What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=1988). Intervention: Single casual blood pressure measurement (SCBPM) vs. Guideline-based office BP measurements and home BP monitoring (HBPM). Primary outcome: Diagnostic accuracy (sensitivity, specificity, negative predictive value) for hypertension.

What does this research mean for the field?

A single casual blood pressure measurement (SCBPM) in primary care settings demonstrates high sensitivity and negative predictive value, making it an effective and feasible screening tool for hypertension diagnosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to assess the effectiveness of a single-casual blood pressure measurement as a screening tool for hypertension in primary care units.

June 3, 2026

Revisiting Blood Pressure Screening in Primary Care: The Value of a Single Casual Blood Pressure Measurement

Key Result

In 1,988 adults, a single casual blood pressure measurement demonstrated high sensitivity and negative predictive value for hypertension diagnosis compared to guideline-based measurements.

Key Points

The study aims to assess the effectiveness of a single-casual blood pressure measurement as a screening tool for hypertension in primary care units.
Conducted a diagnostic accuracy study enrolling adults in primary care units (PCUs).
Performed a single-casual blood pressure measurement followed by guideline-based measurements and home blood pressure monitoring.
Measurements were conducted by trained healthcare professionals and medical students in 68 PCUs.
In total, 1988 participants were included, median age 64 years, with a 73.5% patient population.
SCBPM showed high negative predictive value and specificity compared to guideline-based office and home measurements.
Older age and body mass index were associated with diagnostic disagreement between SCBPM and guideline measurements.

Study Design

Type

Cross-Sectional (n=1,988)

Multicenter

Yes

Structured PICO

Does a single casual blood pressure measurement accurately screen for hypertension compared to guideline-based measurements in adults attending primary care units?

Population

1,988 adults attending primary care units (median age 64 years, 57.8% female) evaluated for hypertension using a single casual blood pressure measurement.

Exposure

Single casual blood pressure measurement (SCBPM) performed in the waiting room

Comparator

Guideline-based office BP measurements (3 measurements in a quiet room) and home BP monitoring (HBPM)

Outcome

Diagnostic performance (sensitivity, negative predictive value, specificity) of SCBPM for hypertension diagnosissurrogate

A single casual blood pressure measurement in the waiting room is a feasible screening tool with high negative predictive value for hypertension diagnosis in primary care.

Abstract

Objective: Worldwide, only ∼45% of hypertensive patients are diagnosed, and ∼30% controlled. We recently found that in real-world primary care (PC) settings, only 13.2% of PC physicians measure blood pressure (BP) in all patients, primarily due to heavy workloads. Furthermore, BP is usually measured only in patients, and not in visitors or accompanying persons in PC units (PCUs). Therefore, simple and practical screening tools are needed to address these limitations and improve the detection of hypertension in PC. In this setting, the involvement of trained healthcare professionals (HCPs) in BP measurements is a practical tool to increase hypertension diagnosis. The objective of the study was to evaluate the potential role of a single-casual blood pressure measurement (SCBPM) as a feasible screening tool to improve the diagnosis of hypertension in PCUs. Design and method: This is a diagnostic accuracy study. Adults attending PCUs (patients, accompanying persons, and visitors) were enrolled. On the 1st-visit, an SCBPM was performed in the waiting room, followed by 3 measurements according to guidelines in a quiet room. Additionally, participants underwent home BP monitoring (HBPM) and 2nd-visit measurements. Office BP measurements, including SCBPM, were performed using validated devices. Trained HCPs and medical students conducted measurements in 68 PCUs. Results: In this study, 1988 participants were included median age: 64 (interquartile-range: 52.0-74.0) years, 57.8% female; 73.5% patients, and 83.0% of them for a regular visit. Mean BP values across measurement methods are presented in Table-1a. The diagnostic performance of SCBPM is presented in Table-1b. SCBPM demonstrated high negative predictive value (NPV) and specificity in relation to guideline-based office BP measurements and HBPM. In Figures-1a,b, BP distributions in the total population and in untreated participants are presented. In multivariate logistic regression, older age and body-mass index were independently associated with more greater diagnostic disagreement between SCBPM and guideline-based measurements at the 1st-visit.Conclusions: This feasible SCBPM protocol demonstrated high sensitivity and NPV, confirmed by HBPM and 2nd-visit measurements, suggesting a potential role as an excellent screening tool for hypertension diagnosis.

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