Which of the Following Readings Would Indicate Hypertension

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

Published in final edited form as:

PMCID: PMC2941726

NIHMSID: NIHMS233354

What is the optimal interval between successive abode blood force per unit area readings using an automated oscillometric device?

Kazuo Eguchi

^a Sectionalization of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Nippon

Sujith Kuruvilla

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

Gbenga Ogedegbe

^b Heart for Behavioral Cardiovascular Wellness, Columbia University Medical Middle, Columbia Academy Medical College, 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 University, Stony Brook, New York, U.s.a.

Thomas G. Pickering

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

Abstruse

Objectives

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

Design

We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female person patients). The study consisted of 3 clinic visits, with two 4-week periods of self-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with society randomized, the oscillometric HBP device (HEM-5001) could be programmed to take three consecutive readings at either 10-south 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 retentiveness of the monitors.

Results

The analyses were performed using the second–third HBP readings. The average systolic BP/diastolic BP for the 10-south and 1-min intervals at home were 136.one ±fifteen.8/77.five ±9.5 and 133.2 ±fifteen.five/76.9 ±9.3 mmHg (P = 0.001/0.xix for the differences in systolic BP and diastolic BP), respectively. The one-min BP readings were significantly closer to the boilerplate of awake ambulatory BP (131 ±14/79 ±x mmHg) than the 10-southward interval readings. At that place was no pregnant departure in patients' compliance in taking acceptable numbers of readings at the dissimilar time intervals.

Conclusion

The ane-min interval betwixt HBP readings gave a closer agreement with the daytime average BP than the 10-south interval.

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

Introduction

Habitation blood force per unit area (HBP) measurement is increasingly used in clinical exercise. A number of studies and reviews [one] have demonstrated that habitation BP is superior to dispensary BP in its reproducibility [2–4], for predicting target organ harm [5–seven] and future cardiovascular events in full general populations [8,9], hypertensive patients [10], and patients with kidney disease [11]. The international BP guidelines for the apply of home BP [12–xiv] accept stated that when a series of readings is taken, a minimum of ii readings should exist taken at intervals of at to the lowest degree ane min, and the average of those readings should be used to represent the patient's blood pressure.

About of the currently available habitation monitors take but i reading when the device is triggered, but the latest generation of monitors will have multiple readings automatically at fixed intervals. Nonetheless, doing this will take longer than taking a unmarried reading, raising the possibility that compliance with the procedure will be less. Although an interval of 1 min between readings has been recommended, in that location is some testify that an interval of less than 15 southward may be as accurate as the conventional ane-min interval [15,xvi]. Nonetheless, these studies were performed in clinical settings by trained research 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 one min between measurements. In addition, it has been observed that there is a progressive fall of BP with multiple readings, the extent of which varies co-ordinate to the interval betwixt successive readings. At the present fourth dimension, there have been no studies comparing the feasibility and accurateness of short time intervals with the more conventional 1-min interval for readings taken past oscillometric home monitors. We performed this report to test the hypotheses that repeated oscillometric home BP measurement using 10-s intervals are equally accurate equally those using the conventional 1-min intervals; and patient compliance is amend when 10-s intervals are used.

Methods

Patients were recruited from the hypertension clinic at Columbia University New York-Presbyterian Infirmary. 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 plan to alter treatment for the next ii months. Xl-two out of 56 patients were taking antihypertensive medications. Patients with major arrhythmias or with arm circumference greater than 40 cm were excluded. The following variables were assessed at the initial visit: age, sexual activity, race, body mass alphabetize, history of cardiovascular disease, and handedness. Arm circumference was measured, and the advisable cuff size was selected [12].

Clinic BP measurements

Clinic BP was measured at baseline and at the quaternary and 8th calendar week visits. Patients sat quietly with their backs supported, without crossing their legs, and with both artillery supported at middle level for 5 min earlier the measurements were made. Clinic BP was measured with auscultation by a doctor (3 readings) using a mercury sphygmomanometer and past an automated BP monitor [Omron HEM-5001 (Kyoto, Japan), the home monitor used in the study] with iii readings at 1 min intervals, giving a full of six 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 average of 9 readings (3 on three occasions over an 8-calendar week period) taken under rigorously standardized conditions.

