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Prospective Register Of patients undergoing repeated OFfice and Ambulatory Blood Pressure Monitoring (PROOF-ABPM): protocol for an observational cohort study
  1. James P Sheppard1,
  2. Una Martin2,
  3. Paramjit Gill3,
  4. Richard Stevens1,
  5. Richard J McManus1
  1. 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  2. 2School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
  3. 3Institute of Applied Health Research, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr James P Sheppard; james.sheppard{at}


Introduction The diagnosis and management of hypertension depends on accurate measurement of blood pressure (BP) in order to target antihypertensive treatment appropriately. Most BP measurements take place in a clinic setting, but it has long been recognised that readings taken out-of-office (via home or ambulatory monitoring) estimate true underlying BP more accurately. Recent studies have shown that the change in clinic BP over multiple readings is a significant predictor of the difference between clinic and out-of-office BP. Used in combination with patient characteristics, this change has been shown to accurately predict a patient's out-of-office BP level. The present study proposes to collect real-life BP data to prospectively validate this new prediction tool in routine clinical practice.

Methods and analysis A prospective, multicentre observational cohort design will be used, recruiting patients from primary and secondary care. All patients attending participating centres for ambulatory BP monitoring will be eligible to participate. Anonymised clinical data will be collected from all eligible patients, who will be invited to give informed consent to permit identifiable data to be collected for data linkage to external outcome registries. Descriptive statistics will be used to calculate the sensitivity, specificity, positive and negative predictive values of the out-of-office BP prediction tool. Area under the receiver operator characteristic curve statistics will be used to examine model performance.

Ethics and dissemination Ethical approval for this study has been obtained from the National Research. Ethics Service Committee South Central—Oxford A (reference; 15/SC/0184), and site-specific R&D approval has been acquired from the relevant NHS trusts. All findings will be presented at relevant conferences and published in peer-reviewed journals, on the study website and disseminated in lay and social media where appropriate.

  • Secondary Care
  • Diagnostics

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors JPS, UM, PG and RJM had the original idea. JPS wrote the first draft of the protocol and manuscript. All authors subsequently refined the manuscript and approved the final version.

  • Funding This work is funded by a Medical Research Council Strategic Skills Postdoctoral Fellowship held by JPS (MR/K022032/1). RJM holds an NIHR Professorship and receives support from the NIHR Oxford CLAHRC. All equipment used in the study was purchased commercially.

  • Competing interests None declared.

  • Ethics approval National Research Ethics Service Committee South Central–Oxford A (reference; 15/SC/0184).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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