Long-term relationship between unattended automated blood pressure and auscultatory BP measurements in hypertensive patients

Authors

SEIDLEROVÁ Jitka CERAL Jiří MATEŘÁNKOVÁ Markéta KÖNIG Petr ŘIHÁČEK Ivan VYSOČANOVÁ Petra SOUČEK Miroslav FILIPOVSKÝ Jan

Year of publication 2019
Type Article in Periodical
Magazine / Source BLOOD PRESSURE
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.1080/08037051.2018.1540260
Doi http://dx.doi.org/10.1080/08037051.2018.1540260
Keywords Ambulatory blood pressure monitoring; attended office blood pressure; BPTru device; blood pressure measurement; unattended automated blood pressure
Description Aims: Unattended automated office blood pressure (uAutoOBP) has attracted more attention since SPRINT trial had been published. However, its long-term relationship to attended office blood pressure (AuscOBP) is not known. Material and methods: Stable treated hypertensive subjects were examined in four Czech academic hypertension centers. All subjects attended four clinical visits three months apart. uAutoOBP was measured with the BP Tru device; AuscOBP was measured three times with auscultatory method by the physician. 24-hour ambulatory blood pressure monitoring (ABPM) was performed within one week from the second clinical visit. Results: Data on 112 subjects aged 65.6 +/- 10.8 years with mean AuscOBP 128.2 +/- 12.2/78.5 +/- 10.3 mm Hg are reported. Across the four clinical visits, the uAutoOBP was by 10.1/3.7 mm Hg lower than AuscOBP and the mean difference was similar during all four visits (P >=.061). Both uAutoOBP and AuscOBP had similar intra-individual variability during study follow-up as demonstrated by similar intraclass correlation coefficients (ICC, for systolic ICC = 0.50, for diastolic ICC = 0.72). However, the intra-individual variability of the systolic AuscOBP and uAutoOBP difference was high as demonstrated by low ICCs for absolute (ICC = 0.17 [95%CI, 0.09 - 0.25]) and low kappa coefficients for categorized differences (kappa <= 0.16). The main determinant of AuscOBP-uAutoOBP difference was AuscOBP level. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. Conclusions: Although mean AuscOBP-uAutoOBP differences were relatively similar across the four clinical visits, intra-individual variability of this difference was high. The AuscOBP-uAutoOBP difference was poor tool to identify hypertension control categories defined on the basis of AuscOBP and ABPM. Therefore, uAutoOBP cannot be used as a replacement for ABPM.

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