A bit weird. Waiting room AOBP was 8/7 mmHg higher than unattended AOBP, yet both had the same diagnostic performance. They invented a diagnostic cutoff for the waiting room AOBP (>140/85) based on ROC curves for daytime ABPM as reference. Feels a bit like cheating, no?

Measuring BP over a sweater sleeve? As accurate as the optimal method!
But using a non-validated device or leaving the arm unsupported? Expect higher readings than what’s actually seen on awake ABPM.

Underpowered pilot study, so hoping to confirm this in larger trials soon!

Thanks! I wonder myself what the « gold standard » should be for BP accuracy. I don’t think it’s auscultatory BP (even for validation studies 🔥😱). We chose awake ABPM as it’s the most objective. We just launched a larger study on non-validated devices accuracy, so we’ll know more soon!

But we know bedtime BP meds reduce nighttime BP better than morning BP meds. The problem is it doesn’t change outcomes. Nighttime BP is not a good surrogate marker of CVD!

Another great finding with the @cartagene.bsky.social cohort, and an incredible collaboration with Greg Hundemer and many other colleagues.

We show that the thresholds associated with the best discrimination for MACE risk were renin < 4.0 ng/L and ARR > 70 pmol/L per ng/L, both exhibiting a 2-fold higher risk of MACE.

You just made me cry…

It’s an excerpt from their book. Starts with « A few months ago »… it was in 2017. Sad that Stat published this outdated piece like it’s late-breaking news.

Always important to individualize. This situation is not common, and I’m not sure there is any data that shows we should treat (or not treat).

That’s what we just did in Canada! Target is SBP < 130 mmHg for all

www.cmaj.ca/content/197/...

A new era in hypertension management-Simplified and practical guidelines. Here is what you need to know: 130/80mmHg and ARB-diuretic combination.

No, the target is SBP < 130. Once it’s achieved, no specific intervention is recommended even if DBP remains « high ».

Next up, the comprehensive Hypertension Canada guidelines, where we will dive into specific subjects.
pubmed.ncbi.nlm.nih.gov/39461618/

Thanks to all involved, including committee members, patient-partners and external reviewers.

Lastly, we thank all who provided comments and questions in the public external review phase. This allowed the committee to greatly improve the Guideline. Answers are provided to frequently received questions here: www.cmaj.ca/content/cmaj...

We all know patients need to be involved in the care and to help, a Patient guideline has been developped:
www.cmaj.ca/content/cmaj...