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Home blood pressure measurement: reproducibility and relationship with left ventricular mass
R H Kok1, F W Beltman, W F Terpstra
1Department of General Practice, University of Groningen, Groningen, The Netherlands. rhjkok@worldonline.nl
Insights
Home blood pressure monitoring showed lower reproducibility compared to ambulatory monitoring and was similar to office blood pressure measurements. Ambulatory blood pressure also showed a potentially stronger relationship with left ventricular mass index.
Area of Science:
- Cardiology
- Hypertension Management
- Diagnostic Accuracy
Background:
- Accurate blood pressure measurement is crucial for hypertension management.
- Home blood pressure (HBP) monitoring is widely used but its reproducibility and clinical correlation require further investigation.
- Comparing HBP with ambulatory blood pressure (ABP) and office blood pressure (OBP) is essential for clinical decision-making.
Purpose of the Study:
- To assess the reproducibility of HBP measurements.
- To compare the relationship between HBP, ABP, and OBP with left ventricular mass index (LVMI).
Main Methods:
- 84 untreated hypertensive patients (60-74 years) underwent HBP, ABP, and OBP measurements at baseline and 12 weeks.
- Left ventricular mass index (LVMI) was assessed echocardiographically at 12 weeks.
- Reproducibility coefficients and correlation coefficients were calculated.
Main Results:
- Systolic and diastolic blood pressures decreased significantly for HBP and OBP after 12 weeks (P<0.05), but not for ABP.
- ABP demonstrated higher reproducibility coefficients compared to HBP and OBP.
- Correlations between LVMI and ABP were stronger than with HBP and OBP, though not statistically significant.
Conclusions:
- HBP measurements were less reproducible than ABP and similar to OBP.
- ABP may have a stronger association with LVMI than HBP and OBP, warranting further investigation.
- Findings suggest ABP may offer superior diagnostic and prognostic value in hypertensive patients.
Objective:
To evaluate the reproducibility and relationship with left ventricular mass index of home blood pressure in comparison with ambulatory and office blood pressures.
Methods:
We measured home, ambulatory and office blood pressures of 84 previously untreated hypertensive patients, aged 60-74 years, from primary care, at baseline and after 12 weeks, without active intervention in between. Left ventricular mass index was determined echocardiographically during week 12.
Results:
Decreases in systolic and diastolic blood pressures were found after 12 weeks for mean home and office blood pressures (P<0.05), but not for mean ambulatory blood pressure. The coefficients of reproducibility for systolic and diastolic ambulatory blood pressures were 26.4 and 16.0, respectively. Correlation coefficients for correlation of left ventricular mass index to ambulatory blood pressure (0.51 and 0.36) were higher than the correlation coefficients for home (0.31 and 0. 16) and office (0.32 and 0.21) blood pressures, for systolic and diastolic values, respectively. However, we could find no statistically significant difference among the correlation coefficients for all three types of measurements.
Conclusions:
Home blood pressure was considerably less reproducible than ambulatory blood pressure and no different from office blood pressure in this respect. The relationship with left ventricular mass index appeared to be stronger for ambulatory than it was for home and office blood pressures, although not statistically significant so.