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Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research
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COI: 1:CAS:528:DC%2BD2cXhtFaiu7rI, PID: 15611362
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Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45(1):142–61. doi:10.1161/01.HYP.0000150859.47929.8e.
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77951735232
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Effects of intensive blood-pressure control in type 2 diabetes mellitus
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Group AS, Cushman WC, Evans GW, Byington RP, Goff DC Jr, Grimm RH Jr, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1575–85. doi:10.1056/NEJMoa1001286.
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A randomized trial of intensive versus standard blood-pressure control
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COI: 1:CAS:528:DC%2BC28XntVSku78%3D, PID: 26551272, The SPRINT Trial results suggest that targeting a systolic BP of <120 mmHg may provide significant benefits related to cardiovascular outcomes and all-cause mortality. How to incorporate these results into clinical practice is receiving much debate, especially given the variability in how clinic BP is measured
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•• Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103–16. The SPRINT Trial results suggest that targeting a systolic BP of <120 mmHg may provide significant benefits related to cardiovascular outcomes and all-cause mortality. How to incorporate these results into clinical practice is receiving much debate, especially given the variability in how clinic BP is measured.
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74949121981
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Measurement of blood pressure in the office: recognizing the problem and proposing the solution
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COI: 1:CAS:528:DC%2BC3cXlsleltg%3D%3D, PID: 20038756, This review is one of the most often-cited in regard to differences in BP readings between research and routine office settings. It establishes that BPs taken in the clinic setting may produce readings that are 10/5 mmHg higher than would be observed in a research setting
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• Myers MG, Godwin M, Dawes M, Kiss A, Tobe SW, Kaczorowski J. Measurement of blood pressure in the office: recognizing the problem and proposing the solution. Hypertension. 2010;55(2):195–200. This review is one of the most often-cited in regard to differences in BP readings between research and routine office settings. It establishes that BPs taken in the clinic setting may produce readings that are 10/5 mmHg higher than would be observed in a research setting.
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Hypertension
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Myers, M.G.1
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Epidemiological perspective of body position and arm level in blood pressure measurement
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Both body and arm position significantly influence blood pressure measurement
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Netea RT, Lenders JW, Smits P, Thien T. Both body and arm position significantly influence blood pressure measurement. J Hum Hypertens. 2003;17(7):459–62. doi:10.1038/sj.jhh.1001573.
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The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension
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Beckett L, Godwin M. The BpTRU automatic blood pressure monitor compared to 24 hour ambulatory blood pressure monitoring in the assessment of blood pressure in patients with hypertension. BMC Cardiovasc Disord. 2005;5(1):18. doi:10.1186/1471-2261-5-18.
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PID: 24112304, In this study, the authors report the mean BPs of six automated measurements, all of which occur with an observer in attendance. The mean SBP decreased significantly over the course of the six measurements, particularly over the first three or four measurements
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• Brothwell S, Dutton M, Ferro C, Stringer S, Cockwell P. Optimising the accuracy of blood pressure monitoring in chronic kidney disease: the utility of BpTRU. BMC Nephrol. 2013;14:218. In this study, the authors report the mean BPs of six automated measurements, all of which occur with an observer in attendance. The mean SBP decreased significantly over the course of the six measurements, particularly over the first three or four measurements.
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BMC Nephrol
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0036591587
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Lane D, Beevers M, Barnes N, Bourne J, John A, Malins S, et al. Inter-arm differences in blood pressure: when are they clinically significant? J Hypertens. 2002;20(6):1089–95.
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PID: 22160847, This study demonstrates that differences in the method of manual BP measurement (guideline-based versus routine) not only results in differing levels of observed BP, but that these differences may frequently lead to different treatment recommendations for patients. This study was also the only study found comparing guideline-based manual technique to routine technique that randomized the order of measurement type
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•• Ray GM, Nawarskas JJ, Anderson JR. Blood pressure monitoring technique impacts hypertension treatment. J Gen Intern Med. 2012;27(6):623–9. This study demonstrates that differences in the method of manual BP measurement (guideline-based versus routine) not only results in differing levels of observed BP, but that these differences may frequently lead to different treatment recommendations for patients. This study was also the only study found comparing guideline-based manual technique to routine technique that randomized the order of measurement type.
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Graves JW, Nash C, Burger K, Bailey K, Sheps SG. Clinical decision-making in hypertension using an automated (BpTRU) measurement device. J Hum Hypertens. 2003;17(12):823–7. doi:10.1038/sj.jhh.1001626.
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Use of automated office blood pressure measurement to reduce the white coat response
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Myers MG, Valdivieso M, Kiss A. Use of automated office blood pressure measurement to reduce the white coat response. J Hypertens. 2009;27(2):280–6. doi:10.1097/HJH.0b013e32831b9e6b.
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Minor DS, Butler KR Jr, Artman KL, Adair C, Wang W, McNair V, et al. Evaluation of blood pressure measurement and agreement in an academic health sciences center. J Clin Hypertens (Greenwich). 2012;14(4):222–7. doi:10.1111/j.1751-7176.2012.00599.x.
