AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENTS RECORDED WITH AND WITHOUT PRECEDING REST AND ITS ASSOCIATION WITH AWAKE AMBULATORY BLOOD PRESSURE. (April 2021)

• Record Type: Journal Article
• Authors: Andreadis, Emmanuel; Geladari, Charalampia; Angelopoulos, Epameinondas
• Is Part Of: Journal of hypertension. Volume 39(2021)e-Supplement 1
• Publication Date: 2021-04
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000745768.30981.aa
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract: Objective: Automated office blood pressure (AOBP) measurement, attended or unattended, eliminates the white-coat effect (WCE) showing a strong association with awake ambulatory blood pressure (ABP). This study examined the difference in AOBP readings, with and without 5 min of rest prior to 3 readings recorded at 1-min intervals and their relation to awake ABP levels. Design and method: This was a method comparison study performed in 100 consecutive hypertensive patients referred for suspected hypertension. Inclusion criteria: a. individuals aged > / = 18 years who had never taken or who had not received antihypertensive medication for at least the previous 6 months, b. subjects on stable antihypertensive medication for at least 4 weeks. Hypertension was obtained by an average office reading of systolic BP (SBP) > / = 140 mmHg or diastolic BP (DBP) / = 90 mmHg on three consecutive visits, based on semi-automated oscillometric technique. Exclusion criteria: secondary hypertension, atrial fibrillation, gross proteinuria, renal failure with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 or heart failure (HF) with ejection fraction < 30%. Written informed consent was obtained from all patients and the study was approved by the scientific board of the hospital. Results: Cross-sectional data from 100 randomized selected hypertensives, 61 men and 39 women, with a mean age of 52.2+/-10.8 years, 82% treated, were analyzed. The mean systolic AOBP values without preceding rest was 127.0+/-18.2 mmHg and the mean systolic AOBP values with 5 minutes of preceding rest was 125.7+/-17.9 mmHg, (p = 0.05). A significant order effect was observed for the mean systolic BP values when AOBP without 5 min of preceding rest was performed as the first measurement (130.0+/-17.7 versus 126.5+/-16.2, p = 0.008). When we used a target systolic AOBP > / = 130 mmHg awake ABP yielded lower readings while at a target systolic AOBP value of < 130 mmHg higher awake ABP values were obtained. Conclusions: Our findings indicate that systolic AOBP can be initially checked without any preceding rest and if readings are normal can be accepted. Otherwise when AOBP is > / = 130 mmHg, measurements should be rechecked with 5 min of rest.