Evidence map›Paper›PMID 26399981›Full record

SynthesisAmerican journal of hypertension2016

Predictors of the Home-Clinic Blood Pressure Difference: A Systematic Review and Meta-Analysis.

James P Sheppard, Ben Fletcher, Paramjit Gill, Una Martin, Nia Roberts, Richard J McManus

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in American journal of hypertension, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Relations between white coat effect of blood pressure and arterial stiffness.Journal of clinical hypertension (Greenwich, Conn.) · 2022
    Article
  11. Article
  12. White Coat Uncontrolled Hypertension in Teleconsultation: A New and Frequent Entity.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2022
    Article
  13. Observational
  14. Article
  15. Masked Hypertension: Fragile in More Ways Than One.Hypertension (Dallas, Tex. : 1979) · 2020
    Article
  16. Article
  17. Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

James P SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK; james.sheppard@phc.ox.ac.uk.
Ben FletcherNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK;
Paramjit GillPrimary Care Clinical Sciences, University of Birmingham, Birmingham, UK;
Una MartinSchool of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK;
Nia RobertsBodleian Healthcare Libraries, Knowledge Centre, University of Oxford, Oxford, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK;
University of Oxford · GBUniversity of Birmingham · GB

Funding

Department of Health CDF/01/017Department of Health NIHR-RP-02-12-015Department of Health RP-PG-1209-10051Medical Research Council MR/K022032/1
6 · The paper itself

Abstract

backgroundPatients may have lower (white coat hypertension) or higher (masked hypertension) blood pressure (BP) at home compared to the clinic, resulting in misdiagnosis and suboptimal management of hypertension. This study aimed to systematically review the literature and establish the most important predictors of the home-clinic BP difference.

methodsA systematic review was conducted using a MEDLINE search strategy, adapted for use in 6 literature databases. Studies examining factors that predict the home-clinic BP difference were included in the review. Odds ratios (ORs) describing the association between patient characteristics and white coat or masked hypertension were extracted and entered into a random-effects meta-analysis.

resultsThe search strategy identified 3,743 articles of which 70 were eligible for this review. Studies examined a total of 86,167 patients (47% female) and reported a total of 60 significant predictors of the home-clinic BP difference. Masked hypertension was associated with male sex (OR 1.47, 95% confidence interval (CI) 1.18-1.75), body mass index (BMI, per kg/m(2) increase, OR 1.07, 95% CI 1.01-1.14), current smoking status (OR 1.32, 95% CI 1.13-1.50), and systolic clinic BP (per mm Hg increase, OR 1.10, 95% CI 1.01-1.19). Female sex was the only significant predictor of white coat hypertension (OR 3.38, 95% CI 1.64-6.96).

conclusionsThere are a number of common patient characteristics that predict the home-clinic BP difference, in particular for people with masked hypertension. There is scope to incorporate such predictors into a clinical prediction tool which could be used to identify those patients displaying a significant masked or white coat effect in routine clinical practice.

Indexed as

Blood PressureBlood Pressure Monitoring, AmbulatoryOffice VisitsAdultAgedFemaleHumansMaleMasked HypertensionMiddle AgedOdds RatioPredictive Value of TestsReproducibility of ResultsRisk FactorsWhite Coat Hypertensionambulatory blood pressure monitoringhypertensionmasked hypertensionprimary carewhite coat hypertension.

Identifiers

PMID26399981
PMCPMC4829055
OpenAlexW2330794512

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.