Table 2.
Test Characteristics for Detecting Masked Daytime Hypertension (n=137; top panel) and Masked Daytime and/or Nocturnal Hypertension (n=254; bottom panel) Associated With Prehypertension, Upper Range of Prehypertension, and an Elevated Clinic BP Diagnostic Index in the Pooled Validation Cohort of Participants in the Improving the Detection of Hypertension Study and Jackson Heart Study (n=675)
| Prehypertensiona | Upper Range of Prehypertensionb | Elevated Clinic BP Diagnostic Index Using Different Derived Cut Pointsc | ||||||
|---|---|---|---|---|---|---|---|---|
| ≥190 mm Hg | ≥201 mm Hg | ≥207 mm Hg | ≥212 mm Hg | ≥214 mm Hg | ≥217 mm Hg | |||
| n=320 | n=130 | n=572 | n=472 | n=415 | n=351 | n=330 | n=291 | |
| Masked daytime hypertension | ||||||||
| Sensitivity, % (No.) | 82.5 (113/137) | 42.3 (58/137) | 98.5 (135/137) | 93.4 (128/137) | 89.8 (123/137) | 81.0 (111/137) | 78.8 (108/137) | 71.5 (98/137) |
| Specificity, % (No.) | 61.5 (331/538) | 86.6 (466/538) | 18.8 (101/538) | 36.1 (194/538) | 45.7 (246/538) | 55.4 (298/538) | 58.7 (316/538) | 64.1 (345/538) |
| PPV, % (No.) | 35.3 (113/320) | 44.6 (58/130) | 23.6 (135/572) | 27.1 (128/472) | 29.6 (123/415) | 31.6 (111/351) | 32.7 (108/330) | 33.7 (98/291) |
| NPV, % (No.) | 93.2 (331/355) | 85.5 (466/545) | 98.1 (101/103) | 95.6 (194/203) | 94.6 (246/260) | 92.0 (298/324) | 91.6 (316/345) | 89.8 (345/384) |
| Masked daytime and/or nocturnal hypertensiond | ||||||||
| Sensitivity, % (No.) | 71.3 (181/254) | 34.3 (87/254) | 97.2 (247/254) | 90.6 (230/254) | 83.9 (213/254) | 73.2 (186/254) | 71.3 (181/254) | 64.6 (164/254) |
| Specificity, % (No.) | 67.0 (282/421) | 89.8 (378/421) | 22.8 (96/421) | 42.5 (179/421) | 52.0 (219/421) | 60.8 (256/421) | 64.6 (272/421) | 69.8 (294/421) |
| PPV, % (No.) | 56.6 (181/320) | 66.9 (87/130) | 43.2 (247/572) | 48.7 (230/472) | 51.3 (213/415) | 53.0 (186/351) | 54.8 (181/330) | 56.4 (164/291) |
| NPV, % (No.) | 79.4 (282/355) | 69.4 (378/545) | 93.2 (96/103) | 88.2 (179/203) | 84.2 (219/260) | 79.0 (256/324) | 78.8 (272/345) | 76.6 (294/384) |
Abbreviations: BP, blood pressure; NPV: negative predictive value; PPV, positive predictive value.
aPrehypertension: among adults with nonelevated clinic blood pressure (BP) (ie, systolic BP <140 mm Hg and diastolic BP <90 mm Hg), clinic systolic BP ≥120 mm Hg and <140 mm Hg, or clinic diastolic BP ≥80 mm Hg and <90 mm Hg. bUpper range of prehypertension: among adults with nonelevated clinic BP (ie, systolic BP <140 mm Hg and diastolic BP <90 mm Hg), clinic systolic BP ≥130 mm Hg and <140 mm Hg, or clinic diastolic BP ≥85 mm Hg and <90 mm Hg. cClinic BP diagnostic index cut points associated with 99% (190 mm Hg), 95% (201 mm Hg), 90% (207 mm Hg), 85% (212 mm Hg), 80% (214 mm Hg), and 75% (217 mm Hg) sensitivity. dMasked daytime and/or nocturnal hypertension: clinic systolic/diastolic BP <140/90 mm Hg and daytime hypertension (ie, mean daytime systolic BP ≥135 mm Hg or mean diastolic BP ≥85 mm Hg) and/or nocturnal hypertension (ie, mean nighttime systolic BP ≥120 mm Hg or mean diastolic BP ≥70 mm Hg).