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Automated Office Blood Pressure Measurements in Waiting Room or Isolated Room for Diagnosis and Phenotyping of
Marisol Sánchez Bacaicoa1, Sergio Rico2, Alejandra Gullón3
1Cardiology Department Hospital Regional de Málaga Spain.
Insights
Waiting room automatic office blood pressure measurement (AOBPM) is as effective as isolated room AOBPM for diagnosing hypertension. Both methods outperform standard office blood pressure readings, improving hypertension status assessment.
Area of Science:
- Cardiology
- Hypertension Research
- Diagnostic Accuracy
Background:
- Standard office blood pressure measurement can be inaccurate for diagnosing hypertension.
- Automatic office blood pressure measurement (AOBPM) offers a potential solution without needing a dedicated room.
- Waiting room AOBPM could enhance hypertension diagnosis efficiency.
Purpose of the Study:
- To compare the diagnostic performance of waiting room AOBPM, isolated room AOBPM, and standard office blood pressure measurement.
- To evaluate hypertension phenotyping using these different measurement methods.
- To validate AOBPM methods against 24-hour ambulatory blood pressure monitoring.
Main Methods:
- A cross-sectional study involving 548 participants.
- Comparison of three blood pressure measurement techniques: standard office, unattended isolated room AOBPM, and unattended waiting room AOBPM.
- Reference standard: 24-hour ambulatory blood pressure monitoring (daytime ambulatory blood pressure monitoring).
Main Results:
- Waiting room AOBPM and isolated room AOBPM demonstrated comparable and superior performance in stratifying hypertension status versus standard office measurements.
- Diagnostic accuracy for white coat syndrome was higher with waiting room AOBPM.
- Unattended AOBPM showed higher accuracy for detecting masked hypertension.
Conclusions:
- Waiting room AOBPM is an effective alternative to isolated room AOBPM for assessing hypertension status.
- Both AOBPM methods provide better hypertension diagnosis than standard office readings.
- The choice of measurement site (waiting room vs. isolated room) influences hypertension phenotype detection.
Background:
Automatic office blood pressure measurement (AOBPM) in the waiting room could improve the performance of diagnosing hypertension without requiring an isolated room to carry out exploration.
Methods:
In a cross-sectional study, we compared the performance to diagnose and phenotyping hypertension by 3 methods of blood pressure measurements, standard office blood pressure, unattended AOBPM in an isolated room or in an office waiting room AOBPM, compared with daytime ambulatory blood pressure measurement (daytime ambulatory blood pressure monitoring) from a 24-hour ambulatory blood pressure monitoring as a reference. The cutoff values for hypertension and validation for waiting room or isolated room AOBPM were performed by receiver operating characteristic curves and Bland-Altman plots compared with daytime ambulatory blood pressure monitoring.
Results:
Out of the 548 participants recruited, 349 (64%) had hypertension, while 199 (36%) were being studied for a diagnosis of hypertension. Waiting room AOBPM and unattended AOBPM stratified hypertension status in a comparable way (n=398; 73% [95% CI, 69%-76%; and n=417; 75% [95% CI, 72%-79%] participants, respectively), and both methods stratified better hypertension status than standard office blood pressure measurement did (n=338; 62% [95% CI, 57%-65%]). Overall, the diagnostic accuracy for white coat syndrome was better for waiting room AOBPM, while for masked hypertension it was by unattended AOBPM (80% [95% CI, 77%-83%] versus 87% [95% CI, 83%-89%] and 88% 95% CI, 85%-90%] versus 73% [95% CI, 69%-76%], respectively).
Conclusions:
To assess hypertension status, waiting room AOBPM is equivalent to unattended AOBPM in an isolated room and both better than standard office blood pressure measurement. The detection of hypertension phenotypes differs depending on the site of the measurement, waiting room or isolated room.
Registration:
URL: https://clinicaltrials.gov; unique identifier: NCT06198855.
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