Strategies for Classifying XXXX Based on Office, Home, and Ambulatory Blood Pressure Measurement.

@entity1 @entity101 @entity1011
UNASSIGNED: @entity101 guidelines propose home or ambulatory blood pressure monitoring as indispensable after office measurement. However, whether preference should be given to home or ambulatory monitoring remains undetermined. In 831 untreated outpatients (mean age, 50.6 years; 49.8% @entity1 ), we measured office (3 visits), home (7 days), and 24-h ambulatory blood pressures. We applied @entity101 guidelines for cross-classification of @entity1 into normotension or white-coat, masked, or sustained @entity101 . Based on office and home blood pressures, the prevalence of white-coat, masked, and sustained @entity101 was 61 (10.3%), 166 (20.0%), and 162 (19.5%), respectively. Using daytime (from 8 am to 6 pm) instead of home blood pressure confirmed the cross-classification in 575 @entity1 (69.2%), downgraded risk from masked @entity101 to normotension (n=24) or from sustained to white-coat @entity101 (n=9) in 33 (4.0%), but upgraded risk from normotension to masked @entity101 (n=179) or from white-coat to sustained @entity101 (n=44) in 223 (26.8%). Analyses based on 24-h ambulatory blood pressure were confirmatory. In adjusted analyses, both the urinary albumin-to- @entity1011 ratio (+20.6%; confidence interval, 4.4-39.3) and aortic pulse wave velocity (+0.30 m/s; confidence interval, 0.09-0.51) were higher in @entity1 who moved up to a higher risk category. Both indexes of target organ damage and central augmentation index were positively associated (P <=0.048) with the odds of being reclassified. In conclusion, for reliably diagnosing @entity101 and starting treatment, office measurement should be followed by ambulatory blood pressure monitoring. Using home instead of ambulatory monitoring misses the high-risk diagnoses of masked or sustained @entity101 in over 25% of @entity1 .
