Diagnosis of hypertension using home or ambulatory blood pressure monitoring: comparison with the conventional strategy based on repeated clinic blood pressure measurements

Stergiou, George S.; Skeva, Irini I.; Baibas, N. M.; Kalkana, Chrysa B.; Roussias, Leonidas G.; Mountokalakis, Theodore D.

doi:10.1016/s0895-7061(00)00725-1

Cited by 53 publications

(77 citation statements)

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“…The structured nature of the comparison in this study arguably explains why we have demonstrated a higher correlation between SBPM and ABPM than in previous studies. [35][36][37] As SBPM is equivalent to ABPM at predicting target organ damage, 37,38 it could be surmised that differences between ABPM and SBPM are simply because of different measurement strategies, rather than reflecting any real difference in BP.…”

Section: Discussionmentioning

confidence: 99%

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

McGowan

Padfield

2010

J Hum Hypertens

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lines for self-monitoring of blood pressure (SBPM). We aimed to demonstrate the equivalence of SBPM with ambulatory blood pressure monitoring (ABPM) in the assessment of hypertension. A total of 87 consecutive subjects referred from primary care for standard ABPM underwent a 1-week period of SBPM, as defined by the ESH guidelines, either before or after ABPM. There was no difference in mean blood pressure (BP): SBPM 142/ 87 mm Hg, daytime average ABPM 141/86 mm Hg. The intra-class correlation coefficient was 0.72 and 0.89 for systolic and diastolic pressure, respectively. SBPM is concordant with ABPM in classifying subjects as hypertensive or normotensive in 87% of cases (j ¼ 0.56). The coefficient of variation of SBPM compared with ABPM was 5%. In answer to a direct question 81% of subjects preferred SBPM to ABPM. The current self-monitoring schedule recommended by the ESH, AHA and ASH is valid. The mean BP obtained from SBPM is equivalent to awake-time BP on ABPM, the accepted reference standard for 'out of office' BP measurement. SBPM is simpler to carry out, preferred by patients and should be considered on a par with ABPM.

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Section: Discussionmentioning

confidence: 99%

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

McGowan

Padfield

2010

J Hum Hypertens

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“…[1][2][3][4][5][6] This is because this method has stronger prognostic ability than the conventional office measurements, 7 increases the precision of the diagnosis of hypertension by detecting the white coat and the masked hypertension phenomena [8][9][10] and improves patients' compliance and hypertension control rates. 11,12 An important practical issue in the clinical application of home BP monitoring is to define the optimal schedule of measurements.…”

Section: Introductionmentioning

confidence: 99%

The optimal home blood pressure monitoring schedule based on the Didima outcome study

et al. 2009

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This study investigated the optimal schedule for home blood pressure (HBP) monitoring that has the greatest prognostic ability and provides the most reliable assessment of HBP. The Didima study assessed the value of HBP (duplicate morning and evening measurements, 3 days) in predicting cardiovascular events in the general population (662 adults, 8.2±0.2 years followup). Criteria for the optimal monitoring schedule were stabilization of mean HBP, its variability (standard deviation (s.d.)) and hazard ratios (HRs) of cardiovascular events per 1 mm Hg HBP increase. By averaging more readings (1-12), there was a progressive decline in average HBP and its s.d. and increase in HR, with most of these benefits achieved on the second day (8 readings) and little additional benefit obtained on the third day (12 readings). The first day gave higher and more unstable HBP values (higher s.d.) with less prognostic ability (lower HR). The first HBP readings per occasion gave higher values but with similar prognostic ability as the second readings taken 1 min later. There was little difference in average HBP between morning and evening readings with no prognostic superiority of morning readings. In conclusion, by averaging more readings the average HBP and its variability are reduced and the prognostic ability improved. Any aspect of HBP monitoring (first or second readings, morning or evening) has similar prognostic ability. The first day gives higher and unstable values with lower prognostic ability and should be better discarded. These data validate the HBP monitoring schedule proposed by the European Society of Hypertension.

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“…Some studies found no difference between HBP and daytime ABP, [4][5][6][7] whereas others showed the HBP values to be higher 8 or lower, 9-11 particularly in children and adolescents. [12][13][14] Differences in BP levels between the two methods in these studies are attributed to intrinsic differences between the two methods, but also, at least in part, to the different devices used for each method (ambulatory and home monitoring).…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Numerous studies have compared HBP with ABP measurements. [4][5][6][7][8][9][10][11][12][13][14] In each of these studies, HBP and ABP measurements have been obtained using different devices, usually oscillometric, but of different manufacturers specifically designed for each method. 15 Thus, the observed differences in BP levels between these two methods are attributed, at least in part, to the different devices used.…”

Section: Introductionmentioning

confidence: 99%

Are there really differences between home and daytime ambulatory blood pressure? Comparison using a novel dual-mode ambulatory and home monitor

et al. 2009

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Several studies compared blood pressure (BP) at home (HBP) with ambulatory BP (ABP), but using different devices, which contribute to differences in measured BP. A novel dual-mode device allowing ABP and HBP monitoring (Microlife WatchBPO3) was validated according to the European Society of Hypertension International Protocol and used to compare the two methods. In the validation study, 33 subjects were assessed with simultaneous BP measurements taken by 2 observers (connected mercury sphygmomanometers) 4 times, sequentially with 3 measurements taken using the tested device. Absolute observer-device BP differences were classified within 5/10/15 mm Hg zones. Measurements with p5 mm Hg difference were calculated per participant. In the validation study, the device produced 70/89/96 measurements within 5/10/15 mm Hg, respectively, for systolic BP and 67/95/99 for diastolic BP. Twenty-eight subjects had at least two of their systolic BP differences p5 mm Hg and one subject had no difference p5 mm Hg, whereas for diastolic BP, it was 22 and 1 subjects, respectively. Mean device-observers BP difference was À0.3±5.6/À2.4±4.8 mm Hg (systolic/diastolic). In the application study, the difference between daytime ABP and HBP was 0.5 ± 7.9 mm Hg for systolic BP (mean ± standard deviation, 95% confidence intervals (CI) À1.9, 2.9, P ¼ NS) and 0.6 ± 5.5 for diastolic BP (95% CI À1.1, 2.3, P ¼ NS). In conclusion, the Microlife WatchBPO3 device for ABP and HBP monitoring fulfils the International Protocol validation criteria. Using this device, no clinically important difference between daytime ABP and HBP was detected. These data justify the use of the same diagnostic threshold for both methods.

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Diagnosis of hypertension using home or ambulatory blood pressure monitoring: comparison with the conventional strategy based on repeated clinic blood pressure measurements

Cited by 53 publications

References 0 publications

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

Self blood pressure monitoring: a worthy substitute for ambulatory blood pressure?

The optimal home blood pressure monitoring schedule based on the Didima outcome study

Are there really differences between home and daytime ambulatory blood pressure? Comparison using a novel dual-mode ambulatory and home monitor

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