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Comparison of nurse attended and unattended automated office blood pressure with conventional measurement techniques in clinical practice

Journal of Human Hypertension volume 36, pages 833–838 (2022)Cite this article

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Abstract

Accuracy in blood pressure measurement is critical for proper hypertension diagnosis and treatment in clinical practice. Automated office blood pressure (AOBP) can simplify the measurement process, reducing human error and minimizing the white-coat effect in the unattended mode. The aim of this study was to compare AOBP, both unattended and nurse attended, with conventional office and out-of-office blood pressure measurement techniques. Four different methods of blood pressure measurement were performed in a cohort of hypertensive patients: conventional office blood pressure (OBP), unattended automated office blood pressure (uAOBP), nurse attended automated office blood pressure (nAOBP), and home blood pressure monitoring (HBPM). uAOBP and nAOBP were conducted with the same rigorous standardized procedure. We enrolled 118 consecutive patients. nAOBP values were slightly higher than uAOBP ones (respectively 132.8/73.3 ± 19.4/12.9 and 129.2/71.1 ± 19.0/12.3 mmHg), even if the difference was influenced by order of execution of AOBP measurement. nAOBP was significantly lower than HBPM and OBP (mean values 135.2/80.9 ± 16.6/8.1 and 140.9/84.6 ± 18.7/10.8 mmHg, respectively). AOBP, either attended or unattended, provides lower values than conventional OBP. uAOBP and nAOBP values showed small differences, even if they are not completely interchangeable. This evidence reflects a lower white-coat effect, even in nurse attended technique, but is also due to a lower measurement error through the application of a rigorous standardized protocol.

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Fig. 1: Boxplots of comparison of blood pressure with different measurement tecnique.
Fig. 2: Bland–Altman plots of comparison between office blood pressure and automated office blood pressure techniques.
Fig. 3: Bland–Altman plots of comparison between unattended and nurse attended blood pressure.
Fig. 4: Bland–Altman plots of comparison between automated office blood pressure technique and home blood pressure.

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Acknowledgements

We thank Mrs. Roberta Pellegrini for her dedication and precious support. The study did not receive any financial assistance.

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Author notes

  1. These authors equally contributed: Fanelli Elvira, Di Monaco Silvia.

Authors and Affiliations

  1. Department of Medical Sciences, University of Turin, Internal Medicine and Hypertension Unit, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy

    Elvira Fanelli, Silvia Di Monaco, Marco Pappaccogli, Elisabetta Eula, Chiara Fasano, Chiara Bertello, Franco Veglio & Franco Rabbia

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  1. Elvira Fanelli
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Correspondence to Elvira Fanelli.

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Fanelli, E., Di Monaco, S., Pappaccogli, M. et al. Comparison of nurse attended and unattended automated office blood pressure with conventional measurement techniques in clinical practice. J Hum Hypertens 36, 833–838 (2022). https://doi.org/10.1038/s41371-021-00575-8

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