Key result
Unattended automated blood pressure measurement reduces systolic readings by ~9 mmHg versus attended measurement.
Why the study?
Hypertension is prevalent and poorly controlled in rheumatoid arthritis, but data on unattended BP measurement and its impact on hypertensive organ damage are very limited.
Does unattended blood pressure measurement yield lower values and correlate better with left ventricular mass compared to traditional attended measurement in patients with rheumatoid arthritis?
RCT (n=62)
Open-label
Randomised cross-over
No
Does unattended blood pressure measurement yield lower values and correlate better with left ventricular mass compared to traditional attended measurement in patients with rheumatoid arthritis?
In patients with rheumatoid arthritis, unattended automated blood pressure measurement yields significantly lower values than traditional attended measurement and correlates more closely with left ventricular mass, suggesting it may better reflect hypertension-induced target organ damage.
Answers are grounded in this paper and cite their sources.
Favors unattended automated BP measurement in rheumatoid arthritis to minimize overestimation; extends white-coat effect mitigation to this high-risk population.
BACKGROUND: Hypertension is characterised by a high prevalence, low awareness and poor control among rheumatoid arthritis (RA) patients. Correct blood pressure (BP) measurement is highly important in these subjects. The "unattended" BP measurement aims to reduce the "white-coat effect," a phenomenon associated with cardiovascular risk. Data on "unattended" BP measurement in RA and its impact on hypertensive organ damage are very limited. METHODS: BP was measured in the same patient both traditionally ("attended" BP) and by the "unattended" protocol (3 automated office BP measurements, at 1-min intervals, after 5 min of rest, with patient left alone) by a randomised cross-over design. Patients underwent clinical examination, 12-lead electrocardiography and trans-thoracic echocardiography to evaluate cardiac damage. CONCLUSIONS: In RA patients, "unattended" BP is lower than traditional ("attended") BP and more closely associated with LV mass. In these patients, the "unattended" automated BP measurement is a promising tool which requires further evaluation.KEY MESSAGES"Unattended" automated blood pressure registration, aimed to reduce the "white-coat effect" is lower than "attended" value in rheumatoid arthritis patients."Unattended" blood pressure is more closely associated with left ventricular mass than "attende" registration.
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Bartoloni et al. (2021) conducted an RCT in Rheumatoid arthritis (n=62). Unattended automated blood pressure measurement vs. Traditional attended blood pressure measurement was evaluated on Systolic blood pressure (MD -8.8 mmHg, p=<0.0001). Unattended automated blood pressure measurement yielded significantly lower systolic values (121.7 vs 130.5 mmHg, p<0.0001) compared to traditional attended measurement in patients with rheumatoid arthritis.
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