Which of the Following Is Used as a Comparison Point to Readings Taken at Regular Intervals?

J Hypertens. Author manuscript; available in PMC 2010 Sep 19.

Published in terminal edited grade as:

PMCID: PMC2941726

NIHMSID: NIHMS233354

What is the optimal interval between successive home blood pressure readings using an automated oscillometric device?

Kazuo Eguchi

^a Segmentation of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Nihon

Sujith Kuruvilla

^b Center for Behavioral Cardiovascular Health, Columbia University Medical Center, Columbia Academy Medical College, New York

Gbenga Ogedegbe

^b Center for Behavioral Cardiovascular Health, Columbia University Medical Heart, Columbia University Medical Higher, New York

William Gerin

^b Centre for Behavioral Cardiovascular Health, Columbia Academy Medical Center, Columbia Academy Medical College, New York

Joseph E. Schwartz

^c Section of Psychiatry and Behavioral Science, Stony Brook Academy, Stony Beck, New York, USA

Thomas G. Pickering

^b Center for Behavioral Cardiovascular Health, Columbia University Medical Center, Columbia Academy Medical College, New York

Abstract

Objectives

To analyze whether a shorter interval between three successive dwelling house blood pressure (HBP) readings (10 s vs. 1 min) taken twice a day gives a meliorate prediction of the average 24-h BP and better patient compliance.

Pattern

We enrolled 56 patients from a hypertension dispensary (mean age: 60 ±fourteen years; 54% female patients). The study consisted of three clinic visits, with 2 4-week periods of self-monitoring of HBP betwixt them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with order randomized, the oscillometric HBP device (HEM-5001) could exist programmed to have 3 consecutive readings at either x-s or 1-min intervals, each of which was done for 4 weeks. Patients were asked to mensurate three HBP readings in the morning and evening. All the readings were stored in the memory of the monitors.

Results

The analyses were performed using the second–3rd HBP readings. The boilerplate systolic BP/diastolic BP for the 10-southward and i-min intervals at abode were 136.1 ±15.8/77.5 ±9.5 and 133.2 ±15.five/76.9 ±ix.iii mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The one-min BP readings were significantly closer to the average of awake convalescent BP (131 ±14/79 ±ten mmHg) than the 10-southward interval readings. There was no meaning difference in patients' compliance in taking adequate numbers of readings at the different time intervals.

Conclusion

The 1-min interval between HBP readings gave a closer agreement with the daytime boilerplate BP than the x-s interval.

Keywords: convalescent BP monitoring, home BP, measurement interval, multiple BP measurements

Introduction

Domicile blood pressure (HBP) measurement is increasingly used in clinical practice. A number of studies and reviews [one] accept demonstrated that habitation BP is superior to clinic BP in its reproducibility [2–4], for predicting target organ damage [5–seven] and futurity cardiovascular events in general populations [8,9], hypertensive patients [x], and patients with kidney disease [11]. The international BP guidelines for the use of dwelling house BP [12–fourteen] accept stated that when a series of readings is taken, a minimum of two readings should be taken at intervals of at least i min, and the average of those readings should be used to represent the patient'south claret pressure.

Most of the currently available dwelling house monitors take only one reading when the device is triggered, but the latest generation of monitors volition accept multiple readings automatically at fixed intervals. However, doing this volition take longer than taking a unmarried reading, raising the possibility that compliance with the procedure will exist less. Although an interval of ane min between readings has been recommended, there is some evidence that an interval of less than fifteen s may be as authentic as the conventional 1-min interval [15,16]. However, these studies were performed in clinical settings by trained enquiry staff. Alternatively, in that location is the possibility that taking multiple BP measurements at shorter intervals is less accurate because of hyperemia of the upper arm [17], which has been investigated during measurements made with the Korotkoff method, and this may be the source of the recommendation to wait at least 1 min between measurements. In addition, it has been observed that at that place is a progressive fall of BP with multiple readings, the extent of which varies co-ordinate to the interval between successive readings. At the present time, there have been no studies comparing the feasibility and accuracy of short time intervals with the more conventional ane-min interval for readings taken by oscillometric habitation monitors. We performed this written report to test the hypotheses that repeated oscillometric dwelling BP measurement using ten-s intervals are as accurate as those using the conventional 1-min intervals; and patient compliance is better when 10-s intervals are used.

