The shortest automated office blood pressure protocol (3/30/30) did not differ significantly from the longest protocol (5/60/60) in systolic or diastolic hypertension classification.
Observational (n=212)
No
Does a shorter unattended automated office blood pressure protocol (3-minute delay, 30-second intervals) provide similar accuracy to the standard 5-minute delay, 60-second interval protocol in patients referred for hypertension evaluation?
Shorter automated office blood pressure protocols (3-minute delay, 30-second intervals) provide similar accuracy to standard longer protocols, which may improve clinical adoption by saving time.
BACKGROUND: Guidelines advise automated office blood pressure (AOBP) with an initial 5-minute delay and multiple measurements at least 60 seconds apart. Recent studies suggest that AOBP may be accurate with shorter delays or intervals, but evidence in clinical settings is limited. METHODS: Patients referred to 1 hypertension (HTN) center underwent 24-hour ambulatory blood pressure monitoring (ABPM) and 1 of 4 nonrandomized, unattended AOBP protocols: a 3- or 5-minute delay with a 30- or 60-second interval, i.e., 3 min/30 s/30 s, 3/60/60, 5/30/30 and 5/60/60 protocols. HTN was defined as systolic blood pressure (SBP) ≥140 or diastolic blood pressure ≥90 mm Hg. RESULTS: We compared differences in mean blood pressure and HTN classification between average AOBP and awake-time ABPM by t-tests and Fisher's exact test. Among 212 participants (mean 58.9 years, 61% women, 25% Black), there was substantial overlap in the probability distributions of awake-time ABPM and each of the 3 AOBP measures. SBP means were similar between the 5/60/60 and 3/30/30 protocols and 5/30/30 and 3/60/60 protocols. The 5/30/30 was associated with a higher proportion of systolic HTN, while the 3/60/60 protocol was associated with a higher proportion of diastolic HTN. There were no significant differences in systolic or diastolic HTN between 5/60/60 and 3/30/30 protocols with respect to awake-time ABPM. CONCLUSIONS: In this quality improvement study, the shortest AOBP protocol did not differ significantly from the longest protocol. The time savings of shorter protocols may improve AOBP adoption in clinical practice without meaningfully compromising accuracy.
Lynn-Green et al. (Thu,) conducted a observational in Hypertension (n=212). 3-minute delay with 30-second interval AOBP protocol vs. 5-minute delay with 60-second interval AOBP protocol was evaluated on Differences in mean blood pressure and hypertension classification between average AOBP and awake-time ABPM. The shortest automated office blood pressure protocol (3/30/30) did not differ significantly from the longest protocol (5/60/60) in systolic or diastolic hypertension classification.
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