Automated office blood pressure readings as good as ambulatory readings

By Bianca Nogrady
Automated office blood pressure (AOBP) readings can be as accurate as awake ambulatory readings, and more accurate than office readings, new research suggests.

A systematic review and meta-analysis, published in JAMA Internal Medicine, examined 31 studies involving 9279 participants that compared different methods of BP measurement.

They showed that routine office systolic BP readings were on average 14.5 mmHg higher than systolic AOBP readings in samples with automated readings of 130 mmHg or more. However, there was no significant difference between systolic awake ambulatory BP readings and AOBP readings.

The study suggested that BP measurements done under research conditions were also significantly higher than systolic AOBP readings.

The authors noted that the AOBP readings performed in the studies involved multiple readings, with a fully automated system and the patient sitting alone in a quiet space.

‘Using this approach, AOBP has been the preferred technique for office BP measurement in the evidence-based Hypertension Canada guidelines since 2016 and is now routinely used by many Canadian primary care physicians,’ they wrote.

Commenting on the study, Dr Genevieve Gabb, Senior Staff Specialist in General Medicine at Royal Adelaide Hospital and coauthor on the National Heart Foundation of Australia’s 2016 hypertension guidelines, said although automated office sphygmomanometers are available in Australia, they are rarely used in the fully automated fashion.

‘I think using AOBP measurement would be helpful, because it would improve the robustness, the reliability of blood pressure readings and I think improve the identification of people who really are at risk and have concerns with their blood pressure,’ she said.

She told Medicine Today that the fact that AOBP measurement was similar to ambulatory measurement was useful.

‘That’s important because ambulatory BP readings have closer relationships to CV risk and CV events, so you can much better target patients who are likely to benefit from treatment.’
JAMA Internal Medicine 2019; doi: 10.1001/jamainternmed.2018.6551.