Body characteristics may influence the performance of different measurement techniques, raising questions about whether certain approaches are better suited for specific obesity phenotypes.

Investigators evaluated the diagnostic performance of ambulatory, home, and office blood pressure monitoring across different obesity classifications. The results were presented at the ESH 2026. A total of 281 participants underwent ambulatory blood pressure monitoring (ABPM), home blood pressure monitoring (HBPM), and office blood pressure measurement (OBPM) and were categorized according to body mass index (BMI), waist circumference, and waist-to-hip ratio.

Findings

• In participants with obesity based on BMI, office blood pressure measurement demonstrated the highest accuracy (78.9%), sensitivity (86.0%), and specificity (72.9%).
• Among individuals with greatly increased waist circumference, office blood pressure measurement achieved an accuracy of 79.0%, sensitivity of 80.6%, and specificity of 77.1%.
• In participants with an increased waist-to-hip ratio, office blood pressure measurement showed an accuracy of 78.4%, sensitivity of 80.2%, and specificity of 76.0%.
• Home blood pressure monitoring performed best in overweight individuals (accuracy 75.8%, sensitivity 86.0%, specificity 58.8%) and in those with increased waist circumference (accuracy 81.5%, sensitivity 91.7%, specificity 73.3%).

The findings suggest that the diagnostic performance of blood pressure measurement techniques varies according to obesity-related anthropometric characteristics. Office blood pressure measurement appeared most accurate among patients with obesity and central adiposity, while home blood pressure monitoring performed particularly well in overweight individuals and those with increased waist circumference.