BACKGROUND: Accurate blood pressure (BP) readings and correctly interpreting the obtained values are of great importance. However, there is considerable variation in the different BP measuring methods suggested in guidelines and used in hypertension trials. OBJECTIVE: To compare the different methods used to measure BP; measuring once, the method used for a large study such as the UKPDS, and the methods recommended by various BP guidelines. METHODS: In 223 patients with type 2 diabetes from five family practices BP was measured according to a protocol to obtain the following data: A = first reading, B = mean of two initial readings, C = at least four readings and the mean of the last three readings with less than 15% coefficient of variation difference, D = mean of the first two consecutive readings with a maximum of 5 mm Hg difference. Mean outcomes measure is the mean difference between different BP measuring methods in mm Hg. RESULTS: Significant differences in systolic/diastolic BP were found between A and B [mean difference (MD) systolic BP 1.6 mm Hg, P < 0.001], B and C (MD 5.7/2.8 mm Hg, P < 0.001), B and D (MD 6.2/2.8 mm Hg, P < 0.001), A and C (MD 7.3/3.3 mm Hg), and A and D (MD 7.9/3.0 mm Hg, P < 0.001). CONCLUSION: Different methods to assess BP during one visit in the same patient lead to significantly different BP readings and can lead to overestimation of the mean BP. These differences are clinically relevant and show a gap between different methods in trials, guidelines and daily practice.
BACKGROUND: Accurate blood pressure (BP) readings and correctly interpreting the obtained values are of great importance. However, there is considerable variation in the different BP measuring methods suggested in guidelines and used in hypertension trials. OBJECTIVE: To compare the different methods used to measure BP; measuring once, the method used for a large study such as the UKPDS, and the methods recommended by various BP guidelines. METHODS: In 223 patients with type 2 diabetes from five family practices BP was measured according to a protocol to obtain the following data: A = first reading, B = mean of two initial readings, C = at least four readings and the mean of the last three readings with less than 15% coefficient of variation difference, D = mean of the first two consecutive readings with a maximum of 5 mm Hg difference. Mean outcomes measure is the mean difference between different BP measuring methods in mm Hg. RESULTS: Significant differences in systolic/diastolic BP were found between A and B [mean difference (MD) systolic BP 1.6 mm Hg, P < 0.001], B and C (MD 5.7/2.8 mm Hg, P < 0.001), B and D (MD 6.2/2.8 mm Hg, P < 0.001), A and C (MD 7.3/3.3 mm Hg), and A and D (MD 7.9/3.0 mm Hg, P < 0.001). CONCLUSION: Different methods to assess BP during one visit in the same patient lead to significantly different BP readings and can lead to overestimation of the mean BP. These differences are clinically relevant and show a gap between different methods in trials, guidelines and daily practice.
Authors: Joseph E Ebinger; Matthew Driver; David Ouyang; Patrick Botting; Hongwei Ji; Mohamad A Rashid; Ciantel A Blyler; Natalie A Bello; Florian Rader; Teemu J Niiranen; Christine M Albert; Susan Cheng Journal: EClinicalMedicine Date: 2022-05-13
Authors: Lizzy M Brewster; Sjoerd van Bree; Jaap C Reijneveld; Nicolette C Notermans; W M Monique Verschuren; Joseph F Clark; Gert A van Montfrans; Marianne de Visser Journal: J Neurol Date: 2008-01-22 Impact factor: 4.849
Authors: Swati Sakhuja; Byron C Jaeger; Oluwasegun P Akinyelure; Adam P Bress; Daichi Shimbo; Joseph E Schwartz; Shakia T Hardy; George Howard; Paul Drawz; Paul Muntner Journal: J Clin Hypertens (Greenwich) Date: 2022-02-09 Impact factor: 3.738
Authors: Sarah J Billups; Joseph J Saseen; Joseph P Vande Griend; Lisa M Schilling Journal: J Clin Hypertens (Greenwich) Date: 2018-07-15 Impact factor: 3.738
Authors: David Ly; Alex Z Fu; Fu Z Alex; Christopher Hebert; Hebert Christopher Journal: J Clin Hypertens (Greenwich) Date: 2009-03 Impact factor: 3.738