ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2007
Zero end-digit preference in recorded blood pressure and its impact on classification of patients for pharmacologic management in primary care - PREDICT-CVD-6.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sources of inaccuracy in the measurement of adult patients' resting blood pressure in clinical settings: a systematic review.Journal of hypertension · 2017Pooled it
- A systematic review of glomerular hyperfiltration assessment and definition in the medical literature.Clinical journal of the American Society of Nephrology : CJASN · 2015Pooled it
- End-digit preference of readings of grip strength measured with analogue-display devices.Scientific reports · 2025Article
- Zero End-Digit Preference in Blood Pressure and Implications for Cardiovascular Disease Risk Prediction-A Study in New Zealand.Journal of clinical medicine · 2024Article
- Low Concordance Between Blood Pressures Measured in Periodic Health Examinations and in a Workplace-Based Hypertension Management Program.Phenomics (Cham, Switzerland) · 2022Article
- Blood Pressure during Blood Collection and the Implication for Absolute Cardiovascular Risk Assessment.Pulse (Basel, Switzerland) · 2020Article
- Using out-of-office blood pressure measurements in established cardiovascular risk scores: a secondary analysis of data from two blood pressure monitoring studies.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Prevalence of high blood pressure in Iranian adults based on the 2017 ACC/AHA guideline.Medical journal of the Islamic Republic of Iran · 2019Article
- Prospective external validation of the Predicting Out-of-OFfice Blood Pressure (PROOF-BP) strategy for triaging ambulatory monitoring in the diagnosis and management of hypertension: observational cohort study.BMJ (Clinical research ed.) · 2018Observational
- Are self-reported telemonitored blood pressure readings affected by end-digit preference: a prospective cohort study in Scotland.BMJ open · 2018Article
- Exploring Vital Sign Data Quality in Electronic Health Records with Focus on Emergency Care Warning Scores.Applied clinical informatics · 2017Article
- Observational
- Are anesthesia start and end times randomly distributed? The influence of electronic records.Journal of clinical anesthesia · 2014Article
- End digit preference in blood pressure measurement in a hypertension specialty clinic in southwest Nigeria.Cardiovascular journal of Africa · 2012Article
- Spatial and temporal investigations of reported movements, births and deaths of cattle and pigs in Sweden.Acta veterinaria Scandinavica · 2009Article
- Long-term temporal trends in cardiovascular and metabolic risk factors.Wiener klinische Wochenschrift · 2009Article
- End-digits preference for self-reported height depends on language.BMC public health · 2008Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost blood pressure recordings end with a zero end-digit despite guidelines recommending measurement to the nearest 2 mmHg. The impact of rounding on management of cardiovascular disease (CVD) risk is unknown.
aimTo document the use of rounding to zero end-digit and assess its potential impact on eligibility for pharmacologic management of CVD risk. DESIGN OF STUDY: Cross-sectional study.
settingA total of 23,676 patients having opportunistic CVD risk assessment in primary care practices in New Zealand.
methodTo simulate rounding in practice, for patients with systolic blood pressures recorded without a zero end-digit, a second blood pressure measure was generated by arithmetically rounding to the nearest zero end-digit. A 10-year Framingham CVD risk score was estimated using actual and rounded blood pressures. Eligibility for pharmacologic treatment was then determined using the Joint British Societies' JBS2 and the British Hypertension Society BHS-IV guidelines based on actual and rounded blood pressure values.
resultsZero end-digits were recorded in 64% of systolic and 62% of diastolic blood pressures. When eligibility for drug treatment was based only on a Framingham 10year CVD risk threshold of 20% or more, rounding misclassified one in 41 of all those patients subject to this error. Under the two guidelines which use different combinations of CVD risk and blood pressure thresholds, one in 19 would be misclassified under JBS2 and one in 12 under the BHS-IV guidelines mostly towards increased treatment.
conclusionZero end-digit preference significantly increases a patient's likelihood of being classified as eligible for drug treatment. Guidelines that base treatment decisions primarily on absolute CVD risk are less susceptible to these errors.
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