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Hypertens Res. 2019 Jun 21. doi: 10.1038/s41440-019-0287-6. [Epub ahead of print]

Comparison of blood pressure values-self-measured at home, measured at an unattended office, and measured at a conventional attended office.

Author information

1
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. kei@asayama.org.
2
Tohoku Institute for Management of Blood Pressure, Sendai, Japan. kei@asayama.org.
3
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
4
Tohoku Institute for Management of Blood Pressure, Sendai, Japan.
5
Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
6
Miyakawa Clinic of Internal Medicine and Pediatrics, Yokohama, Japan.
7
Yokohama Sotetsu bldg. Clinic of Internal Medicine, Yokohama, Japan.
8
Katsuya Clinic, Amagasaki, Japan.
9
Department of Clinical Gene Therapy, Osaka University Graduate School of Medicine, Osaka, Japan.
10
Ryukyu Clinical Research Unit, University of the Ryukyus, Nishihara, Japan.
11
Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan.
12
Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Nishihara, Japan.
13
Department of Cardiology and Hypertension, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
14
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
15
Jichi Medical University Center of Excellence, Cardiovascular Research and Development (JCARD), Shimotsuke, Japan.
16
Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
17
Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
18
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
19
Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University Hospital, Sendai, Japan.
20
Yokohama Rosai Hospital, Japan Organization of Occupational Health and Safety, Yokohama, Japan.

Abstract

Self-measured blood pressure (BP) at home (HBP) has been commonly used in clinical practice. Although the unattended office BP (UBP), in which a patient is left alone before and during the measurement, has been investigated, the advantages of UBP over HBP or conventionally measured attended office BP obtained using automated devices (CBP) remain unclear. We performed a multicenter clinical study in Japan to compare the UBP, CBP, and HBP among 308 patients with hypertension at 3 clinics (women, 57.8%; mean age 71.8 years; under antihypertensive drug therapy, 96.4%). The patients measured HBP twice in the morning and twice in the evening for 5 days according to the Japanese Society of Hypertension guidelines. Using the Omron HEM-907 cuff-oscillometric device, the UBP and CBP were measured in line with the protocol in the Systolic blood PRessure INtervention Trial (SPRINT) and in accordance with the guidelines, respectively. Correlation coefficients were ≤0.16 for the comparison of UBP versus morning and evening HBP for the systolic measurement, whereas they were approximately 0.5 (P < 0.001) for the diastolic measurement. The difference between UBP minus HBP was small on average but varied among individuals (mean ± SD for UBP minus morning HBP: 0.9 ± 17.8/-4.5 ± 10.5 mmHg; UBP minus evening HBP: 5.7 ± 17.8/-0.1 ± 11.3 mmHg). In contrast, the measurement values of CBP and UBP were highly correlated (r ≥ 0.72), but the difference between CBP minus UBP was 10.4 ± 12.0/4.2 ± 6.5 mmHg. Based on the low correlations and wide range of differences, UBP cannot be used as an alternative to HBP.

KEYWORDS:

Conventional office blood pressure. Automated office blood pressure. Home blood pressure. Patient population. Attended and unattended measurement

PMID:
31222188
DOI:
10.1038/s41440-019-0287-6

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