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Discrepancies in office blood pressure measurement protocols across international guidelines: "Houston, we've got a

Vanildo S Guimarães-Neto1,2, Annelise M G Paiva3, Rodrigo Bezerra1,4

  • 1Keizo Asami Institute, Federal University of Pernambuco.

Journal of Hypertension
|June 8, 2026
PubMed

Insights

Different office blood pressure (OBP) measurement protocols recommended by hypertension guidelines lead to clinically significant variations in results. Standardization is needed before setting optimal OBP targets.

Area of Science:

  • Cardiology
  • Hypertension Management
  • Clinical Trials

Background:

  • Office blood pressure (OBP) is crucial for hypertension management.
  • Current hypertension guidelines propose diverse OBP measurement protocols.
  • The clinical impact of these varying protocols is not well understood.

Purpose of the Study:

  • To compare eight guideline-recommended OBP measurement protocols.
  • To assess the clinical implications of differing OBP measurement protocols in treated hypertensive patients.

Main Methods:

  • Compared eight OBP protocols (Japanese, Korean, ISH, NICE, ESC/Brazilian, ESH, Chinese, ACC/AHA).
  • Utilized data from 826 treated hypertensive outpatients in Brazil.
  • Employed aneroid and oscillometric devices for OBP assessment with consecutive 1-min readings and guideline-specific algorithms.

Main Results:

  • Systolic OBP varied by up to 2.8 mmHg across protocols.
  • Prevalence of uncontrolled hypertension ranged from 30.0% to 41.3% (threshold <140/90 mmHg).
  • Prevalence of uncontrolled hypertension ranged from 60.8% to 70.6% (threshold <130/80 mmHg).

Conclusions:

  • Guideline-recommended OBP protocols produce clinically meaningful differences.
  • Current protocols are not interchangeable, impacting hypertension management.
  • Protocol standardization is essential for defining optimal OBP targets.

Keywords:
guidelinesmeasurementsoffice blood pressure

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