Unattended Automated Office Blood Pressure Measurement and Cardiac Target Organ Damage, A Pilot Study
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ORIGINAL ARTICLE
Unattended Automated Office Blood Pressure Measurement and Cardiac Target Organ Damage, A Pilot Study Claudia Palomba1 · Simone Donadio1 · Grazia Canciello1,2 · Maria Angela Losi1,2 · Raffaele Izzo1,2 · Maria Virginia Manzi1,2 · Federica De Pisapia1,2 · Costantino Mancusi1,2 · Nicola De Luca1,2 Received: 24 May 2019 / Accepted: 9 August 2019 © Italian Society of Hypertension 2019
Abstract Introduction The ESC-2018 guidelines suggest the use of Unattended automated office blood pressure (UAOBP) to avoid or at least reduce the white coat effect, even if do not support its use as preferred method. Aim To assess the pressure difference between UAOBP and Attended office blood pressure (AOBP) and to evaluate their correlations with target organ damage in hypertensive patients. Methods UAOBP and AOBP were taken in a cohort of 48 outpatients. The pressure difference between the 2 methods and their correlation with anthropometric and cardiac parameters were analyzed. Results Unattended systolic and diastolic BP were lower than Attended systolic and diastolic BP (135 ± 17 mmHg vs 139 ± 21 mmHg and 79 ± 10 mmHg vs 82 ± 10 mmg). ΔDBP was significantly directly correlated with female sex (r = 0.347, p = 0.016) and it was lower in men compared to women (0.11 ± 8.9 mmHg vs 6.07 ± 7.42 mmHg, p = 0.016). Correlation coefficients for LVMi and RWT for attended and unattended BP were not statistically different (for LVMi r = 0.286 vs r = 0.381, p = 0.61, for RWT r = 0.413 vs r = 0.363, p = 0.78). The relationship between attended and unattended BP was described by the following equation: y = − 4.68 + 1.06*x; where Y is the attended systolic BP and X is the unattended systolic BP; in accordance with this equation, an unattended systolic BP of 140 mmHg corresponds to an attended systolic BP of 143.7 mmHg. Conclusions UAOBP provides significantly lower values than AOBP. The difference in BP values between the two methods is much lower than the one obtained in most clinical studies. Keywords Unattended automated office blood pressure · Arterial hypertension · White coat effect · Cardiac target organ damage
1 Introduction Correct measurement of blood pressure (BP) has a pivotal role in the management and treatment of arterial hypertension. It is therefore necessary to evaluate BP as accurately as possible. Recently a new method of BP measurement, called Unattended automated office blood pressure (UAOBP) has been introduced [1]. Considered by many clinical studies a real alternative to the traditional Attended office blood pressure (AOBP) measurement, UAOBP is performed with * Costantino Mancusi [email protected] 1
Hypertension Research Center, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy
Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy
2
an automatic device and conducted without medical personnel: multiple measurements are automatically taken, while patients are alone in a quiet room. The use of UAOBP eliminates, or at least r
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