Office blood pressure measurement versus ambulatory blood pressure monitoring for detecting undiagnosed hypertension in an apparently healthy Mexican adult cohort: complementary central hemodynamic and arterial stiffness assessment
6 affiliations
- 1Center for Policy, Population and Health Research (CIPPS), National Autonomous University of Mexico
- 2Department of Cardiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
- 3Faculty of Medicine, National Autonomous University of Mexico
- 4Faculty of Medicine, Autonomous University of Tamaulipas
- 5Faculty of Superior Studies Zaragoza, National Autonomous University of Mexico
- 6Department of Public Health, Faculty of Medicine, National Autonomous University of Mexico
Abstract
Background: Office blood pressure measurement is widely used for hypertension screening, but its diagnostic performance is limited by blood pressure variability and white-coat or masked hypertension. Ambulatory blood pressure monitoring (ABPM) provides a more comprehensive assessment, including nighttime blood pressure and circadian patterns. Central aortic pressure (CAP) and arterial stiffness parameters may provide complementary information on vascular hemodynamics.
Objectives: To evaluate the diagnostic performance of office blood pressure measurement for detecting previously undiagnosed hypertension using composite ABPM as the reference standard, and to describe ABPM-derived phenotypes, circadian blood pressure patterns, and central hemodynamic and arterial stiffness parameters.
Methods: This cross-sectional analytical study included 151 adults without a previous diagnosis of hypertension. Participants underwent office blood pressure measurement, 24-hour ABPM, and noninvasive assessment of CAP and arterial stiffness. Composite ABPM hypertension was defined as 24-hour blood pressure >130/80 mmHg, daytime blood pressure >135/85 mmHg, or nighttime blood pressure >120/70 mmHg.
Results: Office blood pressure measurement identified hypertension in 15 participants (9.9%), whereas composite ABPM identified hypertension in 29 (19.2%). Masked hypertension was observed in 18 participants (11.9%) and white-coat hypertension in 4 (2.6%). Nighttime hypertension was present in 29 participants (19.2%). Office blood pressure measurement showed low sensitivity (37.9%) and high specificity (96.7%) for composite ABPM hypertension. The dipper phenotype was observed in 80 participants (53.0%), non-dipper in 59 (39.1%), riser in 6 (4.0%), and extreme dipper in 6 (4.0%). Mean CAP was 120.7 ± 20.4 mmHg, and elevated pulse wave velocity >10 m/s was observed in 9 participants (6.0%).
Conclusion: Office blood pressure measurement underestimated the prevalence of hypertension compared with composite ABPM. ABPM identified masked, nighttime, and circadian blood pressure abnormalities that were not detected by office measurements. CAP, AIx, and PWV provided complementary exploratory information on central hemodynamic and arterial stiffness markers.
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BibTeX
@article{ramirezgonzalez2026office,
title = {{Office blood pressure measurement versus ambulatory blood pressure monitoring for detecting undiagnosed hypertension in an apparently healthy Mexican adult cohort: complementary central hemodynamic and arterial stiffness assessment}},
author = {Julia B. Ramírez-González and Shubhang Sharma-Sharma and Ricardo A. Osorio-Juárez and Jaime Galindo-Uribe and Gerardo Payró-Ramírez and Diana J. Reyes-Antonio and Berenice Hernández-Franco and Itzel Martínez-Nevárez and Ricardo Arturo Méndez-Cobos and Juana K. Rodríguez-García and Reyna L. Pacheco-Domínguez},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = nov,
doi = {10.3389/fcvm.2026.1977185},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1977185/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Office blood pressure measurement versus ambulatory blood pressure monitoring for detecting undiagnosed hypertension in an apparently healthy Mexican adult cohort: complementary central hemodynamic and arterial stiffness assessment
AU - Julia B. Ramírez-González
AU - Shubhang Sharma-Sharma
AU - Ricardo A. Osorio-Juárez
AU - Jaime Galindo-Uribe
AU - Gerardo Payró-Ramírez
AU - Diana J. Reyes-Antonio
AU - Berenice Hernández-Franco
AU - Itzel Martínez-Nevárez
AU - Ricardo Arturo Méndez-Cobos
AU - Juana K. Rodríguez-García
AU - Reyna L. Pacheco-Domínguez
PY - 2026
DA - 2026/11/05
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1977185
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1977185/full
AB - Background: Office blood pressure measurement is widely used for hypertension screening, but its diagnostic performance is limited by blood pressure variability and white-coat or masked hypertension. Ambulatory blood pressure monitoring (ABPM) provides a more comprehensive assessment, including nighttime blood pressure and circadian patterns. Central aortic pressure (CAP) and arterial stiffness parameters may provide complementary information on vascular hemodynamics. Objectives: To evaluate the diagnostic performance of office blood pressure measurement for detecting previously undiagnosed hypertension using composite ABPM as the reference standard, and to describe ABPM-derived phenotypes, circadian blood pressure patterns, and central hemodynamic and arterial stiffness parameters. Methods: This cross-sectional analytical study included 151 adults without a previous diagnosis of hypertension. Participants underwent office blood pressure measurement, 24-hour ABPM, and noninvasive assessment of CAP and arterial stiffness. Composite ABPM hypertension was defined as 24-hour blood pressure >130/80 mmHg, daytime blood pressure >135/85 mmHg, or nighttime blood pressure >120/70 mmHg. Results: Office blood pressure measurement identified hypertension in 15 participants (9.9%), whereas composite ABPM identified hypertension in 29 (19.2%). Masked hypertension was observed in 18 participants (11.9%) and white-coat hypertension in 4 (2.6%). Nighttime hypertension was present in 29 participants (19.2%). Office blood pressure measurement showed low sensitivity (37.9%) and high specificity (96.7%) for composite ABPM hypertension. The dipper phenotype was observed in 80 participants (53.0%), non-dipper in 59 (39.1%), riser in 6 (4.0%), and extreme dipper in 6 (4.0%). Mean CAP was 120.7 ± 20.4 mmHg, and elevated pulse wave velocity >10 m/s was observed in 9 participants (6.0%). Conclusion: Office blood pressure measurement underestimated the prevalence of hypertension compared with composite ABPM. ABPM identified masked, nighttime, and circadian blood pressure abnormalities that were not detected by office measurements. CAP, AIx, and PWV provided complementary exploratory information on central hemodynamic and arterial stiffness markers.
SN - 2297-055X
ER -