Evidence map›Paper›PMID 33319471›Full record

ArticleJournal of clinical hypertension (Greenwich, Conn.)2021

How should we measure blood pressure? Implications of the fourth blood pressure measurement in office blood pressure.

Annina S Vischer, Thenral Socrates, Clemens Winterhalder, Jens Eckstein, Michael Mayr, Thilo Burkard

Registry-linked trialAbstract read
In one paragraph

Article in Journal of clinical hypertension (Greenwich, Conn.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02552030 (iPhone App Compared to Standard RR-measurement - iPARR Trial), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02552030 nacompletednot on this map

iPhone App Compared to Standard RR-measurement - iPARR Trial

TypeinterventionalSponsorJens EcksteinRan2015 to 2016Enrolled1,019ConditionsHypertension, Blood PressureArmscuff device (Omron HBP-1300-E Pro), iPhone 4s
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Annina S VischerMedical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland.ORCID 0000-0001-5188-1723
Thenral SocratesMedical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland.ORCID 0000-0001-9619-5460
Clemens WinterhalderDepartment of Internal Medicine, University Hospital Basel, Basel, Switzerland.ORCID 0000-0003-4169-0194
Jens EcksteinDepartment of Internal Medicine, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-1693-9851
Michael MayrMedical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland.ORCID 0000-0002-1962-8186
Thilo BurkardMedical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland.ORCID 0000-0001-6373-9820

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

According to the European Hypertension Guidelines regarding office blood pressure measurements (OBPMs), the mean between second/third or third/fourth OBPM should be taken if the first two readings differ by ≤10 or >10 mmHg, respectively. Our aim was to explore the value of the fourth OBPM and determine whether a simplified OBPM procedure is feasible without loss of quality. In this cross-sectional study, four standard OBPMs were taken. The mean of the second/third OBPM (S2S3/D2D3) and third/fourth OBPM (S3S4/D3D4) for systolic/diastolic values was calculated. Correlation, agreement, and differences regarding BP classification were explored for the entire cohort and subsets with a difference between the first/second OBPM (S1S2/D1D2) ≤10 and >10 mmHg. Overall (n = 802) and for the subsets with an S1S2 (n = 596) and D1D2 (n = 742) difference ≤10 mmHg, S3S4/D3D4 was in median 0.5 mmHg lower than S2S3/D2D3, respectively (p < .0005 for all). In participants with an S1S2 (n = 206) and D1D2 (n = 60) difference >10 mmHg, S3S4/D3D4 differed numerically from S2S3/D2D3, respectively (p > .1 for all). Overall and for all subsets with an S1S2/D1D2 difference ≤10/>10 mmHg, less subjects were numerically classified as hypertensive with S3S4/D3D4 than with S2S3/D2D3 (p > .04), but BP reclassification occurred in both directions in 1.0%-10.0%, depending on the cohort. In conclusion, the third/fourth OBPM results in lower BP values than the second/third measurement, regardless of the difference between first/second OBPM, whereby BP reclassifications occurred in both directions. Therefore, the cutoff of >10 versus ≤10mmHg difference between first/second OBPM to implement a fourth BPM harbors the risk of distorted results. We therefore recommend using the second/third BPM for standardized OBPM. Trial registration: Registered on clinicaltrials.gov (NCT02552030).

Indexed as

HypertensionBlood PressureBlood Pressure DeterminationBlood Pressure Monitoring, AmbulatoryCross-Sectional StudiesHumansSystolearterial hypertensionblood pressureblood pressure classificationblood pressure measurementsEuropean Society of CardiologyEuropean Society of Hypertensionguidelinesoffice blood pressure

Identifiers

PMID33319471
PMCPMC8030098

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.