title: Conventional versus automated measurement of blood pressure in the office (CAMBO) trial.
abstract: BACKGROUND
  Effective strategies to identify office-induced hypertension in routine clinical practice are required to improve diagnosis and management of hypertension.
  
  
  OBJECTIVE
  To compare the quality and accuracy of automated office blood pressure (AOBP) measurement using the BpTRU device with manual office blood pressure (MOBP) in routine clinical practice using awake ambulatory blood pressure (AABP) as the gold standard.
  
  
  METHODS
  Primary care practices in Eastern Canada were allocated by cluster randomization to use of AOBP (36 practices, 52 physicians) or to MOBP (31 practices, 36 physicians) in patients with systolic hypertension. The last routine MOBP reading pre-enrolment was compared to the blood pressure (BP) at the first visit after enrollment and after 2 years of follow-up. The primary outcome measure was the mean difference between the AABP and MOBP versus AOBP.
  
  
  RESULTS
  The mean (95% confidence interval) decrease in systolic BP from pre- to post-enrollment was greater (P < 0.001) at the first visit in the 252 AOBP patients [-14.3 (-16.6, -12.0)] compared to the 209 MOBP patients [-8.0 (-2.2, -5.8)]. At Year 2, AOBP decreased by -16.3 (-18.6, -14.1) compared to a decrease in MOBP of -12.4 (-14.7, -10.1) (P = 0.02). The mean difference between systolic AABP and MOBP at the first post-enrollment office visit [-7.3 (-9.7, -4.9)] was greater (P < 0.001) than the difference for AOBP [-1.8 (-4.0, 0.4)]. At Year 2, these differences were -5.2 (-7.5, -3.0) for MOBP and -2.8 (-4.9, -0.7) for AOBP (P = 0.13).
  
  
  CONCLUSIONS
  AOBP virtually eliminated office-induced hypertension. The decrease in MOBP was attributed to participation in a research study and not to any specific intervention.
authors: Schulich Heart Centre, Division of Cardiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. martin.myers@sunnybrook.ca
authors: Martin G
authors: MG
authors: Myers
authors: Marshall
authors: M
authors: Godwin
authors: Martin
authors: M
authors: Dawes
authors: Alexander
authors: A
authors: Kiss
authors: Sheldon W
authors: SW
authors: Tobe
authors: Janusz
authors: J
authors: Kaczorowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D019722:Sphygmomanometers; D059466:White Coat Hypertension / Q000175:diagnosis / Q000517:prevention & control