Threshold for diagnosing hypertension by automated office blood pressure using randomsample population data

Peter Wohlfahrt, Renata Cífková, Narine Movsisyan, Šárka Kunzová, Jiří Lešovský, Martin Homolka, Vladimír Soška, Hana Bauerová, Francisco Lopez-Jimenez, Ondřej Sochor

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Objective: Manual office blood pressure (BP) is still recommended for diagnosing hypertension. However, its predictive value is decreased by errors in measurement technique and the white-coat effect. The errors can be eliminated by automated office BP (AOBP) measurement taking multiple readings with the participant resting quietly alone. Therefore, use of AOBP in clinical practice requires a threshold value for hypertension diagnosis. The aim of the present study was to determine an AOBP threshold corresponding to the 140/90mmHg manual office BP using data from a large random population sample. Methods: In 2145 participants (mean age 47.3-11.3 years) randomly selected from a Brno population aged 25- 64 years, BP was measured using manual mercury and automated office sphygmomanometers. Results: Manual SBP (mean difference 6.39-9.76 mmHg) and DBP (mean difference 2.50-6.54 mmHg) were higher than the automated BP. According to polynomial regression, automated systole of 131.06 (95% confidence interval 130.43-131.70) and diastole of 85.43 (95% confidence interval 85.03-85.82) corresponded to the manual BP of 140/90 mmHg. Using this cut-off, the whitecoat hypertension was present in 24% of participants with elevated manual BP, whereas 10% had masked hypertension and 11% masked uncontrolled hypertension. In individuals with masked uncontrolled hypertension, only AOBP was associated with the urinary albumin-creatinine ratio, whereas there was no association with manual BP. Conclusion: AOBP of 131/85mmHg corresponds to the manual BP of 140/90 mmHg. This value may be used as a threshold for diagnosing hypertension using AOBP. However, outcome-driven studies are required to confirm this threshold.

Original languageEnglish (US)
Pages (from-to)2180-2186
Number of pages7
JournalJournal of hypertension
Issue number11
StatePublished - 2016


  • Automated office blood pressure measurement
  • Blood pressure
  • Masked hypertension
  • Mercury sphygmomanometer
  • White coat hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Threshold for diagnosing hypertension by automated office blood pressure using randomsample population data'. Together they form a unique fingerprint.

Cite this