The Gap Between Manual and Automated Office Blood Pressure Measurements Results at a Hypertension Clinic

Rinfret, Félix; Cloutier, Lyne; L'Archevêque, Hélène; Gauthier, Martine; Laskine, Mikhael; Larochelle, Pierre; Ilinca, Monica; Birnbaum, Leora; Cheong, Nathalie Ng; Wistaff, Robert; Nguyen, P.; Roederer, Ghislaine O.; Bertrand, Michel; Lamarre-Cliché, Maxime

doi:10.1016/j.cjca.2017.01.021

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…Other authors revealed that the mean difference between manual DBP readings and automated values was 1.55 ± 0.93 mm Hg, in favor of manual measurements . Relatively small differences between DBP AOBPM and office or research‐grade measurements (−3.0 and −2.4 mm Hg, respectively), with highly variable differences (standard deviation: 8.8 and 6.3 mm Hg, respectively), were previously reported by Rinfret et al Filipovsky et al showed a moderate correlation between the automated and auscultatory or home BP measurements with large limits of agreement. Similar results were reported between DBP AOBPM and ABPM .…”

Section: Discussionmentioning

confidence: 55%

Determination of optimal on‐treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease—Analysis of a SPRINT trial subpopulation

Sobieraj

Lewandowski

Siński

et al. 2019

J of Clinical Hypertension

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Automated office blood pressure measurement (AOBPM) is recommended for diagnosing hypertension; however, optimal treatment targets using this method are not established. Discrepancies between automated and office measurements of blood pressure have been described, producing uncertainty regarding the use of AOBPM in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) results improved our understanding of target AOBPM systolic blood pressure (SBP) levels; however, diastolic blood pressure (DBP) targets remain unknown. Therefore, we sought to determine the optimal on‐treatment DBP range. The analysis was performed on the participants of the SPRINT trial who had hypertension and prior cardiovascular disease. We analyzed the data of 1470 participants (mean age 70.3 ± 9.3 years, 24.1% female) selected from the SPRINT trial database of National Heart, Lung and Blood Institute. The mean achieved SBP and DBP were 127.9 ± 10.7 and 68.3 ± 9.4 mm Hg, respectively. Most of the participants (57.4%) had a DBP lower than 70 mm Hg, while only 11.7% had DPB ≥80 mm Hg. Clinical composite endpoint was defined as myocardial infarction, acute coronary syndrome not resulting in myocardial infarction, stroke, acute decompensated heart failure or death from cardiovascular causes. There were 159 (10.8%) clinical endpoint events. The participants with on‐treatment AOBPM DBP range of 68.6‐78.6 mm Hg showed the lowest hazard risk of a clinical composite endpoint. These results correspond to the office DBP range of 70‐80 mm Hg recommended in ESC guidelines. This is the first attempt to determine the range of optimal DBP values using population‐based AOBPM in patients with prior cardiovascular disease.

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Section: Discussionmentioning

confidence: 55%

Determination of optimal on‐treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease—Analysis of a SPRINT trial subpopulation

Sobieraj

Lewandowski

Siński

et al. 2019

J of Clinical Hypertension

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“…Only attrition bias was relevant in 7 studies due to missing data (BP readings missing, patients lost at follow-up). 16 studies compared AOBP with traditional OBP taken by physicians 4,8,10,12,19,[21][22][23][24]27,28,30,[32][33][34]37 ; 16 studies compared AOBP with awake ABPM 4,8,10,18,19,20,22,[24][25][26]29,[33][34][35]37,38 ; AOBP was compared with HBPM in 7 studies 10,12,24,27,28,30,38 and with non-physician OBP in 10 studies 4,8,15,[18][19][20]31,[36][37][38] .…”

