A16036 Large Discrepancy between Unobserved Automated Office Blood Pressure and Ambulatory Blood Pressure in a High Cardiovascular Risk Cohort

Abstract

Objectives: Recently, automated office blood pressure (AOBP) has been shown to eliminate the white-coat effect and to be more concordant with ambulatory blood pressure monitor (ABPM) and home blood pressure (BP) measurements. The purpose of this study was to compare BP measured by AOBP with that by ABPM in high cardiovascular risk patients. Methods: The study participants were recruited from a prospective cohort study (Cardiovascular and Metabolic Disease Etiology Research Center–High Risk Cohort [CMERC-HI]; clinicaltrials.gov: NCT02003781). 1,208 participants who had undergone both AOBP and ABPM within 7days of each measurement were analyzed for this study. Results: The 95% limits of agreement between systolic AOBP and daytime ABPM systolic blood pressure (SBP) were − 34.78 to 20.19 mmHg (mean difference = − 7.30 ± 14.0). The mean differences in quintiles of AOBP distributions increased with decreasing AOBP measurements [ − 17.8 ± 11.2 (Q1, systolic AOBP < 113), − 10.9 ± 11.1 (Q2, systolic AOBP 113–121), − 8.5 ± 10.7 (Q3, systolic AOBP 121–128), − 4.2 ± 11.8 (Q4, systolic AOBP 128–137), 4.9 ± 14.2 (Q5, systolic AOBP > 137), p < 0.001]. The prevalence of masked uncontrolled hypertension was 310 (25.7%), and the prevalence of white-coat effects was 102 (8.4%). Large discrepancy was significantly associated with lower systolic AOBP, higher ASCVD risk score, and history of cardiovascular disease. Conclusion: Lower range of systolic AOBP showed a large discrepancy with daytime ABPM SBP and a high prevalence of masked hypertension in high-risk patients. The status of BP control should be confirmed by out-of-office BP measurements, even when using AOBP as a clinical BP of reference in high-risk patients.