{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:26:29Z","timestamp":1762917989994,"version":"3.41.2"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Obtaining 24\u2010hour ambulatory blood pressure (\n              <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n              ) is recommended for the detection of masked or white\u2010coat hypertension. Our objective was to determine whether the magnitude of the difference between ambulatory and clinic\n              <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n              s has prognostic implications.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We included 610 participants of the AASK (African American Study of Kidney Disease and Hypertension) Cohort Study who had clinic and ambulatory BPs performed in close proximity in time. We used Cox models to determine the association between the absolute systolic\n              <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n              (\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              ) difference between clinic and awake ambulatory BPs (primary predictor) and death and end\u2010stage renal disease. Of 610\n              <jats:styled-content style=\"fixed-case\">AASK<\/jats:styled-content>\n              Cohort Study participants, 200 (32.8%) died during a median follow\u2010up of 9.9\u00a0years; 178 (29.2%) developed end\u2010stage renal disease. There was a U\u2010shaped association between the clinic and ambulatory\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              difference with risk of death, but not end\u2010stage renal disease. A 5\u2013 to &lt;10\u2013mm\u00a0Hg higher clinic versus awake\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              (white\u2010coat effect) was associated with a trend toward higher (adjusted) mortality risk (adjusted hazard ratio, 1.84; 95%\n              <jats:styled-content style=\"fixed-case\">CI,<\/jats:styled-content>\n              0.94\u20133.56) compared with a 0\u2013 to &lt;5\u2013mm\u00a0Hg clinic\u2010awake\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              difference (reference group). A \u226510\u2013mm\u00a0Hg clinic\u2010awake\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              difference was associated with even higher mortality risk (adjusted hazard ratio, 2.31; 95% CI, 1.27\u20134.22). A \u2265\u22125\u2013mm\u00a0Hg clinic\u2010awake SBP difference was also associated with higher mortality (adjusted hazard ratio, 1.82; 95% CI, 1.05\u20133.15) compared with the reference group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A U\u2010shaped association exists between the magnitude of the difference between clinic and ambulatory\n              <jats:styled-content style=\"fixed-case\">SBP<\/jats:styled-content>\n              and mortality. Higher clinic versus ambulatory BPs (as in white\u2010coat effect) may be associated with higher risk of death in black patients with chronic kidney disease.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.011013","type":"journal-article","created":{"date-parts":[[2019,4,24]],"date-time":"2019-04-24T09:01:28Z","timestamp":1556096488000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Magnitude of the Difference Between Clinic and Ambulatory Blood Pressures and Risk of Adverse Outcomes in Patients With Chronic Kidney Disease"],"prefix":"10.1161","volume":"8","author":[{"given":"Elaine","family":"Ku","sequence":"first","affiliation":[{"name":"Division of Nephrology Department of Medicine University of California, San Francisco San Francisco CA"},{"name":"Division of Pediatric Nephrology Department of Pediatrics University of California, San Francisco San Francisco 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