How Long to Wait Between Blood Pressure Readings

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 habitation blood force per unit area readings using an automated oscillometric device?

Kazuo Eguchi

^a Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan

Sujith Kuruvilla

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

Gbenga Ogedegbe

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

William Gerin

^b Center for Behavioral Cardiovascular Wellness, Columbia Academy Medical Middle, Columbia Academy Medical Higher, New York

Joseph E. Schwartz

^c Department of Psychiatry and Behavioral Scientific discipline, Stony Beck University, Stony Brook, New York, USA

Thomas 1000. Pickering

^b Center for Behavioral Cardiovascular Wellness, Columbia University Medical Centre, Columbia University Medical Higher, New York

Abstruse

Objectives

To clarify whether a shorter interval betwixt three successive home blood pressure level (HBP) readings (x s vs. 1 min) taken twice a day gives a better prediction of the average 24-h BP and better patient compliance.

Design

We enrolled 56 patients from a hypertension clinic (mean age: 60 ±14 years; 54% female patients). The study consisted of three dispensary visits, with two 4-week periods of cocky-monitoring of HBP between them, and a 24-h ambulatory BP monitoring at the second visit. Using a crossover design, with lodge randomized, the oscillometric HBP device (HEM-5001) could be programmed to take 3 consecutive readings at either 10-due south or 1-min intervals, each of which was done for four weeks. Patients were asked to measure out 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–tertiary HBP readings. The average systolic BP/diastolic BP for the ten-s and one-min intervals at home were 136.i ±15.8/77.5 ±9.5 and 133.2 ±15.5/76.ix ±9.3 mmHg (P = 0.001/0.19 for the differences in systolic BP and diastolic BP), respectively. The 1-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 significant departure in patients' compliance in taking adequate numbers of readings at the dissimilar time intervals.

Determination

The 1-min interval betwixt HBP readings gave a closer agreement with the daytime average BP than the 10-southward interval.

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

Introduction

Home claret pressure (HBP) measurement is increasingly used in clinical practise. A number of studies and reviews [1] have demonstrated that dwelling BP is superior to clinic BP in its reproducibility [2–4], for predicting target organ damage [v–seven] and future cardiovascular events in general populations [8,9], hypertensive patients [10], and patients with kidney disease [xi]. The international BP guidelines for the use of home BP [12–xiv] have stated that when a series of readings is taken, a minimum of two readings should be taken at intervals of at least 1 min, and the average of those readings should be used to correspond the patient'due south claret pressure.

Near of the currently available habitation monitors take only one reading when the device is triggered, but the latest generation of monitors will take multiple readings automatically at fixed intervals. However, doing this will take longer than taking a single 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 evidence that an interval of less than 15 s may be every bit accurate as the conventional 1-min interval [fifteen,xvi]. However, these studies were performed in clinical settings by trained research staff. Alternatively, at that place is the possibility that taking multiple BP measurements at shorter intervals is less authentic considering 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 to the lowest degree 1 min between measurements. In addition, information technology has been observed that there is a progressive fall of BP with multiple readings, the extent of which varies according to the interval between successive readings. At the nowadays fourth dimension, in that location have been no studies comparing the feasibility and accuracy of short time intervals with the more than conventional 1-min interval for readings taken by oscillometric home monitors. We performed this study to examination the hypotheses that repeated oscillometric home BP measurement using 10-s intervals are equally accurate as those using the conventional one-min intervals; and patient compliance is meliorate when ten-due south intervals are used.

Methods

Patients were recruited from the hypertension clinic at Columbia University 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 calendar month with no plan to change treatment for the next 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: age, sex, race, trunk mass index, history of cardiovascular disease, and handedness. Arm circumference was measured, and the appropriate gage size was selected [12].

Clinic BP measurements

Clinic BP was measured at baseline and at the 4th and eighth week visits. Patients saturday quietly with their backs supported, without crossing their legs, and with both artillery supported at heart level for 5 min before the measurements were made. Clinic BP was measured with auscultation by a dr. (three readings) using a mercury sphygmomanometer and by an automated BP monitor [Omron HEM-5001 (Kyoto, Japan), the home monitor used in the report] with three readings at 1 min intervals, giving a total of vi 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 clinic BP measurements used in the assay described below was based on the boilerplate of ix readings (three on three occasions over an 8-week period) taken under rigorously standardized conditions.

