Automated Office Blood Pressure is Associated with Urine Albumin Excretion in Hypertensive Subjects

Andreadis, Emmanuel A.; Agaliotis, G.; Angelopoulos, E; Tsakanikas, Aristeidis; Kolyvas, George; Mousoulis, George P.

doi:10.1038/ajh.2012.76

Cited by 28 publications

(16 citation statements)

References 19 publications

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“…Mean AOBP was 129/79 mm Hg compared with a mean daytime ABPM of 128/79 mm Hg, whereas oscillometric result was 134/84 mm Hg and the auscultatory result was 132/83 mm Hg, suggesting that AOBP is a more accurate technique than conventional office measurements in the evaluation of an individual's true BP status. Our findings concur with previous results showing similar values for mean AOBP and daytime ABPM, with both values being significantly lower than conventional office readings; this also suggests that white coat hypertension was significantly more prevalent when routine OBP readings were analyzed 6, 8, 16, 17. Staessen et al reviewed 30 studies in which conventional office readings were compared with daytime ABPM in untreated patients with borderline or definite hypertension; their findings showed that mean OBP was 12/2 and 20/1 mm Hg higher, respectively, than the corresponding mean daytime ABPM 18.…”

Section: Discussionsupporting

confidence: 92%

“…4,5 Furthermore, both AOBP and daytime ambulatory BP have been shown to correlate better with left ventricular mass, microalbuminuria, and intima-media thickness of the carotid artery than conventional clinical readings. [6][7][8] In addition to SPRINT, AOBP has also been used for cardiovascular outcomes in a Canadian study of older community-dwelling people followed up for an average of 4.6 years. In this study, AOBP values of 110 to 119 mm Hg were associated with lower cardiovascular risk.…”

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confidence: 99%

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Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Andreadis

Geladari

Angelopoulos

et al. 2018

JAHA

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BackgroundAutomated office blood pressure (AOBP) measurement is superior to conventional office blood pressure (OBP) because it eliminates the “white coat effect” and shows a strong association with ambulatory blood pressure.Methods and ResultsWe conducted a cross‐sectional study in 146 participants with office hypertension, and we compared AOBP readings, taken with or without the presence of study personnel, before and after the conventional office readings to determine whether their variation in blood pressure showed a difference in blood pressure values. We also compared AOBP measurements with daytime ambulatory blood pressure monitoring and conventional office readings. The mean age of the studied population was 56±12 years, and 53.4% of participants were male. Bland–Altman analysis revealed a bias (ie, mean of the differences) of 0.6±6 mm Hg systolic for attended AOBP compared with unattended and 1.4±6 and 0.1±6 mm Hg bias for attended compared with unattended systolic AOBP when measurements were performed before and after conventional readings, respectively. A small bias was observed when unattended and attended systolic AOBP measurements were compared with daytime ambulatory blood pressure monitoring (1.3±13 and 0.6±13 mm Hg, respectively). Biases were higher for conventional OBP readings compared with unattended AOBP (−5.6±15 mm Hg for unattended AOBP and oscillometric OBP measured by a physician, −6.8±14 mm Hg for unattended AOBP and oscillometric OBP measured by a nurse, and −2.1±12 mm Hg for unattended AOBP and auscultatory OBP measured by a second physician).ConclusionsOur findings showed that independent of the presence or absence of medical staff, AOBP readings revealed similar values that were closer to daytime ambulatory blood pressure monitoring than conventional office readings, further supporting the use of AOBP in the clinical setting.

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Andreadis

Geladari

Angelopoulos

et al. 2018

JAHA

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“…1,4 This association is particularly evident for patients with chronic kidney disease [19][20][21] and patients with resistant hypertension. 13,14,[22][23][24] Although in most of these studies such a correlation has been shown to be quite strong with 24-hour ambulatory BP but weaker with routine office BP, [16][17][18]22,23 2 recently published small studies reported similar correlations of microalbuminuria with either high-quality automated office BP 25 or community pharmacy BP and 24-hour ambulatory BP 26 readings. However, there is scarce information about this association for values of UAE below the lower cutoff used for the definition of microalbuminuria.…”

Section: Discussionmentioning

confidence: 62%

Blood Pressure Control Is Similar in Treated Hypertensive Patients With Optimal or With High-Normal Albuminuria

