PT  - JOURNAL ARTICLE
AU  - Mark C. van der Wel
AU  - Iris E. Buunk
AU  - Chris van Weel
AU  - Theo A. B. M. Thien
AU  - J. Carel Bakx
TI  - A Novel Approach to Office Blood Pressure Measurement: 30-Minute Office Blood Pressure vs Daytime Ambulatory Blood Pressure
AID  - 10.1370/afm.1211
DP  - 2011 Mar 01
TA  - The Annals of Family Medicine
PG  - 128--135
VI  - 9
IP  - 2
4099  - http://www.annfammed.org/content/9/2/128.short
4100  - http://www.annfammed.org/content/9/2/128.full
SO  - Ann Fam Med2011 Mar 01; 9
AB  - PURPOSE Current office blood pressure measurement (OBPM) is often not executed according to guidelines and cannot prevent the white-coat effect. Serial, automated, oscillometric OBPM has the potential to overcome both these problems. We therefore developed a 30-minute OBPM method that we compared with daytime ambulatory blood pressure. METHODS Patients referred to a primary care diagnostic center for 24-hour ambulatory blood pressure monitoring (ABPM) had their blood pressure measured using the same validated ABPM device for both ABPM and 30-minute OBPMs. During 30-minute OBPM, blood pressure was measured automatically every 5 minutes with the patient sitting alone in a quiet room. The mean 30-minute OBPM (based on t = 5 to t = 30 minutes) was compared with mean daytime ABPM using paired t tests and the approach described by Bland and Altman on method comparison. RESULTS We analyzed data from 84 patients (mean age 57 years; 61% female). Systolic and diastolic blood pressures differed from 0 to 2 mm Hg (95% confidence interval, −2 to 2 mm Hg and from 0 to 3 mm Hg) between mean 30-minute OBPM and daytime ABPM, respectively. The limits of agreement were between −19 and 19 mm Hg for systolic and −10 and 13 mm Hg for diastolic blood pressures. Both 30-minute OBPM and daytime ABPM classified normotension, white-coat hypertension, masked hypertension, and sustained hypertension equally. CONCLUSIONS The 30-minute OBPM appears to agree well with daytime ABPM and has the potential to detect white-coat and masked hypertension. This finding makes 30-minute OBPM a promising new method to determine blood pressure during diagnosis and follow-up of patients with elevated blood pressures.