title: Home blood pressure monitoring: a few minutes of rest before measurement may not be appropriate.
abstract: BACKGROUND
  Home blood pressure measurement (HBPM) is recommended for the diagnosis and follow-up of hypertensive patients. While measurement protocols emphasize a rest period before taking the measurement, this directive has not been supported by any specific study to date. This analysis aimed to determine whether the respect or nonrespect of rest before HBPM could introduce a difference between daytime ambulatory blood pressure measurement (ABPM) and HBPM; whether this rest is observed "in real life" among educated hypertensive patients.
  
  
  METHODS
  In this open, prospective study we compared HBPM, with and without rest, and ABPM among 52 office/clinically controlled hypertensive patients. HBPM was performed during 3 days (French HAS instructions); 24-hour ABPM was performed within 3 days of HBPM. All patients who regularly performed HBPM before the study were asked how they practiced HBPM in real life.
  
  
  RESULTS
  There was a differential impact of rest on differences observed in daytime ABPM and HBPM. Systolic HBPM decreased with rest, while diastolic HBPM did not significantly increase. HBPM systolic BP (SBP) without rest was not significantly different from daytime ABPM SBP (P = 0.27). HBPM SBP without rest was lower than daytime and 24-hour systolic ABPM. Diastolic HBPM after rest was not significantly different from daytime diastolic ABPM (P = 0.09). None of the 38 patients who regularly performed HBPM were compliant with a period of rest before beginning the measurements.
  
  
  CONCLUSIONS
  Rest before HBPM induces a bias that underestimates SBP vs. daytime ABPM and perhaps complicates patient adherence to HBPM protocols.
authors.affiliation: Lorraine University, Nancy, France; Family Medicine Department, Medicine Faculty, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France. Jm.boivin@chu-nancy.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Boivin
authors.affiliation: Lorraine University, Nancy, France; Family Medicine Department, Medicine Faculty, Nancy, France;
authors.forename: Emilie
authors.initials: E
authors.lastname: Boutte
authors.affiliation: Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Fay
authors.affiliation: Lorraine University, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: Lorraine University, Nancy, France; Centre d'Investigation Clinique Plurithématique (CIC-P) Inserm Centre Hospitalo-Universitaire (CHU) Pierre Drouin, Nancy, France.
authors.forename: Faïez
authors.initials: F
authors.lastname: Zannad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012146:Rest; D013599:Systole
keywords: blood pressure; home blood pressure measurement; hypertension; hypertension measurement.