Automated office versus home measurement of blood pressure in the assessment of morning hypertension

Andreadis, Emmanuel A.; Angelopoulos, E; Tsakanikas, Aristeidis; Agaliotis, G.; Kravvariti, Sofia D.; Mousoulis, George P.

doi:10.1097/mbp.0b013e3283503760

Cited by 12 publications

(17 citation statements)

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“…Mean AOBP was 129/79 mm Hg compared with a mean daytime ABPM of 128/79 mm Hg, whereas oscillometric result was 134/84 mm Hg and the auscultatory result was 132/83 mm Hg, suggesting that AOBP is a more accurate technique than conventional office measurements in the evaluation of an individual's true BP status. Our findings concur with previous results showing similar values for mean AOBP and daytime ABPM, with both values being significantly lower than conventional office readings; this also suggests that white coat hypertension was significantly more prevalent when routine OBP readings were analyzed 6, 8, 16, 17. Staessen et al reviewed 30 studies in which conventional office readings were compared with daytime ABPM in untreated patients with borderline or definite hypertension; their findings showed that mean OBP was 12/2 and 20/1 mm Hg higher, respectively, than the corresponding mean daytime ABPM 18.…”

Section: Discussionsupporting

confidence: 92%

“…that white coat hypertension was significantly more prevalent when routine OBP readings were analyzed. 6,8,16,17 Staessen et al reviewed 30 studies in which conventional office readings were compared with daytime ABPM in untreated patients with borderline or definite hypertension; their findings showed that mean OBP was 12/2 and 20/1 mm Hg higher, respectively, than the corresponding mean daytime ABPM. 18 The main issues of office measurements regarding the white coat effect, observer error, and bias problems are presented mainly by auscultatory devices; therefore, oscillometric devices are almost exclusively used for OBP measurement.…”

Section: |mentioning

confidence: 99%

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Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Andreadis

Geladari

Angelopoulos

et al. 2018

JAHA

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BackgroundAutomated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the “white coat effect” and shows a strong association with ambulatory blood pressure.Methods and ResultsWe conducted a cross‐sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland–Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (−5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, −6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and −2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician).ConclusionsOur findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting.

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Section: Discussionsupporting

confidence: 92%

Section: |mentioning

confidence: 99%

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Andreadis

Geladari

Angelopoulos

et al. 2018

JAHA

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“…Resting office BP readings, unattended or partially attended, as obtained by automated or semi‐automated oscillometric devices, respectively, significantly underestimate overall daytime systolic BP load as assessed from 24‐h ABPM. Our results are in agreement with report by some, but not all groups 24–30 . There is clinical heterogeneity between studies comparing these two methods including the time gap between the two tests of up to 1 month, time between actual BP readings during AOBP (1 vs. 2 min), number of AOBP readings (ranging from 3 to 5), populations studied (treated vs. untreated; men vs. women; age, etc.)…”

Section: Discussionsupporting

confidence: 92%

Blood pressure measurement: Should technique define targets?

Hiremath

Ramsay

Ruzicka

2021

J of Clinical Hypertension

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Accurate assessment of blood pressure (BP) is the cornerstone of hypertension management. The objectives of this study were to quantify the effect of medical personnel presence during BP measurement by automated oscillometric BP (AOBP) and to compare resting office BP by AOBP to daytime average BP by 24‐h ambulatory BP monitoring (ABPM). This study is a prospective randomized cross‐over trial, conducted in a referral population. Patients underwent measurements of casual and resting office BP by AOBP. Resting BP was measured as either unattended (patient alone in the room during resting and measurements) or as partially attended (nurse present in the room during measurements) immediately prior to and after 24‐h ABPM. The primary outcome was the effect of unattended 5‐min rest preceding AOBP assessment as the difference between casual and resting BP measured by the Omron HEM 907XL. Ninety patients consented and 78 completed the study. The mean difference between the casual and Omron unattended systolic BP was 7.0 mm Hg (95% confidence interval [CI] 4.5, 9.5). There was no significant difference between partially attended and unattended resting office systolic BP. Resting office BP (attended and partially attended) underestimated daytime systolic BP load from 24‐h ABPM. The presence or absence of medical personnel does not impact casual office BP which is higher than resting office AOBP. The requirement for unattended rest may be dropped if logistically challenging. Casual and resting office BP readings by AOBP do not capture the complexity of information provided by the 24‐h ABPM.

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“…A recent study concluded that despite their methodological differences, there seems to be considerable similarity between morning home BP and morning ambulatory BP and thus these methods appear to be interchangeable in the assessment of hypertension. [12]…”

Section: Discussionmentioning

confidence: 99%

“…The degree of overestimation by HBPM was lower than OBPM in our study has also shown by Agena et al [6] The manual sphygmomanometer readings could be replaced by automated OBPM reducing errors and are similar to mean awake ABPM. [12]…”

Section: Discussionmentioning

confidence: 99%

Prospective blood pressure measurement in renal transplant recipients

et al. 2014

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Blood pressure (BP) control at home is difficult when managed only with office blood pressure monitoring (OBPM). In this prospective study, the reliability of BP measurements in renal transplant patients with OBPM and home blood pressure monitoring (HBPM) was compared with ambulatory blood pressure monitoring (ABPM) as the gold standard. Adult patients who had living-related renal transplantation from March 2007 to February 2008 had BP measured by two methods; OBPM and ABPM at pretransplantation, 2nd, 4th, 6th, and 9th months and all the three methods: OBPM, ABPM, and HBPM at 6 months after transplantation. A total of 49 patients, age 35 ± 11 years, on prednisolone, tacrolimus, and mycophenolate were evaluated. A total of 39 were males (79.6%). Systolic BP (SBP) and diastolic BP (DBP) measured by OBPM were higher than HBPM when compared with ABPM. When assessed using OBPM and awake ABPM, both SBP and DBP were significantly overestimated by OBPM with mean difference of 3-12 mm Hg by office SBP and 6-8 mm Hg for office DBP. When HBPM was compared with mean ABPM at 6 months both the SBP and DBP were overestimated by and 7 mm Hg respectively. At 6 months post transplantation, when compared with ABPM, OBPM was more specific than HBPM in diagnosing hypertension (98% specificity, Kappa: 0.88 vs. 89% specificity, Kappa: 0.71). HBPM was superior to OBPM in identifying patients achieving goal BP (89% specificity, Kappa: 0.71 vs. 50% specificity Kappa: 0.54). In the absence of a gold standard for comparison the latent class model analysis still showed that ABPM was the best tool for diagnosing hypertension and monitoring patients reaching targeted control. OBPM remains an important tool for the diagnosis and management of hypertension in renal transplant recipients. HBPM and ABPM could be used to achieve BP control.

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Automated office versus home measurement of blood pressure in the assessment of morning hypertension

Abstract: The AOBP technique could replace mHBP monitoring in the assessment of morning BP, as it provides comparable data in relation to the awake ambulatory BP. Given the simplicity of this method, it could be more readily applied in a larger number of individuals.

Cited by 12 publications

References 0 publications

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Blood pressure measurement: Should technique define targets?

Prospective blood pressure measurement in renal transplant recipients

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