Diagnostic Thresholds for Ambulatory Blood Pressure Moving Lower: A Review Based on a Meta-Analysis—Clinical Implications

Authors: Hansen, Tine W.; Kikuya, Masahiro¹; Thijs, Lutgarde²; Li, Yan³; Boggia, José⁴; Björklund-Bodegârd, Kristina⁵; Torp-Pedersen, Christian⁶; Jeppesen, Jørgen⁶; Ibsen, Hans⁶; Staessen, Jan A.²

Source: The Journal of Clinical Hypertension, Volume 10, Number 5, May 2008 , pp. 377-381(5)

Publisher: Wiley-Blackwell

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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.

J Clin Hypertens (Greenwich). 2008;10:377-381.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1751-7176.2008.07681.x

Affiliations: 1: Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan; 2: the Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium; 3: the Center for Epidemiological Studies and Clinical Trials, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; 4: Departamento de Fisiopatología, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay; 5: the Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Sweden 6: the Copenhagen University Hospital, Copenhagen, Denmark;

Publication date: 2008-05-01

Diagnostic Thresholds for Ambulatory Blood Pressure Moving Lower: A Review Based on a Meta-Analysis—Clinical Implications

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