This study by Bos and Buis (Annals of Family Medicine, 2017) sought to determine if measuring patients’ blood pressure using a convenient automated office blood pressure monitoring system that registers BP every 5 minutes over 30 minutes (OBP30) could reduce the overtreatment of ‘white-coat hypertension’ (isolated office hypertension).
Prospectively collected data using a cross-sectional study design
201 patients with a mean age of 68.6 years (56.7% female) underwent OBP30 if warranted following an elevated office blood pressure (OBP) in a primary care setting. Indications for the OBP30 included suspected ‘white-coat hypertension’, new diagnosis of hypertension, inconsistent office readings, monitoring of medication effects, suspected therapy resistance and suspected episodes of hypotension. The mean systolic OBP30 was 22.8 mm Hg lower compared to mean systolic OBP (95% CI, 19.8–26.1 mm Hg) and mean diastolic OBP30 was 11.6 mm Hg lower compared to mean diastolic OBP (95% CI, 10.2–13.1 mm Hg). Differences were larger in patients older than 70 years. There was impact on management as the decision to place patients on medications dropped from 79.1% to 24.9% based on OBP30 readings. The authors conclude that OBP30 is an effective technique and “promising method” for reducing overtreatment even in patients not suspected of having ‘white-coat hypertension’ in a primary healthcare setting.
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