Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Sewell, Keri ; Halanych, Jewell H. ; Russell, Louise B. ; Andreae, Susan J. ; Cherrington, Andrea L. ; ... More +
Sewell, Keri ; Halanych, Jewell H. ; Russell, Louise B. ; Andreae, Susan J. ; Cherrington, Andrea L. ; Martin, Michelle Y. ; Pisu, Maria ; Safford, Monika M. Less -
Description:
Introduction

Blood pressure measurement in clinical care settings seldom follows the protocol recommended by national guidelines, potentially leading to overestimates or underestimates of blood pressure control. We evaluated blood pressure measurement methods as a source of bias in determining blood pressure control among community-dwelling adults with diabetes.

Methods

In a community-based trial of patients with diabetes, we measured both “clinical blood pressure” (clinical BP) (taken by a community nurse or medical assistant instructed to “take the participant’s blood pressure like you do in your own clinic”) and “research blood pressure” (research BP) (research staff followed a guideline-concordant protocol). Each participant had both types of blood pressure assessment on the same day over the course of 2 hours.

Results

The 227 participants had a mean age of 59 years; 86% were black and 74% were women. The mean clinical BP was 5 mm Hg higher than the mean research BP for systolic blood pressure (P < .001) and 2 mm Hg higher for diastolic blood pressure (P < .001). The proportion of participants whose clinical BP was 130/80 mm Hg or higher was 8 percentage points higher than the proportion whose research BP was 130/80 mm Hg or higher (P < .001), and the proportion whose clinical BP was 140/90 mm Hg or higher was 10 percentage points higher than the proportion whose research BP was 140/90 mm Hg or higher (P < .001). Among those aged 65 years or older, the proportion whose clinical BP was 130/80 mm Hg or higher was 10 percentage points higher than proportion whose research BP was 130/80 mm Hg or higher, and the proportion whose clinical BP was 140/90 mm Hg or higher was 14 percentage points higher than the proportion whose research BP was 140/90 mm Hg or higher. Whites and smokers had the greatest risk for having a clinical BP 5 mm Hg or more higher than their research BP.

Conclusion

Measurement biases in clinical settings may be a component of observed poor blood pressure control rates in real-world settings.


Subjects:
[+]
Aged Blood Pressure Blood Pressure Determination Blood Pressure Monitoring, Ambulatory Diabetes Mellitus Female Humans Hypertension Male Middle Aged Original Research
Source:
Prev Chronic Dis. 13.
Pubmed ID:
26741995
Pubmed Central ID:
PMC4707947
Document Type:
Journal Article
Funding:
K24 HL111154/HL/NHLBI NIH HHS/United States ; P30 DK079626/DK/NIDDK NIH HHS/United States ; K24HL111154/HL/NHLBI NIH HHS/United States
K24 HL111154/HL/NHLBI NIH HHS/United States ; P30 DK079626/DK/NIDDK NIH HHS/United States ; K24HL111154/HL/NHLBI NIH HHS/United States Less -
Place as Subject:
Alabama
Location:
North America
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:c4659e5efc0bb6c98a2380105268f2521af16586c9f4fe810162911e2d270090
Download URL:
https://stacks.cdc.gov/view/cdc/37475/cdc_37475_DS1.pdf
File Type:

Supporting Files

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