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Blood Press. 2019 Feb;28(1):34-39. doi: 10.1080/08037051.2018.1540260. Epub 2018 Nov 25.

Long-term relationship between unattended automated blood pressure and auscultatory BP measurements in hypertensive patients.

Author information

1
a Internal Department II, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.
2
b Biomedical Centre, Faculty of Medicine in Pilsen , Charles University , Prague , Czech Republic.
3
c Department of Cardiology , Faculty Hospital Hradec Králové , Hradec Králové , Czech Republic.
4
d Faculty of Medicine, 2nd Department of Internal Medicine , St. Anne's University Hospital Brno, Masaryk University , Brno , Czech Republic.
5
e Department of Cardiology , Faculty Hospital Bohunice , Brno , Czech Republic.

Abstract

AIMS:

Unattended automated office blood pressure (uAutoOBP) has attracted more attention since SPRINT trial had been published. However, its long-term relationship to attended office blood pressure (AuscOBP) is not known.

MATERIAL AND METHODS:

Stable treated hypertensive subjects were examined in four Czech academic hypertension centers. All subjects attended four clinical visits three months apart. uAutoOBP was measured with the BP Tru device; AuscOBP was measured three times with auscultatory method by the physician. 24-hour ambulatory blood pressure monitoring (ABPM) was performed within one week from the second clinical visit.

RESULTS:

Data on 112 subjects aged 65.6 ± 10.8 years with mean AuscOBP 128.2 ± 12.2/78.5 ± 10.3 mm Hg are reported. Across the four clinical visits, the uAutoOBP was by 10.1/3.7 mm Hg lower than AuscOBP and the mean difference was similar during all four visits (P≥.061). Both uAutoOBP and AuscOBP had similar intra-individual variability during study follow-up as demonstrated by similar intraclass correlation coefficients (ICC, for systolic ICC = 0.50, for diastolic ICC = 0.72). However, the intra-individual variability of the systolic AuscOBP and uAutoOBP difference was high as demonstrated by low ICCs for absolute (ICC = 0.17 [95%CI, 0.09 - 0.25]) and low κ coefficients for categorized differences (κ ≤ 0.16). The main determinant of AuscOBP-uAutoOBP difference was AuscOBP level. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM.

CONCLUSIONS:

Although mean AuscOBP-uAutoOBP differences were relatively similar across the four clinical visits, intra-individual variability of this difference was high. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. Therefore, uAutoOBP cannot be used as a replacement for ABPM.

KEYWORDS:

Ambulatory blood pressure monitoring; BPTru device; attended office blood pressure; blood pressure measurement; unattended automated blood pressure

PMID:
30474412
DOI:
10.1080/08037051.2018.1540260
[Indexed for MEDLINE]

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