Methods

Patients were recruited from the hypertension clinic at Columbia Academy New York-Presbyterian Hospital. The inclusion criteria were a diagnosis of known or suspected hypertension, and, if treated, having been on a stable dose of medication for at least 1 month with no program to change treatment for the side by side 2 months. Twoscore-two out of 56 patients were taking antihypertensive medications. Patients with major arrhythmias or with arm circumference greater than xl cm were excluded. The following variables were assessed at the initial visit: historic period, sex, race, trunk mass alphabetize, history of cardiovascular affliction, and handedness. Arm circumference was measured, and the appropriate cuff size was selected [12].

Dispensary BP measurements

Clinic BP was measured at baseline and at the 4th and 8th week visits. Patients sat quietly with their backs supported, without crossing their legs, and with both arms supported at heart level for 5 min before the measurements were made. Dispensary BP was measured with auscultation past a doc (three readings) using a mercury sphygmomanometer and by an automatic BP monitor [Omron HEM-5001 (Kyoto, Japan), the home monitor used in the report] with iii readings at 1 min intervals, giving a full of half-dozen clinic readings at each visit. The sequence of the clinic BP measurements was randomly assigned at each visit. Thus, each of the two types of dispensary BP measurements used in the analysis described below was based on the boilerplate of nine readings (three on three occasions over an 8-week period) taken under rigorously standardized conditions.

Home BP measurement

The HBP monitor used for this study was an Omron HEM-5001 device, which tin can be gear up to automatically take three readings, at either 10-s or 1-min intervals. Although this device has non been subjected to a formal validation test, it uses the same algorithm equally the HEM-737, which has passed the Association for the Advocacy of Medical Instrumentation (AAMI) validation protocol [eighteen]. Patients were given a HBP monitor and instructed in its use. They were instructed to measure dwelling house BP afterwards a v min rest. It was preset by the investigators to take iii readings at either ten-s or 1-min intervals, based on random assignment, for the initial 4-week abode monitoring catamenia. The 1-min (or 10-s) interval was betwixt the end of the outset reading and the start of the next reading. They were asked to measure morning time HBP and evening HBP on at to the lowest degree 4 days/week for 8 weeks. The measurement results (date, time, BP, and pulse rate) were automatically stored in the retention of the monitor. Patients were asked to visit the investigator'south office at the 4th and eighth week and bring the monitor, at which times the data were uploaded to a computer. At the fourth week visit, the interval setting of the home monitor was inverse by the research staff from 1 min to x s (H1 grouping) or from 10 due south to 1 min (H2 group).

Ambulatory BP measurement

Ambulatory BP (ABP) measurement over 24 h was performed at the second visit. Patients were asked to go on a diary that included the fourth dimension of going to bed, waking-up, meals, and other events. ABP monitoring was performed with a Spacelabs 90207 device (SpaceLabs Medical, Inc., Redmond, Washington, USA). Blood force per unit area was measured every 15 min between 0700 and 2300 h and every thirty min during the night. Patients were asked to send the device and diary back to the investigator's part afterward completion of ABP monitoring. The boilerplate awake and sleep ABP value were calculated based on the patients' diaries. This study was canonical by the Institutional Review Board of Columbia University, and written informed consent was obtained from all participants.

Statistical analyses

Nosotros used the mean of the beginning–second, second–third, and the beginning–third readings for the analyses of the home BPs. BP readings labeled equally 'morning' and 'evening' were used as morning time and evening readings, but BP measurements taken at other times were excluded from the analyses. The averages and the differences betwixt home BP readings taken at 10-southward and 1-min intervals were compared using paired t-tests. Morning and evening BP readings were combined when 10-southward and i-min intervals were compared and when habitation BP was compared with dispensary BP or ABP measures. The associations between home BP, clinic BP and ABP were compared using the intraclass correlation coefficient (ICC) for agreement [19]. For all analyses, a significance level of P value less than 0.05, 2-tailed, was used. The preliminary information processing of the HBP and ABP data was performed in SAS nine.1 (SAS Establish, Research Triangle, North Carolina, United states of america). All statistical analyses were performed with SPSS, 13.0 (SPSS, Inc., Chicago, Illinois, USA).