Habitation BP measurement

The HBP monitor used for this study was an Omron HEM-5001 device, which can be set to automatically take three readings, at either x-s or 1-min intervals. Although this device has non been subjected to a formal validation exam, information technology uses the same algorithm as the HEM-737, which has passed the Association for the Advocacy of Medical Instrumentation (AAMI) validation protocol [18]. Patients were given a HBP monitor and instructed in its utilize. They were instructed to mensurate habitation BP after a 5 min rest. It was preset by the investigators to accept three readings at either 10-s or 1-min intervals, based on random assignment, for the initial 4-week home monitoring period. The i-min (or 10-due south) interval was between the cease of the first reading and the start of the next reading. They were asked to measure morning time HBP and evening HBP on at least four days/calendar week for viii weeks. The measurement results (date, time, BP, and pulse rate) were automatically stored in the memory of the monitor. Patients were asked to visit the investigator's part at the 4th and 8th week and bring the monitor, at which times the information were uploaded to a computer. At the 4th week visit, the interval setting of the habitation monitor was changed past the research staff from i min to 10 s (H1 grouping) or from x s to 1 min (H2 group).

Ambulatory BP measurement

Ambulatory BP (ABP) measurement over 24 h was performed at the 2nd visit. Patients were asked to proceed 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, United states of america). Blood pressure level was measured every xv min between 0700 and 2300 h and every 30 min during the night. Patients were asked to ship the device and diary back to the investigator's office after completion of ABP monitoring. The average awake and sleep ABP value were calculated based on the patients' diaries. This study was approved by the Institutional Review Board of Columbia Academy, and written informed consent was obtained from all participants.

Statistical analyses

Nosotros used the mean of the start–second, second–third, and the first–3rd readings for the analyses of the home BPs. BP readings labeled as 'morning' and 'evening' were used equally morning and evening readings, only 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 ane-min intervals were compared using paired t-tests. Forenoon and evening BP readings were combined when 10-s and one-min intervals were compared and when domicile BP was compared with clinic BP or ABP measures. The associations betwixt 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 data processing of the HBP and ABP data was performed in SAS 9.1 (SAS Institute, Research Triangle, North Carolina, U.s.). All statistical analyses were performed with SPSS, 13.0 (SPSS, Inc., Chicago, Illinois, The states).

Results

Initially, 57 consecutive patients seen in the hypertension dispensary were enrolled for the study. Because one patient withdrew from the study at the 2nd visit, 56 patients completed the study protocol. As shown in Table 1, the hateful age of the patients was 60 years, ii-thirds were White, and 75% were on antihypertensive treatment. Office BP level measured by the HEM-5001 (131 ±fifteen/76 ±ix mmHg) was similar to awake BP (131 ± xiv/79 ±ten mmHg), but home BP boilerplate (135 ±15/77 ±nine mmHg) calculated by both 10 and one-min intervals) was college than office and awake ABP. The average of all 3 successive readings (get-go to 3rd), across morning and evening assessments, was 136/78 mmHg, the average of the commencement and 2nd readings was 137/78 mmHg, and the average of the second and tertiary readings was 135/77 mmHg when they were calculated by the average of both measurement intervals. Figure one shows the differences among the iii sequent home systolic BP readings in the morning time, separately for the data assessed at 10-due south and one-min intervals. At both sampling intervals, the second readings were significantly lower than the first readings, and the 3rd readings were significantly lower than the first and the second readings. The similar trends were observed for morning diastolic BP (DBP) and evening systolic BP (SBP)/DBP.

Changes of morning time BP past measurement times and a comparison of domicile systolic BP in the morn across three consecutive readings taken at 10-s vs. 1-min intervals. *P <0.001 vs. get-go readings, ^† P <0.001 vs. 2nd readings.

Tabular array one

Baseline characteristics

Variables	Average or percentage
Number of patients	56
Age (years)	60.0 ±14.4
Sexual activity [number (%) of men]	26 (46.iv%)
White race (%)	34 (60.vii%)
Trunk mass alphabetize (kg/m2)	26.6 ± half dozen.4
Diagnosed hypertension (%)	51 (91.1%)
History of hypertension (years)	8.3 ± 9.one
On antihypertensive treatments (%)	42 (75%)
Type 2 diabetes (%)	iii (5.iv%)
History of cardiovascular diseasea (%)	viii (xiv.three%)
Patients with big adult cuff (%)	8 (xiv.three%)

Bland–Altman plots for the averages of awake ABP and home BP showed that the difference between awake and home SBP/DBP was similarly distributed across the BP range for both the x-due south and ane-min intervals and was less than twenty mmHg for all just one participant (data are non shown).

