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We tested the accuracy of PROOF-BP in a diverse US population and evaluated a newly developed US-specific algorithm (PROOF-BP-US).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Adults with \u22652 office BP readings and \u226510 awake BP readings on 24-hour ambulatory BP monitoring from 4 pooled US studies were included. We compared mean awake BP with predicted out-of-office BP using PROOF-BP and PROOF-BP-US. Our primary outcomes were hypertensive out-of-office systolic BP (SBP) \u2265130 mm Hg and diastolic BP (DBP) \u226580 mm Hg.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We included 3,058 adults, mean (SD) age was 52.0 (11.9) years, 38% were male, and 54% were Black. The area under the receiver-operator characteristic (AUROC) curve (95% confidence interval) for hypertensive out-of-office SBP was 0.81 (0.79\u20130.82) and DBP was 0.76 (0.74\u20130.78) for PROOF-BP. For PROOF-BP-US, the AUROC curve for hypertensive out-of-office SBP was 0.82 (0.81\u20130.83) and for DBP was 0.81 (0.79\u20130.83). The optimal predicted out-of-office BP ranges for out-of-office BP measurement referral were 120\u2013134\/75\u201384 mm Hg for PROOF-BP and 125\u2013134\/75\u201384 mm Hg for PROOF-BP-US. The 2017 American College of Cardiology\/American Heart Association BP guideline (referral range 130\u2013159\/80\u201399 mm Hg) would refer 93.1% of adults not taking antihypertensive medications with office BP \u2265130\/80 mm Hg in the National Health and Nutrition Examination Survey for out-of-office BP measurement, compared with 53.1% using PROOF-BP and 46.8% using PROOF-BP-US.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>PROOF-BP and PROOF-BP-US accurately predicted out-of-office hypertension in a diverse sample of US adults.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajh\/hpac005","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T20:10:50Z","timestamp":1642191050000},"page":"533-542","source":"Crossref","is-referenced-by-count":9,"title":["Predicting Out-of-Office Blood Pressure in a Diverse US 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