Unattended automatic office BP measurements can’t replace home monitoring

  • Asayama K & al.
  • Hypertens Res
  • 21 Jun 2019

  • International Clinical Digest
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Takeaway

  • Unattended office systolic BP measurement (UBP) does not correlate with home measures and cannot substitute for home-based BP monitoring (HBP).
  • The idea was that removing medical staff might reduce the white-coat effect, but individual variation between the two was quite high.
  • With medical staff present (conventional BP measurement; CBP), BPs were 11/4 mmHg higher, on average.  

Why this matters

  • Unattended BP measurement is not a suitable alternative to HBP. 

Key results

  • Systolic BP values did not correlate between UBP and HBP (r≤0.16).
  • Although average differences were small, the individual variation was high.
  • CBP and UBP did correlate strongly (r≥0.72; P<.0001>
  • CBP and morning HBP systolic measurements differed by an average of 13.8 (standard deviation, 19.0) mmHg.
  • CBP and HBP systolic evening measurements differed by 9.0 (18.0) mmHg.

Study design

  • Multicenter study of 308 patients (57.8% women; mean age, 71.8 years) at 3 Japanese hypertension clinics.
  • All but 11 were on antihypertensives.
  • Funding: Japanese Society of Hypertension.

Limitations

  • Limitations of cross-sectional design, no causality established.