Home BP measurement

The HBP monitor used for this report was an Omron HEM-5001 device, which tin be set to automatically accept three readings, at either ten-s or i-min intervals. Although this device has non been subjected to a formal validation exam, it uses the aforementioned algorithm as the HEM-737, which has passed the Association for the Advancement of Medical Instrumentation (AAMI) validation protocol [xviii]. Patients were given a HBP monitor and instructed in its use. They were instructed to measure dwelling BP after a 5 min residuum. It was preset by the investigators to take three readings at either x-southward or one-min intervals, based on random assignment, for the initial 4-week habitation monitoring period. The i-min (or 10-s) interval was betwixt the terminate of the starting time reading and the starting time of the next reading. They were asked to measure forenoon HBP and evening HBP on at to the lowest degree 4 days/week for 8 weeks. The measurement results (date, fourth dimension, BP, and pulse rate) were automatically stored in the memory of the monitor. Patients were asked to visit the investigator'south office at the 4th and 8th week and bring the monitor, at which times the information were uploaded to a calculator. At the 4th week visit, the interval setting of the home monitor was changed by the enquiry staff from 1 min to x s (H1 group) 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 along a diary that included the time 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 pressure level was measured every 15 min betwixt 0700 and 2300 h and every 30 min during the nighttime. Patients were asked to send the device and diary back to the investigator's office after completion of ABP monitoring. The average awake and slumber ABP value were calculated based on the patients' diaries. This written report was approved by the Institutional Review Board of Columbia University, and written informed consent was obtained from all participants.

Statistical analyses

We used the mean of the first–second, second–third, and the first–third readings for the analyses of the domicile BPs. BP readings labeled every bit 'forenoon' and 'evening' were used as morning and evening readings, just BP measurements taken at other times were excluded from the analyses. The averages and the differences between home BP readings taken at 10-s and 1-min intervals were compared using paired t-tests. Morn and evening BP readings were combined when x-south and ane-min intervals were compared and when home 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, two-tailed, was used. The preliminary data processing of the HBP and ABP data was performed in SAS ix.1 (SAS Institute, Research Triangle, Due north Carolina, United states of america). All statistical analyses were performed with SPSS, thirteen.0 (SPSS, Inc., Chicago, Illinois, USA).

Results

Initially, 57 consecutive patients seen in the hypertension dispensary were enrolled for the written report. Because one patient withdrew from the study at the 2d visit, 56 patients completed the written report protocol. As shown in Tabular array ane, the mean age of the patients was 60 years, two-thirds were White, and 75% were on antihypertensive treatment. Office BP level measured by the HEM-5001 (131 ±15/76 ±9 mmHg) was similar to awake BP (131 ± 14/79 ±x mmHg), merely abode BP boilerplate (135 ±15/77 ±9 mmHg) calculated by both ten and 1-min intervals) was higher than office and awake ABP. The boilerplate of all three successive readings (starting time to third), across morning time and evening assessments, was 136/78 mmHg, the average of the first and second readings was 137/78 mmHg, and the average of the second 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 3 sequent home systolic BP readings in the morning, separately for the data assessed at ten-s and 1-min intervals. At both sampling intervals, the second readings were significantly lower than the get-go readings, and the third readings were significantly lower than the get-go and the second readings. The similar trends were observed for morning time diastolic BP (DBP) and evening systolic BP (SBP)/DBP.

Changes of morning time BP by measurement times and a comparison of abode systolic BP in the morning across three consecutive readings taken at ten-southward vs. 1-min intervals. *P <0.001 vs. commencement readings, ^† P <0.001 vs. 2nd readings.

Table 1

Baseline characteristics

Variables	Boilerplate or percentage
Number of patients	56
Historic period (years)	60.0 ±fourteen.4
Sex [number (%) of men]	26 (46.4%)
White race (%)	34 (60.7%)
Body mass index (kg/mii)	26.6 ± 6.4
Diagnosed hypertension (%)	51 (91.1%)
History of hypertension (years)	8.3 ± 9.i
On antihypertensive treatments (%)	42 (75%)
Blazon 2 diabetes (%)	3 (5.four%)
History of cardiovascular diseasea (%)	8 (14.3%)
Patients with large developed cuff (%)	8 (fourteen.3%)

Banal–Altman plots for the averages of awake ABP and home BP showed that the deviation betwixt awake and dwelling SBP/DBP was similarly distributed across the BP range for both the 10-s and i-min intervals and was less than twenty mmHg for all just ane participant (information are non shown).

Table 2 shows the average dwelling house BP levels, the differences from home BP to ambulatory awake BP, and the differences between the first and second, or the second and third readings. All of the data are combined BP measurements of forenoon and evening. As shown, the average SBPs measured at 10-s intervals were consistently college than those measured at 1-min intervals. The values of readings averaged from the commencement to 2d were significantly higher than those averaged from the second to third (Table 2a). There were no significant differences in DBP levels betwixt x-due south and 1-min intervals. Table ii(b) shows the comparisons between ABP and domicile BP readings. The average abode BP measured at 10-s and 1-min intervals was consistently higher than the awake SBP, only at that place were no significant differences betwixt the domicile BP averages of the second–3rd readings taken at i-min intervals and the awake SBP. These differences betwixt home SBP and ambulatory awake SBP were significantly college in the 10-due south intervals. The intraclass correlations of agreement between ten-s 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 fourth dimension. Table ii(c) shows the comparisons of the first vs. second and 2d vs. tertiary readings taken at 10-s vs. 1-min intervals for the home BPs. The differences betwixt the first and 2nd readings were significantly larger in 1-min intervals than in the 10-s intervals. The differences betwixt the second and third readings were significantly larger when the interval betwixt them was ten-due south than when information technology was ane-min, for both systolic and diastolic BP.

Table 2

Comparison between habitation BP readings taken at 10-s and 1-min intervals

	10-s intervals	1-min intervals	P
(a) Average dwelling BP levels
First–third SBP (mmHg)	137.0 ± xv.6	134.7 ± 15.4	0.005
First–tertiary DBP (mmHg)	77.nine ± 9.4	77.ii ± 9.1	0.15
Outset–second SBP (mmHg)	138.0 ± 15.v††	135.six ± 15.four††	0.005
Offset–second DBP (mmHg)	78.2 ± 9.4††	77.4 ± 9.ii†	0.07
Second–3rd SBP (mmHg)	136.ane ± 15.8	133.ii ± xv.five	0.001
2nd–third DBP (mmHg)	77.5 ± 9.five	76.nine ± 9.3	0.19
(b) Differences from home BP to awake SBP/DBP
Beginning–third SBP (mmHg)	six.0 ± ten.four***	3.7 ± 10.7*	0.005
Showtime–third DBP (mmHg)	−1.two ± seven.seven	−1.9 ± 7.half-dozen	0.fifteen
Commencement–2d SBP (mmHg)	vii.0 ± 10.4***	four.6 ± 10.7**	0.005
First–second DBP (mmHg)	−0.9 ± 7.7	−1.8 ± 7.6	0.07
Second–third SBP (mmHg)	v.1 ± 10.5**	two.two ± ten.9	<0.001
Second–3rd DBP (mmHg)	−1.6 ± 7.seven	−2.2 ± seven.viii	0.nineteen
(c) Differences from outset to second or 2nd to third readings
Get-go minus second SBP	one.4 ± 2.5 (4)	3.vii ± iii.2 (16)	<0.001
Get-go minus second DBP	0.7 ± i.8 (0)	0.7 ± 1.7 (one)	0.99
Second minus third SBP	two.3 ± 1.five (3)	one.2 ± 1.four (1)	<0.001
Second minus third DBP	0.7 ± 0.nine (0)	0.ii ± 0.nine (0)	0.002

Automatic measurement of dispensary BP

Additionally, nosotros compared the dispensary measurement of HEM-5001 and mercury sphygmomanometer. The average BP levels were 129 ± 15/77 ± 10 mmHg when taken past the mercury sphygmomanometer and 131 ± xv/76 ± 9 mmHg for the HEM-5001. The interclass correlations of agreement betwixt 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 every bit the number of each set of domicile BP readings taken per week. The numbers of occasions per calendar week that three measurements were taken in the morning were five.2 ± 1.2 days for the reading taken with 10-due south intervals and 5.three ± i.four days for the 1-min intervals (P = 0.91). There were no differences in the evening BP readings. And then, the departure in compliance betwixt the two measurement intervals was negligible (and not statistically significant).

