ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO343

Unattended Compared with Attended Automated Office Blood Pressure Measurements: A Systematic Review and Meta-Analysis

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Deragon, Valérie, Universite de Montreal, Montreal, Quebec, Canada
  • Baati, Youssef, Universite de Montreal, Montreal, Quebec, Canada
  • Trudelle, Laurence, Universite de Montreal, Montreal, Quebec, Canada
  • Merabtine, Amel, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Picone, Dean S., University of Sydney, Sydney, New South Wales, Australia
  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
Background

Standardized automated office blood pressure (AOBP) measurement is widely accepted as the preferred method to monitor BP. However, disagreements persist as to the need to perform AOBP in an unattended manner, where the patient is left alone in a quiet room. In 2019, two meta-analyses assessing the differences between unattended and attended BP readings showed opposite results and prompting the publication of several more studies. Our objective was to reevaluate the BP differences between unattended and attended AOBP when both are performed in an identical manner.

Methods

This systematic review with meta-analysis was conducted according to the PRISMA guidelines. Studies were included if both unattended and attended AOBP were measured on the same participants in a randomized or alternating sequence manner during a single visit with the same device and an identical measurement protocol. The primary outcome was the difference between unattended and attended systolic (SBP) and diastolic (DBP) BP, expressed as weighted mean differences (95% confidence interval) using random-effects models.

Results

From 8,088 screened studies, data was extracted from 15 studies which met the inclusion criteria (n=1,747 participants). In the pooled analysis, the attended compared with unattended BP was higher for SBP by 2.7 mmHg (95%CI 0.6 to 4.7) and DBP by 0.9 mmHg (95%CI 0.1 to 1.8). In leave-one out analyses, results were similar except when excluding the study with the most extreme BP difference (Chotruangnapa 2023) where the difference became non-significant.

Conclusion

Standardized attended AOBP measurements result in slightly higher readings than unattended AOBP. Whether such small differences translate into clinically significant changes in management of BP remains uncertain. Therefore, standardized attended AOBP could remain a reasonable option for BP measurement in a real-life clinical setting.