Poster presentation at Society of General Internal Medicine Annual Meeting on May 13, 2004.The authors have no conflicts of interest to report.
How Well Do Clinic-Based Blood Pressure Measurements Agree with the Mercury Standard?
Version of Record online: 13 JUN 2005
Journal of General Internal Medicine
Volume 20, Issue 7, pages 647–649, July 2005
How to Cite
Kim, J. W., Bosworth, H. B., Voils, C. I., Olsen, M., Dudley, T., Gribbin, M., Adams, M. and Oddone, E. Z. (2005), How Well Do Clinic-Based Blood Pressure Measurements Agree with the Mercury Standard?. Journal of General Internal Medicine, 20: 647–649. doi: 10.1111/j.1525-1497.2005.0105.x
- Issue online: 13 JUN 2005
- Version of Record online: 13 JUN 2005
- Received for publication January 3, 2005 Accepted for publication January 3, 2005
- blood pressure measurement assessment;
- clinic method;
- mercury device
Background: Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement.
Objective: To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP.
Design: Prospective reliability study.
Patients: One hundred patients with an International Classification of Diseases—9th edition code for hypertension were enrolled.
Measures: Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records.
Results: Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to 0.86). Overall, clinic-based readings overestimated the mercury readings, with a mean overestimation of 8.3 mmHg for SBP and 7.1 mmHg for DBP. Based on the clinic-based measure, 21% of patients were misdiagnosed with uncontrolled hypertension.
Conclusions: Health professionals should be aware of this potential difference when utilizing clinic-based BP values for making treatment decisions and/or assessing quality of care.