Blood Pressure in Patients with Arterial Hypertension and Overweight or Obesity During Office Measurement and Daily Monitoring


Victoriia Potaskalova


Arterial hypertension (AH) is one of the most common chronic diseases in the world. More than 1.5 billion people suffer from hypertension. According to official statistics, in Ukraine in 2021 more than 13 million patients with AH were registered, and annually this disease is detected in 1 million Ukrainians.

The objective: to determine the levels of blood pressure (BP) in overweighted or obese patients with AH who use antihypertensive drugs during office measurement and 24-hours monitoring of BP.

Materials and methods. The study analyzed the results of treatment of 395 overweighted or obese patients (139 women and 236 men) with essential AH. All patients received antihypertensive treatment for at least 3 months before study start. Patients were divided into five groups depending on blood pressure. The control group included 33 age-matched individuals.

During the study BP was measured in physician’s office with use of mechanical tonometer with a shoulder cuff and ambulatory 24-hours blood pressure monitoring (ABPM) was performed for all patients.

Results. The results of office blood pressure measurement and ABPM were analyzed. Normal BP was detected in 34.7% of patients with AH and high BMI. In 10.9% of patients systolic blood pressure (SBP) remains above 139 mm Hg despite of drug use, in 16.3% of patients the grade 1 AH was diagnosed, in 23.2% – grade 2, and in 14.9% – grade 3 AH was deter mined during office blood pressure measurement. It was found that men are 1.7 times more likely had uncontrolled AH comparing to women.

The further analyze of the BP data showed that office BP levels were higher then home. Target blood pressure levels were found in 87% of patients during ABPM, although in the office measurement this figure was 54%, 5% of patients could not withstand the BP monitoring during the day with an automatic device due to pain.

No difference in heart rate was determined in study patients by different types of measurement.

Conclusions. In patients with AH and high body mass index, office measurement reveals insufficient reduction of blood pressure (BP) in 35% of patients despite of antihypertensive drugs use. At the same time ABPM found target BP achievement in 87% of patients. Thus, ABPM should be performed in overweighted or obese patients with AH before making the decision to increase the antihypertensive drug dose to avoid possible undesirable BP decrease.


How to Cite
Potaskalova, V. (2022). Blood Pressure in Patients with Arterial Hypertension and Overweight or Obesity During Office Measurement and Daily Monitoring. Family Medicine, (1-2), 60–66.
Author Biography

Victoriia Potaskalova, Bogomolets National Medical University

Viktoriia S. Potaskalova,

Department of Clinical Pharmacology and Clinical Pharmacy


Wijkman MO, Malachias MVB, Claggett BL, Cheng S, Matsushita K, Shah AM, et al. Resistance to antihypertensive treatment and long-term risk: The Atherosclerosis Risk in Communities study. J Clin Hypertens (Greenwich). 2021;23(10):1887–96. doi: 10.1111/jch.14269.

Velarde GP, Sherazi S, Kraemer DF, Bravo-Jaimes K, Butterfield R, Amico T. et al. Clinical and Biochemical Markers of Cardiovascular Structure and Function in Women With the Metabolic Syndrome. Am J Cardiol. 2015;116(11):1705–10. doi: 10.1016/j.amjcard.2015.09.010

Tsentr hromadskoho zdorovya MOZ Ukrayiny. Doslidzhennya STEPS – poetapnyy pidkhid do nahlyadu za faktoramy ryzyku neinfektsiynykh zakhvoryuvan v Ukrayini. STEPS Poshyrenist faktoriv ryzyku neinfektsiynykh zakhvoryuvan Ukrayina 2019 [Internet]. Kopenhahen: Vsesvitnya orhanizatsiya okhorony zdorovya, Yevropeyske rehionalne byuro. Available at:

Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals. Part 1: Blood pressure measurement in humans. Circulation. 2005;111(5):697–715.

Takami Y, Yamamoto K, Arima H, Sakima A. Target blood pressure level for the treatment of elderly hypertensive patients: a systematic review and metaanalysis of randomized trials. Hypertens Res. 2019;42(5):660–8. doi: 10.1038/s41440-019-0227-5.

Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 13 – benefits and adverse events in older and younger patients with hypertension: overview, metaanalyses and meta-regression analyses of randomized trials. J Hypertens. 2018;36(8):1622–36. doi: 10.1097/HJH.0000000000001787.

Boytsov SA, Balanova YuA, Shalnova SA, et al. Arterial hypertension among individuals of 25–64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovasc Therapy Prevent. 2014;13(4):4–14. doi: 10.15829/1728-8800-2014-4-4-14.

Bagheri P, Khalili D, Seif M, Rezaianzadeh A. Dynamic behavior of metabolic syndrome progression: a comprehensive systematic review on recent discoveries. BMC Endocr Disord. 2021;21(1):54. doi: 10.1186/s12902-021-00716-7.

