First Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Kraków, Poland
Pol Arch Intern Med. 2024 May 28;134(5). doi: 10.20452/pamw.16699. Epub 2024 Mar 15.
Hypertension is a leading cardiovascular risk factor. Accurate blood pressure (BP) measurement is pivotal in hypertension diagnosis and management. Conventional office blood pressure measurements (OBPMs) are error‑prone, exacerbated by the white‑coat effect. Unattended automated office blood pressure measurement (UAOBPM) is emerging as an alternative, mitigating the white‑coat effect. However, its ability to predict hypertension‑mediated organ damage (HMOD) remains disputable.
This study compares UAOBPM with OBPM in terms of their association with various types of HMOD, including left ventricular hypertrophy, left atrial enlargement, left ventricular systolic and diastolic dysfunction, intima‑media complex thickening, microalbuminuria, and abnormal pulse wave velocity.
A total of 219 hypertensive patients were recruited, interviewed, and examined. Subsequently, BP measurements were conducted in a randomized manner: 1) UAOBPM, after 5 minutes of solitary rest in an examination room, BP was automatically measured 3 times at 1‑minute intervals; 2) OBPM, after 5 minutes of rest, a physician performed 3 consecutive BP measurements at 1‑minute intervals. Subsequent evaluations aimed to detect HMOD and included echocardiography, carotid artery ultrasound, pulse wave velocity assessment, and laboratory tests.
UAOBP values were lower than the OBP ones (mean [SD], 124.7 [14.4] vs 128.2 [14.2] mm Hg; P <0.001 for systolic BP, and 73.3 [10.2] vs 75.2 [10.6] mm Hg; P <0.001 for diastolic BP). Correlation and receiver operating characteristic curve analyses revealed no superiority of either method in predicting HMOD.
The UAOBPM did not prove superior to OBPM in predicting HMOD. Further research is warranted to determine the role of UAOBPM in clinical practice.
高血压是主要的心血管风险因素。准确测量血压（BP）对于高血压的诊断和管理至关重要。传统的诊室血压测量（OBPM）容易出错，白大衣效应会加剧这种错误。自动诊室血压测量（UAOBPM）作为一种替代方法正在出现，可以减轻白大衣效应。然而，其预测高血压介导的器官损害（HMOD）的能力仍存在争议。
本研究比较了 UAOBPM 和 OBPM 在与各种类型 HMOD 的相关性，包括左心室肥厚、左心房增大、左心室收缩和舒张功能障碍、内膜-中层复合体增厚、微量白蛋白尿和异常脉搏波速度。
共招募了 219 名高血压患者，对其进行了访谈和检查。随后，以随机方式进行 BP 测量：1）UAOBPM，在诊室单独休息 5 分钟后，自动测量 3 次，间隔 1 分钟；2）OBPM，休息 5 分钟后，医生连续测量 3 次，间隔 1 分钟。随后的评估旨在检测 HMOD，包括超声心动图、颈动脉超声、脉搏波速度评估和实验室检查。
UAOBP 值低于 OBP 值（均值[标准差]，收缩压 124.7[14.4] vs 128.2[14.2]mmHg；P<0.001，舒张压 73.3[10.2] vs 75.2[10.6]mmHg；P<0.001）。相关性和受试者工作特征曲线分析显示，两种方法在预测 HMOD 方面均无优势。
UAOBPM 在预测 HMOD 方面并不优于 OBPM。需要进一步研究以确定 UAOBPM 在临床实践中的作用。