Results

Initially, 57 consecutive patients seen in the hypertension clinic were enrolled for the written report. Considering one patient withdrew from the study at the 2nd visit, 56 patients completed the study protocol. As shown in Table 1, the mean age of the patients was 60 years, two-thirds were White, and 75% were on antihypertensive handling. Office BP level measured by the HEM-5001 (131 ±15/76 ±nine mmHg) was like to awake BP (131 ± 14/79 ±x mmHg), but home BP boilerplate (135 ±fifteen/77 ±9 mmHg) calculated by both ten and one-min intervals) was higher than function and awake ABP. The average of all three successive readings (starting time to third), across morning and evening assessments, was 136/78 mmHg, the boilerplate of the first and second readings was 137/78 mmHg, and the boilerplate of the 2nd and third readings was 135/77 mmHg when they were calculated by the average of both measurement intervals. Figure 1 shows the differences among the three consecutive home systolic BP readings in the morn, separately for the information assessed at 10-s and one-min intervals. At both sampling intervals, the second readings were significantly lower than the first readings, and the tertiary readings were significantly lower than the outset and the second readings. The similar trends were observed for morning diastolic BP (DBP) and evening systolic BP (SBP)/DBP.

Changes of morning BP by measurement times and a comparing of dwelling systolic BP in the morn across 3 consecutive readings taken at 10-southward vs. 1-min intervals. *P <0.001 vs. get-go readings, ^† P <0.001 vs. 2d readings.

Tabular array 1

Baseline characteristics

Variables	Boilerplate or percent
Number of patients	56
Age (years)	lx.0 ±fourteen.iv
Sex [number (%) of men]	26 (46.4%)
White race (%)	34 (60.7%)
Trunk mass alphabetize (kg/m2)	26.six ± 6.four
Diagnosed hypertension (%)	51 (91.1%)
History of hypertension (years)	8.3 ± nine.1
On antihypertensive treatments (%)	42 (75%)
Blazon Two diabetes (%)	3 (v.4%)
History of cardiovascular diseasea (%)	8 (14.3%)
Patients with large adult gage (%)	8 (14.three%)

Bland–Altman plots for the averages of awake ABP and home BP showed that the difference between awake and dwelling house SBP/DBP was similarly distributed across the BP range for both the 10-s and 1-min intervals and was less than 20 mmHg for all simply i participant (data are not shown).

Table 2 shows the average home BP levels, the differences from habitation BP to convalescent awake BP, and the differences betwixt the first and 2d, or the 2nd and third readings. All of the information are combined BP measurements of morn and evening. As shown, the average SBPs measured at 10-s intervals were consistently higher than those measured at 1-min intervals. The values of readings averaged from the first to 2d were significantly college than those averaged from the 2nd to 3rd (Table 2a). There were no meaning differences in DBP levels betwixt ten-s and i-min intervals. Tabular array 2(b) shows the comparisons between ABP and dwelling BP readings. The average habitation BP measured at 10-s and 1-min intervals was consistently college than the awake SBP, but there were no significant differences between the home BP averages of the second–3rd readings taken at 1-min intervals and the awake SBP. These differences between domicile SBP and ambulatory awake SBP were significantly higher in the 10-s intervals. The intraclass correlations of agreement between 10-s and 1-min intervals of the abode BP and awake SBP were 0.712/0.725 for SBP and 0.693/0.673 for DBP when two readings of the dwelling house BP were used each fourth dimension. Table 2(c) shows the comparisons of the first vs. second and second vs. third readings taken at x-s vs. 1-min intervals for the home BPs. The differences between the first and second readings were significantly larger in 1-min intervals than in the 10-southward intervals. The differences between the second and third readings were significantly larger when the interval betwixt them was x-due south than when it was 1-min, for both systolic and diastolic BP.

