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Age and the difference between awake ambulatory blood pressure and office blood pressure: a meta-analysis

Joji Ishikawa1, Yukiko Ishikawa, Donald Edmondson

  • 1Center for Behavioral Cardiovascular Health, Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, USA. geroge@jichi.ac.jp

Blood Pressure Monitoring
|May 12, 2011
PubMed

Insights

Office blood pressure (OBP) is higher than ambulatory blood pressure (ABP) only after age 50 for systolic and 45 for diastolic BP. OBP exceeds home blood pressure (HBP) at all ages, while ABP is higher than HBP in younger individuals.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Ambulatory blood pressure (ABP) is a superior predictor of cardiovascular events compared to office blood pressure (OBP).
  • The 'white coat effect' traditionally suggests ABP is lower than OBP.
  • Emerging evidence indicates age-related variations in the OBP-ABP difference.

Purpose of the Study:

  • To systematically analyze the relationship between office blood pressure (OBP) and ambulatory blood pressure (ABP) across different age groups.
  • To compare OBP with home blood pressure (HBP) and ABP in relation to age.

Main Methods:

  • A meta-analysis of population studies published before April 2009 was conducted using PubMed.
  • Studies assessing OBP and either ABP or HBP were included.
  • Random effect models were employed due to heterogeneity in study outcomes.

Main Results:

  • Office blood pressure (OBP) increased more steeply with age than awake ambulatory blood pressure (ABP).
  • OBP surpassed awake systolic/diastolic ABP around ages 51.3/42.7 in men and 51.9/42.3 in women.
  • OBP exceeded home blood pressure (HBP) at all ages, whereas awake ABP was higher than HBP in younger individuals, becoming similar in older age groups.

Conclusions:

  • Office blood pressure (OBP) is higher than awake ambulatory blood pressure (ABP) only after approximately 50 years for systolic and 45 years for diastolic BP.
  • Conversely, OBP consistently exceeds HBP across all age groups.
  • Age significantly influences the comparison between different blood pressure measurement methods.
Abstract

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