Title:Automated Office Blood Pressure-Eliminating White Coat Hypertension in Clinical Practice
VOLUME: 8 ISSUE: 2
Author(s):Martin G. Myers
Affiliation:Schulich Heart Program, Division of Cardiology, Sunnybrook Health Sciences Centre, A-202, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5.
Keywords:Blood pressure measurement, automated sphygmomanometers, Hawthorne effect
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.
