ACCURACY OF SEQUENTIAL BLOOD PRESSURE MEASUREMENTS IN COMPARISON TO AMBULATORY BLOOD PRESSURE MEASUREMENTS

Abstract

Objective: Accurate blood pressure measurement is crucial for diagnosis and follow up hypertension. Office blood pressure may be misleading in certain situations. Our study aimed to compare the accuracy and degree of agreement of automated sequential blood pressure with office blood pressure and ambulatory blood pressure readings Design and method: This was a cross sectional observational study that included patients who were known to be hypertensive and coming to check up their blood pressure. The study was conducted in Kasr El-Aini Specialized hypertension clinic. Full medical history, clinical examination, electrocardiogram, fundus examination and essential labs (e.g. urine analysis, fasting blood sugar, serum potassium, creatinine, lipid profile and hemoglobin) were done for each patient. Office blood pressure was recorded by using digital sphygmomanometer device (Omrone-6 automated device), automated sequential blood pressure by using the Mobile-O- Graph, PWA device over half an hour. The ambulatory blood pressure readings were taken within 24 hours from the previous measurements. All measurements were taken according to the European society guidelines for the management of hypertension. Results: 64 patients were included. Their age ranged between 20 and 85 years (mean ± SD of age 50.0 ± 15.0 years). There were 51.1% female. The office blood pressure readings were significantly higher than the automated sequential blood pressure (142.7 ± 15.5 versus 137.8 ± 16.7 mmHg, P < 0.0001) for systolic blood pressure and (88.5 ± 12.3 versus 86.1 ± 13.8 mmHg, P < 0.0001) for diastolic blood pressure. And higher than the day time ambulatory blood pressure readings (142.7 ± 15.5 versus 135.8 ± 15.7 mmHg, P < 0.0001) for systolic blood pressure and (88.5 ± 12.3 versus 82.1 ± 13.7 mmHg, P < 0.0001) for diastolic blood pressure. The automated sequential blood pressure has a strong positive correlation with day time ambulatory blood pressure(r = 0.74, P < 0.0001). There is a moderate degree of agreement between sequential systolic blood pressure and day time systolic ambulatory blood pressure (kappa = 0.59, P < 0.001). Conclusions: Automated sequential blood pressure measurement is significantly lower than office blood pressure measured by semi-automated electronic devices, and provides a reading which has significant correlation with the day time ambulatory blood pressure.