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Diagnosis of true uncontrolled hypertension using both home and ambulatory blood pressure monitoring

Journal of Human Hypertension volume 28, pages 176–179 (2014)Cite this article

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Abstract

The definitive diagnosis of hypertension based on home blood pressure (BP) monitoring (HBPM) results may be practical, particularly in the primary care setting; however, some hypertensive patients are overlooked by HBPM alone. It is unclear which HBP cutoff value should set for patients who require ambulatory BP monitoring (ABPM). In the present study, home systolic BP (SBP) data (6 BP measurements taken for 3 days in the morning and evening) and 24-h ambulatory SBP data from 462 hypertensive subjects were obtained from a real-world clinical study. Using HBPM as an initial step for the definitive diagnosis of hypertension, 381 of 462 total subjects had a home SBP value of ⩾135 mm Hg. Of these 381 subjects, 90.3% had ambulatory SBP values of ⩾130 mm Hg. Among the other 81 subjects with home SBP values of <135 mm Hg, 60.5% had ambulatory SBP values of ⩾130 mm Hg (‘true uncontrolled hypertension’). These percentages differed significantly (P<0.0001). The cutoff home SBP value of 135 mm Hg could discriminate between subjects who did not require ABPM (home SBP value of ⩾135 mm Hg) and those who did (home SBP value of <135 mm Hg) for the diagnosis of true uncontrolled hypertension.

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Acknowledgements

Kazuomi Kario, the principal investigator of ACHIEVE-ONE, supervised its conduct and data analysis and had primary responsibility for the working of this paper. The author did not receive remuneration for performing the study. This study was financially supported by Ajinomoto Pharmaceuticals Co., Ltd (Tokyo, Japan) and Mochida Pharmaceutical Co., Ltd (Tokyo Japan).

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  1. Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan

    K Kario

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Correspondence to K Kario.

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Kario, K. Diagnosis of true uncontrolled hypertension using both home and ambulatory blood pressure monitoring. J Hum Hypertens 28, 176–179 (2014). https://doi.org/10.1038/jhh.2013.73

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