Home blood pressure: Accuracy is independent of monitoring schedules

Long-term morbidity and mortality from hypertension are more closely relate d to home than to casual office blood pressure levels. There is no generall y accepted recommendation on how to best schedule home blood pressure (HBP) recordings, perhaps because the effect of varying the home monitoring sche dule on the HBP average is not well studied. The goals of this analysis are to describe the effects of HBP monitoring schedules on the accuracy of res ultant HBP averages and to determine which monitoring schedule parameters c orrelate with HBP accuracy. Twelve published studies, each including home, office, and awake ambulatory blood pressure means were identified. Accuracy of office and HBP averages were determined by their agreement with corresp onding awake ambulatory averages. Variations in HBP monitoring schedule par ameters did not significantly affect the accuracy of the resultant HBP aver ages among the studies. In univariate analyses, no individual parameter cor related significantly with the final HBP average accuracy. As the total num ber of HBP readings obtained increased, or as other monitoring schedule par ameters intensified, the superior accuracy of HBP levels as compared to tha t of casual office values also failed to significantly improve. No HBP accu racy differences were found among groups characterized by different HBP sch edule parameter ranges. In conclusion, the accuracy of HBP measurements, as determined by their agreement with an awake ambulatory mean, is maintained regardless of substantial variations in HBP monitoring schedules. Therefor e, the majority of the benefits derived from HBP monitoring will likely be achieved by obtaining only a few HBP measurements using a minimally complex monitoring schedule. Am J Hypertens 2000; 13:625-631 (C) 2000 American Jou rnal of Hypertension, Ltd.