title: Evaluation of Criteria to Detect Masked Hypertension.
abstract: The prevalence of masked hypertension (out-of-clinic daytime systolic/diastolic blood pressure (SBP/DBP) ≥135/85 mm Hg on ambulatory blood pressure monitoring [ABPM] among adults with clinic SBP/DBP <140/90 mm Hg) is high. It is unclear who should be screened for masked hypertension. The authors 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 mm Hg and ≥217 mm Hg and prehypertension status was 98.5%, 71.5%, and 82.5%, respectively. Using National Health and Nutrition Examination Survey data (n=11,778), the authors 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.
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL.
authors.forename: John N
authors.initials: JN
authors.lastname: Booth
authors.affiliation: University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Columbia University Medical Center, New York, NY.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Diaz
authors.affiliation: Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
authors.affiliation: Columbia University Medical Center, New York, NY.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Bello
authors.affiliation: Columbia University Medical Center, New York, NY.|Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
authors.affiliation: Columbia University Medical Center, New York, NY. ds2231@columbia.edu.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult