The Reproducibility of Racial Differences in Ambulatory Blood Pressure Phenotypes and Measurements; Methodological Issues

Dear editor, I was interested to read the paper by Husain A and colleagues published in the Am J Hypertens 2017 October.¹ The purpose of the authors was to evaluate the reproducibility of differences in ambulatory blood pressure (BP) monitoring phenotypes and other parameters (sustained hypertension, masked hypertension, nocturnal hypertension, and nondipping) between African Americans and Whites. A total of 420 participants untreated for hypertension attended 2 research visits 1 week apart during which traditional office BP averages and ambulatory BP monitoring session averages were determined. They computed percent agreement in ambulatory BP monitoring phenotypes across the 2 visits stratified by race and associated kappa statistics with 95% confidence intervals. Agreement was quantified using the kappa statistic, its 95% confidence interval and P value. Kappa statistics were calculated based on the agreement between the binary outcomes of whether or not a subject had a particular phenotype between sessions.

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