What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

Abstract

Objectives-To clarify whether a shorter interval between three successive home blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance.Design-We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female patients). The study consisted of three clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to measure three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors.Results-The analyses were performed using the second-third HBP readings. The average systolic BP/diastolic BP for the 10-s and 1-min intervals at home were 136.1 ±15.8/77.5 ±9.5 and 133.2 ±15.5/76.9 ±9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-min BP readings were significantly closer to the average of awake ambulatory BP (131 ±14/79 ±10 mmHg) than the 10-s interval readings. There was no significant difference in patients' compliance in taking adequate numbers of readings at the different time intervals.Conclusion-The 1-min interval between HBP readings gave a closer agreement with the daytime average BP than the 10-s interval.

Correlations between different measures of clinic, home, and ambulatory blood pressure in hypertensive patients

“…When head-to-head comparisons among clinic BP, HBP, and ABP have been performed [19,20,22], the level of agreement was not very good [19,20] or differed by age or sex [22], which could be because of the white coat effect or a device-specific effect. In this study, a pronounced white coat effect was not observed, perhaps because office BP was rigorously measured following the international guidelines after at least 5-min rest, measured by a physician postdoc rather than by a more senior doctor, and multiple measurements (more than six readings) were taken in one occasion after seeing a doctor [17]. The fact that BP levels were on average in the prehypertension range may also explain why office BP did not consistently exceed ABP [17].…”

“…In this study, a pronounced white coat effect was not observed, perhaps because office BP was rigorously measured following the international guidelines after at least 5-min rest, measured by a physician postdoc rather than by a more senior doctor, and multiple measurements (more than six readings) were taken in one occasion after seeing a doctor [17]. The fact that BP levels were on average in the prehypertension range may also explain why office BP did not consistently exceed ABP [17]. Another reason could be a device effect.…”

“…We used the second and the third readings of multiple HBP readings taken at 1-min intervals because this was closer to the ABP in our recent publication [17]. Obtaining more than 100 HBP readings is not very difficult, but good quality data would be produced from the second and the third readings of consecutive three BP measurements with 1-min intervals [17].…”

Evaluation of day-by-day variability of home blood pressure using a home blood pressure telemonitoring system

“…The significant correlation of having a job with home BPV could be because of higher physical activity by the employed patients compared with the patients without a job, or with inconsistent resting times before the HBP measurement [26] (i.e. a shorter resting time when an employed patient is pressed for time in the morning).…”

Association between asleep blood pressure and brain natriuretic peptide during antihypertensive treatment

“…The clinic BP was measured using a validated cuff oscillometric device (HEM-5001; Omron Healthcare, Kyoto Japan [18]) after the patients had rested for at least 5 min in the sitting position. Noninvasive ABPM was performed on a weekday with automatic devices (TM-2425 or TM-2430, A&D Co Inc, Japan [19,20]) that recorded the BP and pulse rate every 30 min for 24 h. The ABPM was performed at enrollment and after 6th month of treatment.…”