title: Thirty-minute compared to standardised office blood pressure measurement in general practice.
abstract: BACKGROUND
  Although blood pressure measurement is one of the most frequently performed measurements in clinical practice, there are concerns about its reliability. Serial, automated oscillometric blood pressure measurement has the potential to reduce measurement bias and white-coat effect'.
  
  
  OBJECTIVE
  To study agreement of 30-minute office blood pressure measurement (OBPM) with standardised OBPM, and to compare repeatability.
  
  
  METHODS
  Method comparison study in two general practices in The Netherlands.
  
  
  METHODS
  Thirty-minute and standardised OBPM was carried out with the same, validated device in 83 adult patients, and the procedure was repeated after 2 weeks. During 30-minute OBPM, blood pressure was measured automatically every 3 minutes, with the patient in a sitting position, alone in a quiet room. Agreement between 30-minute and standardised OBPM was assessed by Bland-Altman analysis. Repeatability of the blood pressure measurement methods after 2 weeks was expressed as the mean difference in combination with the standard deviation of difference (SDD).
  
  
  RESULTS
  Mean 30-minute OBPM readings were 7.6/2.5 mmHg (95% confidence interval [CI] = 6.1 to 9.1/1.5 to 3.4 mmHg) lower than standardised OBPM readings. The mean difference and SDD between repeated 30-minute OBPMs (mean difference = 3/1 mmHg, 95% CI = 1 to 5/0 to 2 mmHg; SDD 9.5/5.3 mmHg) were lower than those of standardised OBPMs (mean difference = 6/2 mmHg, 95% CI = 4 to 8/1 to 4 mmHg; SDD 10.9/6.3 mmHg).
  
  
  CONCLUSIONS
  Thirty-minute OBPM resulted in lower readings than standardised OBPM and had a better repeatability. These results suggest that 30-minute OBPM better reflects the patient's true blood pressure than standardised OBPM does.
authors.affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. n.scherpbier@elg.umcn.nl
authors.forename: Nynke
authors.initials: N
authors.lastname: Scherpbier-de Haan
authors.forename: Mark
authors.initials: M
authors.lastname: van der Wel
authors.forename: Gijs
authors.initials: G
authors.lastname: Schoenmakers
authors.forename: Steve
authors.initials: S
authors.lastname: Boudewijns
authors.forename: Petronella
authors.initials: P
authors.lastname: Peer
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.forename: Theo
authors.initials: T
authors.lastname: Thien
authors.forename: Carel
authors.initials: C
authors.lastname: Bakx
mesh_terms: D001795:Blood Pressure Determination / Q000379:methods / Q000592:standards; D005260:Female; D058006:General Practice / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015203:Reproducibility of Results