Discordance between ambulatory versus clinic blood pressure according to global cardiovascular risk group.
OBJECTIVE
The detection of white coat hypertension (WCH), treated normalized hypertension, and masked hypertension (MH) is important to improve the effectiveness of hypertension management. However, whether global cardiovascular risk (GCR) profile has any effect on the discordance between ambulatory blood pressure (ABP) and clinic blood pressure (CBP) is unknown.


METHODS
Data from 1,916 subjects, taken from the Korean Multicenter Registry for ABP monitoring, were grouped according to diagnostic and therapeutic thresholds for CBP and ABP (140/90 and 135/85 mmHg, respectively). GCR was assessed using European Society of Hypertension 2007 guidelines.


RESULTS
The mean subject age was 54.1 ± 14.9 years, and 48.9% of patients were female. The discordancy rate between ABP and CBP in the untreated and treated patients was 32.5% and 26.5%, respectively (p = 0.02). The prevalence of WCH or treated normalized hypertension and MH was 14.4% and 16.0%, respectively. Discordance between ABP and CBP was lower in the very high added-risk group compared to the moderate added-risk group (odds ratio [OR], 0.649; 95% confidence interval [CI], 0.487 to 0.863; p = 0.003). The prevalence of WCH or treated normalized hypertension was also lower in the very high added-risk group (OR, 0.451; 95% CI, 0.311 to 0.655).


CONCLUSIONS
Discordance between ABP and CBP was observed more frequently in untreated subjects than in treated subjects, and less frequently in the very high added-risk group, which was due mainly to the lower prevalence of WCH or treated normalized hypertension.
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Jinho
J
Shin
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Sung Ha
SH
Park
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Ju Han
JH
Kim
Department of Internal Medicine, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea.
Sang Hyun
SH
Ihm
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kwang-il
KI
Kim
Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
Woo Shik
WS
Kim
Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Wook Bum
WB
Pyun
Department of Preventive Medicine, Dong-A University College of Medicine, Busan, Korea.
Yu-Mi
YM
Kim
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Sung-il
SI
Choi
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Soon Kil
SK
Kim
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D009819:Office Visits; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D059466:White Coat Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology
Blood pressure monitoring, ambulatory; Hypertension; Masked hypertension; Risk assessment; White coat hypertension