Screening for High Blood Pressure in Adults: U.S. Preventive Services Task Force Recommendation Statement

Siu, Albert L.; Bibbins‐Domingo, Kirsten; Grossman, David C.; Baumann, Linda C.; Davidson, Karina W.; Ebell, Mark H.; García, Francisco; Gillman, Matthew W.; Herzstein, Jessica; Kemper, Alex R.; Krist, Alex H.; Kurth, Ann; Owens, Douglas K; Phillips, William R.; Phipps, Maureen G.; Pignone, Michael

doi:10.7326/m15-2223

Cited by 413 publications

(285 citation statements)

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“…Additionally, the 2013 European Society of Hypertension and European Society of Cardiology states AOBP is a potential method to improve BP reproducibility and reconcile variations between office and out-of-office methods, such as awake ABPM and HBPM monitoring [13]. The U.S. Preventive Services Task Force also states that AOBP can produce similar results as awake ABPM, but does not make specific recommendations on in-office BP methods [17]. See Table 2 for in-office methods preferred by various guidelines.…”

Section: Implementation In Clinical Practice and Potential Limitationsmentioning

confidence: 99%

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A Modern Method to Monitor Office Blood Pressure

Khazan

Hough

2017

Innov Pharm

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The diagnosis and management of hypertension relies on accurate and precise blood pressure (BP) measurements and monitoring techniques. Variability in traditional office based BP readings can contribute to misclassification and potential misdiagnosis of hypertension, leading to inappropriate treatment and possibly avoidable adverse drug events. Both home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) can improve characterization of BP status over traditional office values and can predict cardiovascular morbidity and mortality risk; however, they are limited by availability and/or practical use in many situations. Available in-office blood pressure measuring methods include manual auscultation, automated oscillometric, and automated office blood pressure (AOBP) devices. A strong correlation exists between AOBP and awake ABPM measurements and has been linked to better prediction of end-organ damage and white coat response compared to standard office BP methods. While AOBP does not provide nocturnal BP readings, it can be utilized in several outpatient settings, and has the capability to decrease utilization of ABPM, white coat effect, and improve optimization of cardiovascular assessment, evaluation, and therapeutic assessment in clinical practice. Hypertension affects over 80 million adults in the United States (US) and is a major risk factor for cardiovascular morbidity and mortality [1]. The condition’s ubiquitous nature and broad impact potentially makes understanding the diagnosis and treatment of hypertension key elements of managing cardiovascular risk. Though much attention is paid to the treatment of hypertension, from 2009 to 2012, 45.9% of US patients with hypertension were uncontrolled [1]. Appreciating the aspects of proper assessment of blood pressure is crucial and creates the foundation for approaching hypertension management. Until recently, hypertension was defined as an appropriately measured office systolic blood pressure (SBP) of greater than or equal to 140 mmHg and/or diastolic blood pressure (DBP) greater than or equal to 90 mmHg, with the patient seated and resting for 5 minutes in a proper position, and preferentially, measured as an average of two readings taken 1 or 2 minutes apart [1-5]. While serving as the primary method, standard office blood pressure assessment with either manual or traditional automated BP cuffs is limited in accuracy and application in everyday practice, and faces many challenges. As such, an understanding of the potential limitations of current BP strategies, and the roles and rationale for novel assessment techniques are of value to clinicians [6]. Conflict of Interest: We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Review

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Section: Implementation In Clinical Practice and Potential Limitationsmentioning

confidence: 99%

“…ABPM has also been endorsed by many major practice organizations [13,14,[16][17][18][19]. The 2011 United Kingdom guidelines on adult hypertension diagnosis and management recommend that ABPM be offered for patients with office BP greater than 140/90 mmHg [20].…”

Section: Alternative Methods Of Blood Pressure Assessmentmentioning

confidence: 99%

A Modern Method to Monitor Office Blood Pressure

Khazan

Hough

2017

Innov Pharm

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“…Most studies making this point relied on conventional office blood pressure. However, all current hypertension guidelines11, 12, 13, 14 endorse the use of ambulatory monitoring as the state‐of‐the‐art method for monitoring blood pressure, because the greater number of readings obtained over the whole day outside the medical environment enhance risk stratification.…”

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confidence: 99%

Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population

Wei

Yang

Thijs

et al. 2018

JAHA

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BackgroundNo longitudinal study compared associations of echocardiographic indexes of diastolic left ventricular function studies with conventional (CBP) and daytime ambulatory (ABP) blood pressure in the general population.Methods and ResultsIn 780 Flemish (mean age, 50.2 years; 51.7% women), we measured left atrial volume index (LAVI), peak velocities of the transmitral blood flow (E) and mitral annular movement (e′) in early diastole and E/e′ 9.6 years (median) after CBP and ABP. In adjusted models including CBP and ABP, we expressed associations per 10/5‐mm Hg systolic/diastolic blood pressure increments. LAVI and E/e′ were 0.65/0.40 mL/m2 and 0.17/0.09 greater with higher systolic/diastolic ABP (P≤0.028), but not with higher baseline CBP (P≥0.086). e′ was lower (P≤0.032) with higher diastolic CBP (−0.09 cm/s) and ABP (−0.19 cm/s). When we substituted baseline CBP by CBP recorded concurrently with echocardiography, LAVI and E/e′ remained 0.45/0.38 mL/m2 and 0.15/0.08 greater with baseline ABP (P≤0.036), while LAVI (+0.53 mL/m2) and E/e′ (+0.19) were also greater (P<0.001) in relation to concurrent systolic CBP. In categorized analyses of baseline data, sustained hypertension or masked hypertension compared with normotension or white‐coat hypertension was associated with greater LAVI (24.0 versus 22.6 mL/m2) and E/e′ (7.35 versus 6.91) and lower e′ (10.7 versus 11.6 cm/s; P≤0.006 for all) with no differences (P≥0.092) between normotension and white‐coat hypertension or between masked hypertension and sustained hypertension.Conclusions ABP is a long‐term predictor of diastolic left ventricular function, statistically outperforming distant but not concurrent CBP. Masked hypertension and sustained hypertension carry equal risk for deterioration of diastolic left ventricular function.

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“…Recently, the US Preventive Services Task Force guidelines recommended that out-of-clinic BP measurement be undertaken to confirm the diagnosis of hypertension and exclude white coat hypertension. 15 Currently, masked hypertension, which has important predictive value for CVD events, has been less integrated in hypertension guidelines and clinical practice compared with white coat hypertension. To further develop our understanding of masked hypertension, the next steps are clear.…”

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confidence: 99%