Self-reported or ambulatory blood pressure compared to blood pressure measured in the clinic setting

Office-based blood pressure measurements appear to produce higher readings than self measurements or ambulatory blood pressure measurements.

A systematic review including 18 studies on the distribution of readings between the three blood pressure measurement methods was abstracted in DARE. For both systolic and diastolic BP measurements, readings taken in the clinic setting were significantly higher than those taken from self-measurement (SMBP) or ambulant (ABP) methods (P<0.05). Readings were similar when SMBP and ABP were compared, but this occurred in only 3 studies. It was not possible to determine whether BP differences were reproducible. From 16 studies that addressed the prevalence of white coat hypertension (various definitions) based on ABP, the largest of these (using the greatest number of measurements) revealed a rate of 20% amongst hypertensive patients.

A systematic review included 18 studies on normotensive persons not selected based on blood pressure, with a total of 5425 (of which at least 3518 were normotensive) subjects. The average self-recorded blood pressure in normotensive subjects was 115/71, and in subject not selected on the basis of blood pressure 119/74 mmHg. The method of the mean + 2 SD = 137/89 mmHg.

Comment: The quality of evidence is downgraded by study quality.

Ədəbiyyat

1. Thijs L, Staessen JA, Celis H, de Gaudemaris R, Imai Y, Julius S, Fagard R. Reference values for self-recorded blood pressure: a meta-analysis of summary data. Arch Intern Med 1998 Mar 9;158(5):481-8.
2. Appel LJ, Robinson KA, Guallar E, Erlinger T, Masood SO, Jehn M, Fleisher L, Powe NR, Bass EB. Utility of blood pressure monitoring outside of the clinic setting. Evid Rep Technol Assess (Summ) 2002 Nov;(63):1-5.