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Unattended Automated Office Blood Pressure Measurement and Cardiac Target Organ Damage, A Pilot Study
Claudia Palomba1, Simone Donadio1, Grazia Canciello1,2
1Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, 80131, Naples, Italy.
Insights
Unattended automated office blood pressure (UAOBP) readings are lower than attended readings, offering a potentially more accurate assessment of hypertension. This method shows comparable correlations with target organ damage to traditional attended measurements.
Area of Science:
- Cardiology
- Hypertension Management
- Diagnostic Methods
Background:
- The ESC-2018 guidelines recommend Unattended automated office blood pressure (UAOBP) to mitigate the white coat effect in hypertension management.
- However, UAOBP is not universally adopted as the preferred method for blood pressure monitoring.
Purpose of the Study:
- To compare blood pressure readings obtained via UAOBP and Attended office blood pressure (AOBP).
- To evaluate the correlation of both UAOBP and AOBP with target organ damage in hypertensive patients.
Main Methods:
- A cohort of 48 outpatients had both UAOBP and AOBP measurements taken.
- The study analyzed the pressure differences between the two methods and their correlation with anthropometric and cardiac parameters.
Main Results:
- Unattended systolic and diastolic blood pressure values were lower than attended measurements (135±17 mmHg vs 139±21 mmHg and 79±10 mmHg vs 82±10 mmHg).
- The difference in diastolic blood pressure (ΔDBP) correlated with female sex and was lower in men than women.
- Correlation coefficients for left ventricular mass index (LVMi) and রেডিওfrequency waveform technology (RWT) did not significantly differ between attended and unattended BP measurements.
Conclusions:
- UAOBP yields significantly lower blood pressure values compared to AOBP.
- The observed difference in blood pressure between UAOBP and AOBP is smaller than reported in many clinical studies, suggesting UAOBP's potential utility.
Introduction:
The ESC-2018 guidelines suggest the use of Unattended automated office blood pressure (UAOBP) to avoid or at least reduce the white coat effect, even if do not support its use as preferred method.
Aim:
To assess the pressure difference between UAOBP and Attended office blood pressure (AOBP) and to evaluate their correlations with target organ damage in hypertensive patients.
Methods:
UAOBP and AOBP were taken in a cohort of 48 outpatients. The pressure difference between the 2 methods and their correlation with anthropometric and cardiac parameters were analyzed.
Results:
Unattended systolic and diastolic BP were lower than Attended systolic and diastolic BP (135 ± 17 mmHg vs 139 ± 21 mmHg and 79 ± 10 mmHg vs 82 ± 10 mmg). ΔDBP was significantly directly correlated with female sex (r = 0.347, p = 0.016) and it was lower in men compared to women (0.11 ± 8.9 mmHg vs 6.07 ± 7.42 mmHg, p = 0.016). Correlation coefficients for LVMi and RWT for attended and unattended BP were not statistically different (for LVMi r = 0.286 vs r = 0.381, p = 0.61, for RWT r = 0.413 vs r = 0.363, p = 0.78). The relationship between attended and unattended BP was described by the following equation: y = - 4.68 + 1.06*x; where Y is the attended systolic BP and X is the unattended systolic BP; in accordance with this equation, an unattended systolic BP of 140 mmHg corresponds to an attended systolic BP of 143.7 mmHg.
Conclusions:
UAOBP provides significantly lower values than AOBP. The difference in BP values between the two methods is much lower than the one obtained in most clinical studies.
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