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 blood pressure diagnostic index in the pooled validation cohort of the Improving the Detection of Hypertension Study and Jackson Heart Study participants (n=675).
| Prehypertensiona | Upper range of prehypertensionb |
Elevated clinic blood pressure diagnostic index using different derived cut-pointsc |
||||||
|---|---|---|---|---|---|---|---|---|
| ≥ 190 mmHg |
≥ 201 mmHg |
≥ 207 mmHg |
≥ 212 mmHg |
≥ 214 mmHg |
≥ 217 mmHg |
|||
| N=320 | N=130 | N=572 | N=472 | N=415 | N=351 | N=330 | N=291 | |
| Masked daytime hypertension | ||||||||
| Sensitivity | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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) |
PPV: positive predictive value.
NPV: negative predictive value.
Prehypertension: Among adults with non-elevated clinic blood pressure (i.e., systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg), clinic systolic blood pressure ≥ 120 mmHg and < 140 mmHg or clinic diastolic blood pressure ≥ 80 mmHg and < 90 mmHg.
Upper range of prehypertension: Among adults with non-elevated clinic blood pressure (i.e., systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg), clinic systolic blood pressure ≥ 130 mmHg and < 140 mmHg or clinic diastolic blood pressure ≥ 85 mmHg and < 90 mmHg.
Clinic blood pressure diagnostic index cut-points associated with 99% (190 mmHg), 95% (201 mmHg), 90% (207 mmHg), 85% (212 mmHg), 80% (214 mmHg), and 75% (217 mmHg) sensitivity.
Masked daytime and/or nocturnal hypertension: Clinic systolic/diastolic blood pressure < 140/90 mmHg and daytime hypertension (i.e., mean daytime systolic blood pressure ≥ 135 mmHg or mean diastolic blood pressure ≥ 85 mmHg) and/or nocturnal hypertension (i.e., mean nighttime systolic blood pressure ≥ 120 mmHg or mean diastolic blood pressure ≥ 70 mmHg).