Related Experiment Video
Updated: Sep 30, 2025
Simultaneous Electrocardiography Recording and Invasive Blood Pressure Measurement in Rats
Published on: January 31, 2019
Time Sequence of Measurement Affects Blood Pressure Level in an African American Cohort
Michael Marshall1, Nancy Jackson2, Brittni McClellan1
1Department of Internal Medicine, Ascension Providence Hospital.
Insights
Automated Office Blood Pressure (AOBP) readings taken after a physician visit, with or without a Medical Assistant (MA), may offer more accurate hypertension management for African Americans. This study found lower BP post-visit compared to pre-visit measurements.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Measurement
Background:
- Uncontrolled hypertension poses severe risks, particularly for African Americans, including stroke and heart failure.
- Accurate blood pressure (BP) monitoring is crucial for effective hypertension management.
- The impact of measurement timing and the presence of a Medical Assistant (MA) on Automated Office Blood Pressure (AOBP) in African Americans remains understudied.
Purpose of the Study:
- To investigate the influence of measurement timing (pre- vs. post-physician visit) on AOBP readings.
- To assess the effect of a Medical Assistant's (MA) presence during AOBP monitoring.
- To evaluate AOBP accuracy for hypertension treatment decisions in African American patients.
Main Methods:
- A two-phase, single-blinded, non-randomized trial involving hypertensive African American patients.
- Utilized Omron 907 and Welch Allyn Connex Spot Monitor AOBP devices for BP measurement.
- Employed descriptive statistics and T-tests to analyze BP data.
Main Results:
- Phase 1 (N=148): Pre-physician visit BP (141/82 mmHg) was significantly higher than post-visit BP (134/80 mmHg) (p ≤ 0.02).
- Post-visit readings from different AOBP devices showed no statistical difference (p = 0.72).
- Phase 2 (n=50): MA presence yielded higher readings, but post-visit BP trends aligned with Phase 1 findings.
Conclusions:
- Post-physician visit AOBP measurements, irrespective of MA presence, may offer more accurate BP readings.
- This timing could improve hypertension treatment decisions in African American patients.
- Further research supports AOBP's role in targeted hypertension management.
Introduction:
Uncontrolled hypertension can result in severe clinical conditions such as stroke, chronic kidney disease and congestive heart failure, especially in African American populations. To the knowledge of the authors, the effect of time sequence on blood pressure (BP) using an Automated Office Blood Pressure (AOBP) device has not been documented in an African American cohort. The objective of this study was to investigate the possible influence of time sequence of measurement (pre- and post-physician visit) on BP readings in an African American cohort, in the presence or absence of a Medical Assistant (MA) via AOBP monitoring.
Methods:
A two-phase, single-blinded, non-randomized trial was conducted at MI-based Ascension Providence Hospital with a convenience sample of hypertensive patients. BP readings were taken using both an Omron 907 (Omron Corp., Kyoto, Japan) and a Welch Allyn (WA) Connex Spot Monitor (Welch Allyn, Inc., Skaneateles Falls, NY) AOBP devices. Descriptive statistics were generated, and T-tests were performed.
Results:
In Phase 1, (N = 148), the mean systolic/diastolic readings for the pre-physician visits (141/82 mmHg) were statistically significantly higher than the post-visit readings (134/80 mmHg) (p ≤ 0.02). Post-visit physician readings from either AOBP device did not differ statistically (p = 0.72). In Phase 2 (n = 50), the presence of an MA resulted in significantly higher readings than when an MA was absent, however, the results of Phase 2 also supported the trends for lower BP post-physician visit found in Phase 1.
Conclusion:
Based on the consistency of these results, a post-physician visit AOBP reading, in the presence or absence of an MA, may provide a more accurate BP measurement to determine whether or not to treat hypertension in African American patients.
Related Concept Videos
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:23Assessment of blood pressure in brachial artery(two-step method)
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure: