Is a manual blood pressure more accurate

Is a manual blood pressure more accurate
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Download / Read Online Is a manual blood pressure more accurate
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Log in here if you are a BMA member. Enter the terms you wish to search for. Stroke Prevention Clinic, Quinte Health Care, Belleville, ON, Canada. To compare the quality and accuracy of manual office blood pressure and automated office blood pressure using the awake ambulatory blood pressure as a gold standard. Primary care practices in five cities in eastern Canada. Difference in systolic blood pressure between awake ambulatory blood pressure minus automated office blood pressure and awake ambulatory blood pressure minus manual office blood pressure. Digit preference with readings ending in zero was substantially reduced by use of automated office blood pressure. In compliant, otherwise healthy, primary care patients with systolic hypertension, introduction of automated office blood pressure into routine primary care significantly reduced the white coat response compared with the ongoing use of manual office blood pressure measurement. The quality and accuracy of automated office blood pressure in relation to the awake ambulatory blood pressure was also significantly better when compared with manual office blood pressure. Recent studies suggest that an accurate office blood pressure reading requires at least 14 minutes, including a period of rest before the first measurement. The likelihood of such careful adherence to protocols for blood pressure measurement in routine, community based, office practice would seem to be low. In recognising these concerns about manual office blood pressure measurement, some experts in hypertension have recently recommended a more limited role for such readings. Proposals for improved assessment of blood pressure status include greater reliance on home and 24 hour ambulatory blood pressure monitoring. Detection and elimination of the white coat response also reduces the number of patients who receive unnecessary drug treatment. Although the evidence supporting greater use of home and 24 hour ambulatory blood pressure monitoring is substantial, to consider abandoning office blood pressure measurement because of the deficiencies associated with conventional manual office readings is both premature and unwise. The use of independently validated, fully automated sphygmomanometers designed for professional use reduces or eliminates many of the factors contributing to imprecise blood pressure readings in routine clinical practice. The absence of a health professional during blood pressure measurement also seems to reduce the anxiety that many patients experience during visits to their doctor. Patients with predominantly systolic hypertension were eligible for the study, as the white coat response is associated with a disproportionate increase in systolic blood pressure. This report presents findings from the first phase of CAMBO, examining whether automated office blood pressure can reduce the white coat response and improve on the quality and accuracy of manual office blood pressure by producing readings that are similar to and more strongly correlated with the awake ambulatory blood pressure. We invited community based family physicians in five Canadian cities who were using manual office blood pressure in their clinical practice to participate in the study. We stratified randomisation to management with automated or manual office blood pressure measurement by city to minimise possible regional differences in blood pressure measurement and management of hypertension arising from any imbalance between the groups. We set a target of 10 patients for each site, with a minimum of five patients. We allowed up to 15 patients for practices in which two or three physicians at one site were randomised as a single cluster. Patients already receiving antihypertensive treatment were eligible if their systolic blood pressure was at least 140 mm Hg and their diastolic pressure was below 90 mm Hg. Potential participants were sent a letter from the office of their family physician asking if they would be interested in participating in CAMBO. Patients who agreed to attend for a baseline visit were seen by a study nurse, who explained the details of the study and verified that the patients satisfied all of the inclusion criteria. The last routine manual office blood pressure recorded on the visit immediately before entry into the study was documented. We defined excess alcohol consumption as 14 or more standard alcoholic beverages a week for men and nine or more beverages a week for women. The BpTRU is a fully automated sphygmomanometer that records blood pressure by the oscillometric method. It is designed to take an initial reading to verify that the cuff is properly positioned to obtain valid readings. The display shows the mean of the five readings, as well as individual measurements. A rest period is not needed before the first reading. Recent studies have noted similar readings when taken at one or two minute intervals. We explained the operation of the device to the physicians and their sta filexlib.
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