAHA.118.11657.
Vongpatanasin W, Ayers C, Lodhi H, Das SR, Berry JD, Khera A, Victor RG, Lin F-C, Viera AJ, Yano Y, de Lemos JA. Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline. Hypertension. 2018 Dec;72(6):1312–1319.

Published In

Hypertension

DOI

EISSN

1524-4563

Publication Date

December 2018

Volume

72

Issue

6

Start / End Page

1312 / 1319

Location

United States

Related Subject Headings

  • United States
  • Severity of Illness Index
  • Prospective Studies
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Blood Pressure Monitoring, Ambulatory