Predicting Out-of-Office Blood Pressure in a Diverse US Population.

American journal of hypertension 2022 Jun 16

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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 United Kingdom 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 4 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 (SBP) ≥130 mm Hg and diastolic BP (DBP) ≥80 mm Hg. 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 (AUROC) curve (95% confidence interval) for hypertensive out-of-office SBP was 0.81 (0.79-0.82) and DBP was 0.76 (0.74-0.78) for PROOF-BP. For PROOF-BP-US, the AUROC curve for hypertensive out-of-office SBP was 0.82 (0.81-0.83) and for DBP 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 mm Hg for PROOF-BP and 125-134/75-84 mm Hg for PROOF-BP-US. The 2017 American College of Cardiology/American Heart Association BP guideline (referral range 130-159/80-99 mm Hg) would refer 93.1% of adults not taking antihypertensive medications with office BP ≥130/80 mm Hg 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.

Citation

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, Yiyi Zhang. Predicting Out-of-Office Blood Pressure in a Diverse US Population. American journal of hypertension. 2022 Jun 16;35(6):533-542