Nurse-recorded auscultatory blood pressure at a single visit predicts target organ changes as well as ambulatory blood pressure

Aim To determine whether high-quality nurse-recorded auscultatory blood pressure (BP) values obtained at a single visit predict cardiovascular target organ changes as closely as ambulatory BP measurements. Methods In a randomly selected population sample (n=458, 21% receiving antihypertensive treatment; approximately 40% hypertensive), we compared high-quality single visit nurse-recorded auscultatory BP values to same-day 24-h ambulatory BP in their ability to predict multiple target organ changes [left ventricular mass index (LVMI), left ventricle (LV) mean wall thickness (MWT), early-to-late transmitral velocity ratios (E/A), (echocardiography); log of urinary albumin-to-creatinine ratios (log ACR) (24-h urine samples); large artery dysfunction [carotid-femoral pulse wave velocity (PWV) and central augmentation index (Alc) (applanation tonometry)]. Results Nurse-recorded systolic BP (SBP) measurements obtained at a single visit were as closely associated with LVMI (r=0.44), LV MWT (r=0.44), E/A (r = -0.55), log ACR (r=0.20), PWV (r=0.62) and AIc (r=0.41) (P<0.0001 for all relations) as was 24-h SBP (LVMI; r=0.33, LV MWT; r=0.37, E/A; r=0.35, log ACR; r=0.24, PWV; r=0.41, and AIc; r=0.18, P<0.001 for all relations) and either day or night SBP. On multivariate regression analysis with both nurse-recorded SBP and 24-h SBP in the same model, nurse-recorded SBP was independently associated with LVMI (P=0.006), LV MWT (P=0.03), E/A (P<0.02), PWV 0.0001) and AIc (P=0.0002), and 24-h SBP was independently and positively associated with log ACR (P<0.005), and PWV (P=0.01). Conclusion One or more, high-quality single visit nurse-recorded auscultatory BP measurements may be equally as effective as ambulatory BP in predicting target organ damage in a population sample of African ancestry. J Hypertens 27:287-297 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.