White Coat and Masked Hypertension in Chronic Kidney Disease: Importance of the Difference Between Office and Out-of-Office Blood Pressure Measurements

Background Obtaining 24‐hour ambulatory blood pressure (BP) is recommended for the detection of masked or white‐coat hypertension. Our objective was to determine whether the magnitude of the difference between ambulatory and clinic BPs has prognostic implications. Methods and Results 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 BP (SBP) difference between clinic and awake ambulatory BPs (primary predictor) and death and end‐stage renal disease. Of 610 AASK Cohort Study participants, 200 (32.8%) died during a median follow‐up of 9.9 years; 178 (29.2%) developed end‐stage renal disease. There was a U‐shaped association between the clinic and ambulatory SBP difference with risk of death, but not end‐stage renal disease. A 5– to
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