Is It Time for a Blood Pressure Measurement “Bundle”?
The poor reliability of clinic-based blood pressure (BP) measurements is not news to any practicing primary care provider (PCP). Many studies have documented significant differences between BP values measured in the context of a clinic visit, a research study, at home, and using ambulatory monitors.1–3 For this very reason, some PCPs habitually repeat the BP measurements provided by their staff, something they wouldn’t necessarily consider for more reliable primary care measures like a patient’s body weight.
The study by Ray and colleagues in this issue of JGIM adds to the literature about the reliability of clinic-based BP measurements in a number of ways.4 First, the authors explore the magnitude of the differences between two BP values independently measured on 40 of their hypertensive patients - one measured by clinical staff at triage, and the other by research assistants using BP measurement methods recommended by the American Heart Association (AHA).5 Second, the authors use trai ...
- Hodgkinson, J, Mant, J, Martin, U, Guo, B, Hobbs, FD, Deeks, JJ (2011) Relative effectiveness of clinic and home blood pressure monitoring compared with ambulatory blood pressure monitoring in diagnosis of hypertension: systematic review. BMJ 342: pp. d3621 CrossRef
- Powers, BJ, Olsen, MK, Smith, VA, Woolson, RF, Bosworth, HB, Oddone, EZ (2011) Measuring blood pressure for decision making and quality reporting: where and how many measures. Ann Intern Med 154: pp. 781-788
- Kim, JW, Bosworth, HB, Voils, CI, Olsen, M, Dudley, T, Gribbin, M (2005) How well do clinic-based blood pressure measurements agree with the mercury standard?. J Gen Intern Med 20: pp. 647-649 CrossRef
- Ray GM, Nawarskas JJ, Anderson JR. Blood Pressure Monitoring Technique Impacts Hypertension Treatment. J Gen Intern Med. 2011; doi:10.1007/s11606-011-1937-9.
- Pickering, TG, Hall, JE, Appel, LJ, Falkner, BE, Graves, J, Hill, MN (2005) Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 111: pp. 697-716 CrossRef
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- Powers, BJ, Oddone, EZ, Bosworth, HB (2011) Measuring blood pressure for decision making and quality reporting. Ann Intern Med 155: pp. 565-566
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- Is It Time for a Blood Pressure Measurement “Bundle”?
Journal of General Internal Medicine
Volume 27, Issue 6 , pp 615-617
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- Author Affiliations
- 1. Center for Evidence-based Practice, University of Pennsylvania Health System, 3535 Market Street, Mezzanine, Suite 50, Philadelphia, PA, 19104, USA
- 2. Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- 3. Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- 4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA