Document Detail


A proposed algorithm for diagnosing hypertension using automated office blood pressure measurement.
MedLine Citation:
PMID:  20150823     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To validate an algorithm for the interpretation of automated office blood pressure (AOBP) measurement based upon data from untreated patients referred by physicians in the community for 24-h ambulatory blood pressure monitoring (ABPM).
METHODS: An algorithm for interpreting AOBP readings was developed taking into account the previously documented equivalence of AOBP and mean awake ambulatory BP (ABP; mmHg), which were each classified as optimum BP (<130/80), borderline BP (130-139/80-89) and hypertension (>or=140/90). This classification was applied to data derived from 254 untreated patients undergoing 24-h ABPM, AOBP and routine manual BP taken at the patient's own family physician's office.
RESULTS: The mean awake ABP (135.3 +/- 12.4/81.0 +/- 10.2) was similar to the mean AOBP (132.6 +/- 17.4/80.0 +/- 11.1) with both values being significantly (P < 0.001) lower than the routine manual BP (149.7 +/- 15.2/89.3 +/- 9.5). Of the 69 patients with a systolic AOBP at least 140, only five (7.3%) exhibited white-coat hypertension with a normal mean awake ambulatory systolic BP less than 130. Similarly, of the 47 patients with a diastolic AOBP at least 90, none had optimum BP (diastolic BP < 80 mmHg on ABPM). White-coat hypertension was significantly (P = 0.005/P = 0.006) more prevalent for systolic/diastolic BP (22.1%/13.4%) when routine, manual BP readings were analysed.
CONCLUSION: In contrast to routine manual office BP, a diagnosis of hypertension by AOBP is unlikely to be associated with an optimum awake ABP.
Authors:
Martin G Myers
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  703-8     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Cardiology, University of Toronto, Schulich Heart Centre, Toronto, Ontario, Canada. martin.myers@sunnybrook.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Algorithms*
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Female
Humans
Hypertension / diagnosis*,  physiopathology
Male
Middle Aged
Office Automation*
Systole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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