Evaluation of Criteria to Detect Masked Hypertension.

Evaluation of Criteria to Detect Masked Hypertension.
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DOI:
10.1111/jch.12830
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发表时间:
2016-11
期刊:
Journal of clinical hypertension (Greenwich, Conn.)
影响因子:
--
通讯作者:
Shimbo D
Shimbo D
中科院分区:
其他
文献类型:
--
作者:
Booth JN 3rd;Muntner P;Diaz KM;Viera AJ;Bello NA;Schwartz JE;Shimbo D

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在门诊收缩压/舒张压<140/90 mmHg的成人中,门诊外日间动态血压监测(ABPM)收缩压/舒张压(SBP/DBP)≥ 135/85 mmHg的高血压患病率较高。目前尚不清楚谁应该筛查隐性高血压。我们推导了一个门诊血压(CBP)指数,以确定人群的高血压筛查。以75%~99%敏感性和高血压前期作为ABPM检测标准。在推导队列(n = 695)中,指数为门诊SBP +1.3 * 门诊DBP。在一个外部验证队列(n = 675)中,使用指数≥ 190 mmHg和≥ 217 mmHg以及高血压前期状态的隐蔽高血压敏感性分别为98.5%、71.5%和82.5%。使用NHANES数据(n = 11,778),我们估计这些阈值将分别涉及1.186亿、4440万和5930万美国成年人进行ABPM筛查,以检查是否存在隐性高血压。总之,CBP指数提供了一个有用的方法来识别候选人的高血压筛查使用ABPM。
The prevalence of masked hypertension, out-of-clinic daytime systolic/diastolic blood pressure (SBP/DBP)≥135/85 mmHg on ambulatory blood pressure monitoring (ABPM) among adults with clinic SBP/DBP<140/90 mmHg, is high. It is unclear who should be screened for masked hypertension. We derived a clinic blood pressure (CBP) index to identify populations for masked hypertension screening. Index cut-points corresponding to 75% to 99% sensitivity and prehypertension were evaluated as ABPM testing criterion. In a derivation cohort (n=695), the index was clinic SBP+1.3*clinic DBP. In an external validation cohort (n=675), the sensitivity for masked hypertension using an index ≥190 mmHg and ≥217 mmHg and prehypertension status was 98.5%, 71.5% and 82.5%, respectively. Using NHANES data (n=11,778), we estimated that these thresholds would refer 118.6, 44.4 and 59.3 million US adults, respectively, to ABPM screening for masked hypertension. In conclusion, the CBP index provides a useful approach to identify candidates for masked hypertension screening using ABPM.
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