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17 18 We designed the Conventional versus Automated Measurement of Blood pressure in the Office (CAMBO) trial to evaluate the effect of automated versus manual office blood pressure measurement on the management of hypertensive patients in routine, community based, clinical practice over a two year period.
The difference for diastolic manual office blood pressure was not significant (P=0.26).
Replacement of manual office blood pressure measurement with automated office blood pressure virtually eliminated the difference between the routine manual office blood pressure and the awake ambulatory blood pressure (white coat effect).
Digit preference, with manual office blood pressure readings being rounded off to the nearest zero, was common in both the automated and manual office blood pressure groups at the last routine office visit before enrolment.
The last routine manual office blood pressure recorded on the visit immediately before entry into the study was documented.
We told physicians randomised to the manual office blood pressure control group to continue recording blood pressure as before.
The last routine manual office blood pressure (mm Hg) was obtained from each patient's medical record before enrolment.
The routine manual office systolic blood pressure readings also correlated poorly with the awake ambulatory blood pressure.
Under these circumstances, both automated office blood pressure and a proper manual office blood pressure are generally not feasible.
A change in technique for manual office blood pressure measurement on the part of the medical staff seems less likely, as readings taken on the first visit after enrolment were not any more accurate than the routine manual office blood pressure; digit preference was still present, and manual office blood pressure readings still correlated relatively poorly with the awake ambulatory blood pressure.
Interventions Practices were randomly allocated to either ongoing use of manual office blood pressure (control group) or automated office blood pressure (intervention group) using the BpTRU device.
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