COMPARISON OF MANUAL VERSUS AUTOMATED BLOOD-PRESSURE MEASUREMENTS IN TREATED HYPERTENSIVE PATIENTS

This study assesses differences in blood pressure (BP) levels prospect ively between office (manual) measurement and ambulatory blood pressur e monitoring (ABPM) in 70 treated, essential, hypertensive patients. T he objective was to determine whether ABPM is superior to office measu rement for assessing adequacy of therapy. Twenty-four patients receive d monotherapy and 46 received multiple therapy. Thirty-five patients w ere administered medication in the morning only, whereas 33 were admin istered medication in the morning and evening both. Mean systolic BP b y manual method was identical to that obtained by ABPM (141.98 +/- 14. 98 mm Hg versus 141.46 +/- 16.33 mm Hg, respectively). However, mean d iastolic BP by manual method was significantly higher than that obtain ed by ABPM (90.38 +/- 9.01 mm Hg versus 86.69 +/- 10.65 mm Hg, respect ively; P < 0.001). Significant correlations (P < 0.01) were found betw een the BP levels measured by these two methods, although individual r eadings differed by 10 mm Hg or more systolic and by 5 mm or more dias tolic in many subjects. No significant differences were noted in BP le vels measured by either method for patients treated by monotherapy or multiple therapy, and none were noted whether they were taking medicat ion in the morning or in both the morning and evening. In addition, no differences were noted in BP levels using either method for race. Thu s, this study shows that the office measurement is grossly similar to ABPM for assessment of adequacy of therapy in treated hypertensive pat ients whose blood pressure is controlled adequately. However, ABPM is found to be superior to office measurement in identifying hypertensive patients whose blood pressure is not controlled adequately or is unco ntrolled.