Section: Characteristic Of the Included Studiesmentioning

confidence: 99%

Comparison of Automated Office Blood Pressure With Office and Out-Off-Office Measurement Techniques

et al. 2019

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Automated office blood pressure (AOBP) has emerged as valuable tool to assess patient's blood pressure (BP) status, but the lack of strong evidences to establish a threshold value for hypertension diagnosis limits its use in clinical practice. We aimed at synthesizing the published literature through a meta-analysis of studies comparing AOBP with other BP measurement techniques and at analysing the differences between AOBP and physician's office BP, non-physician's office BP, daytime ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). We searched PubMed database for articles published up to April 2018; eligible studies compared AOBP with office and/or out-of-office measurement techniques and reported the BP differences or BP values obtained. Twenty-six studies, for a total of 7,116 patients were included in the analysis. AOBP values were lower than physician (systolic blood pressure, SBP-10.48 mmHg [95% CI-13.15 to-7.81] / diastolic blood pressure, DBP-4.44 mmHg [95% CI-6.07 to-2.80]) and non-physician office ones (SBP-6.89 mmHg [95% CI-8.75 to-5.04] / DBP-3.82 mmHg [95% CI-4.86 to-2.78]). No significant differences were detected between AOBP and daytime ABPM (SBP-1.85 mmHg [95% CI-4.50 to 0.79] / DBP 0.12 mmHg [95% CI-1.42 to 1.66]) and HBPM (SBP-2.65 mmHg [95% CI-8.42 to 3.12]) / DBP-1.67 mmHg [95% CI-4.20 to 0.87]). AOBP readings did not differ significantly from out-of-office blood pressure, still remaining an office technique; it may improve hypertension diagnosis by overcoming some of office BP limitations, including the white-coat effect.

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“…We relied on clinical BP measures, which are known to vary. There is evidence, however, that clinical measures are not systematically different from research BP measures [30] and many large studies have relied on clinical BP measures to describe patterns associated with adverse pregnancy outcomes [31]. In addition, larger studies with a greater number of non-acute pre-pregnancy BP measures are needed to validate our findings.…”

Section: Discussionmentioning

confidence: 79%

Pre-conception blood pressure and evidence of placental malperfusion

Atlass

Menke

Parks

et al. 2020

BMC Pregnancy Childbirth

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Background: Evidence of placental maternal vascular malperfusion is associated with significant perinatal outcomes such as preeclampsia, intrauterine growth restriction and preterm birth. Elevations in pre-pregnancy blood pressure increase the risk for poor perinatal outcomes; however, the evidence linking pre-pregnancy blood pressure and placental malperfusion is sparse. Materials and methods: We conducted a retrospective case-control study of women with singleton gestations with placental evaluations who delivered at Magee-Womens Hospital in 2012. Charts from 100 deliveries with placental malperfusion lesions (vasculopathy, advanced villous maturation, infarct, or fibrin deposition) and 102 deliveries without placental malperfusion were randomly selected for screening. Blood pressure, demographic, and clinical data were abstracted from pre-pregnancy electronic medical records and compared between women with and without subsequent placental malperfusion lesions. Results: Overall, 48% of women had pre-pregnancy records, and these were similarly available for women with and without placental malperfusion. Women with placental malperfusion demonstrated a reduction in their pre-to early pregnancy decrease in diastolic blood pressure (DBP). Adjusted for race, pre-pregnancy BMI, age, pre-conception interval, and gestational age at the first prenatal visit, the difference in pre-to early pregnancy DBP was significantly less in women with placental malperfusion compared to those without this pathologic finding (− 1.35 mmHg drop vs − 5.6mmg, p < 0.05). Conclusion: A blunted early gestation drop in DBP may be a risk factor for placental malperfusion, perhaps related to early pregnancy vascular maladaptation. The ability of the electronic medical record to provide pre-pregnancy data serves as an underutilized approach to study pre-pregnancy health.

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The Gap Between Manual and Automated Office Blood Pressure Measurements Results at a Hypertension Clinic

Cited by 17 publications

References 22 publications

Determination of optimal on‐treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease—Analysis of a SPRINT trial subpopulation

Determination of optimal on‐treatment diastolic blood pressure range using automated measurements in subjects with cardiovascular disease—Analysis of a SPRINT trial subpopulation

Comparison of Automated Office Blood Pressure With Office and Out-Off-Office Measurement Techniques

Pre-conception blood pressure and evidence of placental malperfusion

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