Tabular array two shows the average home BP levels, the differences from home BP to ambulatory awake BP, and the differences betwixt the first and second, or the 2d and third readings. All of the data 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 offset to second were significantly higher than those averaged from the 2d to tertiary (Table 2a). There were no pregnant differences in DBP levels betwixt 10-s and 1-min intervals. Table ii(b) shows the comparisons between ABP and home BP readings. The boilerplate home BP measured at ten-s and 1-min intervals was consistently higher than the awake SBP, but there were no meaning differences between the home BP averages of the second–third readings taken at one-min intervals and the awake SBP. These differences between habitation SBP and ambulatory awake SBP were significantly higher in the 10-s intervals. The intraclass correlations of agreement between 10-due south and 1-min intervals of the home BP and awake SBP were 0.712/0.725 for SBP and 0.693/0.673 for DBP when two readings of the home BP were used each time. Tabular array 2(c) shows the comparisons of the first vs. second and second vs. 3rd readings taken at 10-south 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-s intervals. The differences between the 2d and tertiary readings were significantly larger when the interval between them was ten-south than when it was 1-min, for both systolic and diastolic BP.

Table 2

Comparison betwixt home BP readings taken at 10-s and one-min intervals

	10-s intervals	1-min intervals	P
(a) Average dwelling BP levels
Outset–3rd SBP (mmHg)	137.0 ± xv.vi	134.7 ± 15.four	0.005
First–third DBP (mmHg)	77.ix ± 9.iv	77.two ± 9.one	0.15
First–second SBP (mmHg)	138.0 ± fifteen.5††	135.6 ± 15.4††	0.005
Get-go–2d DBP (mmHg)	78.2 ± ix.4††	77.4 ± 9.ii†	0.07
Second–third SBP (mmHg)	136.1 ± xv.8	133.two ± xv.5	0.001
2nd–third DBP (mmHg)	77.v ± 9.v	76.9 ± 9.3	0.19
(b) Differences from home BP to awake SBP/DBP
First–third SBP (mmHg)	6.0 ± 10.4***	3.7 ± 10.7*	0.005
Outset–tertiary DBP (mmHg)	−one.ii ± vii.vii	−1.nine ± 7.6	0.xv
First–second SBP (mmHg)	vii.0 ± 10.four***	four.6 ± ten.7**	0.005
First–second DBP (mmHg)	−0.9 ± 7.7	−1.eight ± vii.vi	0.07
Second–3rd SBP (mmHg)	5.one ± 10.5**	2.two ± 10.nine	<0.001
Second–tertiary DBP (mmHg)	−one.6 ± 7.7	−2.2 ± vii.8	0.xix
(c) Differences from first to 2nd or second to third readings
First minus 2d SBP	i.four ± 2.5 (4)	3.vii ± 3.2 (16)	<0.001
Showtime minus second DBP	0.vii ± one.8 (0)	0.7 ± 1.seven (1)	0.99
Second minus third SBP	ii.three ± ane.5 (iii)	i.2 ± ane.4 (ane)	<0.001
Second minus third DBP	0.7 ± 0.9 (0)	0.ii ± 0.9 (0)	0.002

Automated measurement of clinic BP

Additionally, we compared the clinic measurement of HEM-5001 and mercury sphygmomanometer. The average BP levels were 129 ± 15/77 ± 10 mmHg when taken by the mercury sphygmomanometer and 131 ± fifteen/76 ± nine 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 week that iii measurements were taken in the morning were v.two ± i.2 days for the reading taken with ten-s intervals and 5.3 ± one.4 days for the ane-min intervals (P = 0.91). There were no differences in the evening BP readings. So, the divergence in compliance between the two measurement intervals was negligible (and not statistically significant).

Word

This study has shown that BP readings of a 10-s interval of multiple dwelling house BP measurements were college than readings taken using the conventional 1-min interval. The 1-min interval of iii measurements tended to requite a improve gauge of the average daytime BP level, and, therefore, the 1-min interval would be better for clinical employ. This is the outset report testing the validity of using very short time intervals betwixt BP measurements made at home.

The validity of using very short intervals between oscillometric BP measurements in the clinic has been reported by two groups. Yarows et al. [xv] reported that a 15-south interval between BP measurements was equally accurate as a ane-min interval in normotensive volunteers. Koehler et al. [16] showed that multiple BPs measured over a period of 10–15 s were similar to those taken at ane-min intervals using a sphygmomanometer and automatic devices (which were not cited as validated). Our results are consistent with these reports, simply the previous studies were performed but in clinical settings because dwelling house monitors with preset measurement intervals were not available. In contrast, with the advent of new engineering science, we have been able to examine the results of using ii different and standardized measurement intervals for readings taken at home. We used the awake ABP as the comparator measure and also compared the domicile readings with readings taken in the clinic under standardized weather condition using both mercury sphygmomanometer readings and automated device readings. The main finding of the study was that though the intraclass correlations of understanding for the ten-southward and 1-min intervals at home with awake ABP were similar, the mean SBP levels taken at ten-due south intervals were significantly higher than SBP taken at one-min intervals, and the boilerplate home BP with ane-min intervals was closer to the daytime ABP. Because the BP measurements of ten-s and i-min intervals were done in the same patients crossed over, the baseline BP level was similar, and arm size, cuff size, and deflation fourth dimension were exactly the aforementioned for the two measurement conditions. Therefore, we do not think that these factors affected the differences betwixt the 10-s and i-min interval measurements.