Oliveras¹,

Armario²,

Lucas³

et al. 2014

American Journal of Hypertension

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Blood pressure (BP) control rates are known to be insufficient worldwide. Although some improvement has occurred over time, 1 the lack of BP control has a prevalence of approximately 60% in European countries 2 and >50% in the United States. 1 As regards subclinical target organ damage, left ventricular hypertrophy is associated with worse BP control, 3 and the relationship between urinary albumin excretion (UAE) and BP levels has also been widely explored. Thus, analyses of the data from the National Health and Nutrition Examination Survey have shown an association between microalbuminuria and uncontrolled office BP in a hypertensive population when the cutoff of 30 mg/g of UAE to define microalbuminuria was used, 1,4 regardless of the degree of renal function. On the other hand, several studies have shown the prognostic value of albuminuria for overall mortality and cardiovascular and renal morbidity at levels of UAE well below the cutoff point of 30 mg/g. [5][6][7] Recently, the meta-analysis by Hallan et al. 7 that evaluated large cohorts of general population, vascular high-risk patients, and individuals with chronic kidney disease showed that the association of UAE with end-stage renal disease and mortality risks was linear with no threshold. In agreement with this, the division of normoalbuminuria into 2 different categories-optimal UAE (<10 mg/g) and high-normal UAE (10-29 mg/g)-has been proposed. 8 However, it is unclear whether the relationship between BP and UAE is different between patients with optimal and high-normal UAE. Accordingly, we hypothesize that UAE could be associated with office BP control at levels lower than those that define microalbuminuria (i.e., 30 mg/g) in patients with treated hypertension. Although elevated urinary albumin excretion (UAE) is associated with cardiovascular prognosis and high blood pressure (BP), it is unknown whether differences in BP control could also exist between patients with different grades of UAE, even in the normal range. We sought to explore the association between different levels of UAE and BP control in treated hypertensive patients.

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“…Automated office BP measurement (AOBP) has been proven to correlate well with ABPM . There is also some evidence of a correlation with end‐organ damage . Observer error is eliminated and WCE is greatly reduced if measurement is performed with an observer absent, in an uninterrupted private space.…”

Section: Characteristics Of Common Methods Of Bp Measurementmentioning

confidence: 99%

“…[19][20][21] There is also some evidence of a correlation with end-organ damage. [22][23][24] Observer error is eliminated and WCE is greatly reduced if measurement is performed with an observer absent, in an uninterrupted private space. Measurement is completed with 3 to 6 preprogrammed readings over 4 to 7 minutes.…”

Section: Characteristics Of Common Methods Of Bp Measurementmentioning

confidence: 99%

Choosing the optimal method of blood pressure measurement for limited‐resource rural communities in the “Community Health Assessment Program—Philippines”

Guenter

Angeles

Kaczorowski

et al. 2017

J of Clinical Hypertension

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The Community Health Assessment Program-Philippines (CHAP-P) is an international collaboration of investigators whose aim is to adapt a previously proven Canadian community-based cardiovascular awareness and prevention intervention to the Philippines and other low-middle-income countries. Choosing a method of blood pressure measurement for the research program presents a challenge. There is increasing consensus globally that blood pressure measurement with automated devices is preferred. Recommendations from low-middle-income countries, including the Philippines, are less supportive of automated blood pressure devices. The value placed on factors including device accuracy, durability, cost, energy source, and complexity differ with local context. Our goal was to support the progress of local policy concerning blood pressure measurement while testing a comprehensive approach to community-based screening for cardiovascular risk. The authors describe the challenges in making a choice of blood pressure device and the approach to determine optimal method of measurement for our research program.

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Automated Office Blood Pressure is Associated with Urine Albumin Excretion in Hypertensive Subjects

Abstract: In this study, microalbuminuria correlated similarly with high-quality AOBP and ABP readings, further supporting the use of AOBP in the clinical setting.

Cited by 28 publications

References 19 publications

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Attended and Unattended Automated Office Blood Pressure Measurements Have Better Agreement With Ambulatory Monitoring Than Conventional Office Readings

Blood Pressure Control Is Similar in Treated Hypertensive Patients With Optimal or With High-Normal Albuminuria

Choosing the optimal method of blood pressure measurement for limited‐resource rural communities in the “Community Health Assessment Program—Philippines”

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