Comparison of Office, Home and 24-Hour Ambulatory Blood Pressures in Borderline and Mild Hypertension

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Abstract
Clinic/office (casual), home (self), and twenty-four-hour ambulatory (ABP) blood pressure determinations were compared in 32 subjects defined by conventional office criteria as mild or borderline hypertensives. Office diastolic blood pressures (mean 93.1 .+-. 5.3 mmHg) were significantly higher than either home (mean 88.9 .+-. 7.1 mm Hg) or awake ABP (mean 88.4 .+-. 8.4 mmHg) readings for the total group, as well as for the mild hypertension subgroup (office mean 96.0 .+-. 3.5 mm Hg, home mean 91.0 .+-. 8.0, awake ABP mean 90.4 .+-. 8.8) but not for the borderline subgroup. In the total study group, office diastolic blood pressure (DBP) correlated better with home DBP (r = 0.58, p = 0.0005), than with the awake ABP (r = 0.40, p = 0.02). Home DBP correlated well with awake DBP (r = 0.48, p = 0.006). In subgroup analysis, office DBPs correlated well with home (self) readings for both the mild (r = 0.53, p = 0.03) and the borderline (r= 0.62, p = 0.01) subgroups. When office DBPs were compared with awake ABP DBPs, the correlation coefficient for the mild subgroup was significant (r = 0.49, p = 0.04); this was not the case for the borderline subgroup (r = 0.10, p = NS). Comparison of home (self) DBPs with awake ABP determinations revealed a good correlation for the borderline subgroup (r = 0.63, p = 0.01) but not for the mild subgroup (r = 0.35, p = NS). A substantial proportion of the subjects (in both the mild and borderline subgroup) had a normal mean DBP (> 90 mmHg) as determined by both home (self) and awake ABP readings. The authors conclude that office measurements alone are of limited value in assessing the overall blood pressure status of mild and borderline hypertensives.