Ann Intern Med

Blood pressure readings vary widely by monitoring method

August 20, 2025

Study details: This systematic review and network meta-analysis evaluated the agreement between various blood pressure monitoring (BPM) methods using office-based BPM (OBPM) as the reference. Researchers analyzed 65 studies (N=40,022), comparing systolic BP values across convenient OBPM, automated OBPM, home BPM, and ambulatory BPM (daytime, nighttime, and 24-hour). Meta-regression assessed how differences varied by baseline BP levels.

Results: Compared with research OBPM, systolic BP readings were:

• Higher by 2.69 mm Hg (95% confidence interval [CI], -0.13 to 5.51 mm Hg) with convenient OBPM
• Lower by 4.57 mm Hg (CI, 2.54-6.60 mm Hg) with automated OBPM
• Lower by 4.59 mm Hg (CI, 2.83-6.34 mm Hg) with home BPM
• Lower by 4.22 mm Hg (CI, 2.62-5.82 mm Hg) with daytime ambulatory BPM
• Lower by 18.14 mm Hg (CI, 16.21-20.06 mm Hg) with nighttime ambulatory BPM
• Lower by 8.63 mm Hg (CI, 6.97-10.28 mm Hg) with 24-hour ambulatory BPM

Discrepancies increased with higher reference BP levels.

Clinical impact: These findings challenge the consistency of BP readings across methods and suggest that current hypertension guidelines may need revision. Automated office and ambulatory monitoring offer more accurate assessments, especially at elevated BP levels, and may reduce misclassification due to white coat or masked hypertension effects.

Source:

Yeh JT, et al. (2025, August 19). Ann Intern Med. Agreement Between Different Types of Blood Pressure Monitoring : A Systematic Review and Network Meta-analysis. https://pubmed.ncbi.nlm.nih.gov/40825202/