腎臓学と治療学ジャーナル

Measuring Blood Pressure in the Office: The Argument for Wider Clinical Use of Automated Devices

Abstract

Thomas G ,Doleh T ,Rafey MA ,Gebreselassie S ,Butler R ,Emmanuel L Bravo *

Objective: Accurate measurement of blood pressure (BP) remains a fundamental step in diagnosing and managing hypertension. The aim of this study is to evaluate the accuracy of office BP measurement using an automated office blood pressure (AOBP) device (BpTRU®) performed in a 5-minute cycle.

Participants and methods: 117 consecutive patients (mean age 55 ± 17 years, 60% women) referred for management of hypertension over a nine-month period are included in this study. BP readings with the BpTRU® device (BP recorded five times in five minutes), mean awake ambulatory blood pressure (ABP), and routine BP readings taken in the patient’s primary care physician (PCP) office were compared.

Results: Average of 5 BP readings for mean blood pressure using the AOBP device was similar to the mean awake ABP (systolic BP 133 ± 4 mmHg vs.135 ± 3 mmHg; (p = 0.2) and diastolic BP 80 ± 2 mmHg vs. 79 ± 2 mmHg; (p = 0.7)). Both systolic AOBP and awake ABP values were significantly lower than the systolic BP recorded in PCP office (144 ± 5 mmHg) (p < 0.001). The coefficient of correlation between the systolic/diastolic AOBP and the average of awake ABP (r = 0.70/0.72) was highly significant (p < 0.001). With the AOBP device, the first systolic reading was significantly higher than the average of the 2nd to 6th systolic readings (141 ± 2 mmHg vs. 133 ± 4 mmHg, p < 0.001).

Conclusion: BP measurement performed with the AOBP device in a 5-minute cycle more accurately measures BP in a physician office setting when compared to single BP measurement. Relying on the1st BP measurement or a single reading may lead to over estimation of BP.