Give-and-take

This written report has shown that BP readings of a 10-s interval of multiple home BP measurements were higher than readings taken using the conventional one-min interval. The 1-min interval of three measurements tended to requite a meliorate estimate of the average daytime BP level, and, therefore, the 1-min interval would exist meliorate for clinical use. This is the first study testing the validity of using very curt fourth dimension intervals between BP measurements fabricated 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. [fifteen] reported that a 15-s interval betwixt BP measurements was as accurate as a 1-min interval in normotensive volunteers. Koehler et al. [sixteen] showed that multiple BPs measured over a period of x–xv s were similar to those taken at one-min intervals using a sphygmomanometer and automatic devices (which were non cited every bit validated). Our results are consistent with these reports, merely the previous studies were performed only in clinical settings considering dwelling monitors with preset measurement intervals were not available. In contrast, with the advent of new technology, nosotros take been able to examine the results of using 2 different and standardized measurement intervals for readings taken at home. We used the awake ABP equally the comparator measure and likewise compared the domicile readings with readings taken in the clinic under standardized conditions using both mercury sphygmomanometer readings and automated device readings. The principal finding of the written report 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 10-s intervals were significantly college than SBP taken at 1-min intervals, and the average abode BP with 1-min intervals was closer to the daytime ABP. Because the BP measurements of ten-due south and 1-min intervals were done in the same patients crossed over, the baseline BP level was like, and arm size, gage size, and deflation time were exactly the same for the two measurement weather. Therefore, we do non think that these factors affected the differences between the 10-due south and 1-min interval measurements.

The differences betwixt the first and the 2nd readings were larger for 1-min intervals than for x-s intervals, and, conversely, the departure of the second and the third readings were larger for 10-s intervals than for 1-min intervals. Recent domicile BP guidelines have stated that the average of the first and 2nd readings should be used for clinical do [13,fourteen], but taking the average SBP of the second and 3rd readings may all-time 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 apply to all other devices. There has hitherto been footling investigation into how long the intervals between measurements should exist [xv,16]. Hypertension guidelines accept empirically recommended to wait for 1 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, as adamant past their agreements with awake ABP, is similar regardless of substantial variations in HBP monitoring schedules, though the measurement interval event was not discussed. Many of the patients in the present study could have started their measurements right subsequently some activities without resting a few minutes. Consequently, their BP stabilized a few minutes later offset 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 2d and the third readings of the 10-s intervals during which the BP was notwithstanding going down. For keeping patients' rest, three successive measurements of 1-min intervals would exist better choice in clinical do. Our results can lead to a conclusion that the i-min measurement interval is preferable to the 10-s interval for home 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 by the HEM-5001 was very like to role BP taken by a mercury manometer. The intraclass correlations of agreement in the HEM-5001 and mercury readings were splendid for both SBP and DBP. This is not an official validation study, but the HEM-5001 appears to be as accurate as a mercury sphygmomanometer.

Rationale for taking a ane-min interval between readings

In the American Heart Clan BP measurement guideline [12], the post-obit argument was described without any citation: 'iii readings should be taken in succession, separated by at to the lowest degree 1 min. The commencement is typically the highest, and the average should be used every bit the claret pressure reading.' The rationale for taking 1 min intervals betwixt multiple measurements appears arbitrary. Venous congestion or hyperemia has traditionally been thought to touch 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 [15,16]. Ischemia in an arm distal to the measurement gage can lower the recorded BP by v–15 mmHg if the ischemia is maintained at 20 mmHg above the systolic BP for 90 s, only information technology raises the BP much less if the ischemia is maintained for only 30 south [22]. Every bit the proper technique is to inflate the gage to 20 mmHg above the SBP and utilise a deflation rate of ii mmHg/s, the ischemia from total occlusion of the cuff should just last ten s, and is thus unlikely to modify the measurement of the BP.

Compliance

The compliance measure was, unexpectedly, not statistically different between the ten-southward and i-min intervals of BP measurement. We asked patients to measure their BP on as many days equally possible and at to the lowest degree 4 days/calendar week. Because the patients in this study were from a hypertension clinic that usually recommends that patients measure out their home BP, the bulk of them were used to taking frequent readings. Still, if we had recruited patients who had never measured home BP, at that place might have been a difference in compliance betwixt the 10-due south and 1-min intervals, especially in the mornings when time is oft about pressing. A further study may be needed to resolve this issue.

