MedicalResearch.com Interview with:
Dr. Wanpen Vongpatanasin, M.D.
Professor of Medicine
Program Director, Hypertension Fellowship Program
UT Southwestern Medical Center in Dalla
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The new US hypertension guideline places a greater emphasis on out-of-office blood pressure measurement, and maintains that a clinic BP of 130/80 mm Hg is equivalent to the same reading for home BP monitoring or daytime ambulatory BP monitoring. That is based, however, on data from non-US cohorts, primarily from Japanese cohorts and some European populations. None has been studied in the US population until now.
To find out, we analyzed large multi-ethnic studies of primarily young and middle-aged adults in Dallas, Texas, and Durham, N.C., that compared home blood pressure to clinic measurements, using the regression correlation (i.e. regression approach). To confirm the findings, we use another approach called “outcome approach” by determining risks of stroke, MI, and death associated with a clinic systolic blood pressure reading of 130 mmHg from the 3,132 participants in the Dallas study during an 11-year follow up.
Then, we determined the home blood pressure levels that carried the same heart disease risk and stroke risk as the clinic systolic 130 mm Hg reading.
We found that the level of home blood pressure of 130/80 mm Hg actually best correlates with blood pressure taken at the doctor’s office of 130/80 mmHg. This is true for whites, blacks and Hispanic patients in both treated and untreated population.
MedicalResearch.com: What should readers take away from your report?
Response: We should incorporate home readings in the diagnosis of hypertension and titration of blood pressure medications using the same cutoff of 130/80 mmHg regularly.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Increasing number of studies have shown that home blood pressure monitoring-guided treatment led to better blood pressure control than usual care but randomized clinical trials are needed to determine if home blood pressure monitoring-guides treatment will have impact on long term cardiovascular outcome.
Wanpen Vongpatanasin et al. Diagnostic Thresholds for Blood Pressure Measured at Home in the Context of the 2017 Hypertension Guideline Analysis From 2 US Cohorts. Hypertension, 2018 [link]
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