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Introduction <p>Unattended blood pressure (BP) measurement was introduced following the results of the SPRINT study. Conflicting results have been reported in relation to the concordance between unattended BP, attended BP and 24-hour ambulatory monitoring (ABPM).</p> Aim <p>To evaluate the concordance between measurements of BP in unattended, attended and ABPM modes, and to analyse sex differences in the diagnostic accuracy in relation to the 24h ABPM.</p> Methods <p>307 patients were enrolled in 6 hypertension centers belonging to the Italian Society of Hypertension. Patients underwent BP measurement in unattended and attended modes before ABPM. BP was defined as controlled if the 24-hour average blood pressure was &lt;130/80 mmHg on ABPM.</p> Results <p>Patients with 59.6 ±13.6 years, with a female prevalence of 48% and a duration of hypertensive disease of 11.6±8.4 years were enrolled. The unattended and attended BP values were 136±16/ 78 ±11 mmHg and 137±19/ 82±13 mmHg respectively (<i>p</i>&lt;0.05 for diastolic BP). In ROC curve analysis, the unattended BP showed an accuracy in correctly identifying patients with uncontrolled hypertension equal to 0.71, higher than attended BP, equal to 0.65 (<i>p</i>&lt;0.05). This difference in a sex-specific analysis was larger for females in whom the unattended BP measurement showed an AUC of 0.712 versus an AUC of 0.620 for the attended BP (<i>p</i>&lt;0.05).</p> Conclusions <p>Our data suggests that unattended BP may be particularly useful in identifying patients with uncontrolled BP more accurately than attended BP. This advantage, due to a virtual elimination of the white coat effect, is more marked in females.</p> Graphical abstract <p></p>

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Sex Differences in the Usefulness of Unattended Blood Pressure Measurement in Patients with Arterial Hypertension

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月13日

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  • Ilaria Fucile,
  • Maria Virginia Manzi,
  • Maria Lembo,
  • Maddalena Tesone,
  • Alessandro Maloberti,
  • Valeria Bisogni,
  • Christian Basile,
  • Grazia Canciello,
  • Lucia La Mura,
  • Martino F. Pengo,
  • Giulio Geraci,
  • Fabio Bertacchini,
  • Silvia Monticone,
  • Valeria Visco,
  • Giacomo Pucci,
  • Costantino Mancusi

摘要

Introduction

Unattended blood pressure (BP) measurement was introduced following the results of the SPRINT study. Conflicting results have been reported in relation to the concordance between unattended BP, attended BP and 24-hour ambulatory monitoring (ABPM).

Aim

To evaluate the concordance between measurements of BP in unattended, attended and ABPM modes, and to analyse sex differences in the diagnostic accuracy in relation to the 24h ABPM.

Methods

307 patients were enrolled in 6 hypertension centers belonging to the Italian Society of Hypertension. Patients underwent BP measurement in unattended and attended modes before ABPM. BP was defined as controlled if the 24-hour average blood pressure was <130/80 mmHg on ABPM.

Results

Patients with 59.6 ±13.6 years, with a female prevalence of 48% and a duration of hypertensive disease of 11.6±8.4 years were enrolled. The unattended and attended BP values were 136±16/ 78 ±11 mmHg and 137±19/ 82±13 mmHg respectively (p<0.05 for diastolic BP). In ROC curve analysis, the unattended BP showed an accuracy in correctly identifying patients with uncontrolled hypertension equal to 0.71, higher than attended BP, equal to 0.65 (p<0.05). This difference in a sex-specific analysis was larger for females in whom the unattended BP measurement showed an AUC of 0.712 versus an AUC of 0.620 for the attended BP (p<0.05).

Conclusions

Our data suggests that unattended BP may be particularly useful in identifying patients with uncontrolled BP more accurately than attended BP. This advantage, due to a virtual elimination of the white coat effect, is more marked in females.

Graphical abstract