Age and the difference between awake ambulatory blood pressure and office blood pressure

Ishikawa, Joji; Ishikawa, Yukiko; Edmondson, Donald; Pickering, Thomas G.; Schwartz, Joseph E.

doi:10.1097/mbp.0b013e328346d603

Cited by 44 publications

(40 citation statements)

References 57 publications

(93 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A significant influence of age on the ABP-HBP difference was also shown, with elderly patients showing smaller difference than the younger ones. This finding is in line with a recent meta-analysis by Ishikawa et al, 15 which showed no difference between awake ABP and HBP in older subjects, whereas in the younger HBP was lower.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Diagnostic accuracy of home vs. ambulatory blood pressure monitoring in untreated and treated hypertension

et al. 2012

View full text Add to dashboard Cite

Several studies with relatively small size and different design and end points have investigated the diagnostic ability of home blood pressure (HBP). This study investigated the usefulness of HBP compared with ambulatory monitoring (ABP) in diagnosing sustained hypertension, white coat phenomenon (WCP) and masked hypertension (MH) in a large sample of untreated and treated subjects using a blood pressure (BP) measurement protocol according to the current guidelines. A total of 613 subjects attending a hypertension clinic (mean age 53 ± 12.4 (s.d.) years, men 57%, untreated 59%) had measurements of clinic BP (three visits, triplicate measurements per visit), HBP (6 days, duplicate morning and evening measurements) and awake ABP (20-min intervals) within 6 weeks. Sustained hypertension was diagnosed in 50% of the participants by ABP and HBP (agreement 89%, j¼0.79), WCP in 14 and 15%, respectively (agreement 89%, j¼0.56) and MH in 16% and 15% (agreement 88%, j¼0.52). Only 4% of the subjects (27/613) showed clinically significant diagnostic disagreement with BP deviation 45 mm Hg above the diagnostic threshold (for HBP or ABP). By taking ABP as reference, the sensitivity, specificity, positive and negative predictive value of HBP in detecting sustained hypertension were 90, 89, 89 and 90%, respectively, WCP 61, 94, 64 and 94% and MH 60, 93, 60 and 93%. Similar diagnostic agreement was found in untreated and treated subjects. HBP appears to be a reliable alternative to ABP in the diagnosis of hypertension and the detection of WCP and MH in both untreated and treated subjects.

show abstract

Section: Discussionsupporting

confidence: 82%

“…In a recent metaanalysis of 27 studies (n¼12 127), Ishikawa et al 15 showed that increasing age, female gender and not using oscillometric device for clinic BP, predispose to WCP detecting by ABP. In a study of 5716 subjects, white coat hypertension detected by ABP was more common among older adults, females and non-smokers.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of home vs. ambulatory blood pressure monitoring in untreated and treated hypertension

et al. 2012

View full text Add to dashboard Cite

show abstract

“…5,8 More recently, a meta-analysis of population studies on adults and children performed in 1990 to 2009 and a recent study from the IDACO (International Database on Ambulatory Blood Pressure and Cardiovascular Outcomes) on 13 population-based cohorts have described higher clinic than daytime BP only in older subjects, but higher daytime than clinic BP in subjects under the age of 50 years. 14,15 Similar results (daytime BP higher than clinic BP) have been described in children and adolescents. 16,17 Most of these previous studies were centered on untreated populations, 5,14,15 and most prior clinical studies have been small (<200 subjects).…”

Section: Hypertensionsupporting

confidence: 72%

“…14,15 Similar results (daytime BP higher than clinic BP) have been described in children and adolescents. 16,17 Most of these previous studies were centered on untreated populations, 5,14,15 and most prior clinical studies have been small (<200 subjects). [6][7][8][9]11 Thus, little is known about the age relationship between clinic and ambulatory BP in large cohorts of hypertensive patients in usual clinical practice, especially in primary care, where most treated and untreated hypertensive people are cared for.…”

Section: Hypertensionsupporting

confidence: 72%

Clinic Versus Daytime Ambulatory Blood Pressure Difference in Hypertensive Patients

et al. 2017

View full text Add to dashboard Cite

C onventional blood pressure (BP) determined in the clinic has been the standard of defining BP status for many decades.1 However, out-of-clinic BP (eg, ambulatory BP monitoring [ABPM]) can provide a more accurate estimate of the true BP and better predict clinical outcomes than conventional BP.1-3 The Framingham Heart Study showed that clinic systolic BP (SBP) rises from adolescence through most of adulthood. 4 In contrast, diastolic BP (DBP) initially increases in young adulthood, levels off at age 50 to 55 years, and then usually decreases after age 60 to 65. BP trajectories obtained using ABPM also increase with age, but the age gradients are less steep than those from conventional BP. 5 It has long been reported that seated clinic BP is usually higher than daytime ambulatory or home-measured BP, mostly in hypertensive patients. [5][6][7][8][9][10][11] The difference in clinic-ambulatory BP values has been used to quantify the so-called whitecoat effect (WCE), which has been related, at least in part, to the alert reaction and transient increase in BP that often occurs during the clinic visit.12,13 Some studies have reported that the clinic-daytime BP differences increase progressively both Abstract-Clinic blood pressure (BP) is usually higher than daytime ambulatory BP in hypertensive patients, but some recent studies have challenged this view, suggesting that this relationship is strongly influenced by age. We used the Spanish ambulatory BP monitoring cohort to examine differences between clinic and daytime BP by age among 104 639 adult hypertensive patients (office systolic/diastolic BP ≥140/90 mm Hg or treated) in usual primary-care practice, across the wide age spectrum. To assess the impact of age, cardiovascular variables, and clinic BP on the clinic-daytime BP differences, we built multivariable regression models of the average BP differences, white-coat hypertension (high clinic BP and normal daytime BP), and masked hypertension (normal clinic BP and high daytime BP). In most patients, mean clinic BP values were higher than daytime BP at all ages. Some 36.7% of patients had white-coat hypertension (amounting to 50% at clinic systolic BP of 140-159 mm Hg) and 3.9% had masked hypertension (amounting to 18% at clinic systolic BP of 130-139 mm Hg). Age explained 0.1% to 1.7% of the variance of quantitative or categorical BP differences (P<0.001). Cardiovascular variables explained an additional 1.6% to 3.4% of the variance (P<0.001). Finally, clinic BP generally explained ≥20% more of the variance (P<0.01). In this large study in usual clinical practice, clinic BP misclassified hypertension status in >40% of patients. This misclassification was not importantly influenced by age but was more evident in patients with borderline/grade 1 hypertension. These findings reinforce the importance of ambulatory BP monitoring for defining BP status in routine clinical practice. (Hypertension. 2017;69:211-219.

show abstract

“…Our results were robust to sensitivity analyses where different definitions of ambulatory hypertension were used. The inverse relationship in younger individuals has received little attention previously, [11][12][13] and most available studies mainly focused on the direct relationship between age and the white coat response. 14,15 As in our work, these studies found that the white coat response increases with increasing age and that it was stronger among individuals with office hypertension.…”

Section: Discussionmentioning

confidence: 99%

Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

et al. 2014

View full text Add to dashboard Cite

show abstract

Age and the difference between awake ambulatory blood pressure and office blood pressure

Cited by 44 publications

References 57 publications

Diagnostic accuracy of home vs. ambulatory blood pressure monitoring in untreated and treated hypertension

Diagnostic accuracy of home vs. ambulatory blood pressure monitoring in untreated and treated hypertension

Clinic Versus Daytime Ambulatory Blood Pressure Difference in Hypertensive Patients

Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

Contact Info

Product

Resources

About