Conventional Versus Automated Measurement of Blood Pressure in the Office

INTERVENTION: Measurement of blood pressure using automated office BP with a target of 135 mmHg versus office mercury sphygmomanometer with a target of 140 mmHg CONDITION: Systolic hypertension ; Circulatory System ; Hypertension PRIMARY OUTCOME: Differences in SBP between the mean awake ambulatory BP and the manual office BP versus the difference in SBP between the mean awake ambulatory BP and the automated office BP SECONDARY OUTCOME: 1. Differences in SBP between the mean awake 24‐hour ambulatory BP and the manual office BP versus the automated BP; 2. Differences in SBP between the mean nocturnal ambulatory BP and the manual office BP versus the automated BP; 3. Differences in coefficients of correlation (r value) between the awake ambulatory BP and the manual versus automated office BP; 4. Differences in the coefficients of correlation between the manual office SBP versus the automated BP versus the mean awake, 24‐hour or nocturnal ambulatory SBP; 5. Differences in the primary outcome between men and women; 6. Adverse effects related to management of hypertension with manual versus automated BP; 7. Differences in intensity of drug therapy for manual versus automated office BP patients; 8. Frequency of medication changes for manual versus automated office BP patients; 9. Cost of drug therapy at year two for manual versus automated office BP patients; 10. Clinical events of serious adverse events reported for manual versus automated office BP patients INCLUSION CRITERIA: Both treated and untreated patients with systolic hypertension under routine family physician (FP) care. For untreated patients, routine office SBP as measured by the patient's FP at the last routine office visit using a mercury device must have SBP =160 mmHg and diastolic blood pressure (DBP) =95 mmHg. For patients already receiving antihypertensive therapy, the last routine office BP as measured by the patient's FP using mercury sphygmomanometry must be SBP =140 mmHg and DBP =90 mmHg.