Blood pressure measurement: Should technique define targets?

Area of Science:

• Cardiology
• Hypertension Management
• Medical Device Technology

Background:

• Accurate blood pressure (BP) assessment is vital for hypertension management.
• Automated oscillometric BP (AOBP) devices are commonly used for BP measurement.
• The impact of medical personnel presence on AOBP accuracy requires clarification.

Purpose of the Study:

• To quantify the effect of medical personnel presence on AOBP measurements.
• To compare resting office BP by AOBP with 24-h ambulatory BP monitoring (ABPM).

Main Methods:

• Prospective randomized cross-over trial in a referral population.
• Patients underwent casual and resting office BP measurements using AOBP (Omron HEM 907XL).
• Resting BP was measured unattended and partially attended, before and after 24-h ABPM.

Main Results:

• Casual office BP was significantly higher than unattended resting office BP (mean difference 7.0 mm Hg).
• No significant difference in resting office systolic BP between partially attended and unattended measurements.
• Resting office BP underestimated daytime systolic BP load from 24-h ABPM.

Conclusions:

• Medical personnel presence does not impact casual office BP readings.
• The requirement for unattended rest before AOBP may be relaxed if logistically difficult.
• Office BP measurements by AOBP do not fully represent the complexity of 24-h ABPM data.