title: Diagnostic thresholds for ambulatory blood pressure moving lower: a review based on a meta-analysis-clinical implications.
abstract: Upper limits of normal ambulatory blood pressure (ABP) have been a matter of debate in recent years. Current diagnostic thresholds for ABP rely mainly on statistical parameters derived from reference populations. Recent findings from the International Database of Ambulatory Blood Pressure in Relation to Cardiovascular Outcome (IDACO) provide outcome-driven thresholds for ABP. Rounded systolic/diastolic thresholds for optimal ABP were found to be 115/75 mm Hg for 24 hours, 120/80 mm Hg for daytime, and 100/65 mm Hg for nighttime. The corresponding rounded thresholds for normal ABP were 125/75 mm Hg, 130/85 mm Hg, and 110/70 mm Hg, respectively, and those for ambulatory hypertension were 130/80 mm Hg, 140/85 mm Hg, and 120/70 mm Hg. However, in clinical practice, any diagnostic threshold for blood pressure needs to be assessed in the context of the patient's overall risk profile. The IDACO database is therefore being updated with additional population cohorts to enable the construction of multifactorial risk score charts, which also include ABP.
authors.affiliation: Research Center for Prevention and Health and Department of Clinical Physiology, Hvidovre University Hospital, Copenhagen, Denmark.
authors.forename: Tine W
authors.initials: TW
authors.lastname: Hansen
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Lutgarde
authors.initials: L
authors.lastname: Thijs
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: José
authors.initials: J
authors.lastname: Boggia
authors.forename: Kristina
authors.initials: K
authors.lastname: Björklund-Bodegârd
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Jørgen
authors.initials: J
authors.lastname: Jeppesen
authors.forename: Hans
authors.initials: H
authors.lastname: Ibsen
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D015201:Meta-Analysis as Topic; D015203:Reproducibility of Results