Automated office blood pressure measurement in Chinese older people in a clinic setting

Abstract

Background: Automated office blood pressure (AOBP) measurement can eliminate the white coat effect of conventional office blood pressure (COBP) measurement. This study aimed to investigate whether AOBP measurement in a waiting area (wa-AOBP) can eliminate the white coat effect and to compare wa-AOBP measurement with home blood pressure monitoring (HBPM) measurements. Methods: A cross-sectional cohort of Chinese older people aged ?65 years who attended a private clinic for management of primary hypertension was recruited between October to December 2019. COBP was measured after a 5-minute rest period, whereas wa-AOBP was measured in the waiting area after leaving the subject unattended for 3 minutes, and the average of three measurements taken at 1-minute intervals was recorded. HBPM measurement was calculated from the average of seven daily measurements. A blood pressure (BP) difference of ?5 mmHg was considered clinically significant. Results: In 133 subjects (mean age, 73.5±6.0 years), respectively for COBP, waAOBP, and HBPM, the mean systolic BP was 133.5±13.2, 127.8±11.0, and 126.2±7.6 mmHg, and the mean diastolic BP was 73.3±9.9, 70.9±8.2, and 73.3±7.3 mmHg. The mean difference between COBP and wa-AOBP was 5.7±7.8 mmHg (p<0.001) for systolic BP and 2.4±5.2 mmHg (p<0.001) for diastolic BP, whereas the mean difference between HBPM and wa-AOBP was 1.4±11.0 mmHg (p=0.149) for systolic BP and 2.4±7.3 mmHg (pcO.OOl) for diastolic BP. Subgroup analysis showed that the difference between COBP and wa-AOBP was more marked in those with higher systolic BP (?135 mmHg) than those with lower systolic BP (<135 mmHg) in terms of systolic BP (9.3±6.2 vs 2.8±7.8 mmHg, p<0.001) and diastolic BP (3.4±4.9 vs 1.6±5.4 mmHg, p=0.05). There was no significant difference in BP between the <75year and ?75-year age groups. Conclusions: wa-AOBP measurement is effective in eliminating the white coat effect of COBP measurement in a clinic setting among older people, particularly those with higher BP. It is a more practical option in clinics with limitation of space. wa-AOBP and HBPM measurements are comparable.

Background: Automated office blood pressure (AOBP) measurement can eliminate the white coat effect of conventional office blood pressure (COBP) measurement. This study aimed to investigate whether AOBP measurement in a waiting area (wa-AOBP) can eliminate the white coat effect and to compare wa-AOBP measurement with home blood pressure monitoring (HBPM) measurements. Methods: A cross-sectional cohort of Chinese older people aged ?65 years who attended a private clinic for management of primary hypertension was recruited between October to December 2019. COBP was measured after a 5-minute rest period, whereas wa-AOBP was measured in the waiting area after leaving the subject unattended for 3 minutes, and the average of three measurements taken at 1-minute intervals was recorded. HBPM measurement was calculated from the average of seven daily measurements. A blood pressure (BP) difference of ?5 mmHg was considered clinically significant. Results: In 133 subjects (mean age, 73.5±6.0 years), respectively for COBP, waAOBP, and HBPM, the mean systolic BP was 133.5±13.2, 127.8±11.0, and 126.2±7.6 mmHg, and the mean diastolic BP was 73.3±9.9, 70.9±8.2, and 73.3±7.3 mmHg. The mean difference between COBP and wa-AOBP was 5.7±7.8 mmHg (p<0.001) for systolic BP and 2.4±5.2 mmHg (p<0.001) for diastolic BP, whereas the mean difference between HBPM and wa-AOBP was 1.4±11.0 mmHg (p=0.149) for systolic BP and 2.4±7.3 mmHg (pcO.OOl) for diastolic BP. Subgroup analysis showed that the difference between COBP and wa-AOBP was more marked in those with higher systolic BP (?135 mmHg) than those with lower systolic BP (<135 mmHg) in terms of systolic BP (9.3±6.2 vs 2.8±7.8 mmHg, p<0.001) and diastolic BP (3.4±4.9 vs 1.6±5.4 mmHg, p=0.05). There was no significant difference in BP between the <75year and ?75-year age groups. Conclusions: wa-AOBP measurement is effective in eliminating the white coat effect of COBP measurement in a clinic setting among older people, particularly those with higher BP. It is a more practical option in clinics with limitation of space. wa-AOBP and HBPM measurements are comparable.