Correlation and Clinical Impact of Ambulatory, Home, and Office Measurements in Hypertensive Patients

Abstract

Aim: Hypertension is a major cardiovascular risk factor and the most common chronic disease. Being far from the targeted level in diagnosis and treatment has led to frequent questioning of measurement methods. Although out-of-office measurements are gaining prominence, the reliability and clinical effects of office and out-of-office measurement methods are open to question in terms of both usability and correlation. Our aim in this study was to evaluate the correlation of ambulatory, home, and office measurements and their clinical implications in hypertensive patients. Material and Method: We evaluated out-of-office blood pressure measurements of patients who were followed up with a diagnosis of hypertension. Patients who were scheduled to have ambulatory blood pressure measurements were asked to have home measurements five days before this measurement. Oscillometric and auscultatory methods used for office measurements. Home measurements were performed with the patient’s own calibrated devices. Ambulatory measurements were performed after five days of home follow-up. Results: The study included 463 patients with a mean age of 49±15 years, 52% of whom were women. The number of patients diagnosed with non-regulated hypertension, based on home (256) and office (220) measurements, was much higher than the number of patients based on daytime (63) and average (87) ambulatory measurements. Among the patients considered regulated according to daytime ambulatory measurements, 157 (71.4%) were evaluated as hypertension according to office blood pressure, and 193 (75.4%) were assessed as non-regulated hypertension according to home blood pressure. When the correlation between blood pressure measurements was analyzed, it was observed that there was a high correlation between home and office blood pressure (r: 0.922, p<0.001) and a low correlation between ambulatory measurements and home and office blood pressure (r: 0.438, r: 0.459, p<0.001). Conclusion: In a significant proportion of patients who were decided to be unregulated while being followed up with a diagnosis of hypertension due to office measurements, it was decided that the follow-up was regulated as a result of ambulatory measurements. The high correlation between home and office measurements and the low correlation between ambulatory measurements, which differs from these methods, are noteworthy.

Keywords

• hypertension
• out-of-office blood pressure
• ambulatory blood pressure

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