The differences betwixt the first and the second readings were larger for 1-min intervals than for 10-southward intervals, and, conversely, the difference of the second and the third readings were larger for ten-due south intervals than for one-min intervals. Recent home BP guidelines have stated that the average of the first and second readings should be used for clinical practice [13,14], but taking the average SBP of the second and third readings may best predict the awake SBP [20]. It should be pointed out that the device we used had a relatively rapid inflation and deflation, and our findings practice not necessarily employ to all other devices. There has hitherto been piddling investigation into how long the intervals between measurements should be [15,16]. Hypertension guidelines have empirically recommended to wait for one or 2 min for the side by side measurement, which has been used for the Korotkoff technique [12]. Brook [21] has reported that the accuracy of HBP measurements, every bit adamant by their agreements with awake ABP, is similar regardless of substantial variations in HBP monitoring schedules, though the measurement interval effect was non discussed. Many of the patients in the present study could take started their measurements correct after some activities without resting a few minutes. Consequently, their BP stabilized a few minutes after beginning the measurements. Namely, the 2d and the third readings of the 1-min interval might have been measured in more stable conditions than in the 2nd and the tertiary readings of the 10-s intervals during which the BP was nevertheless going down. For keeping patients' residue, 3 successive measurements of i-min intervals would be better choice in clinical practice. Our results can pb to a conclusion that the 1-min measurement interval is preferable to the 10-south interval for dwelling BP measurement.

Accuracy of the HEM-5001

In the office BP measurement procedure, we compared the HEM-5001 with a mercury sphygmomanometer. The boilerplate function BP level taken by 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, just the HEM-5001 appears to be as authentic as a mercury sphygmomanometer.

Rationale for taking a ane-min interval between readings

In the American Heart Clan BP measurement guideline [12], the following statement was described without any commendation: 'three readings should exist taken in succession, separated by at to the lowest degree one min. The start is typically the highest, and the average should be used as the blood pressure reading.' The rationale for taking 1 min intervals betwixt 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 brusque time intervals between readings did not produce dissimilar values from conventional intervals when oscillometric devices were used [15,sixteen]. Ischemia in an arm distal to the measurement gage tin can lower the recorded BP by v–15 mmHg if the ischemia is maintained at 20 mmHg above the systolic BP for 90 s, but it raises the BP much less if the ischemia is maintained for merely 30 s [22]. As the proper technique is to inflate the cuff to twenty mmHg above the SBP and utilise a deflation rate of 2 mmHg/s, the ischemia from full apoplexy of the gage should simply last 10 southward, and is thus unlikely to change the measurement of the BP.

Compliance

The compliance measure out was, unexpectedly, not statistically different betwixt the 10-s and 1-min intervals of BP measurement. We asked patients to measure their BP on as many days as possible and at least 4 days/week. Because the patients in this 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. All the same, if we had recruited patients who had never measured home BP, there might accept been a departure in compliance between the 10-s and i-min intervals, especially in the mornings when time is frequently most pressing. A further written report may be needed to resolve this issue.

Study limitations

In this study, average daytime ABP (131/79 mmHg) was equal to part BP (131/76 mmHg), and home BP (135/77 mmHg using ane min intervals and the average of morning time and evening readings) was higher than office BP. The reason for the lower level of part BP than habitation BP was that office BP was measured in the standard condition following the international guidelines after at least 5-min balance; measured past a research assistant (just a physician in Japan) rather than past a md and multiple measurements (more than than six readings) were taken in ane occasion afterwards seeing a dr.. The BP levels in the normal range were some other reason for the relatively lower level of part BP every bit was reported in previous studies which have shown that function BP was the same or lower than the out-of-office BP when they were in normotensive range [23–26]. The use of large adult gage (Due north = 8) may exist another limitation of this study because the time of inflation and deflation is different from that of regular size gage.

Decision

Although both the ten-s and ane-min intervals between three successive home BP readings taken both in the morning and evening showed proficient correlations with the daytime average BP taken by convalescent monitoring, and no difference in patient compliance taking the readings, the ane-min intervals gave average home BP levels that were closer to the daytime ABP and would therefore be recommended as optimal.

