Automated Office Blood Pressure-Eliminating White Coat Hypertension in Clinical Practice

Martin      G. Myers

Abstract

Manual blood pressure (BP) measurement performed according to established guidelines has been the standard method for assessing an individual’s BP status. However, manual BP readings in routine clinical practice rarely adhere to these guidelines with the result that routine office BP is relatively less accurate and about 10/5 mmHg higher than readings taken in the same patient as part of a research study. Automated office BP (AOBP) virtually eliminates officeinduced hypertension (white coat effect) with readings being similar to the awake ambulatory BP and home BP. AOBP also correlates significantly better with the awake ambulatory BP than does manual BP obtained in routine clinical practice. Several devices are now available to health professionals for recording AOBP in clinical practice. AOBP readings are consistent from visit to visit and when taken in different settings. Readings can be obtained during a 4 – 5 minute period with only a one minute interval between readings. AOBP is also not subject to digit preference (rounding off readings to zero values) which is common with routine manual BP. The three principles of AOBP include multiple readings taken with a fully automated sphygmomanometer with the patient being alone. The cut-point for a normal AOBP versus hypertension (135/85 mmHg) is the same as for both the awake ambulatory BP and home BP.

Keywords: Blood pressure measurement, automated sphygmomanometers, Hawthorne effect

« Previous Next »