Online First 2024-03-15

Introduction: Hypertension is a leading cardiovascular risk factor. Accurate blood pressure (BP) measurement is pivotal in hypertension diagnosis and management. Conventional office blood pressure measurements (OBPMs) are error-prone, exacerbated by the white-coat effect. Unattended automated office blood pressure measurement (UAOBPM) is emerging as an alternative, mitigating the white-coat effect. However, its ability to predict hypertension-mediated organ damage (HMOD) remains disputable. Objectives: This study compares UAOBPM with OBPM in terms of their association with various types of HMOD, including left ventricular hypertrophy, left atrial enlargement, left ventricular systolic and diastolic dysfunction, intima-media complex thickening, microalbuminuria, and abnormal pulse wave velocity. Patients and methods: A total of 219 hypertensive patients were recruited, interviewed, and examined. Subsequently, BP measurements were conducted in a randomized manner: 1) UAOBPM, after 5 minutes of solitary rest in an examination room, BP was automatically measured 3 times at 1-minute intervals; 2) OBPM, after 5 minutes of rest, a physician performed 3 consecutive BP measurements at 1-minute intervals. Subsequent evaluations aimed to detect HMOD and included echocardiography, carotid artery ultrasound, pulse wave velocity assessment, and laboratory tests. Results: UAOBP values were lower than the OBP ones (mean [SD], 124.7 [14.4] vs 128.2 [14.2] mm Hg; P <⁠0.001 for systolic BP, and 73.3 [10.2] vs 75.2 [10.6] mm Hg; P <⁠0.001 for diastolic BP). Correlation and receiver operating characteristic curve analyses revealed no superiority of either method in predicting HMOD. Conclusions: The UAOBPM did not prove superior to OBPM in predicting HMOD. Further research is warranted to determine the role of UAOBPM in clinical practice.