IMPACT OF DEVICES AND ENVIRONMENTS ON AUTOMATED OFFICE BLOOD PRESSURE MEASUREMENTS

Abstract

Automated office blood pressure (AOBP) devices are increasingly recommended as preferred BP diagnostic tool. It is unclear how different AOBP devices compare and how the clinical environment impacts on their performance. This study is a prospective randomized factorial parallel four (4) group study comparing the BpTRU and the Omron HEM 907 devices in a closed or open area. Hypertensive patients were recruited during office visits. After standard open room AOBP measurement with a BpTRU device, patients were required to take a second BP measurement with either the BpTRU or Omron device and to either an open or closed area. Absolute BP levels and the difference between the first and second measurements were compared. Diagnostic performance was also assessed. In this study were included 258 patients. Mean age was 66.2±12.0 years and 62% were male. The mean first AOBP was 127.4/73.3 mmHg. The analyses of subsequent measurements showed that there was no influence of open or closed areas on BP means or diagnostic performance. On the other hand, HEM 907 exceeded systolic BpTRU measurements by 4.6 mmHg ( < 0.01) in a closed area and by 3.9 mmHg ( < 0.01) in an open area. There was no significant statistical difference in diastolic BP measures. Diagnostic agreement between the HEM 907 and BpTRU device was 73.4% in open area measurements. While different areas did not influence BP estimates, Omron HEM 907 measurements significantly exceeded BpTRU measurements on systolic average. These differences should be considered when interchanging devices.