Open AccessIs It Possible to Shorten Ambulatory Blood Pressure Monitoring?
Author(s) -
Wolak Talya,
Wilk Lior,
Paran Esther,
Wolak Arik,
Gutmacher Bella,
Shleyfer Elena,
Friger Michael
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12123
Subject(s) - medicine , ambulatory blood pressure , receiver operating characteristic , blood pressure , youden's j statistic , area under the curve , ambulatory , diastole , cardiology , area under curve , pharmacokinetics
The aim of this investigation was to find a time segment in which average blood pressure ( BP ) has the best correlation with 24‐hour BP control. A total of 240 patients with full ambulatory BP monitoring ( ABPM ) were included; 120 had controlled BP (systolic BP [SBP] ≤135 mm H g and diastolic BP [DBP] ≤85 mm H g) and 120 had uncontrolled BP (S BP >135 mm H g and/or D BP >85 mm H g). Each ABPM was divided into 6‐ and 8‐hour segments. Evaluation for correlation between mean BP for each time segment and 24‐hour BP control was performed using receiver operating characteristic curve analysis and Youden's index for threshold with the best sensitivity and specificity. The mean BP in the following segments showed the highest area under the curve ( AUC ) compared with average controlled 24‐hour BP: SBP 2 am to 8 am ( AUC, 0.918; threshold value of 133.5 mm H g, sensitivity−0.752 and specificity−0.904); SBP 2 pm to 10 pm ( AUC, 0.911; threshold value of 138.5 mm H g, sensitivity−0.803 and specificity−0.878); and SBP 6 am to 2 pm ( AUC, 0.903; threshold value of 140.5 mm H g, sensitivity−0.778 and specificity−0.888). The time segment 2 pm to 10 pm was shown to have good correlation with 24‐hour BP control ( AUC >0.9; sensitivity and specificity >80%). This time segment might replace full ABPM as a screening measure for BP control or as abbreviated ABPM for patients with difficulty in performing full ABPM .