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Effect of self-initiated and fully-automated self-measurement on blood pressure

Journal of Human Hypertension volume 34, pages 176–183 (2020)Cite this article

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Abstract

Self-measurement of blood pressure (BP) is regularly used to diagnose hypertension and to monitor BP at home. We recently showed that self-measurement of BP may elicit a pressor or ‘auto-cuff’ response. In this study we examined whether the pressor response is different between self-initiated and fully-automated BP measurement. We performed two randomized crossover studies in outpatients visiting a hypertension clinic. The first cohort of 52 participants performed six unattended self-initiated and six fully-automated BP measurements, while continuously monitoring BP and central haemodynamics using finger photoplethysmography. The second cohort consisted of 120 patients who performed three self-initiated and three fully-automated BP measurements. In the first cohort (mean age 61.2 ± 10.4 years, mean office BP 142.0 ± 19.9/82.5 ± 12.2 mmHg, 36.7% female) average systolic and diastolic BP increased by 7.3 ± 8.5/3.3 ± 4.0 mmHg in the group with self-initiated BP measurements, while BP increased by 3.3 ± 6.3/1.4 ± 3.0 mmHg during fully-automated measurements (p = 0.002/p = 0.002 for difference between groups). The higher BP increase during self-initiated BP measurements resulted from an increase in heart rate and cardiac output. In the second cohort (mean age 58.0 ± 14.1 years, mean office BP 153.6 ± 23.8/86.3 ± 14.0 mmHg, 44.1% female) self-initiated BP measurement resulted in a 2.1 ± 6.8/0.9 ± 4.0 mmHg higher systolic and diastolic BP compared with fully-automated self-measurement (p = 0.001/0.018). In conclusion, our findings suggest that self-initiated BP measurement using a fully-automated method results in a more reliable BP compared with a self-initiated semi-automated method by attenuating the auto-cuff response. These findings may have implications for the self-measurement of BP.

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Acknowledgements

We are greatly indebted to all the participants of the study and to Lotte Zandbergen for her help with the measurements.

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Authors and Affiliations

  1. Department of Vascular Medicine, Amsterdam UMC location Academic Medical Center, Amsterdam, The Netherlands

    Rosanne T. Berkhof, Katia Gazzola & Bert-Jan H. van den Born

  2. Department of Medical Sciences, University of Ferrara, Ferrara, Italy

    Katia Gazzola

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  1. Rosanne T. Berkhof
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  3. Bert-Jan H. van den Born
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Correspondence to Bert-Jan H. van den Born.

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Berkhof, R.T., Gazzola, K. & van den Born, BJ.H. Effect of self-initiated and fully-automated self-measurement on blood pressure. J Hum Hypertens 34, 176–183 (2020). https://doi.org/10.1038/s41371-019-0256-1

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