Direct comparison of the reproducibility of in-office and self-measured home blood pressures

• Published in: Journal of hypertension Vol. 40; no. 2; p. 398
• Main Authors: Asayama, Kei, Ohkubo, Takayoshi, Rakugi, Hiromi, Miyakawa, Masaaki, Mori, Hisao, Katsuya, Tomohiro, Ikehara, Yumi, Ueda, Shinichiro, Ohya, Yusuke, Tsuchihashi, Takuya, Kario, Kazuomi, Miura, Katsuyuki, Ito, Sadayoshi, Umemura, Satoshi
• Format: Journal Article
• Language: English
• Published: Netherlands 01.02.2022
• Subjects: Automation; Blood Pressure; Blood Pressure Determination; Blood Pressure Monitoring, Ambulatory; Humans; Hypertension - diagnosis; Hypertension - drug therapy; Reproducibility of Results
• ISSN: 1473-5598
• DOI: 10.1097/hjh.0000000000003026

The aim was to compare short-term and long-term reproducibilities of in-office unattended blood pressure (BP), namely automated office blood pressure (AOBP), conventionally measured attended office BP, and self-measured home BP. A multicentre, clinical study was conducted in Japan, and 287 Japanese outpatients on antihypertensive drug medication were followed-up for 1 year. The intensity of drug treatment was sustained consistently throughout the study period (defined daily doses, 1.62-1.68; P = 0.12). The mean SBP differences between baseline and 1 month later, as well as baseline and 1 year later, were less than 1.5 mmHg, whereas the standard deviations of the differences for home, AOBP, and attended office measurements for the 1-year interval were 7.7, 14.5, and 15.3 mmHg, respectively. The coefficients of variation were significantly smaller for home BP than for AOBP among all patients at both 1-month and 1-year intervals (P < 0.0001). In the 1-month interval, partial correlation coefficients of home BP (r, 0.73/0.88 for systolic/diastolic measures) were significantly higher than of conventional BP (r, 0.47/0.69). However, the correlations converged to the modest level regardless of BP information (r, 0.49-0.54/0.63-0.73) when the 1-year interval was assessed. Results were confirmatory when patients on the same drug regimen (n = 167) were analysed. A higher reproducibility of home BP was demonstrated compared with in-office BP, including AOBP. However, the modest correlations for the 1-year interval support the importance of regular assessment of BP, regardless of in-office or home measurements for treatment of hypertension.