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Zero End-Digit Preference in Blood Pressure and Implications for Cardiovascular Disease Risk Prediction-A Study in
Tanvi Chandel1, Victor Miranda2, Andrew Lowe1
1Institute of Biomedical Technologies, Auckland University of Technology, Auckland 1010, New Zealand.
Journal of Clinical Medicine
|November 27, 2024
Summary
Rounding systolic blood pressure (SBP) readings can misclassify cardiovascular disease (CVD) risk. Accurate SBP measurement is vital for effective risk assessment and healthcare management.
Area of Science:
- Cardiology
- Public Health
- Biostatistics
Background:
- Blood pressure (BP) readings are frequently rounded to the nearest zero end-digit, despite guidelines allowing rounding to the closest 2 mmHg.
- This practice may impact the accuracy of cardiovascular disease (CVD) risk prediction.
Purpose of the Study:
- To investigate the effect of rounding systolic blood pressure (SBP) values on CVD risk prediction.
- To analyze misclassification rates and potential financial impacts in the New Zealand population.
Main Methods:
- Utilized a dataset of 427,299 individuals from New Zealand primary care facilities.
- Compared CVD risk predictions from a 5-year survival model using original SBP readings versus rounded SBP readings (nearest zero end-digit).
- Analyzed hazard ratios, misclassification rates, and estimated financial impact.
Main Results:
- 32% of SBP values had a terminal digit of zero.
- Significant misclassification occurred: e.g., 2.85% of men and 3.21% of women were misclassified into moderate/high risk categories.
- Other misclassifications included shifts into low and moderate risk categories for both genders.
Conclusions:
- Precise SBP measurement is critical for accurate CVD risk assessment.
- Rounding SBP values can lead to misclassification, potentially affecting patient management and healthcare resource allocation.
- Emphasizes the need for adherence to precise measurement protocols in clinical practice.
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