PRedicting Out-of-OFfice Blood Pressure in the clinic (PROOF-BP)

High blood pressure (hypertension) is an important risk factor for cardiovascular disease, a significant cause of morbidity and mortality worldwide. In the majority of countries, the diagnosis and management of hypertension depends on accurate measurement of blood pressure (BP) in order to target antihypertensive treatment appropriately and avoid unnecessary healthcare costs. Traditionally, blood pressure measurement takes place in the Primary Care physician’s office but these clinic blood pressure measurements are often different from out-of-office blood pressure and can lead to incorrect classification and hence inappropriate management.

Patients with higher clinic blood pressure than the corresponding out-of-office pressure can be classed as ‘white coat hypertensives’ and are at risk of over-treatment. Conversely, patients with higher out-of-office blood pressures than would be expected for the corresponding clinic blood pressure are classified as ‘masked hypertensives’ and are often underdiagnosed and potentially under-treated.

The PRedicting Out-of-OFfice Blood Pressure in the clinic study used characteristics about a patient and their clinic blood pressure level to derive a prediction model for the home-clinic blood pressure difference. The resulting algorithm could be used for targeted triaging of ambulatory or home blood pressure monitoring in routine clinical practice. Identification of such patients could help to better target antihypertensive treatment at those people with most to gain.

This study has been published in the journal Hypertension.