The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension

Beckett, Linda; Godwin, Marshall

doi:10.1186/1471-2261-5-18

Cited by 157 publications

(158 citation statements)

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“…In the aforementioned study by Beckett and Godwin, 12 in 481 patients mean awake ambulatory BP (142/80 mm Hg) was similar to the mean of 5 readings taken with the fully automated BpTRU device (140/80 mm Hg) with the patients resting alone in a quiet examining room. Similar findings were noted in a report 9 from another one of our centers with the mean awake ambulatory BP in 309 patients (134/77 mm Hg) being similar to the mean of 5 automated office BP (AOBP) readings (132/75 mm Hg), once again, taken with the patients resting alone in a quiet examining room.…”

Section: Automated Bp Measurement In the Office Settingmentioning

confidence: 99%

“…In the study of Beckett and Godwin, 12 the coefficient of correlation between the mean awake ambulatory systolic/diastolic BP and the family physician's routine BP was (rϭ0.15/rϭ0.32) compared to (rϭ0.57/rϭ0.61) for readings taken with the automated BpTRU device. Similarly, Myers et al 9 reported a higher correlation (rϭ0.62/rϭ0.72) between the mean awake ambulatory systolic/diastolic BP and the automatic office BP compared to the routine family physician readings (rϭ0.32/rϭ0.48).…”

Section: Automated Bp Measurement In the Office Settingmentioning

confidence: 99%

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Measurement of Blood Pressure in the Office

et al. 2010

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T he widely accepted cut-point for normal blood pressure (BP) in the office setting evolved over several decades, based on data derived from a variety of sources. The Actuarial Society of America was one of the first organizations to publish BP data on thousands of community residents, followed by other classic studies such as Framingham, Western Electric Company, Kaiser Permanente, and the Multiple Risk Factor Intervention Trial. 1,2 In every instance, BP readings were based on measurements taken by specially trained health professionals following guidelines for proper BP measurement. As a result of these and other population studies examining the association between different BP levels and cardiovascular outcomes, the importance of systolic and diastolic hypertension was recognized and an office BP of 140/90 mm Hg became the universally established cut-point for separating normal BP from hypertension. Hypertension Is Not Defined by 140/90 in the "Real World"There are robust scientific data to support the use of 140/90 mm Hg to define hypertension in clinical practice guidelines. However, the guidelines do not take into account widely recognized problems associated with the quality of manual BP measurement in routine clinical practice. 3 More recent recommendations 4 for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the "white coat response" is frequently associated with manual BP recordings performed in community-based practice. In recognizing this limitation of manual office BP, some guidelines have gone so far as to recommend that home BP and 24-hour ambulatory BP monitoring (ABPM) may need to be performed to obtain an accurate measure of a patient's BP status. The greater reliance on 24-hour ABPM and home BP in the diagnosis and management of hypertension is the result of numerous clinical outcome studies 5,6 that show that these measurement techniques are better predictors of cardiovascular events when compared to manual BP readings, even when manual readings are taken carefully in accordance with guidelines.However, most guidelines do not seem to have fully considered the impact conventional routine office BP might have on both the cut-point and ongoing management of hypertension as experienced by primary care physicians. In most instances, an office BP of 140/90 mm Hg is equated to a mean home BP or mean awake ambulatory BP of 135/ 85 mm Hg. However, this relationship has been based on BP readings carefully recorded in accordance with guidelines 4 for proper BP measurement (research-quality office BP readings) and may not reflect the BP obtained by doctors, nurses, and other health professionals in routine office practice. Comparison of Casual and Research-Quality Manual BP MeasurementWhen the primary care physician records BP using a mercury or aneroid device, the resulting value frequently tends to be higher than what it would be if measurement guidelines were strictly adhered to. In a 1995 report from one of our centers, 7 BP data were obtained from 147 hypertensiv...

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Section: Automated Bp Measurement In the Office Settingmentioning

confidence: 99%

Section: Automated Bp Measurement In the Office Settingmentioning

confidence: 99%

Measurement of Blood Pressure in the Office

et al. 2010

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“…Pre-enrollment mean BP of 150/81 mmHg was reduced to 136/78 mmHg with AOBP and 141/80 mmHg with MOBP compared to the awake ABPM reading of 133/74 mmHg [27]. In comparison with MOBP in this evaluation and others, a significantly stronger BP correlation exists between mean AOBP and awake ABPM measurements [8,25,27].…”

Section: Automated Office Blood Pressure Monitoringmentioning

confidence: 72%

“…Importantly, AOBP monitoring does not appear to be affected by location [22,23] and has been studied in a variety of different practice settings, ranging from community-based pharmacies [24], primary care practice exam rooms [25], 24-hour ABPM units [8], and waiting rooms [26]. The ability to obtain valid AOBP readings in waiting rooms exemplifies that additional space or a private room is unnecessary to realize benefits from this device.…”

