Effect of Intensive and Standard Clinic-Based Hypertension Management on the Concordance Between Clinic and Ambulatory Blood Pressure and Blood Pressure Variability in SPRINT

Background Blood pressure ( BP ) varies over time within individual patients and across different BP measurement techniques. The effect of different BP targets on concordance between BP measurements is unknown. The goals of this analysis are to evaluate concordance between (1) clinic and ambulatory...

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Bibliographic Details
Published in:Journal of the American Heart Association 2019-07, Vol.8 (14), p.e011706-e011706
Main Authors: Ghazi, Lama, Pajewski, Nicholas M, Rifkin, Dena E, Bates, Jeffrey T, Chang, Tara I, Cushman, William C, Glasser, Stephen P, Haley, William E, Johnson, Karen C, Kostis, William J, Papademetriou, Vasilios, Rahman, Mahboob, Simmons, Debra L, Taylor, Addison, Whelton, Paul K, Wright, Jackson T, Bhatt, Udayan Y, Drawz, Paul E
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
ambulatory blood pressure monitoring
Antihypertensive Agents - therapeutic use
Blood Pressure Determination - methods
Blood Pressure Monitoring, Ambulatory - methods
circadian rhythm
concordance
Humans
Hypertension - diagnosis
Hypertension - drug therapy
Masked Hypertension - diagnosis
Middle Aged
Original Research
Patient Care Planning
variability
White Coat Hypertension - diagnosis
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Summary:Background Blood pressure ( BP ) varies over time within individual patients and across different BP measurement techniques. The effect of different BP targets on concordance between BP measurements is unknown. The goals of this analysis are to evaluate concordance between (1) clinic and ambulatory BP , (2) clinic visit-to-visit variability and ambulatory BP variability, and (3) first and second ambulatory BP and to evaluate whether different clinic targets affect these relationships. Methods and Results The SPRINT (Systolic Blood Pressure Intervention Trial) ambulatory BP monitoring ancillary study obtained ambulatory BP readings in 897 participants at the 27-month follow-up visit and obtained a second reading in 203 participants 293±84 days afterward. There was considerable lack of agreement between clinic and daytime ambulatory systolic BP with wide limits of agreement in Bland-Altman plots of -21 to 34 mm Hg in the intensive-treatment group and -26 to 32 mm Hg in the standard-treatment group. Overall, there was poor agreement between clinic visit-to-visit variability and ambulatory BP variability with correlation coefficients for systolic and diastolic BP all
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.118.011706