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High Blood Pressure & Cardiovascular Prevention

, Volume 26, Issue 5, pp 391–397 | Cite as

Mean Blood Pressure of the General Population with the Mean of Three Measurements Versus the Mean of the Second and Third Measurements. Ricarto Study

  • Alejandro Villarín CastroEmail author
  • Antonio Segura Fragoso
  • Francisco Javier Alonso Moreno
  • Marta Sánchez Pérez
  • Luis Rodríguez Padial
  • Gustavo Cristóbal Rodríguez Roca
Original article

Abstract

Introduction

Our aim was to determine the difference between measuring blood pressure (BP) with the mean of three determinations versus the mean of the second and the third determinations in a random general population sample.

Methods

Epidemiological study of the general population aged ≥ 18 from the Health Area of Toledo (Spain), based on the health card database. Three readings of systolic and diastolic BP were taken with validated oscillometric devices OMRON HEM-907. The mean of the three readings was compared with the mean of the second and third readings after discarding the first measurement. We analyzed age, sex, BMI, abdominal obesity, dyslipidemia, diabetes mellitus, smoking and sedentary lifestyle. A descriptive study was conducted, as well as the agreement in the diagnosis of hypertension.

Results

1532 subjects were analyzed (mean age 49.01 ± 15.79 years old, 55.5% women). Response rate 36.3%. The mean systolic BP with three readings was 125.39 ± 17.43 mmHg, versus 124.33 ± 17.07 mmHg with the mean of the second and third readings (mean difference 1.01 ± 4.31; Cohen’s D = 0.059). The mean diastolic BP was 73.93 ± 10.89 versus 73.71 ± 10.93 mmHg with both methods (mean difference 0.19 ± 2.11; Cohen’s D = 0.017). Differences by age, sex, BMI, abdominal obesity, dyslipidemia, diabetes, smoking and sedentary lifestyle were all small (Cohen’s D < 0.08). The agreement between both models for classifying subjects as hypertensive/non-hypertensive showed a Kappa value = 0.936 (McNemar’s test p < 0.001).

Conclusions

Determining the mean of three readings of BP does not make a significant difference in relation to the reading of the second and third measurements in a sample of general population.

Keywords

Blood pressure Cardiovascular risk General population Primary Health Care 

Notes

Compliance with Ethical Standards

Funding

This study was funded from 2011 to 2013 by the Government of Castilla-La Mancha, through a Grant for Biomedical and Health Sciences Research (file number PI-2010/043) from Castilla-La Mancha Social and Health Care Foundation (FISCAM). The Foundation of the Spanish Society of Primary Care Physicians (SEMERGEN) has been collaborating since 2013 in the funding of the RICARTO study with an unconditional grant.

Conflict of interest

The authors declare that there is no conflict of interest.

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Copyright information

© Italian Society of Hypertension 2019

Authors and Affiliations

  • Alejandro Villarín Castro
    • 1
    Email author
  • Antonio Segura Fragoso
    • 2
  • Francisco Javier Alonso Moreno
    • 3
  • Marta Sánchez Pérez
    • 4
  • Luis Rodríguez Padial
    • 5
  • Gustavo Cristóbal Rodríguez Roca
    • 6
  1. 1.Toledo Multiprofessional Family and Community Care Teaching UnitToledoSpain
  2. 2.Preventive Medicine and Public Health, Research UnitCastilla-La Mancha Institute of Health Sciences, Talavera de la Reina (Toledo)ToledoSpain
  3. 3.Sillería Health Center (Toledo)ToledoSpain
  4. 4.RICARTO Study, Toledo Primary Care ManagementToledoSpain
  5. 5.Cardiology DepartmentToledo University Hospital ComplexToledoSpain
  6. 6.La Puebla de Montalbán Health Center (Toledo)ToledoSpain

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