Table 2

Comparison between domicile BP readings taken at x-s and i-min intervals

	10-southward intervals	1-min intervals	P
(a) Average domicile BP levels
First–tertiary SBP (mmHg)	137.0 ± 15.six	134.vii ± 15.4	0.005
Showtime–third DBP (mmHg)	77.9 ± 9.4	77.two ± ix.1	0.fifteen
Get-go–second SBP (mmHg)	138.0 ± fifteen.5††	135.6 ± fifteen.four††	0.005
First–second DBP (mmHg)	78.2 ± ix.iv††	77.iv ± 9.2†	0.07
Second–tertiary SBP (mmHg)	136.1 ± fifteen.8	133.2 ± 15.5	0.001
Second–third DBP (mmHg)	77.five ± ix.5	76.9 ± 9.3	0.19
(b) Differences from domicile BP to awake SBP/DBP
First–3rd SBP (mmHg)	6.0 ± ten.iv***	three.7 ± x.seven*	0.005
First–3rd DBP (mmHg)	−1.2 ± 7.7	−1.9 ± vii.vi	0.15
First–second SBP (mmHg)	7.0 ± 10.4***	4.6 ± 10.seven**	0.005
Start–second DBP (mmHg)	−0.9 ± 7.7	−1.8 ± 7.6	0.07
Second–3rd SBP (mmHg)	v.1 ± ten.v**	two.ii ± 10.9	<0.001
Second–third DBP (mmHg)	−1.6 ± seven.7	−2.2 ± 7.viii	0.19
(c) Differences from first to second or second to third readings
Get-go minus second SBP	1.4 ± ii.5 (4)	3.7 ± 3.ii (16)	<0.001
First minus second DBP	0.seven ± 1.8 (0)	0.7 ± i.vii (ane)	0.99
Second minus third SBP	2.3 ± 1.5 (3)	1.two ± one.4 (1)	<0.001
Second minus third DBP	0.seven ± 0.ix (0)	0.2 ± 0.ix (0)	0.002

Automatic measurement of clinic BP

Additionally, nosotros compared the clinic measurement of HEM-5001 and mercury sphygmomanometer. The average BP levels were 129 ± fifteen/77 ± 10 mmHg when taken by the mercury sphygmomanometer and 131 ± xv/76 ± 9 mmHg for the HEM-5001. The interclass correlations of agreement between mercury readings and HEM-5001 were 0.953 for SBP and 0.906 for DBP when three readings were taken each time.

Patient compliance

Compliance was measured as the number of each set of home BP readings taken per week. The numbers of occasions per calendar week that 3 measurements were taken in the morning were 5.two ± 1.two days for the reading taken with 10-s intervals and v.3 ± i.4 days for the ane-min intervals (P = 0.91). There were no differences in the evening BP readings. So, the departure in compliance betwixt the ii measurement intervals was negligible (and not statistically pregnant).

Discussion

This written report has shown that BP readings of a x-s interval of multiple home BP measurements were college than readings taken using the conventional 1-min interval. The 1-min interval of three measurements tended to give a better judge of the average daytime BP level, and, therefore, the 1-min interval would exist better for clinical use. This is the first study testing the validity of using very short time intervals between BP measurements made at home.

The validity of using very brusque intervals between oscillometric BP measurements in the clinic has been reported by two groups. Yarows et al. [15] reported that a 15-southward interval between BP measurements was every bit authentic every bit a 1-min interval in normotensive volunteers. Koehler et al. [16] showed that multiple BPs measured over a period of ten–15 south were like to those taken at i-min intervals using a sphygmomanometer and automated devices (which were not cited equally validated). Our results are consistent with these reports, merely the previous studies were performed only in clinical settings because home monitors with preset measurement intervals were non bachelor. In dissimilarity, with the advent of new technology, nosotros take been able to examine the results of using two dissimilar and standardized measurement intervals for readings taken at home. We used the awake ABP as the comparator measure and also compared the home readings with readings taken in the clinic under standardized conditions using both mercury sphygmomanometer readings and automated device readings. The chief finding of the study was that though the intraclass correlations of agreement for the 10-s and 1-min intervals at home with awake ABP were similar, the mean SBP levels taken at ten-s intervals were significantly higher than SBP taken at 1-min intervals, and the average home BP with i-min intervals was closer to the daytime ABP. Considering the BP measurements of x-s and 1-min intervals were washed in the same patients crossed over, the baseline BP level was similar, and arm size, cuff size, and deflation time were exactly the same for the two measurement conditions. Therefore, we practise non think that these factors affected the differences betwixt the 10-s and 1-min interval measurements.

