Differences of blood pressure measured at clinic versus at home in the morning and in the evening in Europe and Asia: A systematic review and meta‐analysis

Miao, Huanhuan; Yang, Shijie; Zhang, Yuqing

doi:10.1111/jch.14487

Cited by 9 publications

(5 citation statements)

References 54 publications

(263 reference statements)

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“…In the parallel analysis comparing AOBP measurements with the assistance of an instructional video and morning HBP, similar values were derived. AOBP and morning HBP have good agreement with morning ABP [25], although the diurnal change in BP should be considered such that morning HBP is higher than evening HBP in studies conducted in Asia, whereas the values are comparable in European studies [26]. The result of the present study, in which all participants were Asian had concordance with the result of a smaller difference between clinic BP and morning HBP obtained in the previous study [26].…”

Section: Discussionsupporting

confidence: 85%

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Toba,

Ishikawa,

Harada

2023

Blood Pressure Monitoring

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Objectives Automated office blood pressure (AOBP) measurement often requires assistance. Accompanied by an instructional video, AOBP measurement could be performed independently by patients. Design and methods Seventy-five patients with hypertension were enrolled. AOBP was measured three times at 1-min intervals after 5 min of rest by an automated BP measurement device with the assistance of an animated instructional video. The video was designed originally to instruct patients on the way to measure BP appropriately. Perceived stress was evaluated using a questionnaire after the AOBP measurement. Office BP was measured three times using the same device. Home BP measurement was performed on 5 consecutive days. Results The mean age of the patients was 74.5 ± 10.6 years, and 96% were taking antihypertensive drugs. Mean AOBP, office BP and home BP measurements were 135.2 ± 17.2/81.3 ± 11.1, 139.3 ± 16.3/78.6 ± 10.9 and 129.2 ± 16.7/72.7 ± 8.9 mmHg, respectively. Regarding SBP, the mean AOBP was significantly lower than office BP (P = 0.005) and higher than home BP (P = 0.004). The differences in SBP and DBP between AOBP and home BP measurements were significantly related to patients’ perceived stress when performing AOBP measurements (r = 0.289; P = 0.013 and r = 0.328; P = 0.004). In a multivariate analysis, patients’ perceived stress was a significant predictor of the difference between AOBP and home BP (P = 0.013), even after adjusting for age, sex, BMI and mean of AOBP and home BP. Conclusion AOBP values measured with the assistance of an instructional video were between conventional office and home BP measurements. Perceived stress during AOBP measurement was related to the difference in AOBP from home BP.

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Section: Discussionsupporting

confidence: 85%

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Toba,

Ishikawa,

Harada

2023

Blood Pressure Monitoring

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“…In contrast, the difference between home-measured SBP and clinic SBP was much larger (i.e. higher) in Europeans than Asians when measured in the morning [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Management of Hypertension in the Asia-Pacific Region: A Structured Review

Rahman,

Magno,

Cai

et al. 2024

Am J Cardiovasc Drugs

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This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin–angiotensin–aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential. Supplementary Information The online version contains supplementary material available at 10.1007/s40256-023-00625-1.

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“…In our study, the mean difference in SBP readings was 20.46 mmHg, which is higher than the international norm. A systematic review and meta-analysis [ 21 ] also identified disparities between clinic and home SBP values, with mean clinic SBP values being significantly higher than MHSBP values, by 3.79 mmHg (95% CI, 2.77–4.80). The differences were more pronounced in Europe (6.53 mmHg (95% CI, 4.10–8.97)) than in Asia (2.70 mmHg (95% CI, 1.74–3.66)), with the region being a significant predictor of differences [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Home versus Clinic Blood Pressure Monitoring: Evaluating Applicability in Hypertension Management via Telemedicine

Al-Anazi,

Gul,

Al-Harbi

et al. 2023

Diagnostics

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Hypertension is a significant public health concern in Saudi Arabia, affecting 28.6% of the population. Despite the availability of effective treatments, optimal blood pressure control is not always achieved, highlighting the need for effective management strategies. This study aimed to evaluate the applicability of home, compared to clinic, blood pressure measurements for managing hypertension in the Qassim region of Saudi Arabia. The study included 85 adults undergoing antihypertensive treatment. Home blood pressure measurements were obtained during the day and the evening using automated oscillometric sphygmomanometers, whereas clinic measurements were taken during clinic hours. Home blood pressure readings were significantly lower than clinic blood pressure readings, with mean differences of 20.4 mmHg and 4.1 mmHg for systolic and diastolic blood pressures, respectively. There was a positive correlation between the clinic systolic and diastolic blood pressures (r = 0.549, p < 0.001) and a weak correlation between the daytime home and clinic systolic blood pressures (r = 0.218, p < 0.05). This study provides insight into the applicability of home blood pressure monitoring, which may aid in the development of more effective hypertension management strategies, particularly the use of morning home blood pressure monitoring to aid treatment decisions through telehealth medicine.

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Differences of blood pressure measured at clinic versus at home in the morning and in the evening in Europe and Asia: A systematic review and meta‐analysis

Cited by 9 publications

References 54 publications

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Automated office blood pressure measurement with the assistance of an instructional video in patients with hypertension

Management of Hypertension in the Asia-Pacific Region: A Structured Review

Home versus Clinic Blood Pressure Monitoring: Evaluating Applicability in Hypertension Management via Telemedicine

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