Study limitations

In this study, average daytime ABP (131/79 mmHg) was equal to function BP (131/76 mmHg), and habitation BP (135/77 mmHg using 1 min intervals and the average of morning and evening readings) was college than function BP. The reason for the lower level of office BP than dwelling BP was that office BP was measured in the standard status following the international guidelines afterward at least five-min rest; measured by a inquiry banana (simply a physician in Japan) rather than by a doctor and multiple measurements (more than six readings) were taken in one occasion later seeing a doc. The BP levels in the normal range were another reason for the relatively lower level of office BP as 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 gage (N = eight) may be another limitation of this report because the time of inflation and deflation is different from that of regular size cuff.

Conclusion

Although both the ten-s and 1-min intervals betwixt three successive habitation BP readings taken both in the morning and evening showed good correlations with the daytime average BP taken past ambulatory monitoring, and no departure in patient compliance taking the readings, the 1-min intervals gave average domicile BP levels that were closer to the daytime ABP and would therefore exist 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 Advancement of Medical Instrumentation

ABP

Convalescent BP

ABPM

ambulatory BP monitoring

DBP

diastolic claret pressure

HBP

home BP

ICC

intraclass correlation coefficient

SBP

systolic claret pressure level

References

ane. Pickering T American Club of Hypertension Advertising Hoc Console. Recommendations for the use of home (self) and ambulatory blood pressure level monitoring. Am J Hypertens. 1996;9:ane–11. [PubMed] [Google Scholar]

ii. James GD, Pickering TG, Yee LS, Harshfield GA, Riva Southward, Laragh JH. The reproducibility of average convalescent, home, 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 force per unit area measurements over a one-yr catamenia. Am J Hypertens. 1997;x(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 dwelling house, ambulatory, and clinic claret pressure: implications for the design of trials for the cess of antihypertensive drug efficacy. Am J Hypertens. 2002;15:101–104. [PubMed] [Google Scholar]

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

vi. Cuspidi C, Michev I, Meani S, Salerno M, Valerio C, Fusi Five, et al. Left ventricular hypertrophy in treated hypertensive patients with good blood pressure control outside the clinic, just poor dispensary blood force per unit area control. J Hypertens. 2003;21:1575–1581. [PubMed] [Google Scholar]

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

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

ix. Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term take a chance of mortality associated with selective and combined elevation in office, home, and convalescent claret pressure level. 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 self-measurement in elderly treated hypertensive patients. JAMA. 2004;291:1342–1349. [PubMed] [Google Scholar]

11. Agarwal R, Andersen MJ. Blood pressure recordings within and outside the clinic and cardiovascular events in chronic kidney illness. 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 claret pressure measurement in humans and experimental animals. Part 1: blood pressure measurement in humans –a argument for professionals from the Subcommittee of Professional and Public Educational activity of the American Heart Clan Council on High Blood Force per unit area Enquiry. Circulation. 2005;111:697–716. [PubMed] [Google Scholar]

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

fourteen. Parati G, Stergiou GS, Asmar R, Bilo K, de Leeuw P, Imai Y, et al. European Society of Hypertension guidelines for claret force per unit area monitoring at home: a summary report of the 2nd International Consensus Briefing on Habitation Blood Force per unit area Monitoring. J Hypertens. 2008;26:1505–1526. [PubMed] [Google Scholar]

xv. Yarows SA, Patel K, Brook R. Rapid oscillometric blood force per unit area measurement compared to conventional oscillometric measurement. Blood Printing Monit. 2001;6:145–147. [PubMed] [Google Scholar]

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

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

18. Anwar YA, Giacco Due south, McCabe EJ, Tendler BE, White WB. Evaluation of the efficacy of the Omron HEM-737 IntelliSense device for use on adults according to the recommendations of the Clan for the Advocacy of Medical Instrumentation. Blood Printing Monit. 1998;3:261–265. [PubMed] [Google Scholar]

19. Shrout FE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Balderdash. 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. Habitation blood pressure: accuracy is contained of monitoring schedules. Am J Hypertens. 2000;xiii:625–631. [PubMed] [Google Scholar]

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

23. Pickering TG, Harshfield GA, Kleinert HD, Blank S, Laragh JH. Blood force per unit area 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;11(6 Pt one):545–549. [PubMed] [Google Scholar]

25. Kjeldsen SE, Hedner T, Jamerson Yard, Julius Southward, Haley WE, Zabalgoitia M, et al. Hypertension optimal treatment (HOT) report: home blood force per unit area in treated hypertensive subjects. Hypertension. 1998;31:1014–1020. [PubMed] [Google Scholar]

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

stewartards1937.blogspot.com

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941726/

Share this post