The following is a summary of “Agreement Between Guideline Thresholds Using an “All‐in‐One” Device to Measure Office, Home, and Ambulatory Blood Pressures,” published in the December 2023 issue of Cardiology by Kario et al.

Establishing blood pressure (BP) thresholds for diagnosing and managing hypertension across different settings, office, home, and ambulatory readings, varies among guideline recommendations. This study aimed to determine corresponding BP thresholds for office, home, and ambulatory measurements using baseline data from the HI‐JAMP study, employing a validated “all‐in‐one” BP monitoring device.

Analyzing data from 2,322 treated hypertensive patients, this study assessed office BP measurement followed by 24‐hour ambulatory BP monitoring and 5‐day home BP monitoring. Deming regression determined corresponding BP thresholds for office, home, and ambulatory measurements. Values equivalent to office systolic BP (SBP) of 120 and 140 mm Hg were found across 24‐hour ambulatory SBP, daytime ambulatory SBP, nighttime ambulatory SBP, and morning‐evening average home SBP. Values corresponding to office systolic BP (SBP) levels of 120 and 140 mm Hg were observed as follows: 24‐hour ambulatory SBP registered at 115.9 and 127.7 mm Hg; daytime ambulatory SBP at 120.8 and 134.0 mm Hg; nighttime ambulatory SBP at 104.9 and 117.9 mm Hg; and morning‐evening average home SBP at 122.0 and 134.2 mm Hg. Deming regression analysis indicated a nearly identical relationship between morning‐evening average home SBP and daytime ambulatory SBP (home SBP=0.99×daytime ambulatory SBP+0.27 mm Hg; r=0.627). Morning‐evening average home SBP values of 120 and 135 mm Hg aligned with daytime ambulatory SBP values of 119.1 and 133.9 mm Hg, respectively. A home SBP threshold of 130 mm Hg corresponded to 24‐hour and nighttime ambulatory SBP values of 123.5 and 113.6 mm Hg, while a home SBP threshold of 135 mm Hg corresponded to 24‐hour and nighttime ambulatory SBP values of 128.0 and 119.2 mm Hg.

The study observed a similarity between home and ambulatory BP thresholds, reinforcing existing guideline recommendations. The close match between daytime ambulatory SBP and morning‐evening average home SBP levels underscores the clinical significance of these findings, emphasizing the potential utility of home BP monitoring as an adjunct to ambulatory monitoring in managing hypertension.

Source: ahajournals.org/doi/10.1161/JAHA.123.030992