What is it about?
Some national guidelines since 2017 considered the most common method for diagnosing and controlling hypertension (HTN) (office blood pressure (OBP) measurement) as screening only. Automated OBP (AOBP) measurement claims to be a unique method by obtaining a standardized result, even in primary health care. AOBP improves the reliability of data by reducing the influence of various errors on result. However, although the level of AOBP is on average lower than similar OBP in clinical and research practice and is comparable to the mean daily ambulatory BP monitoring, at present, all international guidelines emphasize the mandatory use of ambulatory BP measurements for diagnostic purposes. Whether the results of AOBP and the reference level ≥130/80 mm Hg are equivalent with the same OBP level, the use of which is associated with an increase in the prevalence of hypertension and insufficient control of antihypertensive therapy, is a question for research. Compared with conventional OBP, the use of AOBP in conjunction with outpatient measurement leads to a reduction in the proportion and timing of initiation of treatment in patients with masked HTN, whose cardiovascular risk is similar to that of patients with stable HTN. However, the widespread implementation of AOBP is hindered by the high cost and lack of accumulated data. The review analyzes in detail the limitations and advantages of various types of BP measurement, as well as the potential of using AOBP in modern clinical and research practice.
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Why is it important?
The results of manual or automated office blood pressure (OBP) measurement, including unattended automated OBP, are different in both research and practice, which creates problems in both areas. Knowledge of the sources of measurement errors, up-to-date threshold values, taking into account the equipment for different OBP measurement methods, both separately and in combination with outpatient methods, not only expand the potential of data analysis, but also push the boundaries in difficult cases of using OBP in the diagnosis and management of hypertension.
Perspectives
Writing this article gave me great pleasure as it has co-authors with whom I have a long history of collaboration. I hope this article will help medics in problematic clinical situations. I hope this article makes you think. I hope you find this article useful to you.
Elena Platonova
Read the Original
This page is a summary of: Office blood pressure: overcoming the problems of diagnosis and control of arterial hypertension treatment, CARDIOVASCULAR THERAPY AND PREVENTION, July 2022, Silicea - Poligraf, LLC,
DOI: 10.15829/1728-8800-2022-3263.
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