Measuring Blood Pressure for Decision Making and Quality Reporting: Where and How Many Measures?

The optimal setting and number of blood pressure (BP) measurements that should be used for clinical decision making and quality reporting are uncertain. To compare strategies for home or clinic BP measurement and their effect on classifying patients as having BP that was in or out of control. Secondary analysis of a randomized, controlled trial of strategies to improve hypertension management. (ClinicalTrials.gov registration number: NCT00237692) Primary care clinics affiliated with the Durham Veterans Affairs Medical Center. 444 veterans with hypertension followed for 18 months. Blood pressure was measured repeatedly by using 3 methods: standardized research BP measurements at 6-month intervals; clinic BP measurements obtained during outpatient visits; and home BP measurements using a monitor that transmitted measurements electronically. Patients provided 111,181 systolic BP (SBP) measurements (3218 research, 7121 clinic, and 100,842 home measurements) over 18 months. Systolic BP control rates at baseline (mean SBP