Key result
Different guideline-recommended office BP protocols alter uncontrolled hypertension prevalence by up to ~11%.
Why the study?
Hypertension guidelines recommend different office blood pressure measurement protocols, and the clinical implications of these procedural and analytical differences remain unclear.
Do different guideline-recommended office blood pressure measurement protocols yield different blood pressure values and rates of uncontrolled hypertension in treated hypertensive outpatients?
Cross-Sectional (n=826)
Yes
Do different guideline-recommended office blood pressure measurement protocols yield different blood pressure values and rates of uncontrolled hypertension in treated hypertensive outpatients?
Guideline-recommended office blood pressure protocols yield clinically meaningful differences in blood pressure classification, emphasizing the need for protocol standardization.
Protocol variations may shift control rates by ~11%; leaves open standardization effects on outcomes.
Office blood pressure (OBP) remains a cornerstone of hypertension management. However, contemporary hypertension guidelines recommend different OBP measurement protocols, which vary in procedural details and analytical approaches, and the clinical implications of these differences remain unclear. We compared eight guideline-recommended OBP protocols (Japanese, Korean, ISH, NICE, ESC/Brazilian, ESH, Chinese, and ACC/AHA) in 826 treated hypertensive outpatients (age = 60.2 ± 14.3 years; 40.4% men) from two Brazilian cohorts, using aneroid (n = 394) and oscillometric devices (n = 432). OBP was assessed with consecutive 1-min readings and guideline-specific algorithms. Mean systolic/diastolic OBP and uncontrolled hypertension were analyzed using repeated measures. Systolic OBP differed by up to 2.8 mmHg across protocols, while the prevalence of uncontrolled hypertension ranged from 30.0 to 41.3% using the less than 140/90 mmHg threshold and from 60.8 to 70.6% using the less than 130/80 mmHg threshold. In conclusion, guideline-recommended OBP protocols yield clinically meaningful differences, limiting their interchangeability and highlighting the need for protocol standardization before defining optimal OBP targets.
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Guimarães-Neto et al. (2026) conducted a cross-sectional in Hypertension (n=826). Eight guideline-recommended office blood pressure protocols vs. Within-subject comparison across protocols was evaluated on Mean systolic/diastolic office blood pressure and uncontrolled hypertension. Eight guideline-recommended office blood pressure protocols yielded systolic blood pressure differences up to 2.8 mmHg, causing uncontrolled hypertension prevalence to range from 30.0% to 41.3%.
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