Clinical Impact of after-consult clinic blood pressure: comparison with automated office blood pressure
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Background: It is most important to measure blood pressure (BP) exactly in treating hypertension. Recent recommendations for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the “whitecoat response” is frequently associated with manual BP recordings performed in community-based practice. However, there was no data about after-consult (AC) BP that could reduce whitecoat effect. So we evaluated before-consult (BC) and AC routine clinic BP and research based automated office blood pressure (AOBP) measured. Methods: The study population consisted of 82 consecutive patients with hypertension between April 2019 and December 2019. We measured routine clinic BP and AOBP before and after see a doctor, respectively. Seated blood pressure and pulse are measured at each time after a rest period using an automated device as it offers reduced potential for observer biases. AOBP was measured and measuring BP 3 times un-observed. We compared each BP parameter for identifying exact resting BP state. Results: There was significant difference between BC and AC systolic BP (135.37 ± 16.90 vs. 131.95 ± 16.40 mmHg, p = 0.015). However there was no difference in the BC and AC diastolic blood pressure (73.75 ± 11.85 vs. 74.42 ± 11.71 mmHg, p = 0.415). In the AOBP comparison, there was also significant difference (BC systolic AOBP vs. AC systolic AOBP, 125.17 ± 14.41 vs. 122.98 ± 14.09 mmHg, p = 0.006; BC diastolic ABOB vs. AC diastolic AOBP, 71.99 ± 10.49 vs. 70.99 ± 9.83, p = 0.038). Conclusions: In our study, AC AOBP was most lowest representing resting state. Although AC BP was higher than BC AOBP, it might be used as alternative measurement for reducing whitecoat effect in the routine clinical practice.
Abstract
Background: It is most important to measure blood pressure (BP) exactly in treating hypertension. Recent recommendations for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the “whitecoat response” is frequently associated with manual BP recordings performed in community-based practice. However, there was no data about after-consult (AC) BP that could reduce whitecoat effect. So we evaluated before-consult (BC) and AC routine clinic BP and research based automated office blood pressure (AOBP) measured. Methods: The study population consisted of 82 consecutive patients with hypertension between April 2019 and December 2019. We measured routine clinic BP and AOBP before and after see a doctor, respectively. Seated blood pressure and pulse are measured at each time after a rest period using an automated device as it offers reduced potential for observer biases. AOBP was measured and measuring BP 3 times un-observed. We compared each BP parameter for identifying exact resting BP state. Results: There was significant difference between BC and AC systolic BP (135.37 ± 16.90 vs. 131.95 ± 16.40 mmHg, p = 0.015). However there was no difference in the BC and AC diastolic blood pressure (73.75 ± 11.85 vs. 74.42 ± 11.71 mmHg, p = 0.415). In the AOBP comparison, there was also significant difference (BC systolic AOBP vs. AC systolic AOBP, 125.17 ± 14.41 vs. 122.98 ± 14.09 mmHg, p = 0.006; BC diastolic ABOB vs. AC diastolic AOBP, 71.99 ± 10.49 vs. 70.99 ± 9.83, p = 0.038). Conclusions: In our study, AC AOBP was most lowest representing resting state. Although AC BP was higher than BC AOBP, it might be used as alternative measurement for reducing whitecoat effect in the routine clinical practice.
참고문헌 (14)
- Franklin SS, "Cardiovascular risks related to increased diastolic, systolic and pulse pressure. An epidemiologist’s point of view", Pathol Biol, 47(6), pp.594~603 (1999)
- Agarwal R, "Longitudinal Study of Left Ventricular Mass Growth : Comparative Study of Clinic and Ambulatory Systolic Blood Pressure in Chronic Kidney Disease", Hypertension, 67(4), pp.710~716 (2016)
- Paul K, "ACC", AHA, ABC, pp.ACPM, AGS[DOI]
- Bryan Williams G, "2018 ESC", ESH Guidelines for the management of arterial hypertension, 2018, pp.39(33), 3021~3104
- Martin G, "Measurement of blood pressure in the office : recognizing the problem and proposing the solution", Hypertension, 55(2), pp.195~200 (2010)
- Myers MG, "Consistent relationship between automated office blood pressure recorded in different settings", Blood Press Monit, 14(3), pp.108~111 (2009)
- Myers MG, "Automated blood pressure measurement in routine clinical practice", Blood Press Monit, 11(2), pp.59~62 (2006)
- José R, "Relationship between Clinic and Ambulatory Blood-Pressure Measurements and Mortality", N Engl J Med, 378(16), pp.1509~1520 (2018)
- George C, "Prognostic impact from clinic, daytime, and night-time systolic blood pressure in nine cohorts of 13, 844 patients with hypertension", J Hypertens, 32(12), pp.2332~2340 (2014)
- Fagard RH, "Incidence of cardiovascular events in white-coat, masked and sustained hypertension versus true normotension : a metaanalysis", J Hypertens, 25(11), pp.2193~2198 (2007)
- Verdecchia P, "Independent predictors of isolated clinic(‘white-coat’)hypertension", J Hypertens, 19(6), pp.1015~1020 (2001)
- Andreadis EA, "Automated office blood pressure measurements obtained with and without preceding rest are associated with awake ambulatory blood pressure", J Clin Hypertens, 22(1), pp.32~38 (2020)
- Mancia G, "Ambulatory blood pressure normality : results from the PAMELA study", J Hypertens, 13, pp.1377~1390 (1995)
- Giuseppe Mancia R, "Effect of long-term antihypertensive treatment on white-coat hypertension", Hypertension, 64(6), pp.1388~1398 (2014)