In the aftermath of SPRINT: further comparison of unattended automated office blood pressure measurement and 24-hour blood pressure monitoring
Abstract
Aims: Several papers reported that unattended automated office blood pressure (uAutoOBP) is closely related to daytime ambulatory blood pressure monitoring (ABPM). In the present study, we aim to study uAutoOBP and its relation to 24-hour ABPM and ABPM variability.Material and methods: Stable treated hypertensive subjects were examined in two Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP three times with auscultatory method (AuscOBP) by the physician.
ABPM was performed within one week from the clinical visit.Results: Data on 98 subjects aged 67.79.3 years with 24-hour ABPM 120.3 +/- 10.6/72.7 +/- 7.9mm Hg are reported. uAutoOBP was lower than 24-hour (by -5.2 +/- 11.3/-0.5 +/- 6.9mm Hg) and daytime (by -6.7 +/- 12.82.4 +/- 8.0mm Hg) ABPM and the individual variability of the difference was very large (up to 30mm Hg). The correlation coefficients between ABPM and uAutoOBP were similar compared to AuscOBP (p.17).
Variability of uAutoOBP, but not AuscOBP, readings during one clinical visit was related to short-term blood pressure variability of ABPM. The difference between AuscOBP and uAutoOBP was larger in patients with white-coat effect compared to other blood pressure control groups (25.1 +/- 7.0 vs. 2.2 +/- 10.3mm Hg; p=.0036).Conclusions: Our study shows that uAutoOBP is not good predictor of ambulatory blood pressure monitoring, not even of the daytime values.
It might, however, indicate short-term blood pressure variability and, when compared with AuscOBP, also detect patients with white-coat effect.