The Impact of Measurement Methods on Office Blood Pressure and Management of Hypertension in General Practice

  • Julia Höller
  • Linda Elizabeth Villagomez FuentesEmail author
  • Klaus Matthias
  • Reinhold Kreutz
Original article



The use of unattended automated office blood pressure (uAutoOBP) versus attended automated (aAutoOBP) and manual auscultatory office blood pressure (AuscOBP) measurements is a topic of current controversy.


To evaluate the differences between OBP measurements methods in the general practice (GP) setting.


We first compared aAutoOBP and uAutoOBP in 42 consecutive patients with hypertension (group 1). Secondly, we compared AuscOBP to uAutoOBP measurements in 133 consecutive patients with hypertension (group 2). In addition, we analyzed the achieved OBP targets as recommended in the 2018 European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) guidelines in group 2.


The mean age of patients in group 1 was 71 years (range 34–89 years, 54.8% females). The aAutoOBP and uAutoOBP systolic (131.7 and 131.6 mmHg) and diastolic (83.4 and 82.4 mmHg) mean values were not significantly different. The patient characteristics in group 2 were similar to group 1. We observed a significant difference between AuscOBP and uAutoOBP measurement for both systolic (149.4 versus 129.5 mm Hg) and diastolic (85.4 versus 81.6 mm Hg, p < 0.0001, respectively). Accordingly, 20.3% and 45.9% of patients reached the overall 2018 ESC/ESH systolic and diastolic OBP targets of < 140/80 mmHg according to AuscOBP and uAutoOBP (p < 0.0001).


The attended versus unattended status of automated OBP measurements had no impact on OBP values in GP. However, significantly higher OBP values and lower rates of achieved target OBP were observed by using AuscOBP measurements by physicians in comparison to automated OBP recordings.


Automated office blood pressure Mobil-O-Graph Office blood pressure measurement Target office blood pressure White-coat effect 



We are very grateful for the outstanding support of the entire staff of the Audorfer Gemeinshaftspraxis.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The protocol was in accordance with the 1975 Helsinki Declaration and approved by the Charité ethics committee.

Informed consent

Informed consent was obtained from all participants before inclusion into the study.

Supplementary material

40292_2019_347_MOESM1_ESM.pdf (18 kb)
Supplementary material 1 (PDF 18 kb)


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Copyright information

© Italian Society of Hypertension 2019

Authors and Affiliations

  • Julia Höller
    • 1
  • Linda Elizabeth Villagomez Fuentes
    • 2
    Email author
  • Klaus Matthias
    • 1
  • Reinhold Kreutz
    • 2
  1. 1.Audorfer Gemeinschaftspraxis, General Medicine in OberaudorfBavariaGermany
  2. 2.Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Institute of Clinical Pharmacology and ToxicologyBerlinGermany

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