Impact of repeated blood pressure measurement on blood pressure categorization in a population-based study from India
Often a single blood pressure (BP) measurement is used to diagnose and manage hypertension in busy clinics. However, repeated BP measurements have been shown to be more representative of the true BP status of the individual. Improper measurement of office BP can lead to inaccurate classification, ov...
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| Veröffentlicht in: | Journal of human hypertension 2019-08, Vol.33 (8), p.594-601 |
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| creator | Jose, Arun Pulikkottil Awasthi, Ashish Kondal, Dimple Kapoor, Mudit Roy, Ambuj Prabhakaran, Dorairaj |
| description | Often a single blood pressure (BP) measurement is used to diagnose and manage hypertension in busy clinics. However, repeated BP measurements have been shown to be more representative of the true BP status of the individual. Improper measurement of office BP can lead to inaccurate classification, overestimation of a patient’s true BP, unnecessary treatment, and misinterpretation of the true prevalence of hypertension. There is no consensus among major guidelines on the number of recommended measurements at a single visit or the method of arriving at final clinic BP reading. The participants of the National Family Health Survey (NFHS-4), a nationwide survey conducted in India from 2015 to 2016, were used for the analysis. The prevalence and median difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) for single as well as combinations of two or more readings were calculated. Cross-tabulation was used to assess classification of individuals based on first BP reading compared with the mean of two or more BP measurements. There was a 63% higher prevalence of hypertension when only the first reading was considered for diagnosis in comparison to the mean of the second and third readings. A decrease of 3.6 mmHg and 2.4 mm Hg in mean SBP and DBP, respectively, was observed when the mean of the second and third readings was compared to the first reading. In those who are identified to have grade 1 or higher categories of hypertension, we recommend three BP measurements, with the mean of the second and third measurements being the clinic BP. |
| doi_str_mv | 10.1038/s41371-019-0200-4 |
| format | Article |
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However, repeated BP measurements have been shown to be more representative of the true BP status of the individual. Improper measurement of office BP can lead to inaccurate classification, overestimation of a patient’s true BP, unnecessary treatment, and misinterpretation of the true prevalence of hypertension. There is no consensus among major guidelines on the number of recommended measurements at a single visit or the method of arriving at final clinic BP reading. The participants of the National Family Health Survey (NFHS-4), a nationwide survey conducted in India from 2015 to 2016, were used for the analysis. The prevalence and median difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) for single as well as combinations of two or more readings were calculated. Cross-tabulation was used to assess classification of individuals based on first BP reading compared with the mean of two or more BP measurements. There was a 63% higher prevalence of hypertension when only the first reading was considered for diagnosis in comparison to the mean of the second and third readings. A decrease of 3.6 mmHg and 2.4 mm Hg in mean SBP and DBP, respectively, was observed when the mean of the second and third readings was compared to the first reading. In those who are identified to have grade 1 or higher categories of hypertension, we recommend three BP measurements, with the mean of the second and third measurements being the clinic BP.</description><identifier>ISSN: 0950-9240</identifier><identifier>EISSN: 1476-5527</identifier><identifier>DOI: 10.1038/s41371-019-0200-4</identifier><identifier>PMID: 30979950</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/499 ; 692/699/75/243 ; 692/700/139 ; Adolescent ; Adult ; Blood Pressure ; Blood Pressure Determination ; Classification ; Diagnosis ; Epidemiology ; Female ; Health Administration ; Health risk assessment ; Health Surveys ; Humans ; Hypertension ; Hypertension - classification ; Hypertension - diagnosis ; Hypertension - epidemiology ; Hypertension - physiopathology ; India - epidemiology ; Male ; Measurement ; Medicine ; Medicine & Public Health ; Middle Aged ; Population studies ; Population-based studies ; Predictive Value of Tests ; Pressure measurement ; Prevalence ; Public Health ; Reproducibility of Results ; Review Article ; Risk factors ; Severity of Illness Index ; Young Adult</subject><ispartof>Journal of human hypertension, 2019-08, Vol.33 (8), p.594-601</ispartof><rights>Springer Nature Limited 2019</rights><rights>COPYRIGHT 2019 Nature Publishing Group</rights><rights>Springer Nature Limited 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-5ca5e5fefca0a3be7d729749a0d2f95e1893e4847b1a101d5e5f5bf1f4e67db63</citedby><cites>FETCH-LOGICAL-c470t-5ca5e5fefca0a3be7d729749a0d2f95e1893e4847b1a101d5e5f5bf1f4e67db63</cites><orcidid>0000-0002-9308-9782</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30979950$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jose, Arun Pulikkottil</creatorcontrib><creatorcontrib>Awasthi, Ashish</creatorcontrib><creatorcontrib>Kondal, Dimple</creatorcontrib><creatorcontrib>Kapoor, Mudit</creatorcontrib><creatorcontrib>Roy, Ambuj</creatorcontrib><creatorcontrib>Prabhakaran, Dorairaj</creatorcontrib><title>Impact of repeated blood pressure measurement on blood pressure categorization in a population-based study from India</title><title>Journal of human hypertension</title><addtitle>J Hum Hypertens</addtitle><addtitle>J Hum Hypertens</addtitle><description>Often a single blood pressure (BP) measurement is used to diagnose and manage hypertension in busy clinics. However, repeated BP measurements have been shown