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

Octavio, José; Contreras, Jesús Ruíz; Amair, Pablo; Octavio, Bernardo; Fabiano, Domenico; Moleiro, Federico; Omboni, Stefano; Groppelli, Antonella; Bilo, Grzegorz; Mancia, Giuseppe; Parati, Gianfranco

doi:10.1097/hjh.0b013e328334f220

Cited by 32 publications

(15 citation statements)

References 22 publications

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“…Twenty-four-hour mean BP was defined as the weighted mean of the awake and asleep BP measurements with weights equal to the proportion of the 24-hour period that each person reported being awake and asleep, respectively. 24 Nocturnal hypertension was defined as mean asleep SBP ≥120 mm Hg or mean asleep DBP ≥70 mm Hg. 4 The percent decline in SBP and DBP, separately, from being awake to asleep was calculated as one minus the ratio of the mean asleep to mean awake BP.…”

Section: Methodsmentioning

confidence: 99%

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Booth

Anstey

Bello

et al. 2019

J of Clinical Hypertension

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Nocturnal hypertension and non-dipping blood pressure are each associated with increased risk of cardiovascular disease. We determined differences in nocturnal hypertension and non-dipping systolic/diastolic blood pressure among black and white men and women who underwent 24-hour ambulatory blood pressure monitoring at the Coronary Artery Risk Development in Young Adults study Year 30 Exam in 2015–2016. Asleep and awake periods were determined from actigraphy complemented by sleep diaries. Nocturnal hypertension was defined as mean asleep systolic/diastolic blood pressure ≥ 120/70 mm Hg. Non-dipping systolic and diastolic blood pressure, separately, were defined as a decline in awake-to-asleep blood pressure < 10%. Among 767 participants, the prevalence of nocturnal hypertension was 18.4% and 44.4% in white and black women, respectively, and 36.4% and 59.9% in white and black men, respectively. After multivariable adjustment and compared with white women, the prevalence ratio (95% confidence interval) for nocturnal hypertension was 1.65 (1.18–2.32) for black women, 1.63 (1.14–2.33) for white men, and 2.01 (1.43–2.82) for black men. The prevalence of non-dipping systolic blood pressure was 21.5% and 41.0% in white and black women, respectively, and 20.2% and 37.9% in white and black men, respectively. Compared with white women, the multivariable-adjusted prevalence ratio (95% confidence interval) for non-dipping systolic blood pressure was 1.66 (1.18–2.32), 0.91 (0.58–1.42) and 1.66 (1.15–2.39) among black women, white men, and black men, respectively. Non-dipping diastolic blood pressure did not differ by race-sex groups following multivariable adjustment. In conclusion, black women and men have a high prevalence of nocturnal hypertension and non-dipping systolic blood pressure.

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Section: Methodsmentioning

confidence: 99%

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Booth

Anstey

Bello

et al. 2019

J of Clinical Hypertension

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“…The same time periods were used to determine average daytime and nighttime BPs and evaluate dipping status. Time weighting was applied in calculating average BP values for all time periods …”

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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“…The same time periods were used to determine average daytime and nighttime BPs and to evaluate dipping status. Time weighting was applied in calculating average BP values for all time periods …”

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 32 publications

References 22 publications

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

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 32 publications

References 22 publications

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Race and sex differences in asleep blood pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) study

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