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    The PRedicting Out-of-OFfice Blood Pressure (PROOF-BP) algorithm accurately predicted out-of-office blood pressure (BP) among adults with suspected high BP in the UK and Canada. We tested the accuracy of PROOF-BP in a diverse US population and evaluated a newly developed US-specific algorithm (PROOF-BP-US). Adults with ≥2 office BP readings and ≥10 awake BP readings on 24-hour ambulatory BP monitoring from four pooled US studies were included. We compared mean awake BP with predicted out-of-office BP using PROOF-BP and PROOF-BP-US. Our primary outcomes were hypertensive out-of-office systolic BP ≥130 mmHg and diastolic BP ≥80 mmHg. We included 3,058 adults, mean (SD) age was 52.0 (11.9) years, 38% were male, and 54% were Black. The area under the receiver-operator characteristic curve (95% CI) for hypertensive out-of-office systolic BP was 0.81 (0.79-0.82) and diastolic BP was 0.76 (0.74-0.78) for PROOF-BP. For PROOF-BP-US, the area under the receiver-operator characteristic curve for hypertensive out-of-office systolic BP was 0.82 (0.81-0.83) and for diastolic BP was 0.81 (0.79-0.83). The optimal predicted out-of-office BP ranges for out-of-office BP measurement referral were 120-134/75-84 mmHg for PROOF-BP and 125-134/75-84 mmHg for PROOF-BP-US. The 2017 American College of Cardiology/American Heart Association BP guideline (referral range 130-159/80-99 mmHg) would refer 93.1% of adults not taking antihypertensive medications with office BP ≥130/80 mmHg in the National Health and Nutrition Examination Survey for out-of-office BP measurement, compared with 53.1% using PROOF-BP and 46.8% using PROOF-BP-US. PROOF-BP and PROOF-BP-US accurately predicted out-of-office hypertension in a diverse sample of US adults. © The Author(s) 2022. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.


    Brandon K Bellows, Jingyu Xu, James P Sheppard, Joseph E Schwartz, Daichi Shimbo, Paul Muntner, Richard J McManus, Andrew E Moran, Kelsey B Bryant, Laura P Cohen, Adam P Bress, Jordan B King, James M Shikany, Beverly B Green, Yuichiro Yano, Donald Clark Iii, Yiyi Zhang. Predicting Out-of-Office Blood Pressure in a diverse US population. American journal of hypertension. 2022 Jan 18

    PMID: 35040867

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