Section: Automated Office Blood Pressure Monitoringmentioning

confidence: 99%

A Modern Method to Monitor Office Blood Pressure

Khazan

Hough

2017

Innov Pharm

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The diagnosis and management of hypertension relies on accurate and precise blood pressure (BP) measurements and monitoring techniques. Variability in traditional office based BP readings can contribute to misclassification and potential misdiagnosis of hypertension, leading to inappropriate treatment and possibly avoidable adverse drug events. Both home blood pressure monitoring (HBPM) and 24-hour ambulatory blood pressure monitoring (ABPM) can improve characterization of BP status over traditional office values and can predict cardiovascular morbidity and mortality risk; however, they are limited by availability and/or practical use in many situations. Available in-office blood pressure measuring methods include manual auscultation, automated oscillometric, and automated office blood pressure (AOBP) devices. A strong correlation exists between AOBP and awake ABPM measurements and has been linked to better prediction of end-organ damage and white coat response compared to standard office BP methods. While AOBP does not provide nocturnal BP readings, it can be utilized in several outpatient settings, and has the capability to decrease utilization of ABPM, white coat effect, and improve optimization of cardiovascular assessment, evaluation, and therapeutic assessment in clinical practice. Hypertension affects over 80 million adults in the United States (US) and is a major risk factor for cardiovascular morbidity and mortality [1]. The condition’s ubiquitous nature and broad impact potentially makes understanding the diagnosis and treatment of hypertension key elements of managing cardiovascular risk. Though much attention is paid to the treatment of hypertension, from 2009 to 2012, 45.9% of US patients with hypertension were uncontrolled [1]. Appreciating the aspects of proper assessment of blood pressure is crucial and creates the foundation for approaching hypertension management. Until recently, hypertension was defined as an appropriately measured office systolic blood pressure (SBP) of greater than or equal to 140 mmHg and/or diastolic blood pressure (DBP) greater than or equal to 90 mmHg, with the patient seated and resting for 5 minutes in a proper position, and preferentially, measured as an average of two readings taken 1 or 2 minutes apart [1-5]. While serving as the primary method, standard office blood pressure assessment with either manual or traditional automated BP cuffs is limited in accuracy and application in everyday practice, and faces many challenges. As such, an understanding of the potential limitations of current BP strategies, and the roles and rationale for novel assessment techniques are of value to clinicians [6]. Conflict of Interest: We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Review

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“…En el levantamiento de Ontario, los promedios de la PA obtenidas con el aparato automático fueron menores cuando comparadas a las lecturas manuales 23 . Las lecturas automáticas, cuando no obtenidas de forma simultánea y realizadas sin la presencia del observador, pueden reflejar el verdadero status de la hipertensión en la población por minimizar el efecto de la bata blanca, ya que hay una gran proximidad entre las lecturas automáticas con el promedio de la PA ambulatoria diurna, medición estándar actual para evaluar el riesgo cardiovascular 29 .…”

Section: Pas (Oscilométrico)unclassified

Pressão arterial obtida pelos métodos oscilométrico e auscultatório antes e após exercício em idosos

Scher

Ferriolli

Moriguti

et al. 2010

Arq. Bras. Cardiol.

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Resultados: En el período pre intervención hubo una buena concordancia entre las mediciones de la presión arterial sistólica (PAS) y diastólica (PAD) obtenidas por los dos métodos, habiendo también elevada concordancia general tras las sesiones (Coeficiente de Lin = 0,82 y 0,81, respectivamente). Hubo mejor concordancia de la PAD tras la sesión control que después de las sesiones de ejercicio. La diferencia entre las medidas obtenidas entre los dos métodos fue mayor para la PAD que para la PAS tras todas las sesiones (p < 0.001). Independientemente del método, se puede verificar el descenso de la PAS y de la PAD que se produjeron en los primeros 60 minutos después de la realización de los ejercicios. Sin embargo, en función del gran número de aparatos en el mercado con esta finalidad, existe la necesidad de que los mismos muestren una similitud con los métodos convencionales (auscultatorio y/o medida intraarterial), y que se validen para poblaciones especiales (adultos mayores, gestantes, niños, etc). Respecto a los monitores Omron, diferentes estudios 3-6 vienen considerando estos tipos de aparatos útiles y validan los mismos para el uso hospitalario y domiciliar, ya que hay una correlación satisfactoria con los valores obtenidos con el método indirecto tradicional. ConclusiónLas evaluaciones de estos monitores semiautomáticos, pre y posejercicio son raras todavía. Existe una necesidad de la utilización práctica de estos aparatos en locales como clubes, academias, escuelas, industrias (local de práctica de gimnástica laboral), centros deportivos y lugares públicos como parques, donde el ruido de músicas, máquinas y voces son muy frecuentes. En el método auscultatorio, para identificar los valores de la PA, es necesario auscultar los latidos cardiacos usualmente en la arteria braquial, característica esta perjudicada por el ambiente que ocasiona interferencia en la precisión de la medida. En contrapartida, IntroducciónLa medida de la presión arterial, muy utilizada en la rutina de las evaluaciones clínicas y científicas, se puede llevar a cabo por diversos métodos, y el método auscultatorio se considera como el más utilizado antes, durante y después del ejercicio físico. Con todo, el uso del método oscilométrico (a través de aparatos automáticos o semiautomáticos), el que no sufre influencia del observador, tiene bajo costo y es de fácil manejo, viene creciendo, tanto en la condición de investigación, como en el ambiente clínico y residencial 1 . Esto se debe a la tendencia mundial del abandono del esfigmomanómetro de mercurio, debido a la polución causada por el metal y la facilidad de manejo de los aparatos automáticos, promocionando una mayor participación de los individuos hipertensos en el control de la PA y en la adhesión al tratamiento 1,2 . 638

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The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension

Cited by 157 publications

References 20 publications

Measurement of Blood Pressure in the Office

Measurement of Blood Pressure in the Office

A Modern Method to Monitor Office Blood Pressure

Pressão arterial obtida pelos métodos oscilométrico e auscultatório antes e após exercício em idosos

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