Related Experiment Videos
[A single blood pressure reading during check-up for hypertension leads to a change in management more often than
R Engbersen1, P Smits, J W Lenders
1Academisch Ziekenhuis, afd. Algemene Interne Geneeskunde, Nijmegen.
Insights
Determining the correct number of blood pressure readings is crucial for accurate hypertension management. Using only one or two readings could lead to 11-25% of patients receiving different treatment.
Area of Science:
- Cardiovascular Medicine
- Clinical Hypertension Research
- Diagnostic Accuracy Studies
Context:
- Observational study conducted in an outpatient clinic in the Netherlands.
- Data collected over 30 months from 250-300 patients with hypertension.
- Standardized measurement protocol involving 10 minutes of supine rest before readings.
Purpose:
- To define the optimal number of blood pressure measurements per patient visit for reliable patient management.
- To assess the impact of using fewer readings on clinical decision-making.
- To establish evidence-based guidelines for blood pressure monitoring in hypertensive patients.
Summary:
- 1008 patient visits were analyzed, with blood pressure measured using both mercury sphygmomanometer and a semi-automatic oscillometric method.
- Analysis of 932 visits revealed similar mean readings between the two methods.
- Utilizing only the first diastolic reading resulted in a 25% change in patient management compared to the mean of three readings.
Impact:
- Fewer than three blood pressure readings may lead to suboptimal or incorrect patient management in 11-25% of cases.
- Highlights the importance of multiple readings for accurate hypertension diagnosis and treatment.
- Informs clinical practice regarding standardized blood pressure measurement protocols.
Objective:
To define the number of blood pressure readings necessary during a patient's visit to serve as a correct reference for patient management.
Design:
Observational study.
Setting:
Outpatient clinic in the Netherlands.
Method:
In a period of 30 months blood pressure was measured in 250-300 patients with hypertension during 1008 patients' visits. All readings were done by the same physician in the same room with the same system, after the patients had been submitted to at least 10 minutes of supine rest. Three readings were taken simultaneously with a mercury sphygmomanometer and (via a Y-connector) with a semiautomatic oscillometric method.
Results:
Blood pressure readings of 932 visits were available for further analysis. Both methods gave similar results for the mean of each reading and for the combination of 2 or 3 readings. Based on the first diastolic reading alone instead of the mean of 3 readings, 25% of the patients would have been subjected to different patient management. On the basis of the first two readings II% would have been treated differently.
Conclusion:
No definite recommendation can be made for the ideal number of blood pressure readings per visit, but with only 1 or 2 readings, 11-25% of the subjects would have been submitted to different management.