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Clinical Research in Cardiology

, Volume 108, Issue 9, pp 990–999 | Cite as

Impact of single-visit American versus European office blood pressure measurement procedure on individual blood pressure classification: a cross-sectional study

  • Annina S. VischerEmail author
  • Thenral Socrates
  • Clemens Winterhalder
  • Jens Eckstein
  • Michael Mayr
  • Thilo Burkard
Original Paper

Abstract

Objectives

Recently, ACC/AHA and ESC/ESH guidelines defined different office blood pressure measurement (OBPM) procedures and ranges. We aimed to describe the effect of the different methods to calculate OBPM on BP classification.

Methods and results

Four standardised OBPM were performed in 802 patients within a single visit. BP values were calculated (EUR-/US-BPM) and categorised (EUR-/US-Ranges) according to ACC/AHA and ESC/ESH guidelines. Comparing the BPM procedures, the mean absolute difference of systolic and diastolic BP was 4 (SD ± 5) and 3 (SD ± 3) and a difference ≥ 5 mmHg was found in 35% and 16%, respectively. There was an increase of grade 1/2 arterial hypertension of 87% and 120% comparing BP values categorised according to US-Ranges with EUR-Ranges after applying EUR- or US-BPM to all (p < 0.0001), of 25% and 6% comparing BP values calculated according to US-BPM with EUR-BPM applying EUR- or US-Ranges to all (p = 0.006 and p = 0.17), and of 134% comparing US-Ranges/US-BPM with EUR-Ranges/EUR-BPM (p < 0.0001), respectively. Overall, 16% were reclassified to higher categories when applying US-BPM, and 42–45% of patients classified as “high normal” applying EUR-BPM procedures were reclassified when applying US-BPM procedure, 76–77% of them to “hypertensive” categories.

Conclusion

Besides the effect of the redefinition of BP categories by ACC/AHA, the calculation method of US-BPM compared to EUR-BPM leads to a further relevant increase of patients classified as “hypertensive”. In addition to the definition of uniform outcome-oriented target BP values, there is an urgent need for a universal definition of an OBPM procedure as prerequisite for proper BP classification and patient management.

Keywords

Hypertension Blood pressure Blood pressure determination Epidemiology Prevalence Methodology 

Notes

Acknowledgements

Many thanks to A. Winterhalder for the study coordination, as well as to all participants.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This trial was approved by the local ethics committee (EKNZ 2015-287), was compliant with the Declaration of Helsinki, and all patients provided written informed consent. The trial was registered on clinicaltrials.gov (NCT02552030).

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medical Outpatient Department, ESH Hypertension Center of ExcellenceUniversity Hospital BaselBaselSwitzerland
  2. 2.Department of Internal MedicineUniversity Hospital BaselBaselSwitzerland
  3. 3.Department of CardiologyUniversity Hospital BaselBaselSwitzerland

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