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Original paper
Published online: 2023-01-23
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Office blood pressure variability in non-hypertensive patients during a preventive examination

Łukasz Artyszuk1, Izabela Nawrocka1, Małgorzata Bieńko1, Anita Pietrzak1, Piotr Abramczyk1
DOI: 10.5603/AH.a2023.0002
Affiliations
  1. Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland

open access

Ahead of print
ORIGINAL PAPERS
Published online: 2023-01-23

Abstract

Background. Despite advantages of ambulatory and home blood pressure monitoring, office blood pressure measurement remains the principal method for the diagnosis and management of hypertension. There still seems to be too little evidence to date showing variation in blood pressure during a medical visit and the current recommendations are mainly based on expert’s opinions. The aim of this study was to evaluate the difference between the first two blood pressure measurements performed during a preventive examination and to verify whether the second measurement could influence clinical decisions in non-hypertensive patients. Material and methods. The study involved 52 consecutive patients without history of hypertension or other cardiovascular diseases. Blood pressure and heart rate (HR) were measured twice, the first reading after 5 minutes rest and the second 1 minute later. Results. Significant differences were found between the first (fBPM) and second (sBPM) blood pressure measurements, both systolic blood pressure (SBP) 142.4 mmHg (IQR, 130.8-152.0) vs. 138.1 mmHg (IQR, 125.8-149.5), p<0.001 and diastolic blood pressure (DBP) 85.8 mmHg (IQR, 80.0-91.5) vs. 83.9 mmHg (IQR, 77.0-90.3), p<0.001, and heart rate (HR) 73.1/min (IQR, 64.8-80.0) vs. 71.8/min (IQR, 64.8-77.3), p<0.001. For 63.5% of the participants, the difference between the measurements was over 5 mmHg of SBP and for 23.1% of DBP. According to fBPM, 53.8% of the patients met the criteria for the diagnosis of hypertension and according to sBPM 48.1% (NS). Conclusion. A single blood pressure measurement may result in incorrect diagnosis of hypertension and unnecessary initiation of treatment.

Abstract

Background. Despite advantages of ambulatory and home blood pressure monitoring, office blood pressure measurement remains the principal method for the diagnosis and management of hypertension. There still seems to be too little evidence to date showing variation in blood pressure during a medical visit and the current recommendations are mainly based on expert’s opinions. The aim of this study was to evaluate the difference between the first two blood pressure measurements performed during a preventive examination and to verify whether the second measurement could influence clinical decisions in non-hypertensive patients. Material and methods. The study involved 52 consecutive patients without history of hypertension or other cardiovascular diseases. Blood pressure and heart rate (HR) were measured twice, the first reading after 5 minutes rest and the second 1 minute later. Results. Significant differences were found between the first (fBPM) and second (sBPM) blood pressure measurements, both systolic blood pressure (SBP) 142.4 mmHg (IQR, 130.8-152.0) vs. 138.1 mmHg (IQR, 125.8-149.5), p<0.001 and diastolic blood pressure (DBP) 85.8 mmHg (IQR, 80.0-91.5) vs. 83.9 mmHg (IQR, 77.0-90.3), p<0.001, and heart rate (HR) 73.1/min (IQR, 64.8-80.0) vs. 71.8/min (IQR, 64.8-77.3), p<0.001. For 63.5% of the participants, the difference between the measurements was over 5 mmHg of SBP and for 23.1% of DBP. According to fBPM, 53.8% of the patients met the criteria for the diagnosis of hypertension and according to sBPM 48.1% (NS). Conclusion. A single blood pressure measurement may result in incorrect diagnosis of hypertension and unnecessary initiation of treatment.

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Keywords

blood pressure measurement; hypertension; preventive examination

About this article
Title

Office blood pressure variability in non-hypertensive patients during a preventive examination

Journal

Arterial Hypertension

Issue

Ahead of print

Article type

Original paper

Published online

2023-01-23

Page views

12

Article views/downloads

20

DOI

10.5603/AH.a2023.0002

Keywords

blood pressure measurement
hypertension
preventive examination

Authors

Łukasz Artyszuk
Izabela Nawrocka
Małgorzata Bieńko
Anita Pietrzak
Piotr Abramczyk

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