COMPARISON OF UNATTENDED AUTOMATED OFFICE BLOOD PRESSURE WITH HOME BLOOD PRESSURE AND ITS RELATION TO PULSE WAVE VELOCITY

Abstract

Objective: We assessed whether Unattended automated office blood pressure (UAOBP) was equal to Home blood pressure (HBP) and extended to explore the difference in the correlation between each blood pressure (BP) measure and pulse wave velocity (PWV).Design and method: Study patients were 70 essential hypertensives (mean age 67.0 ± 9.4; male 48.6%; antihypertensive medication use 87.8%). Medical staff measured Attended automated office BP (AAOBP), and 5 minutes later since medical staff left the room, UAOBP was measured. AAOBP, UAOBP, and HBP were recorded as the average of triplicate measurements taken at 30-s intervals. HBP was measured 5 consecutive days in the morning and evening. In this study, we used each systolic BP values. Brachial-ankle PWV (baPWV) was measured to evaluate subclinical organ damage. Results: Average of each systolic BP values were AAOBP 127.6 ± 14.5 mmHg; UAOBP 122.5 ± 13.7 mmHg; Average of morning and evening HBP 129.3 ± 11.7 mmHg; Morning HBP 133.1 ± 12.8 mmHg, Evening HBP 125.6 ± 13.6 mmHg. Average of morning and evening HBP and Morning HBP were significantly higher compared with UAOBP (all P < 0.001). AAOBP (r = 0.246, P = 0.040), Average of morning and evening HBP (r = 0.323, P = 0.006), Morning HBP (r = 0.372, P = 0.002), and Evening HBP (r = 0.204, P = 0.091) were associated with baPWV, whereas UAOBP (r = 0.151, P = 0.211) was not. Among these BP values, only Morning HBP was significantly correlated with baPWV after adjusted for age, gender, body mass index, current smoking, habitual drinking, diabetes, and hyperlipidemia (β = 6.001, P = 0.020). Conclusions: In Japanese hypertensive patients, UAOBP was significantly lower compared with Average of morning and evening HBP and Morning HBP. Morning HBP was associated with subclinical organ damage after adjusted for conventional cardiovascular risk, whereas this association was not found in UAOBP. To evaluate clinical utility of UAOBP in Japanese, follow-up survey is needed.