Manual vs automated blood pressure monitoring

January 01, 0001

Manual vs automated blood pressure monitoring

These Canadian researchers examined in office blood pressure monitoring using manual vs. automated blood pressures devices. They performed a multi-site cluster randomised controlled trial of otherwise healthy patients with systolic (n=555). Enrollees were randomized to either the intervention group of automated blood pressure monitoring or the control group of manual blood pressure monitorying. Results were also compared with the awake ambulatory blood pressure.

The researchers found: "The most recent routine manual office blood pressure (149.5/81.4) was higher than automated office blood pressure (135.6/77.7). In the control group, routine manual office blood pressure before enrolment (149.9/81.8 was reduced to 141.4/80.2 after enrolment), but the reduction in the intervention group from manual office to automated office blood pressure was significantly greater. On the first study visit after enrolment, the estimated mean difference for the intervention group between the awake ambulatory systolic/diastolic blood pressure and automated office blood pressure (-2.3/-3.3) was less than the difference in the control group between the awake ambulatory blood pressure and the manual office blood pressure (-6.5 /-4.3). Systolic/diastolic automated office blood pressure showed a stronger within group correlation with awake ambulatory blood pressure after enrolment compared with manual office blood pressure versus awake ambulatory blood pressure before enrolment… The between group correlation comparing diastolic automated office blood pressure and awake ambulatory blood pressure was stronger than that for manual office blood pressure versus awake ambulatory blood pressure."

The researchers concluded: "In compliant, otherwise healthy, primary care patients with systolic hypertension, introduction of automated office blood pressure into routine primary care significantly reduced the white coat response compared with the ongoing use of manual office blood pressure measurement. The quality and accuracy of automated office blood pressure in relation to the awake ambulatory blood pressure was also significantly better when compared with manual office blood pressure."

This study suggests automated blood pressure cuffs may provide some advantages in office blood pressure monitoring, especially with white coat hypertension.

For the full abstract, click here.

BMJ 342:d286, 7 February 2010 © 2011 BMJ Publishing Group Ltd.
Conventional versus automated measurement of blood pressure in primary care patients with systolic hypertension: randomised parallel design controlled trial. Martin G Myers, Marshall Godwin, Martin Dawes, et al. Correspondence to M Myers: [email protected]

Category: K. Circulatory. Keywords: blood pressure, hypertension, automated, manual, ambulatory, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 25 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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