To explore the difference of blood pressure control rate recommended in Chinese type 2 diabetes guidelines ver. 2013 and ver. 2017 based on home blood pressure monitoring (HBPM) and automated office blood pressure (AOBP) in type 2 diabetes patients with hypertension.

Subjects were enrolled according to the following criteria: (1) type 2 diabetes patients with hypertension who were regularly followed in the Internet Plus Diabetes Shared Cared Clinic of Peking University First Hospital and whose AOBP was measured twice with an arm sphygmomanometer, with the mean value recorded; and (2) using an intelligent arm sphygmomanometer, the patients automatically uploaded their HBPM through APP ≥3 times/quarter, each time they monitored blood pressure in the resting state on the morning or before dinner on separate days. The AOBP and the mean value of HBPM before visit were compared. The difference of the control rate of AOBP and HBPM based on the recommendations of the two versions of guidelines [＜130/80 mmHg, ＜140/80 mmHg (1 mmHg=0.133 kPa)] was analyzed. Chi-square test was used to determine the difference between the blood pressure control rate of AOBP and HBPM; paired t-test was used to analyze the difference between the two sources of blood pressure in the same patient.

Forty patients met the inclusion criteria, and they had 9.5 (5.0, 25.0) times of HBPM in the first quarter before the last visit. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of AOBP were (140.9±17.2) mmHg and (82.8±9.3) mmHg, respectively. The SBP and DBP of HBPM were (128.5±11.1) mmHg and (76.0±9.3) mmHg, respectively (P＜0.001). Based on the results of AOBP, the blood pressure control rates of ＜140/80 mmHg and ＜130/80 mmHg were 32.5% and 5.0% respectively, while the blood pressure control rates of ＜140/80 mmHg and ＜130/80 mmHg were 60.0% and 52.5% respectively based on the results of HBPM. There was a statistically significant difference between the two groups (χ²=17.425, P=0.002). The SBP and DBP of AOBP were overestimated by (15.7±18.9) mmHg and (9.6±9.3) mmHg, respectively (P＜0.001), compared with the mean value of HBPM in patients whose blood pressure of AOBP was ≥140/80 mmHg. The SBP and DBP of AOBP were overestimated by (18.2±14.1) mmHg and (10.4±9.4) mmHg respectively (P＜0.001), compared with the mean value of HBPM in patients whose blood pressure of HBPM was＜130/80 mmHg.

Compared with the HBPM, AOBP significantly overestimates the blood pressure of type 2 diabetes patients with hypertension by about 12.3/6.8 mmHg. When the AOBP is taken as the judgment of blood pressure not reaching the target, the blood pressure may be more overestimated.