Acknowledgments

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

Abbreviations

AAMI

the Association for the Advancement of Medical Instrumentation

ABP

Ambulatory BP

ABPM

ambulatory BP monitoring

DBP

diastolic blood pressure

HBP

home BP

ICC

intraclass correlation coefficient

SBP

systolic blood pressure

References

i. Pickering T American Club of Hypertension Ad Hoc Panel. Recommendations for the apply of dwelling house (self) and convalescent blood pressure monitoring. Am J Hypertens. 1996;9:1–11. [PubMed] [Google Scholar]

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

3. Sakuma M, Imai Y, Nagai Yard, Watanabe N, Sakuma H, Minami North, et al. Reproducibility of home blood pressure level measurements over a 1-year period. Am J Hypertens. 1997;10(7 Pt 1):798–803. [PubMed] [Google Scholar]

4. Stergiou GS, Baibas NM, Gantzarou AP, Skeva Two, Kalkana CB, Roussias LG, et al. Reproducibility of home, 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]

5. Mulè G, Caimi G, Cottone S, Nardi E, Andronico G, Piazza G, et al. Value of home blood pressures as predictor of target organ damage in mild arterial hypertension. J Cardiovasc Risk. 2002;9:123–129. [PubMed] [Google Scholar]

half dozen. Cuspidi C, Michev I, Meani S, Salerno M, Valerio C, Fusi V, et al. Left ventricular hypertrophy in treated hypertensive patients with good blood pressure control exterior the clinic, only poor clinic claret pressure level control. J Hypertens. 2003;21:1575–1581. [PubMed] [Google Scholar]

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

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

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

10. Bobrie G, Chatellier G, Genes N, Clerson P, Vaur 50, Vaisse B, et al. Cardiovascular prognosis of 'masked hypertension' detected by blood pressure cocky-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–1349. [PubMed] [Google Scholar]

11. Agarwal R, Andersen MJ. Claret pressure level recordings within and outside the dispensary and cardiovascular events in chronic kidney affliction. Am J Nephrol. 2006;26:503–510. [PubMed] [Google Scholar]

12. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Colina MN, et al. Recommendations for blood pressure measurement in humans and experimental animals. Part ane: blood pressure level measurement in humans –a statement for professionals from the Subcommittee of Professional person and Public Didactics of the American Middle Association Council on Loftier Claret Force per unit area Research. Apportionment. 2005;111:697–716. [PubMed] [Google Scholar]

13. Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D, et al. Call to action on apply and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society Of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension. 2008;52:1–9. [PubMed] [Google Scholar]

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

fifteen. Yarows SA, Patel K, Brook R. Rapid oscillometric blood pressure measurement compared to conventional oscillometric measurement. Claret Press Monit. 2001;6:145–147. [PubMed] [Google Scholar]

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

17. Rabbany SY, Drzewiecki GM, Noordergraaf A. Peripheral vascular furnishings on auscultatory blood force per unit area measurement. J Clin Monit. 1993;9:9–17. [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 according to the recommendations of the Association for the Advancement of Medical Instrumentation. Claret Press Monit. 1998;3:261–265. [PubMed] [Google Scholar]

19. Shrout Iron, 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 equally determined from ambulatory blood pressure recordings. J Hypertens. 2006;24:1541–1548. [PubMed] [Google Scholar]

21. Brook RD. Dwelling claret pressure: accuracy is independent of monitoring schedules. Am J Hypertens. 2000;13:625–631. [PubMed] [Google Scholar]

22. Rabbany SY, Drzewiecki M, Melbin J, Noordergraaf A. The effect of peripheral resistance on the Korotkoff sound: experiments. AAMI 19th Annual Meeting; 1984. [Google Scholar]

23. Pickering TG, Harshfield GA, Kleinert HD, Blank S, Laragh JH. Blood pressure level during normal daily activities, sleep, and do. 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 South, Laragh JH. The reproducibility of average ambulatory, home, and clinic pressures. Hypertension. 1988;eleven(6 Pt 1):545–549. [PubMed] [Google Scholar]

25. Kjeldsen SE, Hedner T, Jamerson Yard, Julius South, Haley WE, Zabalgoitia M, et al. Hypertension optimal treatment (HOT) study: home claret pressure in treated hypertensive subjects. Hypertension. 1998;31:1014–1020. [PubMed] [Google Scholar]

26. Stergiou GS, Thomopoulou GC, Skeva II, Mountokalakis TD. Habitation blood force per unit area normalcy: the Didima study. Am J Hypertens. 2000;xiii(6 Pt ane):678–685. [PubMed] [Google Scholar]

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