Benetos A, Safar M, Rudnichi A, Richard JL, Ducimetieere P, Guize L. Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension. 1997;30(6):1410–5. doi: 10.1161/01.hyp.30.6.1410.

Brunstrom M, Carlberg B. Association of Blood Pressure Lowering With Mortality and Cardiovascular Disease Across Blood Pressure Levels: A Systematic Review and Meta-analysis. Meta-Analysis. JAMA Intern Med. 2018;178(1):28–36. doi: 10.1001/jamainternmed.2017.6015.

Gerry S, Bonnici T, Birks J, Irtley Sh, Virdee PS, Virdee PS et al. Early warning scores for detecting deterioration in adult hospital patients: systematic review and critical appraisal of methodology. BMJ. 2020;369:m1501. doi: 10.1136/bmj.m1501.

Xiang H, Xue Y, Wang J, Weng Y, Rong F, Peng Y, et al. Cardiovascular Alterations and Management of Patients With White Coat Hypertension: A Meta-Analysis. Front Pharmacol. 2020;11:570101. doi: 10.3389/fphar.2020.570101.

Antza Ch, Vazakidis P, Doundoulakis I, Bouras E, Haidich A.-B, Stabouli S, et al. Masked and white coat hypertension, the double trouble of large arteries: A systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2020;22(5):802–811. doi: 10.1111/jch.13876.

Cohen JB, Lotito MJ, Trivedi UK, Denker MG, Cohen DL, Raymond RT. Cardiovascular Events and Mortality in White Coat Hypertension: A Systematic Review and Meta-analysis. Ann Intern Med. 2019;170(12):853–62. doi: 10.7326/M19-0223.

Van der Wel MC, Buunk IE, van Weel C,. Thien ThABM, Bakx JC. A novel approach to office blood pressure measurement: 30-minute office blood pressure vs daytime ambulatory blood pressure. Ann Fam Med. 2011;9(2):128–35. doi: 10.1370/afm.1211.

Mancia G, Facchetti R, Bombelli M, Grassi G, Sega R. Long-term risk of mortality associated with selective and combined elevation in office, home, and ambulatory blood pressure. Hypertension. 2006;47(5):846–53. doi: 10.1161/

Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C. Ambulatory blood pressure monitoring and risk of cardiovascular disease: a population based study. Am J Hypertens. 2006;19(3):243–50. doi: 10.1016/j.amjhyper.2005.09.018.

Hodgkinson J, Mant J, Martin U, Guo B, Hobbs FDR, Deeks JJ, et al. Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ. 2011;342:d3621. doi: 10.1136/bmj.d3621.

Villeneuve F, Rosenbaum D, Gury C, Girerd X. Influence of blood pressure variability during office visit on the estimation of blood pressure control in treated hypertensive patients. Ann Cardiol Angeiol (Paris). 2012;61(3):198–202. doi: 10.1016/j.ancard.2012.04.022.

Dieterle Th. Blood pressure measurement – an overview. Swiss Med Wkly. 2012;142:w13517. doi: 10.4414/smw.2012.13517.

Trenkwalder P. Automated blood pressure measurement (ABPM) in the elderly. Z Kardiol. 1996;85(Suppl 3):85–91.

National Institute for Health and Care Excellence. Hypertension in adults: diagnosis and management (NG136) [Internet]. NICE guideline. London: NICE; 2019. 43 p. Available from:

Johansson JK, Niiranen TJ, Puukka PJ, Jula AM. Optimal schedule for home blood pressure monitoring based on a clinical approach. J Hypertens. 2010;28(2):259–64. doi: 10.1097/HJH.0b013e328332fa5e.

Niiranen TJ, Johannson JK, Reunanen A, Jula AM. Optimal schedule for home blood pressurer measurement based on prognostic data. The Finn-Home study. Hypertension. 2011;57(6):1081–6. doi: 10.1161/HYPERTENSIONAHA.110.162123.

Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, et al. Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. doi: 10.1371/journal.pmed.1002389.

Noone C, Dwyer CP, Murphy J, Newell J, Molloy GJ. Comparative effectiveness of physical activity interventions and anti-hypertensive pharmacological interventions in reducing blood pressure in people with hypertension: protocol for a systematic review and network metaanalysis. Syst Rev. 2018;7(1):128. doi: 10.1186/s13643-018-0791-9.

Saiz LC, Gorricho J, Garjon J, Celaya MC, Erviti J, Leache L. Blood pressure targets for the treatment of people with hypertension and cardiovascular disease. Cochrane Database Syst Rev. 2018;7(7):CD010315. doi: 10.1002/14651858.CD010315.pub3.