Superiority of ambulatory to physician blood pressure is not an artifact of differential measurement reliability

William Gerin, Joseph E. Schwartz, Richard B. Devereux, Tanya Goyal, Daichi Shimbo, Gbenga Ogedegbe, Nina Rieckmann, Dennis Abraham, William Chaplin, Matthew Burg, Juhee Jhulani, Thomas G. Pickering

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Ambulatory blood pressure is a better predictor of target organ damage and the risk of adverse cardiovascular events than office measurements. Whether this is due to the greater reliability owing to the larger number of measurements that are usually taken using ambulatory monitoring, or the greater validity of these measurements independent of the number, remains controversial. METHODS: We addressed this issue by comparing physician readings and ambulatory measurements as predictors of left ventricular mass index. The number of readings was controlled by using the average of three physician readings and randomly selecting three awake readings from a 24-h ambulatory recording. RESULTS: In a multiple regression analysis that included both the ambulatory and physician blood pressure measurements, only the ambulatory systolic measurements significantly predicted left ventricular mass index (B=0.37, t=3.11, P=0.002); the coefficient for physician's systolic measurements was essentially zero (B=-0.01, t=-0.26, NS). CONCLUSIONS: These findings suggest that the superiority of ambulatory blood pressure as a predictor of target organ damage, compared with physician measurements, cannot be adequately/fully explained by the impact of the larger number of measurements obtained with ambulatory monitoring.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalBlood Pressure Monitoring
Issue number6
StatePublished - Dec 2006


  • Ambulatory blood pressure
  • Hypertension
  • Measurement reliability
  • Target organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Assessment and Diagnosis
  • Advanced and Specialized Nursing


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