Can sphygmomanometers designed for self-measurement of blood pressure in the home be used in office practice?

Abstract

To examine the possibility of measuring automated office (AO) blood pressure (BP) using home BP recorders in place of the more expensive, fully automated devices designed specifically for professional use. Three groups of 100 patients each had five AOBP readings recorded with one of three home BP devices while resting alone in a quiet examining room. These devices were also used to obtain 24 home BP readings during 6 days. Five AOBP readings were also recorded using the BpTRU device and all patients had 24-h ambulatory BP and manual BP readings taken. Mean systolic AOBP was within 3-4 mmHg of the mean awake ambulatory BP for each of the three home BP recorders whether used in the office setting or at home. Diastolic readings tended to be higher than the corresponding awake ambulatory BP. For the 139 patients with hypertension, mean (±standard deviation) AOBP taken with the home BP devices (146±14/86±12) was higher (P<0.001) than the awake ambulatory BP (142±11/81±12) and AOBP taken with the BpTRU device (141±15/82±12). Systolic BP at home (142±14/85±10) was also similar to the awake ambulatory BP but diastolic BP was higher (P<0.001). There were no significant differences in correlation coefficients between each set of AOBP readings and awake ambulatory BP. Home BP devices may be used to record AOBP in selected patients. However, a fully automated sphygmomanometer is still the device of choice for obtaining AOBP readings similar to the awake ambulatory BP in patients with suspected hypertension.