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Comparison of blood pressure control rate by clinic blood pressure versus ambulatory blood pressure in Kor-ABP study
한양대학교 의과대학 내과¹ , 전남대학교 의과대학 내과², 연세대학교 의과대학 내과³, 가톨릭대학교 의과대학 내과⁴, 서울대학교 의과대학 내과 5, 경희대학교 의과대학 내과 6, 이화여자대학교 의과대학 내과7
신진호¹ , 김주한², 박성하³, 임상현⁴,김광일 5, 김우식6, 편욱범7, 김순길¹
Background : Recently, target blood pressures(BP) by ambulatory blood pressure(ABP) or home blood pressure after antihypertensive treatment were suggested in a clinical guideline. Considering the better accuracy of the ABP compared to clinic blood pressure (CBP), there may be some difference between those two references. Methods : Each 653(34.1%) subjects among 1916 subjects in KOR-ABP study were categorized by the target BPs by CBP and ABP. The absolute difference between CBP and ABP was analyzed. And the difference in the proportions of controlled subjects by two references was also analyzed. The reference values for CBP and ABP were 140/90 mmHg and 135/85 mmHg in daytime mean BP, respectively. CBP was measure by A&D UA-767® and ABPM was measured by clinician’s discretion. Results: Age in the treated group was 58.0 ± 13.2 mmHg. 50.7% was female subjects. Daytime ABP was 136.3 ± 15.9 / 84.3 ± 11.4 mmHg and CBP was 144.6 ± 21.7 / 88.5 ± 15.2 mmHg ( p < 0.00001). The proportions of controlled systolic BPs by CBP and ABP were 43.1% and 46.5%( p = 0.13 ). The proportions of controlled diastolic BPs by CBP and ABP were 36.9 % and 37.8 % ( p = 1.0 ). The proportions of the overall controlled BP by CBP and ABP were 36.9 % 37.8 % ( p = 0.7 ) Kappa values were 0.368, 0.385, and 0.437, respectively suggesting fair agreement. Cronbach alpha values were 0.538, 0.556, and 0.608, respectively. Concordance ratio was 68.6 %, 69.4%, and 73.6%, respectively. Conclusion: Clinical decision regarding blood pressure control status can be different in around 30% of cases according to blood pressure measurement method, i.e., CBP versus ABP even though fair agreement is well documented.


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