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Age-dependent changes in blood pressure over consecutive office measurements: impact on hypertension diagnosis and

Panagiota Veloudi1, Christopher L Blizzard, Velandai K Srikanth

  • 1aMenzies Institute for Medical Research, University of Tasmania, Hobart, TasmaniabDepartment of Medicine, School of Clinical Sciences at Monash Health, Monash Medical Centre, Melbourne, Victoria, Australia.

Journal of Hypertension
|March 3, 2017
PubMed

Insights

Blood pressure readings can change significantly between measurements, impacting hypertension diagnosis. Younger individuals show greater blood pressure fluctuations, highlighting the need for refined diagnostic guidelines.

Area of Science:

  • Cardiology
  • Clinical Hypertension Research
  • Public Health

Background:

  • Current hypertension guidelines suggest discarding initial blood pressure (BP) readings or taking single measurements based on anecdotal evidence of BP decrease.
  • The impact of BP fluctuations on hypertension classification and the influence of age remain unclear.

Purpose of the Study:

  • To evaluate changes in systolic blood pressure (SBP) classification across consecutive measurements using different guidelines.
  • To assess the effect of age on SBP classification and the direction of SBP changes.
  • To investigate age-related differences in SBP fluctuations.

Main Methods:

  • Analyzed BP measurements from 20,716 adults in a general population.
  • Classified SBP using the first reading and compared it with average SBP under various guideline protocols.
  • Examined reclassification rates and SBP changes between the first two measurements, stratified by age (<50 and ≥50 years).

Main Results:

  • Reclassification from normal SBP to hypertension was highest with Canadian guidelines (3% younger, 12% older).
  • Reclassification from hypertension to normal SBP was highest with NICE guidelines (70% younger, 44% older).
  • SBP decreased in 56% of individuals, increased in 37%, and remained stable in 7%; younger individuals showed greater SBP differences.

Conclusions:

  • Significant reclassification of hypertension status occurs based on measurement protocols and age.
  • Younger individuals exhibit more pronounced SBP variability, impacting diagnostic accuracy.
  • Evidence supporting current office BP assessment methods for accurate hypertension diagnosis needs enhancement.
Abstract

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