Key result
Attended automated SBP readings run ~6 mmHg higher than unattended readings in clinical practice.
Why the study?
Recent studies have questioned the equivalence between attended and unattended automated office blood pressure, and further research is needed to determine the optimum technique for recording office BP at target.
Does attended automated office blood pressure measurement yield different systolic readings compared to unattended measurement or awake ambulatory blood pressure?
Does attended automated office blood pressure measurement yield different systolic readings compared to unattended measurement or awake ambulatory blood pressure?
Mean Difference: 5.8
The presence of staff during automated office blood pressure measurement increases systolic readings compared to unattended or ambulatory measurements, which may impact hypertension diagnosis and target achievement.
May affect hypertension diagnosis and targets in practice; leaves open whether unattended protocols merit guideline priority.
: The main advantage of automated office (AO)BP in hypertension screening is that it eliminates white-coat effect seen in routine office practice, with readings similar to awake ambulatory (A)BP. Recent studies examining the possible equivalence between AOBP recorded with and without research staff present have reported attended systolic AOBP to be 5.8 mmHg higher. Moreover, attended automated SBP readings in 27 211 patients in clinical practice were 25 mmHg higher than awake ABP. These data are consistent with the presence of staff increasing AOBP. In research studies, all types of office BP measurement at target SBP less than 130 mmHg were generally lower than awake ABP, whereas, in clinical practice, attended automated office BP was slightly higher than awake ABP. However, AOBP may still be preferred, if target BP is to be similar to 24-h ABP. Further research is needed to determine the optimum technique for recording office BP at target.
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Myers et al. (2020) conducted a review in Hypertension (n=27,211). Attended automated office blood pressure measurement vs. Unattended automated office blood pressure measurement or awake ambulatory blood pressure was evaluated on Systolic blood pressure difference (MD 5.8 mmHg). Attended automated systolic blood pressure readings were 5.8 mmHg higher than unattended readings and 25 mmHg higher than awake ambulatory blood pressure in clinical practice.
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