Are Unattended Blood Pressure Measurements Necessary in All Patients Visiting an Outpatient Cardiology Clinic?

High Blood Press Cardiovasc Prev. 2020 Oct;27(5):389-397. doi: 10.1007/s40292-020-00402-0. Epub 2020 Jul 27.

Abstract

Introduction: Unattended automatic office blood pressure (BP) measurement has given new evidence regarding treatment goals.

Aim: We aimed to explore any differences between unattended and conventional office BP measurements in different groups of patients visiting a European Society of Hypertension (ESH) Excellence Centre.

Methods: We performed two unattended (Microlife Watch BP Home) followed by a single attended (mercury sphygmomanometer) BP measurement in 310 patients (mean age 62 ± 15 years, 151 males, 64% hypertensives and 36% normotensive individuals) visiting our ESH Centre for a scheduled follow-up. Office BP < 140 mmHg (systolic) and < 90 mmHg (diastolic) were characterized as controlled or normal in hypertensives and normotensive individuals, respectively.

Results: Attended BP (systolic/diastolic) was higher than unattended BP in total population (p < 0.001 and p = 0.02) and hypertensives (p < 0.001). In hypertensives, attended BP was higher than unattended BP regardless of age, smoking habit, obesity or controlled BP status but it was similar to unattended in diabetic patients. In normotensive individuals, attended BP was higher than unattended BP in older (p = 0.04), non-smoker (p = 0.002) and non-diabetic (p = 0.02) subjects. Finally, unattended BP was important for treatment decisions only in a small group of non-diabetic hypertensive patients (7%) whose unattended BP was controlled while attended BP was uncontrolled.

Conclusions: Unattended BP was lower than attended BP in the majority of hypertensive patients. However, it was useful only in a small percentage of non diabetic hypertensive patients in order to take appropriate treatment plan decisions.

Keywords: Automated blood pressure measurement; Conventional office blood pressure measurement; Diabetes mellitus; Unattended blood pressure measurement.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Pressure Determination*
  • Blood Pressure*
  • Cardiology Service, Hospital*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / physiopathology
  • Hypertension / therapy
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results