Key result
Thirty-minute automated office blood pressure measurement resulted in systolic readings 7.6 mmHg lower than standardised measurements and demonstrated significantly better repeatability.
Why the study?
Does 30-minute automated office blood pressure measurement improve repeatability and reduce measurement bias compared to standardised office blood pressure measurement in adult general practice patients?
Observational (n=83)
Yes
Does 30-minute automated office blood pressure measurement improve repeatability and reduce measurement bias compared to standardised office blood pressure measurement in adult general practice patients?
Effect estimate: Mean difference 7.6 mmHg (95% CI 6.1 to 9.1)
Absolute Event Rate: 126.8% vs 134.4%
Thirty-minute automated office blood pressure measurement yields significantly lower and more reproducible readings than standardized office measurements, suggesting it better reflects true blood pressure by reducing the white-coat effect.
May reduce white-coat bias in office BP assessment; hypothesis-generating for adoption pending prospective validation.
BACKGROUND: Although blood pressure measurement is one of the most frequently performed measurements in clinical practice, there are concerns about its reliability. Serial, automated oscillometric blood pressure measurement has the potential to reduce measurement bias and white-coat effect'. AIM: To study agreement of 30-minute office blood pressure measurement (OBPM) with standardised OBPM, and to compare repeatability. DESIGN AND SETTING: Method comparison study in two general practices in The Netherlands. METHOD: Thirty-minute and standardised OBPM was carried out with the same, validated device in 83 adult patients, and the procedure was repeated after 2 weeks. During 30-minute OBPM, blood pressure was measured automatically every 3 minutes, with the patient in a sitting position, alone in a quiet room. Agreement between 30-minute and standardised OBPM was assessed by Bland-Altman analysis. Repeatability of the blood pressure measurement methods after 2 weeks was expressed as the mean difference in combination with the standard deviation of difference (SDD). RESULTS: Mean 30-minute OBPM readings were 7.6/2.5 mmHg (95% confidence interval [CI] = 6.1 to 9.1/1.5 to 3.4 mmHg) lower than standardised OBPM readings. The mean difference and SDD between repeated 30-minute OBPMs (mean difference = 3/1 mmHg, 95% CI = 1 to 5/0 to 2 mmHg; SDD 9.5/5.3 mmHg) were lower than those of standardised OBPMs (mean difference = 6/2 mmHg, 95% CI = 4 to 8/1 to 4 mmHg; SDD 10.9/6.3 mmHg). CONCLUSION: Thirty-minute OBPM resulted in lower readings than standardised OBPM and had a better repeatability. These results suggest that 30-minute OBPM better reflects the patient's true blood pressure than standardised OBPM does.
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Haan et al. (2011) conducted an observational in Patients requiring blood pressure measurement in general practice (n=83). 30-minute automated office blood pressure measurement (30-minute OBPM) vs. Standardised office blood pressure measurement was evaluated on Mean difference in systolic blood pressure between standardised OBPM and 30-minute OBPM (Mean difference 7.6 mmHg, 95% CI 6.1 to 9.1). Thirty-minute automated office blood pressure measurement resulted in systolic readings 7.6 mmHg lower than standardised measurements and demonstrated significantly better repeatability.
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