Format

Send to

Choose Destination
J Hypertens. 2019 Sep;37(9):1737-1745. doi: 10.1097/HJH.0000000000002112.

Optimizing observer performance of clinic blood pressure measurement: a position statement from the Lancet Commission on Hypertension Group.

Author information

1
Department of Medicine, University of Alberta, Edmonton.
2
Department of Medicine, Physiology and Pharmacology and Community Health Sciences, O'Brien Institute for Public Health and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
3
Hypertension in Africa Research Team (HART), MRC Research Unit: Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
4
Department of Internal Medicine, Holbaek Hospital, Holbaek.
5
Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark.
6
Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK.
7
KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
8
School of Life-Course/Nutritional Sciences, King's College, St. Thomas' & Guy's Hospitals, London, UK.
9
Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
10
American Medical Association, Chicago, Illinois.
11
Resolve to Save Lives, An Initiative of Vital Strategies, New York, New York.
12
Kaiser Permanente South San Francisco Medical Center, South San Francisco, California.
13
American Heart Association, Cardiovascular Center, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA.
14
Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
15
Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Milan, Italy.
16
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.

Abstract

: High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-to-middle-income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.

Supplemental Content

Full text links

Icon for Wolters Kluwer
Loading ...
Support Center