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Identification of the optimal protocol for automated office blood pressure measurement among patients with treated hypertension

journal contribution
posted on 2023-05-19, 15:58 authored by Myles MooreMyles Moore, Martin SchultzMartin Schultz, Mark NelsonMark Nelson, Black, JA, Nathan DwyerNathan Dwyer, Hoban, E, Matthew JoseMatthew Jose, Wojciech Kosmala, Przewlocka-Kosmala, M, Zachwyc, J, Petr OtahalPetr Otahal, Dean PiconeDean Picone, Philip Roberts-ThomsonPhilip Roberts-Thomson, Veloudi, P, James SharmanJames Sharman
Background: Automated office blood pressure (AOBP) involving repeated, unobserved blood pressure (BP) readings during one clinic visit is recommended for in-office diagnosis and assessment of hypertension. However, the optimal AOBP protocol to determine BP control in the least amount of time with the fewest BP readings is yet to be determined and was the aim of this study.

Methods: One hundred and eighty-nine patients (mean age 62.8 ± 12.1 years; 50.3% female) with treated hypertension referred to specialist clinics at 2 sites underwent AOBP in a quiet room alone. Eight BP measurements were taken starting immediately after sitting and then at 2-minute intervals (15 minutes total). The optimal AOBP protocol was defined by the smallest mean difference and highest intraclass correlation coefficient (ICC) compared with daytime ambulatory BP (ABP). The same BP device (Mobil-o-graph, IEM) was used for both AOBP and daytime ABP.

Results: Average 15-minute AOBP and daytime ABP were 134 ± 22/82 ± 13 and 137 ± 17/83 ± 11 mm Hg, respectively. The optimal AOBP protocol was derived within a total duration of 6 minutes from the average of 2 measures started after 2 and 4 minutes of seated rest (systolic BP: mean difference (95% confidence interval) 0.004(-2.21, 2.21) mm Hg, P = 1.0; ICC = 0.81; diastolic BP: mean difference 0.37(-0.90, 1.63) mm Hg, P = 0.57; ICC = 0.86). AOBP measures taken after 8 minutes tended to underestimate daytime ABP (whether as a single BP or the average of more than 1 BP reading).

Conclusions: Only 2 AOBP readings taken over 6 minutes (excluding an initial reading immediately after sitting) may be needed to be comparable with daytime ABP.

History

Publication title

American Journal of Hypertension

Volume

31

Pagination

299-304

ISSN

0895-7061

Department/School

Menzies Institute for Medical Research

Publisher

Elsevier Science Inc

Place of publication

360 Park Ave South, New York, USA, Ny, 10010-1710

Rights statement

© American Journal of Hypertension, Ltd 2017. All rights reserved.

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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