Key result
Multiple steady office BP readings match ambulatory 24-hour averages within ~8 mmHg for SBP.
Why the study?
The possible equivalence and reproducibility between office patient-recorded blood pressure and ambulatory blood pressure measurements were uncertain.
Does office patient-recorded blood pressure provide equivalent reproducibility and agreement compared to 24-h ambulatory blood pressure in untreated patients?
Observational (n=59)
Randomly ordered sessions
Does office patient-recorded blood pressure provide equivalent reproducibility and agreement compared to 24-h ambulatory blood pressure in untreated patients?
Multiple 'steady' office blood pressure readings averaged over two to four visits can provide equivalent reproducibility to 24-hour ambulatory monitoring.
Answers are grounded in this paper and cite their sources.
May support averaged office BP as practical ABPM alternative in untreated patients; leaves open validation in treated or higher-risk groups.
A possible equivalence of office (Off) patient-recorded blood pressure (BP) and ambulatory (Amb) BP was evaluated. The criteria were the between-visits reproducibility (R) of oscillometrically measured supine office (Off), seated Off, and 24-h Amb BP and the agreement between Off and Amb data. Randomly ordered sessions were completed within 4 months in 59 untreated patients with Amb 24-h BP 136/87 (SD 14/10) mmHg and HR 72 (SD 9). R improves as SD of differences between sessions decreases with the number (n) of values included in the average so that SDD = a n(-b), where a and b are constants for each method, data sampling strategy, and group. R of a few steady Off data is better than R of a few Amb data. As n of the averaged values increases, R of Off and Amb methods converges and with n approximately 24 becomes identical. Only further increase in n of Amb data makes R of the Amb method superior than the Off method. The variably elevated initial Off BP distorts R and agreement. After approximately 6 readings, Off BP stabilizes at a lower "steady" level. "Steady" data averaged over visits are close to the Amb 24-h average from two sessions. Supine Off "steady" level is close to supine levels before sleep. The Off versus Amb method agreement improves by averaging "steady" BP from one up to four Off sessions, up to 7 "steady" Off readings over a session, and BP in both arms. At best the SBP agreement is within +/- 7.6 mmHg in 90% of cases with 24-h Amb S/D BP ranging 115-155/75-105 mmHg. The casually elevated BP can be evaluated only by the demonstrated between-visits reproducible 24-h Amb average or by the nearly equivalent average of multiple "steady" data from two to four Off visits.
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K Pávek (2000) conducted an observational in Untreated patients with elevated blood pressure (n=59). Ambulatory blood pressure measurement vs. Office blood pressure measurement was evaluated on Between-visits reproducibility and agreement between office and ambulatory blood pressure data. Ambulatory 24-hour blood pressure averages are nearly equivalent to the average of multiple steady office blood pressure readings from two to four visits, with SBP agreement within +/- 7.6 mmHg.
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