Comparison of the manual blood pressure record with ambulatory blood pressure monitoring in young patients found to be hypertensive during routine medical examination before induction to high altitude areas

Munish Sharma, Anupam Pandit


Background: Ambulatory blood pressure monitoring (ABPM) measurements has been found to be superior to Outpatient Department (OPD) blood pressure measurements (OBPM) for predicting clinical outcomes. There have been various indications of ABPM like to exclude white coat hypertension, evaluation of symptomatic hypotension and hypertension, pregnancy induced hypertension etc. We studied use of ABPM in evaluation of young subjects who were found to be hypertensive in OBPM.

Methods: This prospective study was performed at Command Hospital, Kolkata, India from December 2017 to November 2019.This study had a total of 100 subjects. All patients were young healthy individuals and found to have high blood pressure (BP) readings during routine examination done before induction to high altitude areas (>9000 feet). All subjects who were found to be hypertensive in OBPM were evaluated with 24 hours ABPM at least one week after cessation of all medications. Data expressed as the mean±SD. Comparisons of (a) the peripheral hospital mean systolic and diastolic BP over 01 week and (b) 24 hours mean ABPM.  

Results: In the study, the Mean Systolic BP was 143.33±11.82 with corresponding ABPM 123.92±13.17 which is statistically significant. The mean diastolic BP was 87.30±7.20 mm with corresponding ABPM as 71.55±4.11 MAP in manual blood pressure is 125.55 mm and 103.6 mm in ABPM. The results are highly significant.

Conclusions: The study concludes that automated BP recordings may provide a more accurate estimate of a patient's BP status and may prevent unnecessary labelling of young patients as hypertensive.


Hypertension in young, Ambulatory blood pressure monitoring, Manual blood pressure

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Sokolow M, Werdegar D, Kain H, Hinman A. Relationship between level of blood pressure measured casually and by portable recorders and severity of complications in essential hypertension. Circul. 1966;34:279-98.

Verdecchia P, Schillaci G, Guerrieri M, Gatteschi C, Benemio G, Boldrini F, et al. Diurnal blood pressure changes and left ventricular hypertrophy in essential hypertension. Circul. 1990;81:528-36.

Pavlik VN, Hyman DJ, Toronjo C. Comparison of automated and mercury column blood pressure measurements in health care settings. J Clin Hypertens (Greenwich). 2000;2(2):81-6.

Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C, et al. Ambulatory blood pressure and mortality: a population-based study. Hypertens. 2005;45(4):499-504.

Kaul U, Arambam P, Rao S, Kapoor S, Swahney JP, Sharma K, et al. Usefulness of ambulatory blood pressure measurement for hypertension management in India: the India ABPM study. J Hum hypertens. 2020;(6):457-67.

Yano Y, Reis JP, Colangelo LA, Shimbo D, Viera AJ, Allen NB, et al. Association of blood pressure classification in young adults using the 2017 American College of Cardiology/American Heart Association blood pressure guideline with cardiovascular events later in life. J Amercn Med Assoc. 2018;320:1774-82.

Myers MG, Valdivieso MA. Use of an automated blood pressure recording device, the BpTRU, to reduce the “white coat effect” in routine practice. Am J Hypertens. 2003;16:494-7.