The differences between the first and the second readings were larger for ane-min intervals than for 10-s intervals, and, conversely, the difference of the 2d and the third readings were larger for ten-s intervals than for 1-min intervals. Recent dwelling house BP guidelines have stated that the average of the first and second readings should be used for clinical do [thirteen,14], merely taking the average SBP of the 2nd and third readings may best predict the awake SBP [20]. Information technology should exist pointed out that the device we used had a relatively rapid aggrandizement and deflation, and our findings do not necessarily apply to all other devices. At that place has hitherto been piffling investigation into how long the intervals betwixt measurements should exist [xv,16]. Hypertension guidelines have empirically recommended to wait for 1 or 2 min for the next measurement, which has been used for the Korotkoff technique [12]. Brook [21] has reported that the accuracy of HBP measurements, equally determined by their agreements with awake ABP, is similar regardless of substantial variations in HBP monitoring schedules, though the measurement interval issue was not discussed. Many of the patients in the nowadays study could have started their measurements correct after some activities without resting a few minutes. Consequently, their BP stabilized a few minutes after offset the measurements. Namely, the second and the 3rd readings of the 1-min interval might have been measured in more stable weather condition than in the second and the 3rd readings of the 10-s intervals during which the BP was still going down. For keeping patients' residuum, three successive measurements of 1-min intervals would be better option in clinical practice. Our results tin can lead to a determination that the 1-min measurement interval is preferable to the x-s interval for domicile BP measurement.

Accuracy of the HEM-5001

In the office BP measurement procedure, we compared the HEM-5001 with a mercury sphygmomanometer. The average office BP level taken past the HEM-5001 was very similar to office BP taken past a mercury manometer. The intraclass correlations of agreement in the HEM-5001 and mercury readings were excellent for both SBP and DBP. This is non an official validation study, but the HEM-5001 appears to be as authentic as a mercury sphygmomanometer.

Rationale for taking a i-min interval between readings

In the American Middle Association BP measurement guideline [12], the following statement was described without whatsoever citation: '3 readings should exist taken in succession, separated by at least 1 min. The beginning is typically the highest, and the average should be used equally the blood force per unit area reading.' The rationale for taking one min intervals between multiple measurements appears arbitrary. Venous congestion or hyperemia has traditionally been thought to affect the BP measurement results when the Korotkoff method is used, but in recent reports, very short time intervals between readings did not produce different values from conventional intervals when oscillometric devices were used [fifteen,xvi]. Ischemia in an arm distal to the measurement cuff can lower the recorded BP past 5–15 mmHg if the ischemia is maintained at 20 mmHg above the systolic BP for xc south, simply information technology raises the BP much less if the ischemia is maintained for only 30 s [22]. Every bit the proper technique is to inflate the cuff to 20 mmHg in a higher place the SBP and apply a deflation rate of two mmHg/s, the ischemia from total occlusion of the cuff should only last 10 southward, and is thus unlikely to change the measurement of the BP.

Compliance

The compliance measure was, unexpectedly, non statistically different between the 10-due south and i-min intervals of BP measurement. We asked patients to measure out their BP on as many days as possible and at least 4 days/week. Because the patients in this written report were from a hypertension dispensary that usually recommends that patients measure their home BP, the majority of them were used to taking frequent readings. However, if we had recruited patients who had never measured dwelling house BP, at that place might accept been a difference in compliance betwixt the x-s and 1-min intervals, especially in the mornings when time is often most pressing. A further written report may be needed to resolve this consequence.