to be more representative of the true BP status of the individual. Improper measurement of office BP can lead to inaccurate classification, overestimation of a patient’s true BP, unnecessary treatment, and misinterpretation of the true prevalence of hypertension. There is no consensus among major guidelines on the number of recommended measurements at a single visit or the method of arriving at final clinic BP reading. The participants of the National Family Health Survey (NFHS-4), a nationwide survey conducted in India from 2015 to 2016, were used for the analysis. The prevalence and median difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) for single as well as combinations of two or more readings were calculated. Cross-tabulation was used to assess classification of individuals based on first BP reading compared with the mean of two or more BP measurements. There was a 63% higher prevalence of hypertension when only the first reading was considered for diagnosis in comparison to the mean of the second and third readings. A decrease of 3.6 mmHg and 2.4 mm Hg in mean SBP and DBP, respectively, was observed when the mean of the second and third readings was compared to the first reading. In those who are identified to have grade 1 or higher categories of hypertension, we recommend three BP measurements, with the mean of the second and third measurements being the clinic BP.</description><subject>692/499</subject><subject>692/699/75/243</subject><subject>692/700/139</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Blood Pressure</subject><subject>Blood Pressure Determination</subject><subject>Classification</subject><subject>Diagnosis</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health Administration</subject><subject>Health risk assessment</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - classification</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>India - epidemiology</subject><subject>Male</subject><subject>Measurement</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Predictive Value of Tests</subject><subject>Pressure measurement</subject><subject>Prevalence</subject><subject>Public Health</subject><subject>Reproducibility of Results</subject><subject>Review Article</subject><subject>Risk factors</subject><subject>Severity of Illness Index</subject><subject>Young Adult</subject><issn>0950-9240</issn><issn>1476-5527</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kk1v3CAQhlHVqtmm_QG9VJYqVb2QgoHFHKOoHytFyiU5I2yGDZENLtiH5NcXuknTRK04jOB9ZpgZvQi9p-SEEtZ9yZwySTGhCpOWEMxfoA3lcouFaOVLtCFKEKxaTo7Qm5xvCKli9xodMaKkKuIGrbtpNsPSRNckmMEsYJt-jNE2c4Kc1wTNBKbGCULBwnN1KCn7mPydWXxRfWhMM8d5HX_fcW9yqZiX1d42LsWp2QXrzVv0ypkxw7v7eIyuvn29PPuBzy--785Oz_HAJVmwGIwA4cANhhjWg7SyVZIrQ2zrlADaKQa847KnhhJqKyx6Rx2HrbT9lh2jz4e6c4o_V8iLnnweYBxNgLhm3bZlRUpRyQv68Rl6E9cUSneFkox2jCn2SO3NCNoHF5dkhlpUnwq1Lb2Qrn578g-qHAuTH2IA58v7k4RPfyVcgxmX6xzHta4wPwXpARxSzDmB03Pyk0m3mhJdPaEPntDFE7p6QtfJPtxPtvYT2D8ZDyYoQHsAcpHCHtLj6P-v-gseYsEP</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Jose, Arun Pulikkottil</creator><creator>Awasthi, Ashish</creator><creator>Kondal, Dimple</creator><creator>Kapoor, Mudit</creator><creator>Roy, Ambuj</creator><creator>Prabhakaran, Dorairaj</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9308-9782</orcidid></search><sort><creationdate>20190801</creationdate><title>Impact of repeated blood pressure measurement on blood pressure categorization in a population-based study from India</title><author>Jose, Arun Pulikkottil ; 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However, repeated BP measurements have been shown to be more representative of the true BP status of the individual. Improper measurement of office BP can lead to inaccurate classification, overestimation of a patient’s true BP, unnecessary treatment, and misinterpretation of the true prevalence of hypertension. There is no consensus among major guidelines on the number of recommended measurements at a single visit or the method of arriving at final clinic BP reading. The participants of the National Family Health Survey (NFHS-4), a nationwide survey conducted in India from 2015 to 2016, were used for the analysis. The prevalence and median difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) for single as well as combinations of two or more readings were calculated. Cross-tabulation was used to assess classification of individuals based on first BP reading compared with the mean of two or more BP measurements. There was a 63% higher prevalence of hypertension when only the first reading was considered for diagnosis in comparison to the mean of the second and third readings. A decrease of 3.6 mmHg and 2.4 mm Hg in mean SBP and DBP, respectively, was observed when the mean of the second and third readings was compared to the first reading. In those who are identified to have grade 1 or higher categories of hypertension, we recommend three BP measurements, with the mean of the second and third measurements being the clinic BP.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>30979950</pmid><doi>10.1038/s41371-019-0200-4</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9308-9782</orcidid></addata></record> |
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| subjects | 692/499 692/699/75/243 692/700/139 Adolescent Adult Blood Pressure Blood Pressure Determination Classification Diagnosis Epidemiology Female Health Administration Health risk assessment Health Surveys Humans Hypertension Hypertension - classification Hypertension - diagnosis Hypertension - epidemiology Hypertension - physiopathology India - epidemiology Male Measurement Medicine Medicine & Public Health Middle Aged Population studies Population-based studies Predictive Value of Tests Pressure measurement Prevalence Public Health Reproducibility of Results Review Article Risk factors Severity of Illness Index Young Adult |
| title | Impact of repeated blood pressure measurement on blood pressure categorization in a population-based study from India |
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