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Comparison of office and serial automatic blood pressure readings in renovascular and essential hypertension
G Vreugdenhil1, G Schrey, P W de Leeuw
1Department of Internal Medicine, Zuiderziekenhuis, Rotterdam, The Netherlands.
Insights
Office blood pressure measurements overestimate true blood pressure in both essential hypertension and renovascular hypertension patients. This finding highlights potential inaccuracies in standard clinical blood pressure assessments.
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Background:
- Office blood pressure (BP) is a standard diagnostic tool.
- Accurate BP measurement is crucial for managing hypertension.
- The accuracy of office BP compared to ambulatory BP monitoring in renovascular hypertension is not well-established.
Purpose of the Study:
- To compare office blood pressures with 30-minute automated Dinamap recordings.
- To assess BP measurement differences in essential hypertension versus renovascular hypertension.
- To determine if office BP overestimates true BP in both conditions.
Main Methods:
- Compared office BP with automated Dinamap BP in 30 essential hypertension patients and 19 renovascular hypertension patients.
- Matched patients for age and sex.
- Analyzed differences in systolic and diastolic BP between office and automated measurements.
Main Results:
- No significant differences in office or automated BP between patient groups after matching.
- Systolic BP differences were similar; diastolic BP differences were slightly larger in renovascular hypertension.
- The proportion of patients with a >10 mm Hg pressure drop was comparable.
Conclusions:
- Office blood pressure measurements tend to overestimate 'true' blood pressure.
- This overestimation occurs in both essential hypertension and renovascular hypertension.
- Automated BP monitoring may offer a more accurate assessment in clinical practice.
Abstract:
Office blood pressures were compared with those obtained using a thirty minute recording with an automatic device (Dinamap) in thirty patients with essential hypertension and nineteen subjects with hypertension and renal artery stenosis. When matched for age and sex, no differences were found between both groups of patients with respect to their office or automatically recorded blood pressures. The difference between office and automatically assessed systolic blood pressures was similar in both groups. The difference in diastolic pressures was slightly larger in the group with renal artery stenosis. The number of patients showing a pressure drop greater than 10 mm Hg was comparable in the two groups. We conclude that blood pressure levels obtained in the office overestimate 'true' blood pressure not only in essential but also in renovascular hypertension.