Study limitations

In this study, average daytime ABP (131/79 mmHg) was equal to function BP (131/76 mmHg), and dwelling BP (135/77 mmHg using 1 min intervals and the average of morning and evening readings) was higher than office BP. The reason for the lower level of office BP than home BP was that office BP was measured in the standard status following the international guidelines after at to the lowest degree 5-min rest; measured by a research assistant (but a doctor in Japan) rather than past a physician and multiple measurements (more than than 6 readings) were taken in one occasion afterward seeing a doctor. The BP levels in the normal range were another reason for the relatively lower level of office BP equally was reported in previous studies which take shown that office BP was the same or lower than the out-of-office BP when they were in normotensive range [23–26]. The use of large developed cuff (N = viii) may be some other limitation of this study because the time of inflation and deflation is dissimilar from that of regular size cuff.

Decision

Although both the ten-s and i-min intervals betwixt three successive dwelling house BP readings taken both in the morn and evening showed proficient correlations with the daytime average BP taken by ambulatory monitoring, and no deviation in patient compliance taking the readings, the 1-min intervals gave average habitation BP levels that were closer to the daytime ABP and would therefore be recommended as optimal.

Acknowledgments

The study was supported in part by NHLBI grants PO1 HL 47540 and R24 HL76857 and Omron Healthcare.

Abbreviations

AAMI

the Association for the Advocacy of Medical Instrumentation

ABP

Ambulatory BP

ABPM

ambulatory BP monitoring

DBP

diastolic blood pressure

HBP

dwelling BP

ICC

intraclass correlation coefficient

SBP

systolic blood pressure

References

1. Pickering T American Society of Hypertension Ad Hoc Panel. Recommendations for the use of home (self) and ambulatory blood pressure monitoring. Am J Hypertens. 1996;9:ane–eleven. [PubMed] [Google Scholar]

2. James GD, Pickering TG, Yee LS, Harshfield GA, Riva S, Laragh JH. The reproducibility of average ambulatory, domicile, and clinic pressures. Hypertension. 1988;11:545–549. [PubMed] [Google Scholar]

3. Sakuma M, Imai Y, Nagai K, Watanabe N, Sakuma H, Minami N, et al. Reproducibility of home blood pressure measurements over a 1-year catamenia. Am J Hypertens. 1997;x(7 Pt ane):798–803. [PubMed] [Google Scholar]

iv. Stergiou GS, Baibas NM, Gantzarou AP, Skeva Ii, Kalkana CB, Roussias LG, et al. Reproducibility of dwelling house, ambulatory, and clinic blood pressure: implications for the design of trials for the assessment of antihypertensive drug efficacy. Am J Hypertens. 2002;15:101–104. [PubMed] [Google Scholar]

five. Mulè G, Caimi G, Cottone Due south, Nardi E, Andronico Thou, Piazza Grand, et al. Value of home blood pressures every bit predictor of target organ damage in mild arterial hypertension. J Cardiovasc Run a risk. 2002;9:123–129. [PubMed] [Google Scholar]

six. Cuspidi C, Michev I, Meani South, Salerno M, Valerio C, Fusi 5, et al. Left ventricular hypertrophy in treated hypertensive patients with good claret pressure level control exterior the clinic, simply poor clinic blood force per unit area control. J Hypertens. 2003;21:1575–1581. [PubMed] [Google Scholar]

7. Tachibana R, Tabara Y, Kondo I, Miki T, Kohara K. Home blood pressure is a better predictor of carotid atherosclerosis than office claret pressure in community-dwelling house subjects. Hypertens Res. 2004;27:633–639. [PubMed] [Google Scholar]

8. Ohkubo T, Imai Y, Tsuji I, Nagai K, Kato J, Kikuchi N, et al. Home claret pressure measurement has a stronger predictive ability for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens. 1998;16:971–975. [PubMed] [Google Scholar]

9. Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and convalescent blood pressure level. Hypertension. 2006;47:846–853. [PubMed] [Google Scholar]

