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Automated office blood pressure measurement in primary care
Martin G Myers1, Janusz Kaczorowski, Martin Dawes
1Sunnybrook Health Sciences Centre, Department of Medicine, 2075 Bayview Ave, Toronto, ON M4N 3M5. martin.myers@sunnybrook.ca.
Objective:
To provide FPs with detailed knowledge of automated office blood pressure (AOBP) measurement, its potential role in primary care, and its proper use in the diagnosis and management of hypertension.
Sources Of Information:
Comprehensive monitoring and collection of scientific articles on AOBP by the authors since its introduction.
Main Message:
Automated office blood pressure measurement maintains a role for blood pressure (BP) readings taken in the office setting. Clinical research studies have reported a substantially stronger relationship between awake ambulatory BP measurement and AOBP measurement compared with manual BP recorded during routine visits to the patient's physician. Automated office blood pressure measurement produces mean BP values comparable to awake ambulatory BP and home BP values. Compared with routine manual office BP measurement, AOBP correlates more strongly with awake ambulatory BP measurement, shows less digit preference, is more consistent from visit to visit, is similar both within and outside of the physician's office, virtually eliminates office-induced hypertension, and is associated with less masked hypertension. It is estimated that more than 25% of Canadian primary care physicians are now using AOBP measurement in their office practices. The use of AOBP to diagnose hypertension has been recommended by the Canadian Hypertension Education Program since 2010.
Conclusion:
There is now sufficient evidence to incorporate AOBP measurement into primary care as an alternative to manual BP measurement.
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