Office blood pressure measurement in the 21st century.
Measurement of blood pressure (BP) using the auscultatory method must follow specific rules and conditions to be reliable. Nonetheless, these requirements are often not followed in clinical practice, resulting in inaccurate BP readings. Simply replacing manual sphygmomanometers with an oscillometric device may still produce readings that are associated with a white coat effect. These limitations can be overcome by using an oscillometric sphygmomanometer that automatically records multiple readings with the patient resting quietly and alone, called automated office (AO)BP. AOBP produces office readings with a reduced white coat effect, which are also similar to the awake ambulatory BP. There is also evidence that AOBP is a better predictor of target organ damage than attended office BP. Furthermore, clinical outcome data support AOBP as having both a similar diagnostic threshold as awake ambulatory BP and a lower treatment target. Using AOBP in clinical practice simplifies recording office BP by not requiring an additional period of rest before activation of the device and by not having staff present during the actual measurements. Recent studies have reported that automatic BP measurements taken by staff in research studies with close adherence to guidelines using AOBP devices may produce similar readings to AOBP. Further research is needed to determine the best method for recording BP at systolic targets < 130 mm Hg and the relationship of office BP to ambulatory BP and home BP.
['Myers|Martin G|MG|0000-0003-0468-5417', 'Asmar|Roland|R|', 'Staessen|Jan A|JA|']
D000368:Aged D000369:Aged, 80 and over D001314:Auscultation D001331:Automation D001794:Blood Pressure D001795:Blood Pressure Determination D018660:Blood Pressure Monitoring, Ambulatory D019983:Guideline Adherence D006801:Humans D006973:Hypertension D009819:Office Visits D009991:Oscillometry D012146:Rest D019722:Sphygmomanometers D013599:Systole D059466:White Coat Hypertension
blood pressure measurement automated sphygmomanometers hypertension diagnosis