10. Bobrie G, Chatellier G, Genes N, Clerson P, Vaur Fifty, Vaisse B, et al. Cardiovascular prognosis of 'masked hypertension' detected by blood pressure self-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–1349. [PubMed] [Google Scholar]

eleven. Agarwal R, Andersen MJ. Blood pressure recordings inside and outside the clinic and cardiovascular events in chronic kidney disease. Am J Nephrol. 2006;26:503–510. [PubMed] [Google Scholar]

12. 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 one: 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 Inquiry. Circulation. 2005;111:697–716. [PubMed] [Google Scholar]

13. Pickering TG, Miller NH, Ogedegbe 1000, Krakoff LR, Artinian NT, Goff D, et al. Call to action on use and reimbursement for abode blood force per unit area monitoring: executive summary: a articulation scientific argument from the American Heart Association, American Club Of Hypertension, and Preventive Cardiovascular Nurses Clan. Hypertension. 2008;52:1–nine. [PubMed] [Google Scholar]

14. Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, et al. European Society of Hypertension guidelines for blood pressure monitoring at dwelling: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008;26:1505–1526. [PubMed] [Google Scholar]

15. Yarows SA, Patel 1000, Beck R. Rapid oscillometric claret pressure measurement compared to conventional oscillometric measurement. Blood Press Monit. 2001;vi:145–147. [PubMed] [Google Scholar]

sixteen. Koehler NR, Poli de Figueiredo CE, Mendes-Ribeiro AC. Time interval between pairs of arterial blood pressure measurements: does information technology matter? Am J Hypertens. 2004;17:194–196. [PubMed] [Google Scholar]

17. Rabbany SY, Drzewiecki GM, Noordergraaf A. Peripheral vascular effects on auscultatory blood force per unit area measurement. J Clin Monit. 1993;9:ix–17. [PubMed] [Google Scholar]

18. Anwar YA, Giacco S, McCabe EJ, Tendler Exist, White WB. Evaluation of the efficacy of the Omron HEM-737 IntelliSense device for use on adults co-ordinate to the recommendations of the Association for the Advocacy of Medical Instrumentation. Blood Printing Monit. 1998;iii:261–265. [PubMed] [Google Scholar]

xix. Shrout FE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420–428. [PubMed] [Google Scholar]

20. Verberk WJ, Kroon AA, Kessels AG, Lenders JW, Thien T, van Montfrans GA, et al. The optimal scheme of self blood pressure measurement as determined from convalescent blood pressure recordings. J Hypertens. 2006;24:1541–1548. [PubMed] [Google Scholar]

21. Brook RD. Abode blood force per unit area: accuracy is independent of monitoring schedules. Am J Hypertens. 2000;xiii:625–631. [PubMed] [Google Scholar]

22. Rabbany SY, Drzewiecki G, Melbin J, Noordergraaf A. The upshot of peripheral resistance on the Korotkoff sound: experiments. AAMI 19th Almanac Coming together; 1984. [Google Scholar]

23. Pickering TG, Harshfield GA, Kleinert Hd, Blank Southward, Laragh JH. Blood pressure during normal daily activities, sleep, and exercise. Comparison of values in normal and hypertensive subjects. JAMA. 1982;247:992–996. [PubMed] [Google Scholar]

24. James GD, Pickering TG, Yee LS, Harshfield GA, Riva S, Laragh JH. The reproducibility of average ambulatory, home, and clinic pressures. Hypertension. 1988;xi(6 Pt 1):545–549. [PubMed] [Google Scholar]

25. Kjeldsen SE, Hedner T, Jamerson K, Julius Due south, Haley We, Zabalgoitia One thousand, et al. Hypertension optimal treatment (HOT) report: home blood pressure in treated hypertensive subjects. Hypertension. 1998;31:1014–1020. [PubMed] [Google Scholar]

26. Stergiou GS, Thomopoulou GC, Skeva Two, Mountokalakis TD. Home claret pressure normalcy: the Didima written report. Am J Hypertens. 2000;xiii(six Pt ane):678–685. [PubMed] [Google Scholar]

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