#3948 Differences between in-office and ambulatory blood pressure monitoring (ABPM) for cardiovascular risk stratification in a cohort of hypertensive patients

Abstract Background and Aims cardiovascular risk (CVR) assessment includes in-office blood pressure (BP) measurements, despite its limitations compared to ambulatory blood pressure monitoring (ABPM). The aim of this study is to analyze whether such stratification in patients with uncomplicated hypertension (HT) is modified when using ABPM. Method this is a cross-sectional study in patients with uncomplicated hypertension. For the assessment of the CVR, we used the grades of HT according to office BP defined in the guides and established equivalent grades when using 24-hour and nocturnal ABPM. The kappa index was used to analyze the concordance between both techniques. Results we included 481 patients with uncomplicated HT, 53.0% had >2 risk factors (RF), 40.7% had 1–2 RF, and 6.3% had none. 46.1% of patients presented the same CVR category (kappa index = 0.311; P < 0.001) by in-office BP vs. 24-hour ABPM. Using nocturnal ABPM, the concordance was 40.7% (kappa index = 0.242; P < 0.001). Patients with white coat HT (82%) showed lower CVR when stratified by ABPM. Patients with masked HT (53%) showed higher CVR according to ABPM. Conclusion CVR stratification was specially modified based on the way blood pressure was measured. These changes were more evident when dividing the population into the 4 HT phenotypes, being more significant in patients with white coat HT or masked HT. These results highlight the importance of using advanced measurement techniques as ABPM for BP measurement allowing a more accurate CVR assessment, with the prognostic and therapeutic implications that this entails.