Automated BP ‘more accurate’
Using an automated device to take multiple blood pressure (BP) readings in the office setting may overcome the white coat response and give more valid measurements than using a manual sphygmomanometer, research suggests.
A Canadian research team reports in the British Medical Journal that automated BP measurement gave systolic readings that were significantly closer to and correlated better with mean awake ambulatory BP levels, compared with those from manual measurement.
Professor Martin Myers from the Sunnybrook Health Sciences Center in Toronto, Ontario, also report that introduction of the automated office BP measurement significantly reduced the white coat effect compared with ongoing manual measurement.
In a related editorial, Jonathan Mant, professor of primary care research at the University of Cambridge, and Richard McManus, professor of primary care cardiovascular research at the University of Birmingham, caution that automated measurements did not completely eliminate the possibility of a white coat effect. They note that poor operator error, such as poor arm positioning and using the wrong size cuff, can still affect automated recordings.
The editorialists also point out that six readings taken 2 minutes apart as in the study could be difficult to implement in many primary care settings.
Until further evidence is available, they reason, "doctors should remember that blood pressure thresholds and targets are based on measurements performed under controlled research conditions, and that poor technique can lead to substantial error".
GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Caroline Price