unattended automated oscillometric
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AIMS: Unattended automated office blood pressure (uAutoOBP) may eliminate white-coat effect. In the present study, we studied its relationships to attended office blood pressure (BP) and ambulatory BP monitoring (ABPM). MATERIAL AND METHODS: Stable treated hypertensive subjects were examined in four Czech academic hypertension centres. uAutoOBP was measured with the BP Tru device; attended BP was measured six times: three times with auscultatory method (AuscOBP) by the physician followed optionally by three oscillometric measurements (OscOBP). ABPM was performed within one week from the clinical visit. RESULTS: Data on 172 subjects aged 63.7 ± 12.4 years with AuscOBP 127.6 ± 12.1/77.6 ± 10.0 mm Hg are reported. uAutoOBP was by 8.5 ± 9.0/3.0 ± 6.1 mm Hg lower than AuscOBP. The AuscOBP-uAutoOBP difference increased with the AuscOBP level and it did not depend on any other factor. OscOBP differed by 8.6 ± 8.6/1.9 ± 5.7 mm Hg from uAutoOBP. 24-hour mean BP was by 4.2 ± 12.1/3.5 ± 7.8 mm Hg lower than AuscOBP and by 4.3 ± 11.0/0.5 ± 6.9 mm Hg higher than uAutoOBP; the correlation coefficients of 24-hour mean BP with AuscOBP and with uAutoOBP did not differ (p for difference ≥.13). In the lowest BP group (systolic AuscOBP <120 mm Hg or diastolic AuscOBP <70 mm Hg), both AuscOBP and uAutoOBP were lower than 24-hour mean BP, while in the highest BP group (systolic AuscOBP ≥140 mm Hg or diastolic AuscOBP ≥90 mm Hg), they were higher. CONCLUSIONS: Compared to uAutoOBP, attended BP measurement gives higher values, both when measured with auscultatory or oscillometric method. Inter-individual variability of AutoOBP - uAuscOBP difference, as well of uAutoOBP - ABPM difference, is large. We did not prove that uAutoOBP would be associated to 24-hour ambulatory BP more closely than attended BP.
- MeSH
- automatizace * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku * přístrojové vybavení metody MeSH
- následné studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
PURPOSE: We studied the performance of unattended automated office blood pressure (uAOBP) measurement in children, in relation to oscillometric office BP (OBP) and ambulatory blood pressure monitoring (ABPM). MATERIALS AND METHODS: One hundred and eleven stable treated and untreated outpatients investigated for hypertension underwent uAOBP measurements (seated unattended in a quiet room separate from the renal clinic room, six times after a 5 min rest with the BpTRU device), and immediately before using the oscillometric device. Ambulatory 24 h blood pressure monitoring (ABPM) was performed on the same day in a subgroup of 42 children. RESULTS: UAOBP measurements were successful in 106 children (95%), 5 pre-school children did not tolerate to be alone in the room. The mean ± SD systolic/diastolic uAOBP, OBP and daytime ABP were 109.1 ± 14.0/70.8 ± 10.7 mmHg, 121.6 ± 16.5/77.6 ± 10.5 mmHg and 123.5 ± 11.3/73.7 ± 6.8 mmHg, respectively. Systolic/diastolic uAOBP was significantly lower than OBP by 13.6/7.6 mmHg (p < 0.0001) and lower than daytime ABP by 14.4 ± 0.5/2.9 ± 0.3 mmHg (p < 0.0001). The heart rate was not significantly different during uAOBP than during OBP measurements. On Bland Altman analysis the uAOBP underestimated OBP by a mean of 15.6 mmHg for systolic BP and by 8.6 mmHg for diastolic BP. In all 9 children with white-coat systolic hypertension uAOBP was within the normal range (<95th pc for OBP), in six of nine children with white-coat diastolic hypertension uAOBP was within the normal range however, in three of them it was elevated despite normal ABP. CONCLUSION: uAOBP measurement is feasible in school-aged children, its values are considerably lower than OBP as well as daytime ABP and it could help with detection of white-coat systolic hypertension. The clinical applicability of uAOBP in children should be confirmed in further studies.
OBJECTIVES: There is an ongoing controversy about the magnitude of the difference between unattended automated office blood pressure (AOBP) and conventional office blood pressure (BP). The aim of our study was to compare unattended AOBP with both auscultatory BP and oscillometric attended AOBP in an epidemiological setting. METHODS: In 2588 participants of the Czech post-MoNItoring of CArdiovascular Disease study (a randomly selected 1% representative population sample aged 25-64 years, mean age 48 ± 11 years, 47.5% males), BP was measured using an AOBP device unattended, auscultatory mercury sphygmomanometer and an oscillometric attended AOBP device. RESULTS: On average, auscultatory BP was 10.6/5.6 mmHg higher than unattended AOBP. Similarly, oscillometric attended AOBP was 9.9/3.4 mmHg higher than unattended AOBP, while the mean difference between attended oscillometric AOBP and auscultatory BP was 0.8/2.1 mmHg. Unattended systolic AOBP of 127 mmHg corresponded to SBP of 140 mmHg measured by a conventional sphygmomanometer. The prevalence of hypertension varied depending on the measurement technique and ranged from 31.5 to 40.1%. Reasonable agreement in hypertension diagnosis was observed with unattended AOBP cut-off at least 130/85 mmHg when compared with both auscultatory (McNemar P = 0.07, kappa 0.819) and attended oscillometric AOBP (McNemar P = 0.46, kappa 0.852) thresholds of at least 140/90 mmHg. CONCLUSION: Unattended automated office SBP is on average 10 mmHg lower than the office auscultatory or attended AOBP values. In epidemiological settings, a threshold of unattended AOBP at least 130/85 mmHg should make comparison of hypertension prevalence possible with studies using auscultatory techniques and cut-off values of 140/90 mmHg.
- MeSH
- dospělí MeSH
- hypertenze diagnóza epidemiologie patofyziologie MeSH
- krevní tlak fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- měření krevního tlaku metody MeSH
- prevalence MeSH
- sfygmomanometry MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
