Clinic and home blood pressure monitoring for the detection of ambulatory hypertension among patients on peritoneal dialysis
Hypertension Aug 20, 2019
Vaios V, Georgianos PI, Vareta G, et al. – In this analysis, researchers evaluated the diagnostic performance of clinic and home blood pressure (BP) recordings in a cohort of 81 stable patients receiving peritoneal dialysis. Three different methodologies were used to record BP: triplicate automated clinic BP recordings following a 5-minute seated rest with the validated monitor HEM 705 CP (Omron Healthcare); a 1-week averaged home BP recorded with a validated automated monitor on awaking and at bedtime; and an ambulatory BP monitoring with the Mobil-O-Graph device (IEM, Germany). The area under the curve of receiver operating characteristic curves in detection of ambulatory daytime systolic BP (SBP) ≥ 135 mm Hg was similar for clinic (area under the curve: 0.859; 95% CI: 0.776–0.941) and home SBP (area under the curve: 0.895; 95% CI: 0.815–0.976). Upon Bland-Altman analysis, the investigators found that clinic SBP overestimated daytime ambulatory SBP by 5.02 mmHg with 95% limits of agreement ranging from −17.92 to 27.96 mmHg. Likewise, home SBP overestimated daytime ambulatory SBP by 4.23 mmHg—with wide 95% limits of agreement (−16.05 to 24.51 mmHg). According to findings, 1-week averaged home SBP is of at least comparable accuracy to standardized clinic SBP in diagnosing hypertension confirmed by ambulatory BP monitoring among patients on peritoneal dialysis.
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