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0348231661
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Gustavsen PH, Hoegholm A, Bang LE, Kristensen KS. White coat hypertension is a cardiovascular risk factor: a 10-year follow-up study. J Hum Hypertens. 2003;17(12):811–7. doi:10.1038/sj.jhh.1001643.
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Prevalence of white coat effect in treated hypertensive patients in the community
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Head GA, Mihailidou AS, Duggan KA, Beilin LJ, Berry N, Brown MA, et al. Definition of ambulatory blood pressure targets for diagnosis and treatment of hypertension in relation to clinic blood pressure: prospective cohort study. BMJ. 2010;340:c1104. doi:10.1136/bmj.c1104.
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22
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84889641919
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Waiting a few extra minutes before measuring blood pressure has potentially important clinical and research ramifications
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COI: 1:STN:280:DC%2BC3snnvFWlsg%3D%3D, PID: 23719215, While guidelines recommend a rest period of 5 min before measuring BP, this study observed a significant decrease in BPs after 10 min of seated rest versus just 5 min. These results highlight the relatively arbitrary nature of the 5-min waiting period and suggest that more study is needed
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• Nikolic SB, Abhayaratna WP, Leano R, Stowasser M, Sharman JE. Waiting a few extra minutes before measuring blood pressure has potentially important clinical and research ramifications. J Hum Hypertens. 2014;28(1):56–61. While guidelines recommend a rest period of 5 min before measuring BP, this study observed a significant decrease in BPs after 10 min of seated rest versus just 5 min. These results highlight the relatively arbitrary nature of the 5-min waiting period and suggest that more study is needed.
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J Hum Hypertens
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33744510715
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Automated blood pressure measurement in routine clinical practice
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PID: 16534406, The only study in this review comparing AOBP to manual BP that randomized the order of AOBP versus manual readings. Notably, the authors reported a significantly different mean BP for the manual measurements taken before the automated readings compared with manual measurements taken afterwards. This highlights the importance of randomizing the order of the type of measurements when comparing BP techniques
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• Myers MG. Automated blood pressure measurement in routine clinical practice. Blood Press Monit. 2006;11(2):59–62. The only study in this review comparing AOBP to manual BP that randomized the order of AOBP versus manual readings. Notably, the authors reported a significantly different mean BP for the manual measurements taken before the automated readings compared with manual measurements taken afterwards. This highlights the importance of randomizing the order of the type of measurements when comparing BP techniques.
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Blood Press Monit
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Myers, M.G.1
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Schiffrin EL, Calhoun DA, Flack JM. SPRINT proves that lower is better for nondiabetic high-risk patients, but at a price. Am J Hypertens. 2016;29(1):2–4. doi:10.1093/ajh/hpv190.
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Kjeldsen SE, Lund-Johansen P, Nilsson PM, Mancia G. Unattended blood pressure measurements in the systolic blood pressure intervention trial: implications for entry and achieved blood pressure values compared with other trials. Hypertension. 2016;67(5):808–12. doi:10.1161/hypertensionaha.116.07257.
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Kjeldsen SE, Mancia G. Unobserved automated office blood pressure measurement in the systolic blood pressure intervention trial (SPRINT): systolic blood pressure treatment target remains below 140 mmHg. Eur Heart J Cardiovasc Pharmacother. 2016;2(2):79–80. doi:10.1093/ehjcvp/pvw002.
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Redon J, Mancia G, Sleight P, Schumacher H, Gao P, Pogue J, et al. Safety and efficacy of low blood pressures among patients with diabetes: subgroup analyses from the ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial). J Am Coll Cardiol. 2012;59(1):74–83. doi:10.1016/j.jacc.2011.09.040.
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Bakris GL. The implications of blood pressure measurement methods on treatment targets for blood pressure. Circulation. 2016;134(13):904–5. doi:10.1161/CIRCULATIONAHA.116.022536.
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Mancia G, Kjeldsen SE. Adopting systolic pressure intervention trial (SPRINT)-like office blood pressure measurements in clinical practice. J Hypertens. 2017;35(3):471–2. doi:10.1097/HJH.0000000000001229.
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Automated compared to manual office blood pressure and to home blood pressure in hypertensive patients
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PID: 26852625, While most assume that AOBP measurements experience less variability than manual measurements, this study observed no better repeatability (as measured by intra-class correlation) of AOBP compared with manual measurements
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• Filipovsky J, Seidlerova J, Kratochvil Z, Karnosova P, Hronova M, Mayer O Jr. Automated compared to manual office blood pressure and to home blood pressure in hypertensive patients. Blood Press. 2016;25(4):228–34. doi:10.3109/08037051.2015.1134086. While most assume that AOBP measurements experience less variability than manual measurements, this study observed no better repeatability (as measured by intra-class correlation) of AOBP compared with manual measurements.
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