HOME SELF-MONITORING OF BLOOD-PRESSURE - IS FULLY AUTOMATED OSCILLOMETRIC TECHNIQUE AS GOOD AS CONVENTIONAL STETHOSCOPIC TECHNIQUE

Home blood pressure (HBP) measurement is becoming increasingly popular as an additional source of information for the practicing physician. Whether HBP measured with a fully automated oscillometric device (oHBP ) is more reliable than HBP measured with an aneroid sphygmomanometer and a stethoscope (sHBP) remains unclear. We compared sHBP with oHBP u sing as a reference method daytime ambulatory blood pressure (ABP), as this is believed to be a better index of an individual's overall leve l of pressure. Forty-six hypertensive patients measuring HBP with aner oid devices were retrained by a standard 30 min protocol that included training in the technique of measurement, checking patients' devices, and testing patients' performance in stethoscopic measurement. Patien ts were randomized to measure for 2 weeks either sHBP using their own calibrated aneroid devices or oHBP using a validated fully automated o scillometric device (Omron HEM-705CP). Then 24 h ABP monitoring was pe rformed (SpaceLabs 90207) and patients crossed over for a second 2 wee k period by using the alternative HBP measurement technique. Mean sHBP was not different from mean oHBP, and there was a close correlation b etween them (r = 0.82/0.76 for systolic/diastolic BP, P <.001). Daytim e ABP was not different from oHBP or sHBP and was closely related to b oth of them (oHBP, r = 0.59/0.72 systolic/diastolic BP, P <.001; sHBP, 0.50/0.65, P <.001). Age was significantly related with diastolic ABP -sHBP difference (r = 0.33, P <.05). These results suggest that HBP me asured with validated fully automated oscillometric devices is equally reliable in predicting average ABP as that measured with calibrated a neroid sphygmomanometers used by very carefully trained patients. In c linical practice, HBP monitoring by using reliable automated devices i s probably more feasible than to achieve a high standard of stethoscop ic HBP measuring technique. (C) 1997 American Journal of Hypertension, Ltd.