Self-blood pressure measurement as compared to office blood pressure measurement in a large Indian population; the India Heart Study

Upendra Kaul, G. S. Wander, Nakul Sinha, Jagdish C. Mohan, Soumitra Kumar, Sameer Dani, Chandrashekhar K. Ponde, Brian Pinto, Jamshed Dalal, Jagdish Hiremath, Sunil Kapoor, D. K. Baruah, Tiny Nair, Thomas Alexander, Viswanathan Mohan, Shashank Joshi, N. Sivakadaksham, Stefano Omboni, Priyadarshini Arambam, Viraj SuvarnaWillem J. Verberk*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)


Objective: India Heart Study (IHS) is aimed at investigating the agreement between office blood pressure measurement (OBPM) and self (S)BPM in a hypertension-naive population. Methods: A total of 18 918 individuals (aged 42.6 +/- 11.7 years, 62.7% men), visiting 1237 primary care physicians across India, underwent OBPM. They performed SBPM for a period of 1 week using a validated oscillometric BP monitor that was preprogrammed to adhere to a guideline-based SBPM-schedule and blinded to the results. Thereafter, individuals underwent a second OBPM. Available laboratory results were obtained. Thresholds for elevated OBPM and SBPM were 140/90 and 135/85 mmHg, respectively. Results: On the basis of first-visit OBPM and SBPM, there were 5787 (30.6%) individuals with normotension; 5208 (27.5%) with hypertension; 4485 (23.7%) with white-coat hypertension (WCH) and 3438 (18.2%) with masked hypertension. Thus, a diagnosis contradiction between SBPM and first-visit OBPM was seen in 9870 (41.9%) individuals. On the basis of second-visit OBPM, the normotension, hypertension, WCH and masked hypertension prevalence values were 7875 (41.6%); 4857 (25.7%); 2397 (12.7%) and 3789 (20.0%). There was poor agreement (kappa value 0.37) between OBPM of visit 1 and 2 with a diagnosis difference in 6027 (31.8%) individuals. The majority of masked hypertension and WCH individuals had BP values close to thresholds. Conclusion: There was a poor agreement between OBPM of visit1 and visit 2. Likewise, the agreement between OBPM at both visits and SBPM was poor. SBPM being considered to have a better correlation with patient prognosis should be the preferred method for diagnosing hypertension.

Original languageEnglish
Pages (from-to)1262-1270
Number of pages9
JournalJournal of Hypertension
Issue number7
Publication statusPublished - Jul 2020


  • home blood pressure measurement
  • hypertension management
  • masked hypertension
  • office blood pressure measurement
  • self-blood pressure measurement
  • white-coat hypertension
  • HOME

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