A single office blood pressure measurement differed from the mean of three consecutive measurements by >10 mm Hg systolic in 25.9% of subjects, resulting in 34.3% short-term white coat hypertension.
Cross-Sectional (n=1,000)
No
Does a single office blood pressure measurement reliably reflect the mean of consecutive measurements in adult subjects?
A single office blood pressure measurement frequently differs significantly from the mean of consecutive measurements, leading to potential overdiagnosis of hypertension.
OBJECTIVES: Standard operating procedures for office blood pressure measurement (OBPM) vary greatly between guidelines and studies. We aimed to compare the difference between a single OBPM and the mean of the three following measurements. Further, we studied how many patients with possible hypertension may be missed due to short-term masked hypertension (STMH) and how many might be overdiagnosed due to short-term white coat hypertension (STWCH). DESIGN AND SETTING: In this cross-sectional, single-centre trial, 1000 adult subjects were enrolled. After 5 min of rest, four sequential standard OBPMs were performed at 2 min intervals in a quiet room in sitting position. We compared the first (fBPM) to the mean of the second to fourth measurement (mBPM). STMH was defined as fBPM 2 mm Hg, >5 mm Hg and >10 mm Hg, respectively. In 3.4% of initially normotensives STMH and in 34.3% of initially hypertensives, STWCH was apparent. CONCLUSIONS: There are significant differences between a single OBPM and the mean of consecutive BP measurements. Our study provides evidence that a single OBPM should not be the preferred method and should be discouraged in future guidelines. TRIAL REGISTRATION NUMBER: NCT02552030;Results.
Burkard et al. (Mon,) conducted a cross-sectional in Hypertension (n=1,000). Single office blood pressure measurement vs. Mean of three consecutive measurements was evaluated on Difference between a single OBPM and the mean of the three following measurements. A single office blood pressure measurement differed from the mean of three consecutive measurements by >10 mm Hg systolic in 25.9% of subjects, resulting in 34.3% short-term white coat hypertension.