The impact of changing home blood pressure monitoring cutoff from 135/85 to 130/80 mmHg on hypertension phenotypes

Audes D M Feitosa; Marco A Mota-Gomes; Weimar S Barroso; Roberto D Miranda; Eduardo C D Barbosa; Andréa A Brandão; Fernando Nobre; Decio Mion Jr; Celso Amodeo; José L Lima-Filho; Andrei C Sposito; Wilson Nadruz Jr

doi:10.1111/jch.14261

The impact of changing home blood pressure monitoring cutoff from 135/85 to 130/80 mmHg on hypertension phenotypes

J Clin Hypertens (Greenwich). 2021 Jul;23(7):1447-1451. doi: 10.1111/jch.14261. Epub 2021 May 6.

Authors

Audes D M Feitosa^{1

2

3}, Marco A Mota-Gomes⁴, Weimar S Barroso⁵, Roberto D Miranda⁶, Eduardo C D Barbosa⁷, Andréa A Brandão⁸, Fernando Nobre⁹, Decio Mion Jr¹⁰, Celso Amodeo¹¹, José L Lima-Filho¹, Andrei C Sposito¹², Wilson Nadruz Jr^{1

12}

Affiliations

¹ Laboratory of Immunopathology Keizo Asami, Federal University of Pernambuco, Recife, Brazil.
² Pronto Socorro Cardiológico de Pernambuco (PROCAPE), University of Pernambuco, Recife, Brazil.
³ UNICAP Clinical Research Institute, Recife, Brazil.
⁴ CESMAC University Center, Maceió, Brazil.
⁵ Hypertension League, Federal University of Goiás, Goiânia, Brazil.
⁶ Cardiovascular Section, Geriatrics Division, Federal University of São Paulo, São Paulo, Brazil.
⁷ Department of Hypertension and Cardiometabolism, São Francisco Hospital - Santa Casa de Porto Alegre, Porto Alegre, Brazil.
⁸ School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁹ University of São Paulo, Ribeirão Preto, Brazil.
¹⁰ Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
¹¹ Federal University of São Paulo, São Paulo, Brazil.
¹² Department of Internal Medicine, School of Medical Sciences, State University of Campinas, Campinas, Brazil.

Abstract

This study investigated the impact of changing abnormal home blood pressure monitoring (HBPM) cutoff from 135/85 to 130/80 mmHg on the prevalence of hypertension phenotypes, considering an abnormal office blood pressure cutoff of 140/90 mmHg. We evaluated 57 768 individuals (26 876 untreated and 30 892 treated with antihypertensive medications) from 719 Brazilian centers who performed HBPM. Changing the HBPM cutoff was associated with increases in masked (from 10% to 22%) and sustained (from 27% to 35%) hypertension, and decreases in white-coat hypertension (from 16% to 7%) and normotension (from 47% to 36%) among untreated participants, and increases in masked (from 11% to 22%) and sustained (from 29% to 36%) uncontrolled hypertension, and decreases in white-coat uncontrolled hypertension (from 15% to 8%) and controlled hypertension (from 45% to 34%) among treated participants. In conclusion, adoption of an abnormal HBPM cutoff of 130/80 mmHg markedly increased the prevalence of out-of-office hypertension and uncontrolled hypertension phenotypes.

Keywords: home blood pressure; masked hypertension; office blood pressure; reference values; white-coat hypertension.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Pressure
Blood Pressure Monitoring, Ambulatory
Humans
Hypertension* / diagnosis
Hypertension* / drug therapy
Hypertension* / epidemiology
Masked Hypertension* / diagnosis
Masked Hypertension* / epidemiology
Phenotype
White Coat Hypertension* / diagnosis
White Coat Hypertension* / epidemiology